Background： Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin （Hb） level between 7 and 10 g/dl. As a restdt, the t...Background： Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin （Hb） level between 7 and 10 g/dl. As a restdt, the trigger point of blood transtiision may be different in the emergency use of the existing transfusion guidelines. The present study was designed to evaluate whether the scheme can be safely and effectively used for emergency patients, so as to be supported by multicenter and large sample data in the future. Methods： From June 2013 to June 2014, patients were randomly divided into the experimental group （Peri-operative Transfusion Trigger Score of Emergency [POTTS-E] group） and the control group （control group）. The between-group differences in the patients＇ demography and baseline inlbrmation, mortality and blood transfusion-related complications, heart rate, resting arterial pressure, body temperature, and Hb values were compared. The consistency of red blood cell （RBC） transiiision standards of the two groups of patients with the current blood transfusion guideline, namely the compliance of the guidelines, utilization rate, and per-capita consumption of autologous RBC were analyzed. Results： During the study period, a total of 72 patients were recorded, and 65 of them met the inclusion criteria, which included 33 males and 32 females with a mean age of（34.8 ± 14.6） years. 50 tmderwent abdomen surgery, 4 underwent chest surgery, 11 underwent arms and legs surgery. There was no statistical difference between the two groups for demography and baseline inlbrmation. There was also no statistical differences between the two groups in anesthesia time, intraoperative rehydration, staying time in postanesthetic care unit, emergency hospitalization, postoperative 72 h Acute Physiologic Assessment and Chronic Health Evaluation II scores, blood transliision-related complications and mortality. Only tile POTTS-E group on the 1st postoperative day Hb was lower than group control, P 〈 0展开更多
Remote sensing technology has been widely recognized for contributing to emergency response efforts after the World Trade Center attack on September 11th, 2001. The need to coordinate activities in the midst of a dens...Remote sensing technology has been widely recognized for contributing to emergency response efforts after the World Trade Center attack on September 11th, 2001. The need to coordinate activities in the midst of a dense, yet relatively small area, made the combination of imagery and mapped data strategically useful. This paper reviews the role played by aerial photography, satellite imagery, and LIDAR data at Ground Zero. It examines how emergency managers utilized these datasets, and identifies significant problems that were encountered. It goes on to explore additional ways in which imagery could have been used, while presenting recommendations for more effective use in future disasters and Homeland Security applications. To plan adequately for future events, it was important to capture knowledge from individuals who responded to the World Trade Center attack. In recognition, interviews with key emergency management and geographic information system (GIS) personnel provide the basis of this paper. Successful techniques should not be forgotten, or serious problems dismissed. Although widely used after September 11th, it is important to recognize that with better planning, remote sensing and GIS could have played an even greater role. Together with a data acquisition timeline, an expanded discussion of these issues is available in the MCEER/NSF report “Emergency Response in the Wake of the World Trade Center Attack; The Remote Sensing Perspective” (Huyck and Adams, 2002) Keywords World Trade Center (WTC) - terrorism - emergency response - emergency management - ground zero - remote sensing - emergency operations - disasters - geographic information systems (GIS) - satellite imagery - synthetic aperture radar (SAR) - light detection and ranging imagery (LIDAR)展开更多
Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Co...Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.展开更多
目的建立一套公共卫生应急作业中心(Public Health Emergency Operations Center,PHEOC)信息管理过程中采集、分析、共享卫生应急信息的标准框架,消除信息收集与共享障碍,形成可推广的PHEOC信息管理模式,提高应对突发公共卫生事件的应...目的建立一套公共卫生应急作业中心(Public Health Emergency Operations Center,PHEOC)信息管理过程中采集、分析、共享卫生应急信息的标准框架,消除信息收集与共享障碍,形成可推广的PHEOC信息管理模式,提高应对突发公共卫生事件的应急能力和管理水平。方法本研究以危机生命周期理论为指导,通过文献研究和专家咨询进行PHEOC信息需求调查与论证,并对信息需求进行结构化表达,结合案例分析与定性比较分析,总结提炼国内外的成功经验,探索影响因素,进而从“全风险”“全过程”的视角研制PHEOC信息管理模式。结果本研究建立了PHEOC信息需求分析与表达逻辑模型,开发PHEOC标准数据集框架,并基于上述框架,对PHEOC的信息管理模式进行流程再造。结论本研究成功构建了一个PHEOC信息标准框架,通过对PHEOC信息管理流程再造,形成一套PHEOC全过程信息管理模式,对于消除信息收集与共享障碍,提升我国应对突发公共卫生事件的能力,保障公共卫生安全具有重要意义。展开更多
The objective of this paper is to present the current organization of the Emergency Procedures including Emergency Operating Procedures (EOP) and Severe Accident Management Guidelines (SAMG) in Kozloduy Nuclear Power ...The objective of this paper is to present the current organization of the Emergency Procedures including Emergency Operating Procedures (EOP) and Severe Accident Management Guidelines (SAMG) in Kozloduy Nuclear Power Plant (KNPP) as a function of the severity of the accident conditions. Special attention is paid to SAMG. It is described when the SAMG are used and at which conditions in a transition between the EOPs and the SAMG should be made. The Critical Safety Function Restoration Guidelines and their connections with SAMGs and EOPs are also discussed. The arrangement of SAMG is described in detail, since in the KNPP exist 2 types of SAMGs for Main Control Room (MCR) and for the Accident Management Centre (AMC) and they contain the same strategies, but they are different in format. Both types are symptom oriented procedures, but those for MCR are in 2-column-format with interconnections, whereas those for the AMC are developed in a logical manner and simplified for people, who take decisions. In the paper, they are also discussed the adopted strategies in existing SAMG that should be followed to recover from a damaged core condition and to prevent or mitigate the release of fission products. In the paper, they are also described a number of technical measures for management and mitigation of severe accidents, which are implemented in KNPP before and after the Fukushima accident. Many of them are common for WWER-1000 type of reactors, but some of them are unique and plant specific. This information can be useful for operators of other WWER type reactors or even PWR reactors.展开更多
文摘Background： Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin （Hb） level between 7 and 10 g/dl. As a restdt, the trigger point of blood transtiision may be different in the emergency use of the existing transfusion guidelines. The present study was designed to evaluate whether the scheme can be safely and effectively used for emergency patients, so as to be supported by multicenter and large sample data in the future. Methods： From June 2013 to June 2014, patients were randomly divided into the experimental group （Peri-operative Transfusion Trigger Score of Emergency [POTTS-E] group） and the control group （control group）. The between-group differences in the patients＇ demography and baseline inlbrmation, mortality and blood transfusion-related complications, heart rate, resting arterial pressure, body temperature, and Hb values were compared. The consistency of red blood cell （RBC） transiiision standards of the two groups of patients with the current blood transfusion guideline, namely the compliance of the guidelines, utilization rate, and per-capita consumption of autologous RBC were analyzed. Results： During the study period, a total of 72 patients were recorded, and 65 of them met the inclusion criteria, which included 33 males and 32 females with a mean age of（34.8 ± 14.6） years. 50 tmderwent abdomen surgery, 4 underwent chest surgery, 11 underwent arms and legs surgery. There was no statistical difference between the two groups for demography and baseline inlbrmation. There was also no statistical differences between the two groups in anesthesia time, intraoperative rehydration, staying time in postanesthetic care unit, emergency hospitalization, postoperative 72 h Acute Physiologic Assessment and Chronic Health Evaluation II scores, blood transliision-related complications and mortality. Only tile POTTS-E group on the 1st postoperative day Hb was lower than group control, P 〈 0
基金the Earthquake Engineering Research Centers Program of the National Science Foundation(NSF) under a Supplement to Award Number ECC-9701471 to the Multidisciplinary Center for Earthquake Engineering Research
文摘Remote sensing technology has been widely recognized for contributing to emergency response efforts after the World Trade Center attack on September 11th, 2001. The need to coordinate activities in the midst of a dense, yet relatively small area, made the combination of imagery and mapped data strategically useful. This paper reviews the role played by aerial photography, satellite imagery, and LIDAR data at Ground Zero. It examines how emergency managers utilized these datasets, and identifies significant problems that were encountered. It goes on to explore additional ways in which imagery could have been used, while presenting recommendations for more effective use in future disasters and Homeland Security applications. To plan adequately for future events, it was important to capture knowledge from individuals who responded to the World Trade Center attack. In recognition, interviews with key emergency management and geographic information system (GIS) personnel provide the basis of this paper. Successful techniques should not be forgotten, or serious problems dismissed. Although widely used after September 11th, it is important to recognize that with better planning, remote sensing and GIS could have played an even greater role. Together with a data acquisition timeline, an expanded discussion of these issues is available in the MCEER/NSF report “Emergency Response in the Wake of the World Trade Center Attack; The Remote Sensing Perspective” (Huyck and Adams, 2002) Keywords World Trade Center (WTC) - terrorism - emergency response - emergency management - ground zero - remote sensing - emergency operations - disasters - geographic information systems (GIS) - satellite imagery - synthetic aperture radar (SAR) - light detection and ranging imagery (LIDAR)
文摘Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.
文摘目的建立一套公共卫生应急作业中心(Public Health Emergency Operations Center,PHEOC)信息管理过程中采集、分析、共享卫生应急信息的标准框架,消除信息收集与共享障碍,形成可推广的PHEOC信息管理模式,提高应对突发公共卫生事件的应急能力和管理水平。方法本研究以危机生命周期理论为指导,通过文献研究和专家咨询进行PHEOC信息需求调查与论证,并对信息需求进行结构化表达,结合案例分析与定性比较分析,总结提炼国内外的成功经验,探索影响因素,进而从“全风险”“全过程”的视角研制PHEOC信息管理模式。结果本研究建立了PHEOC信息需求分析与表达逻辑模型,开发PHEOC标准数据集框架,并基于上述框架,对PHEOC的信息管理模式进行流程再造。结论本研究成功构建了一个PHEOC信息标准框架,通过对PHEOC信息管理流程再造,形成一套PHEOC全过程信息管理模式,对于消除信息收集与共享障碍,提升我国应对突发公共卫生事件的能力,保障公共卫生安全具有重要意义。
文摘The objective of this paper is to present the current organization of the Emergency Procedures including Emergency Operating Procedures (EOP) and Severe Accident Management Guidelines (SAMG) in Kozloduy Nuclear Power Plant (KNPP) as a function of the severity of the accident conditions. Special attention is paid to SAMG. It is described when the SAMG are used and at which conditions in a transition between the EOPs and the SAMG should be made. The Critical Safety Function Restoration Guidelines and their connections with SAMGs and EOPs are also discussed. The arrangement of SAMG is described in detail, since in the KNPP exist 2 types of SAMGs for Main Control Room (MCR) and for the Accident Management Centre (AMC) and they contain the same strategies, but they are different in format. Both types are symptom oriented procedures, but those for MCR are in 2-column-format with interconnections, whereas those for the AMC are developed in a logical manner and simplified for people, who take decisions. In the paper, they are also discussed the adopted strategies in existing SAMG that should be followed to recover from a damaged core condition and to prevent or mitigate the release of fission products. In the paper, they are also described a number of technical measures for management and mitigation of severe accidents, which are implemented in KNPP before and after the Fukushima accident. Many of them are common for WWER-1000 type of reactors, but some of them are unique and plant specific. This information can be useful for operators of other WWER type reactors or even PWR reactors.
