Geomorphological method in the elaboration of hazard maps for flash-floods in the municipality of Jucuarán (El Salvador)

This work deals with the elaboration of flood hazard maps. These maps reflect the areas prone to floods based on the effects of Hurricane Mitch in the Municipality of Jucuarán of El Salvador. Stream channels located in the coastal range in the SE of El Salvador flow into the Pacific Ocean and generate alluvial fans. Communities often inhabit these fans can be affected by floods. The geomorphology of these stream basins is associated with small areas, steep slopes, well developed regolite and extensive deforestation. These features play a key role in the generation of flash-floods. This zone lacks comprehensive rainfall data and gauging stations. The most detailed topographic maps are on a scale of 1:25 000. Given that the scale was not sufficiently detailed, we used aerial photographs enlarged to the scale of 1:8000. The effects of Hurricane Mitch mapped on these photographs were regarded as the reference event. Flood maps have a dual purpose (1) community emergency plans, (2) regional land use planning carried out by local authorities. The geomorphological method is based on mapping the geomorphological evidence (alluvial fans, preferential stream channels, erosion and sedimentation, man-made terraces). Following the interpretation of the photographs this information was validated on the field and complemented by eyewitness reports such as the height of water and flow typology. In addition, community workshops were organized to obtain information about the evolution and the impact of the phenomena. The superimposition of this information enables us to obtain a comprehensive geomorphological map. Another aim of the study was the calculation of the peak discharge using the Manning and the paleohydraulic methods and estimates based on geomorphologic criterion. The results were compared with those obtained using the rational method. Significant differences in the order of magnitude of the calculated discharges were noted. The rational method underestimated the results owing to short and discontinuous periods of rainfall data with the result that probabilistic equations cannot be applied. The Manning method yields a wide range of results because of its dependence on the roughness coefficient. The paleohydraulic method yielded higher values than the rational and Manning methods. However, it should be pointed out that it is possible that bigger boulders could have been moved had they existed. These discharge values are lower than those obtained by the geomorphological estimates, i.e. much closer to reality. The flood hazard maps were derived from the comprehensive geomorphological map. Three categories of hazard were established (very high, high and moderate) using flood energy, water height and velocity flow deduced from geomorphological and eyewitness reports.

Hyponatremia and short-term outcomes in patients with acute pulmonary embolism

BACKGROUND: Hyponatremia, a marker of neurohormonal activation, is associated with poor outcomes in acute cardiorespiratory diseases such as myocardial infarction, right and left ventricular heart failure, and pneumonia. The prognostic value of hyponatremia in patients with acute pulmonary embolism (PE) is unknown. We sought to assess whether hyponatremia at presentation was associated with mortality and hospital readmission in patients hospitalized with PE. METHODS: We studied patient discharges with a primary diagnosis of PE from 185 acute care hospitals in Pennsylvania (1/2000-11/2002). We defined hyponatremia as a serum sodium level ≤135 mmol/l, measured at the time of patient presentation. The study outcomes were 30-day all-cause mortality and hospital readmission. We used random-intercept logistic regression to examine the association between hyponatremia and mortality. We adjusted for baseline patient (race, insurance, severity of illness using the Pulmonary Embolism Severity Index) and hospital characteristics (region, hospital size and teaching status). We used the same approach to examine the association between hyponatremia and readmission among patients who were discharged alive. RESULTS: Among 13,728 patient discharges with PE, 2907 (21.1%) had hyponatremia at the time of presentation. Patients with hyponatremia were older (P<0.001) and more likely to have a history of cancer (P<0.001), heart failure (P<0.001), or chronic lung disease (P=0.002) than patients without hyponatremia. Patients with hyponatremia had a higher unadjusted cumulative 30-day mortality (15.2% vs 8.0%;P<0.001) and readmission rate (15.9% vs 11.8%; P< 0.001) than patients without hyponatremia (Figure). After adjustment for race, insurance, severity of illness, and hospital factors, hyponatremia was associated with a significantly greater odds of death (OR 1.71, 95% CI: 1.50-1.95) and hospital readmission (OR 1.29, 95% CI: 1.14-1.46). CONCLUSIONS: In this large, statewide sample of unselected patients with acute PE, hyponatremia was relatively common and was an independent predictor of short-term mortality and hospital readmission. Given that sodium is a low-cost, easily available laboratory parameter, it may be potentially useful in risk-stratifying patients with PE.

Method for Estimating the Magnitude and Frequency of Floods at Ungaged Sites on Unregulated Rural Streams in Iowa, HR-268, 1987

This report provides techniques and procedures for estimating the probable magnitude and frequency of floods at ungaged sites on Iowa streams. Physiographic characteristics were used to define the boundaries of five hydrologic regions. Regional regression equations that relate the size of the drainage area to flood magnitude are defined for estimating peak discharges having specified recurrence intervals of 2, 5, 10, 25, 50, and 100 years. Regional regression equations are applicable to sites on streams that have drainage areas ranging from 0.04 to 5,150 square miles provided that the streams are not affected significantly by regulation upstream from the sites and that the drainage areas upstream from the sites are not mostly urban areas. Flood-frequency characteristics for the mainstems of selected rivers are presented in graphs as a function of drainage area.

Geochemistry of the thermal springs and fumaroles of Basse-Terre Island, Guadeloupe, Lesser Antilles

The purpose of this work was to study jointly the volcanic-hydrothermal system of the high-risk volcano La Soufriere, in the southern part of Basse-Terre, and the geothermal area of Bouillante, on its western coast, to derive an all-embracing and coherent conceptual geochemical model that provides the necessary basis for adequate volcanic surveillance and further geothermal exploration. The active andesitic dome of La Soufriere has erupted eight times since 1660, most recently in 1976-1977. All these historic eruptions have been phreatic. High-salinity, Na-CI geothermal liquids circulate in the Bouillante geothermal reservoir, at temperatures close to 250 degrees C. These Na-CI solutions rise toward the surface, undergo boiling and mixing with groundwater and/or seawater, and feed most Na-CI thermal springs in the central Bouillante area. The Na-Cl thermal springs are surrounded by Na-HCO3 thermal springs and by the Na-Cl thermal spring of Anse a la Barque (a groundwater slightly mixed with seawater), which are all heated through conductive transfer. The two main fumarolic fields of La Soufriere area discharge vapors formed through boiling of hydrothermal aqueous solutions at temperatures of 190-215 degrees C below the ``Ty'' fault area and close to 260 degrees C below the dome summit. The boiling liquid producing the vapors of the Ty fault area has SD and delta(18)O values relatively similar to those of the Na-CI liquids of the Bouillante geothermal reservoir, whereas the liquid originating the vapors of the summit fumaroles is strongly enriched in O-18, due to input of magmatic fluids from below. This process is also responsible for the paucity of CH;I in the fumaroles. The thermal features around La Soufriere dome include: (a) Ca-SO4 springs, produced through absorption of hydrothermal vapors in shallow groundwaters; (b) conductively heated, Ca-Na-HCO3 springs; and (c) two Ca-Na-Cl springs produced through mixing of shallow Ca-SO4 waters and deep Na-Cl hydrothermal liquids. The geographical distribution of the different thermal features of La Soufriere area indicates the presence of: (a) a central zone dominated by the ascent of steam, which either discharges at the surface in the fumarolic fields or is absorbed in shallow groundwaters; and (b) an outer zone, where the shallow groundwaters are heated through conduction or addition of Na-Cl liquids coming from hydrothermal aquifer(s).

Flujos de detritos recientes en la cordillera frontal de Mendoza: Un ejemplo de riesgo natural en la ruta 7 = Recent debris flows in the Frontal Cordillera of Mendoza: An example of natural risk on the Road 7

In this paper is presented a study dealing with the debris flows that reached the national road 7 in January 2005, in the km 1,118.5, Mendoza province. The area is located in the Frontal Cordillera near the limit of the Precordillera. A detailed geomorphologic map has been realized for this study using a Quickbird satellite imagery of the year 2006. Various calculations of volumes, velocities and peak discharges have been performed with the field data and using a geographic information system (GIS). The geomorphologic survey has permitted to propose three propagation scenarios in case of a new event. These allowed creating a map of debris flows susceptibility for the stretch of the road that has been studied. Finally, it has been proposed protection and mitigation measures, based on the results of the study, to protect the road from a new event.

Modelling hydrodynamics in the Rio Parana, Argentina : an evaluation and inter-comparison of reduced-complexity and physics based models applied to a large sand-bed river

Depth-averaged velocities and unit discharges within a 30 km reach of one of the world's largest rivers, the Rio Parana, Argentina, were simulated using three hydrodynamic models with different process representations: a reduced complexity (RC) model that neglects most of the physics governing fluid flow, a two-dimensional model based on the shallow water equations, and a three-dimensional model based on the Reynolds-averaged Navier-Stokes equations. Row characteristics simulated using all three models were compared with data obtained by acoustic Doppler current profiler surveys at four cross sections within the study reach. This analysis demonstrates that, surprisingly, the performance of the RC model is generally equal to, and in some instances better than, that of the physics based models in terms of the statistical agreement between simulated and measured flow properties. In addition, in contrast to previous applications of RC models, the present study demonstrates that the RC model can successfully predict measured flow velocities. The strong performance of the RC model reflects, in part, the simplicity of the depth-averaged mean flow patterns within the study reach and the dominant role of channel-scale topographic features in controlling the flow dynamics. Moreover, the very low water surface slopes that typify large sand-bed rivers enable flow depths to be estimated reliably in the RC model using a simple fixed-lid planar water surface approximation. This approach overcomes a major problem encountered in the application of RC models in environments characterised by shallow flows and steep bed gradients. The RC model is four orders of magnitude faster than the physics based models when performing steady-state hydrodynamic calculations. However, the iterative nature of the RC model calculations implies a reduction in computational efficiency relative to some other RC models. A further implication of this is that, if used to simulate channel morphodynamics, the present RC model may offer only a marginal advantage in terms of computational efficiency over approaches based on the shallow water equations. These observations illustrate the trade off between model realism and efficiency that is a key consideration in RC modelling. Moreover, this outcome highlights a need to rethink the use of RC morphodynamic models in fluvial geomorphology and to move away from existing grid-based approaches, such as the popular cellular automata (CA) models, that remain essentially reductionist in nature. In the case of the world's largest sand-bed rivers, this might be achieved by implementing the RC model outlined here as one element within a hierarchical modelling framework that would enable computationally efficient simulation of the morphodynamics of large rivers over millennial time scales. (C) 2012 Elsevier B.V. All rights reserved.

Flood of May 19, 1990, Along Perry Creek in Plymouth and Woodbury Counties, Iowa, HR-140, 1996

A water-surface-elevation profile and peak discharges for the flood of May 19, 1990, along Perry Creek in Plymouth and Woodbury Counties, Iowa, are presented in this report. The peak discharge for the May 19, 1990, flood on Perry Creek at 38th Street, Sioux City (06600000) is the second largest flood-peak discharge recorded at the streamflow-gaging station for the period 1939-95. The peak discharge for May 19, 1990, of 8,670 cubic feet per second, is approximately equal to the 35-year recurrence-interval discharge. The report provides information on flood stages and discharges and floodflow frequencies for streamflow- gaging stations in the Perry Creek Basin using flood information collected during 1939-95. Information on temporary bench marks and reference points established in the Perry Creek Basin during 1990-93 is also included in the report. A flood history describes rainfall conditions for the three largest floods that occurred during 1939-95 (July 1944, September 1949, and May 1990).

Floods of 1986 and 1990 in the Raccoon River Basin, West-Central Iowa, HR-140, 1992

Water-surface-elevation profiles and peak discharges for the floods of 1973 and 1979 are compared to those of 1986 and 1990 in the Raccoon River basin, west-central Iowa. The profiles illustrate the 1979 and 1986 floods on the Raccoon, South Raccoon, and Middle Raccoon Rivers, the 1973 and 1986 floods on Walnut Creek, and the 1986 flood on Willow Creek and Mosquito Creek. The 1986 flood is the largest on record at U.S. Geological Survey streamflowgaging stations on the Middle Raccoon River tributary at Carroll, Middle Raccoon River near Bayard, Middle Raccoon River at Panora, and Walnut Creek at Des Moines. The 1990 flood discharge is the largest on record at U.S. Geological Survey crest-stage gaging stations on Hardin Creek near Farlin and on East Fork Hardin Creek near Churdan. The flood history given in this report describes rainfall conditions for floods that occurred during 1986 and 1990. Discharge for the 1990 flood on East Fork Hardin Creek near Churdan was 1.01 times larger than the 100-year recurrence-interval discharge.

Floods of July 19-25, 1999, in the Wapsipinicon and Cedar River Basins, Northeast Iowa, HR-140

Severe flooding occurred during July 19-25, 1999, in the Wapsipinicon and Cedar River Basins following two thunderstorms over northeast Iowa. During July 18-19, as much as 6 inches ofrainfall was centered over Cerro Gordo, Floyd, Mitchell, and Worth Counties. During July 20-21, a second storm occurred in which an additional rainfall of as much as 8 inches was centered over Chickasaw and Floyd Counties. The cumulative effect of the storms produced floods with new maximum peak discharges at the following streamflow-gaging stations: Wapsipinicon River near Tripoli, 19,400 cubic feet per second; Cedar River at Charles City, 31,200 cubic feet per second (recurrence interval about 90 years); Cedar River at Janesville, 42,200 cubic feet per second (recurrence interval about 80 years); and Flood Creek near Powersville, 19,000 cubic feet per second. Profiles of flood elevations for the July 1999 flood are presented in this report for selected reaches along the Wapsipinicon, Cedar, and Shell Rock Rivers and along Flood Creek. Information about the river basins, rain storms, and flooding are presented along with information on temporary bench marks and reference points in the Wapsipinicon and Cedar River Basins.

Flood of June 15-17, 1998, Nishnabotna and East Nishnabotna Rivers, Southwest Iowa, HR-140

Record flooding occurred June 15-17, 1998, in the Nishnabotna and East Nishnabotna River basins following severe thunderstorm activity over southwest Iowa. More than 8 inches of rain fell over a large part of Cass County. The rain gage at Atlantic, Iowa recorded a 24-hour total rainfall of 13.18 inches, which established a new official State record for the greatest amount of rainfall in a 24-hour period. The peak discharge was 41,400 cubic feet per second in the East Nishnabotna River near Atlantic, 60,500 cubic feet per second in the East Nishnabotna River at Red Oak, and 65,100 cubic feet per second in the Nishnabotna River above Hamburg. The peak discharge at Atlantic was greater than the theoretical 200-year flood and the peak discharges at Red Oak and Hamburg were greater than the respective theoretical 500-year floods. Information about the basin, the rain storms, the flooding, and a profile of high water marks at selected intervals along the Nishnabotna and East Nishnabotna Rivers are presented in this report.

Floods of September 15-16, 1992, in the Thompson, Weldon, and Chariton River Basins, South-Central Iowa, HR-140, 1997

Water-surface-elevation profiles and peak discharges for the floods of September 15-16, 1992, in the Thompson, Weldon, and Chariton River Basins, south-central Iowa, are presented in this report. The profiles illustrate the 1992 floods along the Thompson, Weldon, Chariton, and South Fork Chariton Rivers and along Elk Creek in the south-central Iowa counties of Adair, Clarke, Decatur, Lucas, Madison, Ringgold, Union, and Wayne. Water-surface-elevation profiles for the floods of July 4, 1981, along the Chariton River in Lucas County and along the South Fork Chariton River in Wayne County also are included in the report for comparative purposes. The September 15-16, 1992, floods are the largest known peak discharges at gaging stations Thompson River at Davis City (station number 06898000) 57,000 cubic feet per second, Weldon River near Leon (station number 06898400) 76,200 cubic feet per second, Chariton River near Chariton (station number 06903400) 37,700 cubic feet per second, and South Fork Chariton River near Promise City (station number 06903700) 70,600 cubic feet per second. The peak discharges were, respectively, 1.7, 2.6, 1.4, and 2.1 times larger than calculated 100-year recurrence-interval discharges. The report provides information on flood stages and discharges and floodflow frequencies for streamflow-gaging stations in the Thompson, Weldon, and Chariton River Basins using flood information collected through 1995. Information on temporary bench marks and reference points established in the Thompson and Weldon River Basins during 1994-95, and in the Chariton River Basin during 1983-84 and 1994-95, also is included in the report. A flood history summarizes rainfall conditions and damages for floods that occurred during 1947, 1959, 1981, 1992, and 1993.

El rol del paciente experto en el tratamiento de las adicciones: una propuesta para paliar las altas tasas de abandono prematuro en comunidades terapéuticas

El objetivo de este estudio recae en cómo y de qué forma el ex adicto a sustancias alteradoras del ánimo (E-ASAA), cursando por el estadio de mantenimiento, puede ejercer el rol de asesor y promotor de salud, como “Paciente Experto”, conjuntamente con los profesionales especializados en drogodependencias. Paralelamente este “cómo y de qué forma” viene a dar respuesta a una necesidad existente en las Comunidades Terapéuticas, a saber, reducir las Altas Voluntarias (AV) de los residentes recién incorporados y tras su Alta Terapéutica (AT). Sin embargo, se requiere de una investigación de tipo cualitativo para determinar los factores desencadenantes que inducen a esta prevalencia de AV y recaídas post-AT. Los resultados extraídos de la investigación a informantes clave muestran como existe un deficitario asesoramiento pre-entrada y acompañamiento post-AT. El E-ASAA, debidamente formado, podría dar respuesta a estas demandas asistenciales, mejorando así la completa reinserción de los usuarios de CCTT. La Propuesta del Proyecto “Mi amigo de Comunidad” integra este conocimiento aportando soluciones.

The region makes the difference: disparities in management of acute myocardial infaction within Switzerland

Purpose: To assess geographical differences within Switzerland regarding management and revascularization procedures for acute myocardial infarction (AMI). Methods: Swiss hospital discharge database for period 2007-2008. The main inclusion criterion was AMI as a primary discharge diagnosis. AMI revascularization procedures were identified and seven Swiss regions (Leman, Mittelland, Northwest, Zurich, Central, Eastern and Ticino) were analyzed. Results: Data from 25,674 AMI discharges were analyzed. Almost half (53.6%) of them were managed in a single hospital, the values ranging from 63.1% (Leman) to 31.4% (Ticino) see table. Relative to the total number of discharges, the highest Intensive Care Unit admission rate was in Leman (69.7%), the lowest (16.4%) in Ticino (Swiss average: 35.8%). Intracoronary revascularization rates were highest in Leman (51.6%) and lowest (30.8%) in Central Switzerland (Swiss average: 41.4%). Bare (non-drug-eluting) stents use was highest in Leman (33.1%) and lowest (7.0%) in Ticino (Swiss average: 15.8%), while drug eluting stent use was highest (32.8%) in Ticino and lowest (13.9%) in Central Switzerland (Swiss average: 24.0%). Coronary artery bypass graft rates were highest (4.6%) in Ticino and lowest (0.4%) in Eastern Switzerland (Swiss average: 2.6%). Mechanical circulatory assistance rates were highest (4.1%) in Zurich and lowest (0.4%) in Ticino (Swiss average: 1.7%). The differences in revascularization procedures remained after adjusting for age, single or multiple hospital management and gender. Conclusion: In Switzerland, significant geographical differences in management and revascularization procedures for AMI were found.

Standardizing admission and discharge processes to improve patient flow: A cross sectional study

Background: The aim of this study was to evaluate how hospital capacity was managed focusing on standardizing the admission and discharge processes. Methods: This study was set in a 900-bed university affiliated hospital of the National Health Service, near Barcelona (Spain). This is a cross-sectional study of a set of interventions which were gradually implemented between April and December 2008. Mainly, they were focused on standardizing the admission and discharge processes to improve patient flow. Primary administrative data was obtained from the 2007 and 2009 Hospital Database. Main outcome measures were median length of stay, percentage of planned discharges, number of surgery cancellations and median number of delayed emergency admissions at 8:00 am. For statistical bivariate analysis, we used a Chi-squared for linear trend for qualitative variables and a Wilcoxon signed ranks test and a Mann–Whitney test for non-normal continuous variables. Results: The median patients’ global length of stay was 8.56 days in 2007 and 7.93 days in 2009 (p<0.051). The percentage of patients admitted the same day as surgery increased from 64.87% in 2007 to 86.01% in 2009 (p<0.05). The number of cancelled interventions due to lack of beds was 216 patients in 2007 and 42 patients in 2009. The median number of planned discharges went from 43.05% in 2007 to 86.01% in 2009 (p<0.01). The median number of emergency patients waiting for an in-hospital bed at 8:00 am was 5 patients in 2007 and 3 patients in 2009 (p<0.01). Conclusions: In conclusion, standardization of admission and discharge processes are largely in our control. There is a significant opportunity to create important benefits for increasing bed capacity and hospital throughput.

Early EEG correlates of neuronal injury after brain anoxia.

OBJECTIVES: EEG and serum neuron-specific enolase (NSE) are used for outcome prognostication in patients with postanoxic coma; however, it is unclear if EEG abnormalities reflect transient neuronal dysfunction or neuronal death. To assess this question, EEG abnormalities were correlated with NSE. Moreover, NSE cutoff values and hypothermic EEG features related with poor outcome were explored.¦METHODS: In a prospective cohort of 61 adults treated with therapeutic hypothermia (TH) after cardiac arrest (CA), multichannel EEG recorded during TH was assessed for background reactivity and continuity, presence of epileptiform transients, and correlated with serum NSE collected at 24-48 hours after CA. Demographic, clinical, and functional outcome data (at 3 months) were collected and integrated in the analyses.¦RESULTS: In-hospital mortality was 41%, and 82% of survivors had good neurologic outcome at 3 months. Serum NSE and EEG findings were strongly correlated (Spearman rho = 0.45; p < 0.001). Median NSE peak values were higher in patients with unreactive EEG background (p < 0.001) and discontinuous patterns (p = 0.001). While all subjects with nonreactive EEG died, 5 survivors (3 with good outcome) had NSE levels >33 μg/L.¦CONCLUSION: The correlation between EEG during TH and serum NSE levels supports the hypothesis that early EEG alterations reflect permanent neuronal damage. Furthermore, this study confirms that absent EEG background reactivity and presence of epileptiform transients are robust predictors of poor outcome after CA, and that survival with good neurologic recovery is possible despite serum NSE levels> 33 μg/L. This underscores the importance of multimodal assessments in this setting.