Temporal and Spatial Patterns of Avifauna on Wetlands in the Vicinity of Bush Field Airport, Augusta, Georgia, USA

Responding to a U.S. Federal court order to improve discharged wastewater quality, Augusta, Georgia initiated development of artificial wetlands in 1997 to treat effluents. Because of the proximity to Augusta Regional Airport at Bush Field, the U.S. Federal Aviation Administration expressed concern for potential increased hazard to aircraft posed by birds attracted to these wetlands. We commenced weekly low-level aerial surveys of habitats in the area beginning January, 1998. Over a one-year period, 49 surveys identified approximately 42,000 birds representing 52 species, including protected Wood Storks and Bald Eagles, using wetlands within 8 km of the airport. More birds were observed during the mid-winter and fall/spring migratory seasons (1,048 birds/survey; October - April) than during the breeding/post-breeding seasons (394 birds/survey; May - September). In winter, waterfowl dominated the avian assemblage (65% of all birds). During summer, wading birds were most abundant (56% of all birds). Habitat changes within the artificial wetlands produced fish kills and exposed mudflats, resulting in increased use by wading birds and shorebirds. No aquatic birds were implicated in 1998 bird strikes, and most birds involved could safely be placed within songbird categories. Airport incident reports further implicated songbirds. These findings suggested that efforts to decrease numbers of songbirds on the airport property must be included in the development of a wildlife hazard management plan. Seasonal differences in site use among species groups should also be considered in any such plan. Other wetlands within 8 km of the airport supported as many or more birds than the artificial wetlands. With proper management of the artificial wetlands, it should be possible to successfully displace waterfowl and wading birds to other wetlands further from the airport.

EFFECTS OF A BIRD HAZARD REDUCTION FORCE ON REDUCING BIRD/AIRCRAFT STRIKE HAZARDS AT THE ATLANTIC CITY INTERNATIONAL AIRPORT, NJ

Bird-aircraft strikes at the Atlantic City International Airport (ACY) increased from 18 in 1989 to 37 in 1990. The number of bird-aircraft strikes involving gulls (Larus spp.) during this time rose from 6 to 27, a 350% increase. The predominant species involved in bird strikes was the laughing gull (L. atricilla). Pursuant to an interagency agreement between the U.S. Department of Transportation (USDOT), Federal Aviation Administration (FAA) and the U.S. Department of Agriculture (USDA)l Animal and Plant Health Inspection Service (APHIS)/Animal Damage Control (ADC), ADC established a Emergency/Experimental Bird Hazard Reduction Force (BHFF) at ACY in 1991. An Environmental Assessment (EA) and Finding of No Significant Impact (FONSI) for the 1991 Emergency/Experimental BHRF was executed and signed by the FAA on 19 May 1991. The BHRF was adopted at this time by the FAA Technical Center as an annual program to reduce bird strikes at ACY. The BHRF goals are to minimize or eliminate the incidence of bird-aircraft strikes and runway closures due to increased bird activities. A BHRF team consisting of ADC personnel patrolled ACY for 95 days from 26 May until 28 August 1992, for a total of 2,949 person-hours. The BHRF used a combination of pyrotechnics, amplified gull distress tapes and live ammunition to harass gulls away from the airport from dawn to dusk. Gullaircraft strikes were reduced during BHRF operations in 1992 by 86% compared to gull strikes during summer months of 1990 when there was not a BHRF team. Runway closures due to bird activity decreased 100% compared to 1990 and 1991 closures. The BHRF should continue at ACY as long as birds are a threat to human safety and aircraft operations.

COMPLETE CONTROL OF NUISANCE BIRDS IN AIRPORT HANGARS

Fogging of ReJeX-iT7 TP-40 offers a very efficient method for the control and dispersal of nuisance birds from many diverse areas. The amount of the repellent is greatly reduced over any other control method. The method is direct and is independent of the activity of the birds. The applications with any fogger, thermal or mechanical, that can deliver droplets of less than 20 microns, can be manually or fully automated and pose only minimal risks to operators or animals. All birds that became a nuisance and safety problem in the hangars of TWA and AA at LaGuardia, and TWA warehouse at Newark Airport were successfully driven out by fogging ReJeX-iT7 TP-40 with a Curtis Dyna-Fog AGolden Eagle@ thermal fogger.

Airport Bird Threat in North America from Large Flocking Birds (geese) (as Viewed by an Engine Manufacturer)--Part 1

In worldwide aviation operations, bird collisions with aircraft and ingestions into engine inlets present safety hazards and financial loss through equipment damage, loss of service and disruption to operations. The problem is encountered by all types of aircraft, both military and commercial. Modern aircraft engines have achieved a high level of reliability while manufacturers and users continually strive to further improve the safety record. A major safety concern today includes common-cause events which involve significant power loss on more than one engine. These are externally-inflicted occurrences, with the most frequent being encounters with flocks of birds. Most frequently these encounters occur during flight operations in the area on or near airports, near the ground instead of at cruise altitude conditions. This paper focuses on the increasing threat to aircraft and engines posed by the recorded growth in geese populations in North America. Service data show that goose strikes are increasing, especially in North America, consistent with the growing resident geese populations estimated by the United States Department of Agriculture (USDA). Airport managers, along with the governmental authorities, need to develop a strategy to address this large flocking bird issue. This paper also presents statistics on the overall status of the bird threat for birds of all sizes in North America relative to other geographic regions. Overall, the data shows that Canada and the USA have had marked improvements in controlling the threat from damaging birds - except for the increase in geese strikes. To reduce bird ingestion hazards, more aggressive corrective measures are needed in international air transport to reduce the chances of serious incidents or accidents from bird ingestion encounters. Air transport authorities must continue to take preventative and avoidance actions to counter the threat of birdstrikes to aircraft. The primary objective of this paper is to increase awareness of, and focus attention on, the safety hazards presented by large flocking birds such as geese. In the worst case, multiple engine power loss due to large bird ingestion could result in an off-airport forced landing accident. Hopefully, such awareness will prompt governmental regulatory agencies to address the hazards associated with growing populations of geese in North America.

Wildlife Risk Management at Vancouver International Airport

The Vancouver International Airport (YVR) is the second busiest airport in Canada. YVR is located on Sea Island in the Fraser River Estuary - a world-class wintering and staging area for hundreds of thousands of migratory birds. The Fraser Delta supports Canada’s largest wintering populations of waterfowl, shorebirds, and raptors. The large number of aircraft movements and the presence of many birds near YVR pose a wide range of considerable aviation safety hazards. Until the late 1980s when a full-time Wildlife Control Program (WCP) was initiated, YVR had the highest number of bird strikes of any Canadian commercial airport. Although the risks of bird strikes associated with the operation of YVR are generally well known by airport managers, and a number of risk assessments have been conducted associated with the Sea Island Conservation Area, no quantitative assessment of risks of bird strikes has been conducted for airport operations at YVR. Because the goal of all airports is to operate safely, an airport wildlife management program strives to reduce the risk of bird strikes. A risk assessment establishes the current risk of strikes, which can be used as a benchmark to focus wildlife control activities and to assess the effectiveness of the program in reducing bird strike risks. A quantitative risk assessment also documents the process and information used in assessing risk and allows the assessment to be repeated in the future in order to measure the change in risk over time in an objective and comparative manner. This study was undertaken to comply with new Canadian legislation expected to take effect in 2006 requiring airports in Canada to conduct a risk assessment and develop a wildlife management plan. Although YVR has had a management plan for many years, it took this opportunity to update the plan and conduct a risk assessment.

Low pressure support changes the rapid shallow breathing index (RSBI) in critically ill patients on mechanical ventilation

Background: The rapid shallow breathing index (RSBI) is the most widely used index within intensive care units as a predictor of the outcome of weaning, but differences in measurement techniques have generated doubts about its predictive value. Objective: To investigate the influence of low levels of pressure support (PS) on the RSBI value of ill patients. Method: Prospective study including 30 patients on mechanical ventilation (MV) for 72 hours or more, ready for extubation. Prior to extubation, the RSBI was measured with the patient connected to the ventilator (Drager (TM) Evita XL) and receiving pressure support ventilation (PSV) and 5 cmH(2)O of positive end expiratory pressure or PEEP (RSBI_MIN) and then disconnected from the VM and connected to a Wright spirometer in which respiratory rate and exhaled tidal volume were recorded for 1 min (RSBI_ESP). Patients were divided into groups according to the outcome: successful extubation group (SG) and failed extubation group (FG). Results: Of the 30 patients, 11 (37%) failed the extubation process. In the within-group comparison (RSBI_MIN versus RSBI_ESP), the values for RSBI_MIN were lower in both groups: SG (34.79 +/- 4.67 and 60.95 +/- 24.64) and FG (38.64 +/- 12.31 and 80.09 +/- 20.71; p<0.05). In the between-group comparison, there was no difference in RSBI_MIN (34.79 +/- 14.67 and 38.64 +/- 12.31), however RSBI_ESP was higher in patients with extubation failure: SG (60.95 +/- 24.64) and FG (80.09 +/- 20.71; p<0.05). Conclusion: In critically ill patients on MV for more than 72h, low levels of PS overestimate the RSBI, and the index needs to be measured with the patient breathing spontaneously without the aid of pressure support.

First-year experience of a Brazilian tertiary medical center in supporting severely ill patients using extracorporeal membrane oxygenation

OBJECTIVES: The aim of this manuscript is to describe the first year of our experience using extracorporeal membrane oxygenation support. METHODS: Ten patients with severe refractory hypoxemia, two with associated severe cardiovascular failure, were supported using venous-venous extracorporeal membrane oxygenation (eight patients) or veno-arterial extracorporeal membrane oxygenation (two patients). RESULTS: The median age of the patients was 31 yr (range 14-71 yr). Their median simplified acute physiological score three (SAPS3) was 94 (range 84-118), and they had a median expected mortality of 95% (range 87-99%). Community-acquired pneumonia was the most common diagnosis (50%), followed by P. jiroveci pneumonia in two patients with AIDS (20%). Six patients were transferred from other ICUs during extracorporeal membrane oxygenation support, three of whom were transferred between ICUs within the hospital (30%), two by ambulance (20%) and one by helicopter (10%). Only one patient (10%) was anticoagulated with heparin throughout extracorporeal membrane oxygenation support. Eighty percent of patients required continuous venous-venous hemofiltration. Three patients (30%) developed persistent hypoxemia, which was corrected using higher positive end-expiratory pressure, higher inspired oxygen fractions, recruitment maneuvers, and nitric oxide. The median time on extracorporeal membrane oxygenation support was five (range 3-32) days. The median length of the hospital stay was 31 (range 3-97) days. Four patients (40%) survived to 60 days, and they were free from renal replacement therapy and oxygen support. CONCLUSIONS: The use of extracorporeal membrane oxygenation support in severely ill patients is possible in the presence of a structured team. Efforts must be made to recognize the necessity of extracorporeal respiratory support at an early stage and to prompt activation of the extracorporeal membrane oxygenation team.

Positive fluid balance is associated with reduced survival in critically ill patients with cancer

Background There are no studies that describe the impact of the cumulative fluid balance on the outcomes of cancer patients admitted to intensive care units ICUs. The aim of our study was to evaluate the relationship between fluid balance and clinical outcomes in these patients. Method One hundred twenty-two cancer patients were prospectively evaluated for survival during a 30-day period. Univariate (Chi-square, t-test, MannWhitney) and multiple logistic regression analyses were used to identify the admission parameters associated with mortality. Results The mean cumulative fluid balance was significantly higher in non-survivors than in survivors [1675?ml/24?h (4712921) vs. 887?ml/24?h (104557), P?=?0.017]. We used the area under the curve and the intersection of the sensibility and specificity curves to define a cumulative fluid balance value of 1100?ml/24?h. This value was used in the univariate model. In the multivariate model, the following variables were significantly associated with mortality in cancer patients: the Acute Physiology and Chronic Health Evaluation II score at admission [Odds ratio (OR) 1.15; 95% confidence interval (CI) (1.051.26), P?=?0.003], the Lung Injury Score at admission [OR 2.23; 95% CI (1.293.87), P?=?0.004] and a positive fluid balance higher than 1100?ml/24?h at ICU [OR 5.14; 95% CI (1.4518.24), P?=?0.011]. Conclusion A cumulative positive fluid balance higher than 1100?ml/24?h was independently associated with mortality in patients with cancer. These findings highlight the importance of improving the evaluation of these patients' volemic state and indicate that defined goals should be used to guide fluid therapy.

Physicochemical analysis of blood and urine in the course of acute kidney injury in critically ill patients: a prospective, observational study

Abstract Background Sequential physicochemical alterations in blood and urine in the course of acute kidney injury (AKI) development have not been previously described. We aimed to describe these alterations in parallel to traditional renal and acid–base parameters. Methods One hundred and sixty eight consecutive critically ill patients with no previous kidney disease, who had an indwelling urinary catheter at ICU admission and who remained with the catheter for at least two days without dialysis were included. A sample of blood and spot urine were collected simultaneously, once daily, until catheter removal or dialysis requirement. Traditional acid–base and renal parameters were sequentially evaluated in parallel to blood and urinary physicochemical parameters. Patients were classified during this period as having or not AKI and, for patients with AKI, duration (transient or persistent) and severity (creatinine-based AKIN stage) were evaluated. Results One hundred and thirteen patients (67.3%) had AKI: 92 at ICU admission and 21 during the observation period. AKI development was characterized in blood by increased values of phosphate and unmeasured anions (SIG), decreased albumin, and in urine by decreased values of sodium (NaU), chloride (ClU) as well as high urinary strong ion difference (SIDu). These alterations began to occur before AKI diagnosis, and they reverted in transient AKI but remained in persistent AKI. NaU, ClU and albumin decreased, and phosphate, SIG and SIDu increased with AKI severity progression. NaU and ClU values increased again when AKIN stage 3 was reached. Conclusions Simultaneous physicochemical analysis of blood and urine revealed standardized alterations that characterize AKI development in critically ill patients. These alterations paralleled AKI duration and severity. Future studies should consider including sequential evaluation of urine biochemistry as part of the armamentarium for AKI diagnosis and management.

Effect of heat and moisture exchangers on the prevention of ventilator-associated pneumonia in critically ill patients

Ventilator-associated pneumonia (VAP) remains one of the major causes of infection in the intensive care unit (ICU) and is associated with the length of hospital stay, duration of mechanical ventilation, and use of broad-spectrum antibiotics. We compared the frequency of VAP 10 months prior to (pre-intervention group) and 13 months after (post-intervention group) initiation of the use of a heat and moisture exchanger (HME) filter. This is a study with prospective before-and-after design performed in the ICU in a tertiary university hospital. Three hundred and fourteen patients were admitted to the ICU under mechanical ventilation, 168 of whom were included in group HH (heated humidifier) and 146 in group HME. The frequency of VAP per 1000 ventilator-days was similar for both the HH and HME groups (18.7 vs 17.4, respectively; P = 0.97). Duration of mechanical ventilation (11 vs 12 days, respectively; P = 0.48) and length of ICU stay (11 vs 12 days, respectively; P = 0.39) did not differ between the HH and HME groups. The chance of developing VAP was higher in patients with a longer ICU stay and longer duration of mechanical ventilation. This finding was similar when adjusted for the use of HME. The use of HME in intensive care did not reduce the incidence of VAP, the duration of mechanical ventilation, or the length of stay in the ICU in the study population.

Endotracheal suction in intubated critically ill adult patients undergoing mechanical ventilation: a systematic review

AIM: identify and analyze in the literature the evidence of randomized controlled trials on care related to the suctioning of endotracheal secretions in intubated, critically ill adult patients undergoing mechanical ventilation. METHOD: the search was conducted in the PubMed, EMBASE, CENTRAL, CINAHL and LILACS databases. From the 631 citations found, 17 studies were selected. RESULTS: Evidence was identified for six categories of intervention related to endotracheal suctioning, which were analyzed according to outcomes related to hemodynamic and blood gas alterations, microbial colonization, nosocomial infection, and others. CONCLUSIONS: although the evidence obtained is relevant to the practice of endotracheal aspiration, the risks of bias found in the studies selected compromise the evidence's reliability.

Airport mobile internet as an indicator of innovation: theoretical model

Trabajo para el doctorado oficial de perspectivas científicas sobre el turismo y la dirección de empresas turísticas, de la Facultad de Economía, Empresa y Turismo de la ULPGC.

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

[EN] Introduction: Candidemia in critically ill patients is usually a severe and life-threatening condition with a high crude mortality. Very few studies have focused on the impact of candidemia on ICU patient outcome and attributable mortality still remains controversial. This study was carried out to determine the attributable mortality of ICU-acquired candidemia in critically ill patients using propensity score matching analysis. Methods: A prospective observational study was conducted of all consecutive non-neutropenic adult patients admitted for at least seven days to 36 ICUs in Spain, France, and Argentina between April 2006 and June 2007. The probability of developing candidemia was estimated using a multivariate logistic regression model. Each patient with ICU-acquired candidemia was matched with two control patients with the nearest available Mahalanobis metric matching within the calipers defined by the propensity score. Standardized differences tests (SDT) for each variable before and after matching were calculated. Attributable mortality was determined by a modified Poisson regression model adjusted by those variables that still presented certain misalignments defined as a SDT > 10%. Results: Thirty-eight candidemias were diagnosed in 1,107 patients (34.3 episodes/1,000 ICU patients). Patients with and without candidemia had an ICU crude mortality of 52.6% versus 20.6% (P < 0.001) and a crude hospital mortality of 55.3% versus 29.6% (P = 0.01), respectively. In the propensity matched analysis, the corresponding figures were 51.4% versus 37.1% (P = 0.222) and 54.3% versus 50% (P = 0.680). After controlling residual confusion by the Poisson regression model, the relative risk (RR) of ICU- and hospital-attributable mortality from candidemia was RR 1.298 (95% confidence interval (CI) 0.88 to 1.98) and RR 1.096 (95% CI 0.68 to 1.69), respectively. Conclusions: ICU-acquired candidemia in critically ill patients is not associated with an increase in either ICU or hospital mortality.