scholarly journals Housing arrangement and vegetation factors associated with single-family home survival in the 2018 Camp Fire, California

Fire Ecology ◽  
2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Eric E. Knapp ◽  
Yana S. Valachovic ◽  
Stephen L. Quarles ◽  
Nels G. Johnson
Keyword(s):  
Canopy Cover ◽  
Radiant Heat ◽  
Building Code ◽  
Fire Damage ◽  
Single Family ◽  
Construction Time ◽  
Related Factors ◽  
Factors Associated ◽  
Survival Percentage ◽  
Before And After

Abstract Background The 2018 Camp Fire, which destroyed 18,804 structures in northern California, including most of the town of Paradise, provided an opportunity to investigate housing arrangement and vegetation-related factors associated with home loss and determine whether California’s 2008 adoption of exterior building codes for homes located in the wildland-urban-interface (WUI) improved survival. We randomly sampled single-family homes constructed: before 1997, 1997 to 2007, and 2008 to 2018, the latter two time periods being before and after changes to the building code. We then quantified the nearby pre-fire overstory canopy cover and the distance to the nearest destroyed home and structure from aerial imagery. Using post-fire photographs, we also assessed fire damage and assigned a cause for damaged but not destroyed homes. Results Homes built prior to 1997 fared poorly, with only 11.5% surviving, compared with 38.5% survival for homes built in 1997 and after. The difference in survival percentage for homes built immediately before and after the adoption of Chapter 7A in the California Building Code (37% and 44%, respectively) was not statistically significant. Distance to nearest destroyed structure, number of structures destroyed within 100 m, and pre-fire overstory canopy cover within 100 m of the home were the strongest predictors of survival, but significant interactions with the construction time period suggested that factors contributing to survival differed for homes of different ages. Homes >18 m from a destroyed structure and in areas with pre-fire overstory canopy cover within 30–100 m of the home of <53% survived at a substantially higher rate than homes in closer proximity to a destroyed structure or in areas with higher pre-fire overstory canopy cover. Most fire damage to surviving homes appeared to result from radiant heat from nearby burning structures or flame impingement from the ignition of near-home combustible materials. Conclusions Strong associations between both distance to nearest destroyed structure and vegetation within 100 m and home survival in the Camp Fire indicate building and vegetation modifications are possible that would substantially improve outcomes. Among those include improvements to windows and siding in closest proximity to neighboring structures, treatment of wildland fuels, and eliminating near-home combustibles, especially in areas closest to the home (0–1.5 m).

scholarly journals Factors associated with single-family home survival in the 2018 Camp Fire, California

2021 ◽  
Author(s):  
Eric Knapp ◽  
Yana S Valachovic ◽  
Stephen L Quarles ◽  
Nels G Johnson
Keyword(s):  
Canopy Cover ◽  
Radiant Heat ◽  
Building Code ◽  
Fire Damage ◽  
Single Family ◽  
Construction Time ◽  
Factors Associated ◽  
Survival Percentage ◽  
Before And After ◽  
The Difference

Abstract Background The 2018 Camp Fire, which destroyed 18,804 structures in northern California, including most of the town of Paradise, provided an opportunity to investigate vegetation and housing factors associated with home loss and determine whether California's 2008 adoption of exterior building codes for homes in the wildland-urban-interface (WUI) improved survival. We randomly sampled single-family homes constructed: before 1997, 1997 to 2007, and 2008 to 2018, the latter two time periods being before and after changes to the building code. We then quantified the nearby overstory canopy cover and the distance to the nearest destroyed home and structure from aerial imagery. Using post-fire photographs, we also assessed fire damage and assigned a cause for damaged but not destroyed homes. Results Homes built prior to 1997 fared poorly, with only 11.5% surviving, compared with 38.5% survival for homes built in 1997 and after. The difference in survival percentage for homes built immediately before and after the adoption of Chap. 7A in the California Building Code (37% and 44%, respectively), was not statistically significant. Distance to nearest destroyed structure, number of structures destroyed within 100 m, and overstory canopy cover within 100 m of the home were the strongest predictors of survival, but significant interactions with the construction time period suggested that factors contributing to survival differed for homes of different ages. Homes > 18 from a destroyed structure and in areas with overstory canopy cover within 30–100 m of the home of < 53% survived at a substantially higher rate. Most fire damage to surviving homes resulted from radiant heat from nearby burning structures or flame impingement from ignition of near-home combustible materials. Conclusions Strong associations between distance to nearest destroyed structure and vegetation within 100 m and home survival in the Camp Fire indicates building and vegetation modifications are possible that would substantially improve outcomes. Among those include improvements to windows and siding in closest proximity to neighboring structures, treatment of wildland fuels, and eliminating near-home combustibles, especially in areas closest to the home (0-1.5 m).

Factors associated with demoralisation syndrome in patients before and after cardiac surgery

2017 ◽  
Vol 27 (3-4) ◽  
Author(s):  
Hsiu‐Yun Liao ◽  
Chaw‐Chi Chiu ◽  
Ying‐Ying Ko ◽  
Hsing‐Mei Chen
Keyword(s):  
Cardiac Surgery ◽  
Factors Associated ◽  
Before And After

Management of Recurrent or Progressing Skull Base Chondrosarcomas: Predictors of Long-Term Outcomes

2020 ◽  
Author(s):  
Jonathan D. Breshears ◽  
Franco DeMonte ◽  
Ahmed Habib ◽  
Paul W. Gidley ◽  
Shaan M. Raza
Keyword(s):  
Natural History ◽  
Skull Base ◽  
Radiation Treatment ◽  
Systemic Disease ◽  
Primary Treatment ◽  
Salvage Treatment ◽  
Low Grade ◽  
Related Factors ◽  
Factors Associated ◽  
Initial Recurrence

Abstract Background Skull base chondrosarcomas (CSA) are difficult tumors to cure and there is little data regarding salvage therapy. Objective This study aims to identify presentation and treatment-related factors which impact the progression free survival (PFS) and disease specific survival (DSS) for recurrent CSA, and to identify salvage treatment factors associated with successful restoration to the natural history following primary treatment. Methods This single-institution retrospective review included patients with recurrent/progressive CSA over a 25-year period. Survival analysis for factors impacting PFS and DSS was performed. Salvage treatment factors associated with achieving PFS ≥newly diagnosed median PFS were identified using univariate statistics. Analysis was performed on first recurrences and all recurrences combined. Results A total of 47 recurrence/progression events were analyzed from 17 patients (median two events/patient, range = 1–8). The overall PFS and DSS for the initial recurrence was 32 (range = 3–267) and 79 (range = 3–285) months, respectively. Conventional grade III or mesenchymal histology significantly predicted shorter PFS and DSS (p < 0.0001). After stratification by histology, previous radiation predicted shorter PFS for low-grade tumors (p = 0.009). Gross total resection (GTR) after a first time recurrence was significantly associated with successful salvage treatment (p < 0.05); however, this was rare. Conclusion In this series, high grade histology and prior radiation treatment negatively impacted salvage treatment outcomes, while GTR was associated with restoration to natural history following primary treatment. Careful consideration of histology, systemic disease status, previous treatments, and the anatomic extent of the skull base disease can optimize the outcomes of salvage intervention.

scholarly journals Simulation-based Training for Pelvic and Breast Physical Examination: Effect on the Anxiety and Self-confidence of Medical Students

2020 ◽  
Vol 42 (11) ◽  
pp. 739-745
Author(s):  
Talles Dias Orsi ◽  
Ana Lucia Ribeiro Valadares ◽  
Paula Miranda Esteves Orsi ◽  
Isabella Miranda Esteves Orsi ◽  
Alexandre Sampaio Moura
Keyword(s):  
Medical Students ◽  
Self Report ◽  
Student Anxiety ◽  
Factors Associated ◽  
Confidence Levels ◽  
Learning Satisfaction ◽  
Self Confidence ◽  
Breast Examination ◽  
Simulation Based ◽  
Before And After

Abstract Objective To evaluate factors associated with anxiety and the effect of simulation-based training (SBT) on student anxiety, self-confidence and learning satisfaction in relation to pelvic and breast examination. Methods A longitudinal study was conducted with 4th year medical students at the Universidade José do Rosário Vellano. A 12-item, self-report questionnaire on student anxiety at performing gynecological examinations was applied before and after SBT, with answers being given on a Likert-type scale. After training, the self-confidence levels and satisfaction of the students related to the learning process were also evaluated. Results Eighty students with a mean age of 24.1 ± 4.2 years were included in the study. Of these, 62.5% were women. Pre-SBT evaluation showed that students were more anxious at performing a pelvic examination than a breast examination (2.4 ± 1.0 versus 1.7 ± 0.8, respectively; p < 0.001). The primary reason for anxiety regarding both pelvic and breast examination was fear of hurting the patient. SBT significantly reduced student anxiety (2.0 ± 0.8 versus 1.5 ± 0.5, respectively; p < 0.001). The satisfaction and self-confidence of the students were found to be high (6.8 ± 0.3 and 6.0 ± 0.9, respectively), with no difference between genders. Conclusion The use of SBT in teaching students to perform pelvic and breast examinations resulted in reduced anxiety and increased self-confidence in a group of medical students of both genders, with high levels of satisfaction in relation to the training.

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