Stages Of Evacuation Research Articles

Starting transients in second throat vacuum ejectors for high altitude testing facilities

The present study aims to investigate the process of vacuum generation in a second throat vacuum ejector system employed for the high altitude testing of rocket motors. The study shows that the vacuum generation progresses with four distinct stages during the initial start-up process. The initial stage consists of a gradual evacuation process (first stage) which is followed by a transition region (second stage) in which the pressure starts to drop fastly and eventually leading to a rapid evacuation stage (third stage). This is followed with the reappearance of a gradual evacuation stage (fourth stage) which terminates with the onset of the started mode operation. It is found that the various stages of evacuation are closely linked to the internal shock wave movement in the supersonic nozzle. The gradual evacuation is found to be caused by the relatively large nozzle exit pressure caused by the multiple shock cells in the nozzle. The rapid evacuation occurs due to the sudden movement of the first shock cell to the nozzle exit and the reappearance of the gradual evacuation happens during the transformation of the nozzle jet from an overexpanded to underexpanded state. The parametric studies show that with increase in diffuser convergent cone angle, the contribution of vacuum generation from the fourth stage reduces due to a reduction in the maximum possible jet expansion. A same trend in vacuum generation is observed when nozzle distance from the second throat section of the ejector diffuser reduces.

Variability in stadia evacuation under normal, high-motivation, and emergency egress

Egress modelling can be used in stadia design. This modelling describes the movement of pedestrians and crowd flow considering wayfinding and decision making in evacuation and circulation. The accuracy of the modelling is highly dependent on project-specific input data that accurately represents the movement of population with associated human factors considered. Currently, there are few contemporary studies of stadia that consider real egress decision making under a range of stimuli of which practitioners may use to influence their modelling and design process. Herein, a range of evacuation urgencies and their effect on pedestrian decision making and wayfinding in stadia are considered: standard post-game egress, egress under high-motivation conditions, and emergency egress. This is done through carefully collected and recorded observation of real stadia in Canada and obtained third party video for stadiums internationally. To reinforce findings, real case studies of other notable emergencies are also considered. Decision making at all stages of evacuation are analyzed. Results indicate that, based on the cases examined, the egress behaviours differ in relation to the level of urgency, such as high motivation and emergency, and gate densities are higher for high motivation egress by a factor of 1.5. The role of staff in the evacuation process is one of the predominant factors in reducing or extending premovement regardless of the scenario. Associated contemporary behavioural theorems are used to explain differences in movement and decision-making in evacuation scenarios.

The Effect of Longitudinal Ventilation System on Smoke Movement and People’s Evacuation in Tunnel Fire

Smoke movement in a model tunnel controlled by longitudinal ventilation system was studied and in this paper. Smoke movement in a tunnel was studied numerically with some equations reviewed. A numerical experiment with Computational Fluid Dynamics (CFD) was carried out. At the initial stage of tunnel fire, the velocity of ventilation fans can be set up as critical speed to slow down smoke movement and high temperature diffusion. However, in evacuation stage, the ventilation speed should be decreased to prevent smoke transmit too fast and hurt people in the downstream. Without longitudinal ventilation system, smoke is distributed symmetrically in the tunnel. When the tunnel has longitudinal ventilation system, smoke will not distribute in the upstream of the tunnel but it will spread quickly to the downstream. If people still evacuate along the center line of the downstream, they may be threatened by the smoke. This study demonstrated both the advantages and disadvantages of longitudinal ventilation system and showed that the velocity of ventilation fans should be carefully chosen.

Modelling electric vehicle charging network capacity and performance during short-notice evacuations

Electric vehicles (EVs) may add new challenges during mass evacuations. Understanding the magnitude of the impacts EVs may have during the pre-departure stage of mass evacuations is an essential first step when planning for mass evacuations in a future where EVs are more common. In this paper, a generalized framework based on a G/G/c/N queueing model (general arrival process, general service process, c charging stations, and N EVs) was developed to estimate the number of vehicles that can be charged in the pre-departure evacuation stage and thus assess the pre-departure impacts. The model outputs are the number of vehicles that have or have not been served during the evacuation period, as well as average queue times and maximum queue lengths. This model is tested using the current electric vehicle fleet and charging infrastructure of Prince George, British Columbia, as a case study with a hypothetical short notice forest fire scenario. It was found that for the present-day case of Prince George, there is not enough charging network capacity to service all vehicles before departure. Increasing the number of charging stations, providing earlier evacuation notices, and ensuring a balanced makeup of level 3 fast-charging of different types were all found to be effective in increasing the number of EVs that received adequate charging before departure.

Распространенность, структура и характер травматизма в г.Рязани и Рязанской области, по данным вызовов бригад скорой медицинской помощи

The aim of the study is to study the prevalence, structure and nature of injuries, to identify the frequency of deaths at the stage of medical evacuation, and to determine the number of injured people who need medical care in medical organizations (LMO), according to the data on requests of the population of the Ryazan region and the city of Ryazan for emergency medical care (SMP). Materials and methods of research. Statistical data on the requests of victims with injuries for emergency medical care in the Ryazan region and the city of Ryazan are analyzed. Materials of the study – maps of calls of the SMP teams in Ryazan and statistical data for the Ryazan region for 2017-2019. The results of the study and their analysis. The most frequent causes of injuries, their nature, the frequency of requests of the population of the Ryazan region and the city of Ryazan for emergency medical care, the number of deaths and the frequency of hospitalizations for injuries were determined.

Russian Experience of Transport Extracorporeal Membrane Oxygenation

Relevance. The present time can be called a period of accumulation of experience of national health systems in different countries of the world in the application of transport extracorporeal membrane oxygenation (ECMO) technology at the pre- and inter-hospital stages of evacuation of patients to specialized ECMO-therapy centers. The role of such centers is to provide timely advice and, if necessary, perform inter-hospital evacuation.Material and methods. The study summarized and analyzed with the help of the national register “RosECMO” the own experience of 13 hospitals in the Russian Federation, who performed 68 inter-hospital evacuations under ECMO conditions by different modes of transport in patients of different age groups with symptoms of circulatory and respiratory failure. The following parameters were evaluated: characteristics of transport ECMO, clinical manifestations of potentially negative effects of transport, hospital survival, as well as the effect of experience (less and more than 10 cases of transport ECMO) of the presented clinics on the difference in the results obtained.Results. Connecting patients to the ECMO device reduces the likelihood of death on the SOFA and APACHE IV scales by 1.2 times (p <0.0001) and 1.4 times (p<0.0001), respectively. Despite the absence of deaths during inter-hospital transportation of patients under ECMO conditions, 14.93% of patients died within 3 days from the moment of their execution, without a significant difference in clinics with different practical experience. The overall hospital survival rate of ECMO transport scenarios in all 13 clinics of the Russian Federation was comparable to the data of the international register 48.52% versus 48.81%, at the same time it was significantly lower (1.3 times) in the group of clinics with less clinical experience 40% versus 52.08% (p<0.0001).Conclusion. The results of the first stage of the study we obtained indicate the prospects of using the method of extracorporeal membrane oxygenation at the stage of inter-hospital evacuation, due to the effective stabilization of the patient’s condition and a significant reduction in the risks of the likelihood of death. Clinics with less clinical experience showed significantly worse results of hospital survival of patients who underwent inter-hospital transportation under conditions of extracorporeal membrane oxygenation compared to clinics with more clinical experience, which can be a significant argument in adopting a model for the development of specialized regional centers for extracorporeal membrane oxygenation. The experience accumulated over the past six years and the analysis of new data from the register of transport cases of extracorporeal membrane oxygenation of the national healthcare system will make it possible to formulate the correct trajectory for the development of the method of extracorporeal membrane oxygenation and its application, including at the stage of pre- and inter-hospital evacuations of patients.

An investigation of fire evacuation performance in irregular underground commercial building affected by multiple parameters

Irregular underground commercial buildings (IUCB) are difficult to evacuate because of large space depth, complex form changes, and dense crowd. Fire evacuation performance of IUCB is of great practical importance with the development of underground buildings. To analyze the influence of different evacuation parameters on the properties of IUCB fire evacuation, this research gives person evacuation time under different strategies, action time of agent, and evacuation time based on IUCB fire evacuation numerical analysis model. A virtual reality system (VRS) including testing equipment and record platform is designed to perform model validation. Influence of three parameters are also analyzed on the performance of IUCB fire evacuation, including evacuation numbers, minimal group effect and pre-action time. Social force model and Generalized random graph model are applied to behaviors of evacuee. The results show that crowd congestion becomes a key factor determining evacuation time after the number of evacuees’ increases by 50.0%. The unbalanced use of exits reduces the overall evacuation rate. The average evacuation time, the overall evacuation time, and the total evacuation time of 95.0% population increase by 13.3%, 36.0%, and 15.9% respectively. When 50.0% of the evacuees are set as the minimal group effect, the overall evacuation time increased by the minimal group effect aggravates the congestion in some routes, but the minimal group effect could reduce the long tail time. Reducing the pre-action time can improve the overall evacuation rate in the early stage of evacuation. The basic linear relationship between pre-action time and evacuation time is presented. This research can provide the guidance for exit fire evacuation for IUCB to be built, which can also reduce the evacuation time in fire evacuation.

Forecast of the medical evacuation in patients with the cardiovascular dysfunction. A retrospective study

Introduction. The prognosis for the patients with the cardiovascular dysfunction and the use vasopressors or cardiotonics is always doubtful. Frequently patientʼs unstability and usage of vasoactive drugs increases the risks of incidents and are contraindication for medical evacuation. The results of published studies indicate that the use of these drugs when transporting patients is accompanied by certain risks, and methods for their prediction are not well described. Objectives. Determine prognostic factors and evaluate the results of medical evacuation in patients requiring vasopressor and cardiotonic support. Materials and methods. The retrospective study included 1210 patients from the database of the Tyumenʼs resuscitative-consultative center and the prospective study included 41 patients who were delivered to the Tyumen level III hospitals in 2019. Patients were distributed into 2 groups — survivors and deceased after evacuation. Results. Our study showed the importance of the integral estimation of severity of patients subjected to medical evacuation and the high predictive value of the National Early Warning Score (NEWS) scale and Full Outline of UnResponsiveness (FOUR) at the stages of evacuation. In the next day after delivery, the Acute Physiology And Chronic Health Evaluation (APACHE II) scale demonstrated high prediction accuracy. Despite the risks associated with the development of undesirable situations during transportation (their frequency according to our data was 12.2 %), the evacuation of patients with cardiovascular dysfunction increases the chance of an favorable outcome 2.8 time. Conclusions. Despite the presence of vascular dysfunction, the evacuation of patients in need of vasopressor and cardiotonic support is a life-saving measure that increases the chances of patients for a favorable outcome by 2.82 times.

ОРГАНІЗАЦІЯ БУХГАЛТЕРСЬКОГО ОБЛІКУ ЕВАКУАЦІЇ ПРОМИСЛОВИХ ПІДПРИЄМСТВ

The article describes the theoretical and methodological features of accounting for the evacuation of industrial enterprises. It was determined that the accounting system plays an important role in the formation of information support for the management of the process of evacuation of industrial enterprises from occupied territories or territories of hostilities. Considering the specifics of the object under study, there is a need to justify new approaches to the organization of accounting for the process of evacuation of an industrial enterprise. Yes, there is a need to identify the subjects of the organization and management of the evacuation process, as well as the subjects of the organization and accounting; establishment of accounting organization stages; determination of responsibility for accounting; organization of primary registration at all stages of evacuation; determination of the form of reporting on enterprise evacuation processes; organization of activities of the accounting service in safe territories; organization of information and communication links; development of a working plan of accounts. The definition of the peculiarities of the accounting organization is related to the accounting system that has developed in Ukraine and allows for the presence of several subsystems that have their own characteristics. We can see the reflection of these changes in the legislative acts and regulatory documents of the state, taking into account the peculiarities of business, formalized in the accounting of industrial enterprises. The accounting of the business structure must contain alternative options for the economic accounting of the evacuation, which is fixed by the order of the enterprise. It is worth noting that the size of the business structure and the scope of its activities largely determine the share of one or another type of accounting. Accounting for the evacuation of industrial enterprises as a specific element of the accounting system should create an organizational and methodological environment. The issue of the organization of accounting for the evacuation of industrial enterprises, in the sectoral aspect, is not sufficiently covered in the scientific literature, therefore there is a need for a theoretical justification and development of models for the organization of accounting at industrial enterprises with the determination of the structure, scope, terms and forms of submission of information for management, which is gaining relevance in a post-industrial society.

Prospects for the use of modern domestic medical devices to eliminate the life - threatening consequences of injuries and treat traumatic shock on the battlefield and advanced stages of medical evacuation

Prospects for the use of modern domestic medical devices to eliminate the life - threatening consequences of injuries and treat traumatic shock on the battlefield and advanced stages of medical evacuation

Prospects for the development of inhalation drugs for the provision of pre-hospital assistance to affected by hazardous chemical substances

Abstract. Pharmacological agents are analyzed, in respect of which it is advisable to develop dosage forms for inhalation use as medical means of protection at the prehospital stage of medical evacuation in case of damage by emergency-hazardous chemicals. It was found that the inhalation intake of hazardous chemicals, especially with a pronounced pulmonotoxic, irritating and generally poisonous effect, is highly likely to develop post-intoxication complications associated with damage to the lung parenchyma, and death. For the therapy of such intoxications, it is advisable to administrate drugs in a dosage form for inhalation administration, which have several advantages: high bioavailability, rapid onset of effect, and severity of local action in various parts of tracheobronchial tree. The data of experimental and clinical studies of the effectiveness of drugs belonging to various pharmacological groups allow us to recommend for the further development of inhaled forms of means of prevention and treatment of toxic pulmonary edema (fluticasone, roflumilast, rolipram). Bronchodilators and donors of sulfhydryl groups (ipratropium bromide, tiotropium bromide, atropine sulfate, fenoterol, salbutamol, formoterol, unitiol dimercaprol) are referred to means of correction of respiratory disorders of various etiologies. Diazepam, midazolam, clonazepam, lorazepam are considered to be the most likely anticonvulsants from the enzodiazepine-class suitable for inhalation. Acetylcysteine, hydroxycobalamin can be used to combat hypoxia. The principal possibility of inhalation application of bioscavengers (acetylcholinesterase, butyrylcholinesterase) for the treatment of cholinopositive symptoms of toxic genesis is shown. Existing methods and means of delivery allow the use of these drugs at the prehospital stage of medical evacuation as part of single dose metered powder inhalers.

Clinical aspects of providing specialized care to people burned after the disaster in Bashkiria in 1989

The contents of the organization of specialized medical care for those burned after a railway accident in Bashkiria in 1989 are investigated. Features of the evacuation and sorting of victims into various burn centers of the Union of Soviet Socialist Republics are described. The data on sorting and evacuation to various regions of the country are given. The materials on the statistics and structure of those who were burned from Bashkiria to medical institutions of federal significance are summarized. Information was collected from various primary sources on the number and structure of patients delivered to the burn clinics of the country. Information was obtained on the treatment methods applied to injured by medical teams of hospitals. The role of the decision of the leadership of the Ministry of Health in organizing the dispersal of a large number of burned, concentrated in Bashkiria, to the regional and federal medical centers of the country is emphasized. Information is given on the participation of both individual specialists, teams, and foreign states in assisting victims of the railway accident in Bashkiria. The significance of the accumulated scientific and practical experience is summarized in several scientific and practical conferences. So, they highlighted the issues of providing victims with medical care at the stages of evacuation, the provision of specialized medical care and rehabilitation at the hospital stage. They indicated that it is necessary to follow the provisions of the military medical doctrine and organize medical care on the principles of staged treatment.

Scientific works of Professor T.Ya. Aryev – the first head of the department of thermal lesions of the Military Medical Academy them. CM. Kirov for the period 1932–1945

Abstract. The subject of scientific research of the first head of the department of thermal lesions of the Military Medical Academy. CM. Kirov Professor Tuviy Yakovlevich Aryev. The presentation of the material is carried out in chronological order and is tied to those events that occurred in the life of a then-young scientist. The role of family members and scientific leaders in choosing a specialty, making a decision on the beginning of scientific work and the research topic, which has become central during the historical period under consideration, is shown. The high quality of the research is indicated by the publication of the results of T.Ya. Aryev in German and French scientific journals. The growth of professional skills was facilitated by the admission to the Department of General Surgery at the Military Medical Academy. The role of the head Professor S.S. Girgolava manifested itself in the fact that two years after the start of research, the monograph Frostbite was written, and a dissertation was successfully defended a year later. The knowledge gained, the development of the principles and methods of performing scientific work have become an integral feature of T.Ya. Aryeva. Even during a business trip to the armed conflict zone on the Halki-Gol River, he was able to collect material and perform a number of works related to the characteristics of surgical combat trauma of that period. The subsequent analysis of the results of the treatment of wounded with frostbite during the Soviet-Finnish War formed the basis for the development of fundamentally new proposals for the prevention, diagnosis and medical care of victims of frostbite at the stages of medical evacuation. New techniques have contributed to increasing the effectiveness of medical support for troops during the Great Patriotic War.

Legal and clinical aspects of emergency burns

The key questions concerning particular sections of the topic Burns in Emergencies are presented. Particular attention is paid to the presentation of terminology. For this, the wording of the Federal Laws, Government Resolutions and Orders of the Ministry of Health of the Russian Federation were used. In accordance with the latter, the classification of emergency situations is given, as well as the criteria by which their damage is assessed. It has been established that the involvement of the forces and means of the Ministry of Defense in the elimination of the consequences of emergency situations is spelled out in the Federal Law. In addition, an argument is made on what basis the citizens of the Russian Federation are obliged to constantly improve their knowledge and practical skills in studying numerous issues of protecting the population, providing assistance to victims, in carrying out emergency rescue operations, etc. situations that led to massive burns. Key features of burns as injuries sustained in emergency situations are formulated. Also, aggravating circumstances are listed that negatively affect the general condition of the victims. The role and place of clinical guidelines as a fundamental development governing the sequence of the organization and content of medical care for those burned at the stages of medical evacuation are indicated. Attention is drawn to the legal significance of the problem.

Prospects for improving pre-hospital care for wounded with gunshot penetrating wounds to the chest

Abstract. The analysis of injuries, life-threatening consequences and outcomes of treatment of wounded with penetrating chest wounds and the results of approbation of a prototype (medical) disposable set UD-02v for the elimination of strained and open pneumothorax, hemothorax, pleural drainage and collection of spilled blood with the possibility of subsequent reinfusion at the pre-hospital stage is presented. The prototype of the UD-02v set was created as part of the implementation of the state defense order in 2018. Its creation is due to the fact that despite the improvement of medical care at the stages of medical evacuation and the widespread use of individual armor protection, chest injuries currently remain a frequent type of combat surgical injury, accounting for 6 to 12% of all injuries. The main cause of death of injured and injured with chest injuries remains blood loss caused by continuing intrapleural bleeding and concomitant damage to other anatomical areas. Stressful pneumothorax, together with intrapleural bleeding, account for 93% of preventable causes of fatal chest injuries at the pre-hospital stage. Untimely elimination of the consequences of severe breast injuries should be considered as a negative factor affecting the outcome of treatment, and significant improvement in treatment results should be expected only in the case of early elimination of the most severe consequences of breast injuries. The developed set of UD-02v exceeds foreign medical devices in its medical and technical characteristics, and is the most promising for acceptance for the supply of the Armed forces of the Russian Federation as part of the samples of complete and service equipment.

Results of providing specialized medical care to victims in road traffic accidents on Federal highway M-8 “Kholmogory” in the Arkhangelsk region

Relevance. Currently, there is a general increase in the severity of injuries due to the dominance of high-energy multiple and concomitant injuries, especially on high-speed federal highways.Intention: To evaluate specialized medical care and hospital mortality in victims of road traffic accidents on the Federal Highway M-8 “Kholmogory” in the Arkhangelsk Region.Methodology. We selected 906 case histories of patients (form 003/y) injured in accidents on the federal highway M-8 “Kholmogory” and urgently admitted to hospitals of the Arkhangelsk region in 2012 - 2018. Registration forms were selected according to the criteria of retrospective full-design documentary observation. Differences between the observation groups were considered statistically significant at p < 0.05 with correction for multiple comparisons (Bonferroni).Results and Discussion. In the healthcare organizations of the Arkhangelsk region, patients with polytrauma received surgical treatment, with percentage of selective and urgent surgeries, average hospital bed days and time in intensive care units significantly higher (p = 0.001) compared to other patients, while isolated injuries were more often (p = 0.001) treated non-sur-gically. Hospital mortality was 6.0%, deceased patients were significantly older (p = 0.015), and pedestrians comprised half of them (p <0.001). Polytrauma was a cause of all deaths, with average severity of 38 points by the ISS severity scale [22; 48] (p = 0.001); more than a half died 1 day after an accident (p = 0.001).Conclusions. One of the possible ways to improve the medical care to victims of road traffic accidents on the federal highways at all stages of medical evacuation is to develop, scientifically justify and implement a systemic register of the health consequences of road traffic injuries in the practice of public health in the regions of Russian Federation.

Особливості використання антибіотиків при вогнепальних переломах довгих кісток

SummaryBackground. Infections associated with medical care pose a serious threat tohumanity. Irrational use of antibiotics leads to the development of resistance ofmicroorganisms to them.The aim of the work was to establish the species composition of microorganismsthat contaminate the gunshot wound and to establish the sensitivity of the isolatedmicroorganisms to antibiotics.Materials and methods. A microbiological study of gunshot wounds of thewounded at a specialized stage of medical care and determination of the sensitivity ofthe isolated microorganisms to antibiotics.Results. The dominance of acinetobacteria (53% of the wounded) andpseudomonads (20% of cases) was established. Analysis of the sensitivity of the isolatedmicroorganisms to antibiotics showed significant resistance of these microorganisms tothe most antibacterial drugs. Among all isolated strains, 11.9% were polyresistant(MDR) according to EUCAST criteria, and 76.5% were microbes with extendedresistance (CDR). Acinetobacter ssp., were resistant to most of the tested antibiotics. Atthe same time, all isolates of Acinetobacter ssp. were sensitive to polymyxin B andcolistin. 75% of Pseudomonas aeruginosa strains were resistant.Conclusion. Contamination of gunshot wounds at the stage of specialized medicalcare by multidrug-resistant gram-negative bacteria indicates nosocomial transmissionin the previous stages of evacuation and requires a clear list of antibacterial drugs thatcan be used to prevent and treat infectious complications.

The gametogenic cycle of the non-native false limpet Siphonaria pectinata (Linnaeus, 1758) in the easternmost limit of its distribution range: implications for its future in the Eastern Mediterranean Basin

The gametogenic cycle of the false-limpet Siphonaria pectinata from the Bizerte channel (Northern Tunisia) was studied through histological characterization of the hermaphroditic gonad during a 1-year study period (May 2015 - May 2016). Spawningintensity in the field as well as the gonadic index were calculated monthly. Both female and male gametes were observed simultaneously within acini of adult individuals and continuously throughout the year. Oogenesis started in the mid-autumn (October), with gonads characterized mainly by proliferation of female cells. After that, oocytes progressively increased in number and volume until summer, when the evacuation stage frequency was the highest. From summer to autumn, some acini were empty fromtheir oocyctes while some others had already begun the proliferation stage, suggesting the lack of a resting phase. Spermatogenesiswas also a continuous process throughout the year, with spermatozoa being mainly observed in late spring (March). These findings suggested that environmental conditions are suitable for the establishment of S. pectinata, first mentioned in 1998 on the Tunisian coast and even suggest that it could continue spreading eastward in the Mediterranean Basin.

The Role of Government in Increasing Community Participation in Village Non-Physical Development 2016-2018 (Case Study of the Village Stage of Harjo, Bantul Regency and Pejambon Village, Bojonegoro Regency)

Community empowerment seeks to improve the quality of human resources, especially in shaping and changing people's behavior to achieve a better life and a higher quality of life. One strategy that must be carried out is by applying the principles of good governance. This research uses descriptive qualitative research methods. This paper aims to indicate that the role of the rural government is (a) to receiving aspirations, (b) the rural government provides solutions by exchanging ideas, (c) Government efforts to prevent the community in terms of fear by providing legal certainty assistance and encouragement to the community by actualization and appreciation for the community. Community participation, namely (a) community participation is carried out through a needs analysis activity in the form of discussion or outreach, (b) Alternative stages of government programs such as Mataram village, Citizenship Scholarship, health card and waste management (c) Stage of program implementation, has been realized, (d) the evacuation stage, the results of the interview did not show any evaluation activities on non-physical development in Panggungharjo Village. Non-physical Village Development includes (a) the economic sector, the development of waste management and the mataram village (b) the education sector, the scholarship program for the poor, (c) the health sector, providing health cards so that the community has easy access to health. Factors Affecting the Role of the Village Government in Increasing Community Participation in Non-Physical Development of the Panggungharjo Village include (a) Leadership Factors, evidenced by the community experiencing changes, (b) Communication factors, with socialization activities. Conclusion: the role of the rural government has become a communication tool, dispute resolution, role as therapy. Community participation, such as in the economic sector, named as realization of the Mataram village program, and waste management, education, scholarships, and health cards. Suggestion: for the rural government The results of this study provide input for the village government how the role of the village government in realizing Village development, which needs to be done by the village government in realizing non-physical Village development is to conduct a periodic evaluation form on each program.

Surgical care to the wounded with large bowel battle truma during the anti-terrorist operation

A study of surgical treatment at the stages of medical evacuation of 83 wounded with a battle trauma to the abdomen and damage to the large bowel, received during the anti-terrorist operation. The wounded patients were divided into two groups: the comparison group — 42 patients with a traditional surgical management, and the main group — 41 patients with a priority surgical management, which depended on the severity of the condition, the severity of internal injuries and operational and tactical circumstances. At the second level of medical care, the surgical management and the extent of surgical interventions were determined: full, abbreviated or damage control surgery. At the III–IV levels of medical care, planned repeated operations “damage control surgery”, “second look”, as well as comprehensive treatment of the consequences and complications of gunshot wounds were performed.A new approach to the choice of surgical management, as well as the standardization of the estent of surgical interventions have reduced the number of postoperative abdominal complications by 27% and mortality rate — by 16.4%.