Survival skills in San Jose are techniques that a person may use in order to sustain life in any type of natural environment or built environment. These techniques are meant to provide basic necessities for human life which include water, food, and shelter. The skills also support proper knowledge and interactions with animals and plants to promote the sustaining of life over a period of time. Practicing with a survival suit An immersion suit, or survival suit is a special type of waterproof dry suit that protects the wearer from hypothermia from immersion in cold water, after abandoning a sinking or capsized vessel, especially in the open ocean.
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Survival skills are often associated with the need to survive in a disaster situation in San Jose .
 Survival skills are often basic ideas and abilities that ancients invented and used themselves for thousands of years.
 Outdoor activities such as hiking, backpacking, horseback riding, fishing, and hunting all require basic wilderness survival skills, especially in handling emergency situations. Bush-craft and primitive living are most often self-implemented, but require many of the same skills.
Jump to navigation Jump to search Progression-free survival (PFS) is "the length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse". In oncology, PFS usually refers to situations in which a tumor is present, as demonstrated by laboratory testing, radiologic testing, or clinically. Similarly, "disease-free survival" is when patients have had operations and are left with no detectable disease. Time to progression (TTP) does not count patients who die from other causes but is otherwise a close equivalent to PFS (unless there are a large number of such events). The FDA gives separate definitions and prefers PFS. PFS is widely used in oncology. Since (as already said) it only applies to patients with inoperable disease[dubious – discuss] that are generally treated with drugs (chemotherapy, target therapies, etc.) it will mostly be considered in relation to drug treatment of cancer. A very important aspect is the definition of "progression" since this generally involves imaging techniques (plain radiograms, CT scans, MRI, PET scans, ultrasounds) or other aspects: biochemical progression may be defined on the basis of an increase in a tumor marker (such as CA125 for epithelial ovarian cancer or PSA for prostate cancer). At present any change in the radiological aspect of a lesion is defined according to RECIST criteria. But progression may also be due to the appearance of a new lesion originating from the same tumor or to the appearance of new cancer in the same organ or in a different organ, or due to unequivocal progression in 'non-target' lesions—such as pleural effusions, ascites, leptomeningeal disease etc. Progression-free survival is often used as an alternative to overall survival (OS): this is the most reliable endpoint in clinical studies, but it will only be available after a longer time than PFS. For this reason, especially when new drugs are tested, there is a pressure (that in some cases may be absolutely acceptable while in other cases may hide economical interests) to approve new drugs on the basis of PFS data rather than waiting for OS data. PFS is considered as a "surrogate" of OS: in some cancers the two elements are strictly related, but in others they are not. Several agents that may prolong PFS do not prolong OS. PFS may be considered as an endpoint in itself (the FDA and EMEA consider it such) in situations where overall survival endpoints may be not feasible, and where progression is likely or very likely to be related to symptomatology. Patient understanding of what prolongation of PFS means has not been evaluated robustly. In a time trade off study in renal cancer, physicians rated PFS the most important aspect of treatment, while for patients it fell below fatigue, hand foot syndrome, and other toxicities. <Park et al> There is an element that makes PFS a questionable endpoint: by definition it refers to the date on which progression is detected, and this means that it depends on which date a radiological evaluation (in most cases) is performed. If for any reason a CT scan is postponed by one week (because the machine is out of order, or the patients feels too bad to go to the hospital) PFS is unduly prolonged. On the other hand, PFS becomes more relevant than OS when in a randomized trial patients that progress while on treatment A are allowed to receive treatment B (these patients may "cross" from one arm of the study to the other). If treatment B is really more effective than treatment A it is probable that the OS of patients will be the same even if PFS may be very different. This happened for example in studies comparing tyrosine kinase inhibitors (TKI) to standard chemotherapy in patients with non-small cell lung cancer (NSCLC) harboring a mutation in EGF-receptor. Patients started on TKI had a much longer PFS, but since patients that started on chemotherapy were allowed to receive TKI on progression, OS was similar. The relationship between PFS and OS is altered in any case in which a successive treatment may influence survival. Unfortunately this does not happen very often for second-line treatment of cancer, and even less so for successive treatments. The advantage of measuring PFS over measuring OS is that PFS appears sooner than deaths, allowing faster trials and oncologists feel that PFS can give them a better idea of how the cancer is progressing during the course of treatment. Traditionally, the U.S. Food and Drug Administration has required studies of OS rather than PFS to demonstrate that a drug is effective against cancer, but recently[when?] the FDA. has accepted PFS. The use of PFS for proof of effectiveness and regulatory approval is controversial. It is often used as a clinical endpoint in randomized controlled trials for cancer therapies. It is a metric frequently used by the UK National Institute for Health and Clinical Excellence and the U.S. Food and Drug Administration to evaluate the effectiveness of a cancer treatment. PFS has been postulated to be a better ("more pure") measure of efficacy in second-line clinical trials as it eliminates potential differential bias from prior or subsequent treatments. However, PFS improvements do not always result in corresponding improvements in overall survival, and the control of the disease may come at the biological expense of side effects from the treatment itself. This has been described as an example of the McNamara fallacy.
Jump to navigation Jump to search Practicing with a survival suit An immersion suit, or survival suit (or more specifically an immersion survival suit) is a special type of waterproof dry suit that protects the wearer from hypothermia from immersion in cold water, after abandoning a sinking or capsized vessel, especially in the open ocean. They usually have built-in feet (boots), and a hood, and either built-in gloves or watertight wrist seals. The first record of a survival suit was in 1930 when a New York firm American Life Suit Corporation offered merchant and fishing firms what it called a safety suit for crews of ocean vessels. The suit came packed in a small box and was put on like a boilersuit. The ancestor of these suits was already invented in 1872 by Clark S Merriman to rescue steamship passengers. It was made from rubber sheeting and became famous by the swim records of Paul Boyton. It was essentially a pair of rubber pants and shirt cinched tight at the waist with a steel band and strap. Within the suit were five air pockets the wearer could inflate by mouth through hoses. Similar to modern-day drysuits, the suit also kept its wearer dry. This essentially allowed him to float on his back, using a double-sided paddle to propel himself, feet-forward. Additionally he could attach a small sail to save stamina while slowly drifting to shore (because neither emergency radio transmitters nor rescue helicopters were invented yet). The first immersion suit to gain USCG approval was invented by Gunnar Guddal. Eventually the suit became accepted as essential safety gear. These suits are in two types: This type is chosen to fit each wearer. They are often worn by deep-sea fishermen who work in cold water fishing grounds. Some of these garments overlap into scubadiver-type drysuits. Others may have many of the features of a survival suit. Since humans are warm blooded and sweat to cool themselves, suits that are worn all the time usually have some method for sweat to evaporate and the wearer to remain dry while working. The first survival suits in Europe were invented by Daniel Rigolet, captain of a French oil tanker. Others had experimented on similar suits abroad. Unlike work suits, "quick don" survival suits are not normally worn, but are stowed in an accessible location on board the craft. The operator may be required to have one survival suit of the appropriate size on board for each crew member, and other passengers. If a survival suit is not accessible both from a crew member's work station and berth, then two accessible suits must be provided. This type of survival suit's flotation and thermal protection is usually better than an immersion protection work suit, and typically extends a person's survival by several hours while waiting for rescue. An adult survival suit is often a large bulky one-size-fits-all design meant to fit a wide range of sizes. It typically has large oversize booties and gloves built into the suit, which let the user quickly don it on while fully clothed, and without having to remove shoes. It typically has a waterproof zipper up the front, and a face flap to seal water out around the neck and protect the wearer from ocean spray. Because of the oversized booties and large mittens, quick don survival suits are often known as "Gumby suits," after the 1960s-era children's toy. The integral gloves may be a thin waterproof non-insulated type to give the user greater dexterity during donning and evacuation, with a second insulating outer glove tethered to the sleeves to be worn while immersed. A ship's captain (or master) may be required to hold drills periodically to ensure that everyone can get to the survival suit storage quickly, and don the suit in the allotted amount of time. In the event of an emergency, it should be possible to put on a survival suit and abandon ship in about one minute. The Submarine Escape Immersion Equipment is a type of survival suit that can be used by sailors when escaping from a sunken submarine. The suit is donned before escaping from the submarine and then inflated to act as a liferaft when the sailor reaches the surface. Survival suits are normally made out of red or bright fluorescent orange or yellow fire-retardant neoprene, for high visibility on the open sea. The neoprene material used is a synthetic rubber closed-cell foam, containing a multitude of tiny air bubbles making the suit sufficiently buoyant to also be a personal flotation device. The seams of the neoprene suit are sewn and taped to seal out the cold ocean water, and the suit also has strips of SOLAS specified retroreflective tape on the arms, legs, and head to permit the wearer to be located at night from a rescue aircraft or ship. The method of water sealing around the face can affect wearer comfort. Low-cost quick-donning suits typically have an open neck from chest to chin, closed by a waterproof zipper. However the zipper is stiff and tightly compresses around the face resulting in an uncomfortable fit intended for short-duration use until the wearer can be rescued. The suit material is typically very rigid and the wearer is unable to look to the sides easily. Suits intended for long-term worksuit use, or donned by rescue personnel, typically have a form-fitting neck-encircling seal, with a hood that conforms to the shape of the chin. This design is both more comfortable and allows the wearer to easily turn their head and look up or down. The suit material is designed to be either loose or elastic enough to allow the wearer to pull the top of the suit up over their head and then down around their neck. Survival suits can also be equipped with extra safety options such as: The inflatable survival suit is a special type of survival suit, recently developed, which is similar in construction to an inflatable boat, but shaped to wrap around the arms and legs of the wearer. This type of suit is much more compact than a neoprene survival suit, and very easy to put on when deflated since it is just welded from plastic sheeting to form an air bladder. Once the inflatable survival suit has been put on and zipped shut, the wearer activates firing handles on compressed carbon dioxide cartridges, which punctures the cartridges and rapidly inflates the suit. This results in a highly buoyant, rigid shape that also offers very high thermal retention properties. However, like an inflatable boat, the inflatable survival suit loses all protection properties if it is punctured and the gas leaks out. For this reason, the suit may consist of two or more bladders, so that if one fails, a backup air bladder is available. Each immersion suit needs to be regularly checked and maintained properly in order to be ready for use all the time. The maintenance of the immersion suits kept on board of the vessels must be done according to the rules of the International Maritime Organization (IMO). There are two Guidelines issued by IMO - MSC/Circ.1047  and MSC/Circ.1114  in relation to immersion suits’ maintenance. The first one gives instruction for monthly inspection and maintenance which must be done by the ship’s crew. The second one is concerning pressure testing which can be done only with special equipment. Usually it is done ashore by specialized companies but can be done also onboard of the vessels if practical. It must be performed every three years for immersion suits less than 12 years old and every second year on older ones. The years are counted from the suit’s date of manufacture.
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