Science.gov

Sample records for aid emergency managers

  1. Emergency Management Computer-Aided Trainer (EMCAT)

    NASA Technical Reports Server (NTRS)

    Rodriguez, R. C.; Johnson, R. P.

    1986-01-01

    The Emergency Management Computer-Aided Trainer (EMCAT) developed by Essex Corporation or NASA and the Federal Emergency Management Administration's (FEMA) National Fire Academy (NFA) is described. It is a computer based training system for fire fighting personnel. A prototype EMCAT system was developed by NASA first using video tape images and then video disk images when the technology became available. The EMCAT system is meant to fill the training needs of the fire fighting community with affordable state-of-the-art technologies. An automated real time simulation of the fire situation was needed to replace the outdated manual training methods currently being used. In order to be successful, this simulator had to provide realism, be user friendly, be affordable, and support multiple scenarios. The EMCAT system meets these requirements and therefore represents an innovative training tool, not only for the fire fighting community, but also for the needs of other disciplines.

  2. CAMEO-Valdez: A user's perspective. [Computer-Aided Management of Emergency Operations

    SciTech Connect

    Haas, T.J.

    1990-01-11

    On the morning of March 24, 1989, the tanker EXXON VALDEZ ran aground on Bligh Reef in Alaska's Prince William Sound. The vessel was carrying over 53 million gallons of North Slope crude oil of which almost 11 million gallons were spilled in the water. The immediately impacted area included most of the western part of the Sound, but eventually, the area expanded to include parts of Seward, Homer, and Kodiak. This event constituted the worst oil spill in the history of this country, and was identified as a 'spill of national significance.' A major response to clean up the oil by EXXON, which was closely monitored by Federal and State agencies and various interest groups, was necessary. Early in the response it was obvious to the Federal On-Scene Coordinator (FOSC) that a computer-aided management system was necessary to monitor the progress of the spill clean-up operations. This paper will describe CAMEO (Computer-Aided Management of Emergency Operations) - Valdez, developed for the FOSC by the National Oceanographic and Atmospheric Administration acting in its role as the Scientific Support Coordinator (SSC). A discussion of how CAMEO was used and an evaluation of its effectiveness will also be presented.

  3. Management of Student Aid.

    ERIC Educational Resources Information Center

    Nevin, Jeanne, Ed.

    The principles, practices, responsibilities, and controls in student financial aid are described in this manual. It traces the flow of funds, management activities, and legal issues as they occur in the process. The emphasis is on sound management principles of a general and permanent nature rather than on specific government requirements that may…

  4. Software aids plant management

    SciTech Connect

    Winiger, T. )

    1992-11-01

    This paper reports that for most utilities, computer aided engineering (CAE) systems are currently used for operating plant support rather than new plant design particularly for nuclear plant maintenance. For nuclear power generating utilities, switching to a modern, integrated CAE information system can offer significant benefits. During the last decade, however, most engineering automation in the power generation industry focused on computer-aided drafting and stand-alone engineering applications. An integrated CAE system can be a useful too, assisting engineers with many engineering and operational activities. It also can be used to manage the massive amount of information created throughout the life of a plant.

  5. [The emergence of Aids in Amazonas].

    PubMed

    Kadri, Michele Rocha; Schweickardt, Júlio César

    2016-01-26

    This article analyzes the historical, social, and political context in which Aids emerged in the Brazilian state of Amazonas, and how local responses were shaped by changes taking place on a national political level. Documental sources from governmental and non-governmental institutions were researched, and the information was supplemented and clarified by oral sources - testimonials of activists and health professionals/managers who have led the organization of healthcare for people with HIV/Aids in the state. This research reveals that the lack of coordination between healthcare institutions and the dearth of any real political will to fight the epidemic in the state have hampered the planning and execution of public strategies and actions covering the whole welfare system in the state. PMID:27276038

  6. First Aid Procedures for Dental Emergencies.

    ERIC Educational Resources Information Center

    Barsky, Nancy Happel; Londeree, Kathy

    1982-01-01

    Guidelines for first aid procedures for temporary relief of dental emergencies include information on: (1) dental first aid supplies; (2) treatment of oral injuries; (3) orthodontic emergencies; (4) toothaches; and (5) prolonged bleeding due to an extraction. Consulting a dentist as soon as possible is strongly recommended. (JN)

  7. Food aid in emergencies: a case for wheat?

    PubMed

    Landman, J

    1999-05-01

    As disasters and conflict increase, a higher proportion of total food aid is given as humanitarian aid. Most food aid is in the form of cereals, primarily wheat. The main donors are the USA and the EU, but there is an increase in the numbers of donors, including non-governmental organizations, buying food rather than using surpluses. Alongside the greater diversity and complexity of food aid, there is more controversy about policy and practice. If disasters are development failures, emergency food aid must be a step in the continuum from relief to rehabilitation. Comparisons of the seventeen countries that were major recipients of food aid (> 10,000 t) in 1997, show diversity in social development, dietary pattern, number of refugees, relative food inadequacy and wasting (i.e. % standard weight-for-height > 2 SD). In the absence of information of consistent quality, what influences the scale of emergency aid is unclear and susceptible to politicization, so that need and supply may not be matched. Local considerations seem to be as important as external food aid for the nutrition of the recipients. Challenges for the future include assuring the nutritional quality of rations to solve deficiency problems. The implications for the professional public health nutritionist working on emergency food provision include continuing professional development to enhance the technical expertise necessary to design appropriate feeds or rations. These public health nutritionists, more than others, require a grounding in social science theories that underpin management, ethics of professionalism and the politics of food aid. PMID:10466177

  8. Emergency Management Guide

    SciTech Connect

    Not Available

    1994-09-01

    This Emergency Management Guide provides guidance for the implementation of the requirements of the Department of Energy (DOE) Emergency Management System (EMS). The DOE EMS is established by DOE 5500.1B, EMERGENCY DEPARTMENT SYSTEM. The provisions of this guide specify neither policy nor responsibilities. It provides an acceptable approach to emergency planning activities at DOE facilities and sites. Other approaches may be used provided that they are approved by the cognizant Program Secretarial Officer (PSO), with the concurrence of the Director of Emergency Operations (DEO).

  9. AIDS in India: emerging from initial chaos.

    PubMed

    Chatterjee, A

    1991-01-01

    India's response to AIDS has ranged from a 3-phase official surveillance program begun by the India Council of Medical Research (ICMR) in 1985, to legislation criticized as "bigoted and superficial", to conflicting messages, panic and confusion. The ICMR has determined that HIV is transmitted mainly by heterosexual contacts in India. In the media the Director-General of the ICMR was cited as recommending that sex with foreign visitors be banned, as a way to contain the HIV epidemic. Media also reported that defective ELISA screening kits were imported into India that infection control in some hospitals is sub-optimal, that the blood and blood products supply is grossly contaminated with HIV and that certain commercial blood donors were infected from giving blood. All foreign students currently must be HIV-negative to get a visa. It is a major problem to plan an AIDS education campaign with India's large illiterate population and dozens of languages. An AIDS network is emerging incorporating ICMR, the All India Institute of Medical Science, the Central Health Education Bureau, Mother Teresa's order, and a newly formed gay awareness group with the newsletter "Bombay Dost." PMID:12343054

  10. Managing emergency department overcrowding.

    PubMed

    Olshaker, Jonathan S

    2009-11-01

    Emergency department (ED) crowding and ambulance diversion has been an increasingly significant national problem for more than a decade. More than 90% of hospital ED directors reported overcrowding as a problem resulting in patients in hallways, full occupancy of ED beds, and long waits, occurring several times a week. Overcrowding has many other potential detrimental effects including diversion of ambulances, frustration for patients and ED personnel, lesser patient satisfaction, and most importantly, greater risk for poor outcomes. This article gives a basic blueprint for successfully making hospital-wide changes using principles of operational management. It briefly covers the causes, significance, and dangers of overcrowding, and then focuses primarily on specific solutions. PMID:19932394

  11. Collaborative Platforms Aid Emergency Decision Making

    NASA Technical Reports Server (NTRS)

    2013-01-01

    Terra. Aqua. Cloudsat. Landsat. NASA runs and partners in many missions dedicated to monitoring the Earth, and the tools used in these missions continuously return data on everything from shifts in temperature to cloud formation to pollution levels over highways. The data are of great scientific value, but they also provide information that can play a critical role in decision making during times of crisis. Real-time developments in weather, wind, ocean currents, and numerous other conditions can have a significant impact on the way disasters, both natural and human-caused, unfold. "NASA has long recognized the need to make its data from real-time sources compatible and accessible for the purposes of decision making," says Michael Goodman, who was Disasters Program manager at NASA Headquarters from 2009-2012. "There are practical applications of NASA Earth science data, and we d like to accelerate the use of those applications." One of the main obstacles standing in the way of eminently practical data is the fact that the data from different missions are collected, formatted, and stored in different ways. Combining data sets in a way that makes them useful for decision makers has proven to be a difficult task. And while the need for a collaborative platform is widely recognized, very few have successfully made it work. Dave Jones, founder and CEO of StormCenter Communications Inc., which consults with decision makers to prepare for emergencies, says that "when I talk to public authorities, they say, If I had a nickel for every time someone told me they had a common operating platform, I d be rich. But one thing we ve seen over the years is that no one has been able to give end users the ability to ingest NASA data sets and merge them with their own."

  12. [Organized emergency medical aid (author's transl)].

    PubMed

    Sefrin, P

    1975-02-01

    The decision to have medical attendance at accidents has changed the structure of the entire accident rescue service. Standardization (DIN) has provided the basis for efficient equipment and new legislation regarding the special training of orderlies as ambulancemen has ensured an highly expert emergency service personnel. The manifold duties of the emergency service physician are outlined. To perform them competently he needs not only a thorough knowledge of the various branches of medicine, especially of resuscitation and maintenance of vital function, but he must also be acquainted with techniques for the rescue and extrication of casualties and with radio-communication. Suggestions are made for the training of emergency medical personnel. PMID:1233465

  13. Emergency Child Aid. Child Health and Safety Series (Module VI).

    ERIC Educational Resources Information Center

    Iscoe, Louise; And Others

    This manual for child care personnel in day care homes and centers provides a step by step review of what to do in common emergency situations. It is emphasized that the manual is not a substitute for the complete first aid course which every careperson should have. Initial sections of the manual focus on preparing for emergency conditions,…

  14. General Framework of Hearing Aid Fitting Management

    PubMed Central

    Oh, Soo Hee

    2016-01-01

    Hearing aids are one of the most widely used treatment options for the hearing impaired and optimal outcomes of hearing aids are supported by comprehensive hearing aid fitting protocols. Currently, the term 'hearing aid fitting' is prevalently used among service and industry sectors with its comprehensive procedures not systematically explicated. In addition, a variety of non-normalized guidelines for hearing aid fitting has led to non-uniform care, outcome variability, and dissatisfaction of the use of hearing aids. The main purpose of the present study is to suggest a general framework of standardized practice for hearing aid fitting management including its pre- and post-fitting stages. The management framework centers on its fitting process with its prior steps of assessment as well as its posterior steps of follow-up, thereby eliminating diverging interpretations and non-uniform practices. Outcomes of this study are also expected to improve potential benefits such as quality of hearing aid fitting, user satisfaction, and cost effectiveness across relevant stakeholders. PMID:27144226

  15. [Crisis management in emergency medicine].

    PubMed

    Mizobata, Yasumitsu

    2016-02-01

    There is no "complete safety" in the medical treatment. Unavoidable events or human errors may frighten the patients' safety. Because of its characteristics, emergency medicine is one of the medical fields where treating the patients under the vast safety is difficult. It is inevitable to understand the background of human errors in the emergency medicine under the "SHEL" model. The implementation of the safety measures, such as minimum encounter, minimum probability, multiple detections, and minimum damage is helpful to prevent unfortunate outcomes. Since the emergency medicine treats the severely injured or critical ill patients, its daily works are the picture of the crisis management, and the most suitable environment to train the crisis management competence. The person in charge of crisis management of the institution should put the emergency department to practical use of medical staffs' crisis management training. PMID:26915239

  16. Value-Based Emergency Management.

    PubMed

    Corrigan, Zachary; Winslow, Walter; Miramonti, Charlie; Stephens, Tim

    2016-02-01

    This article touches on the complex and decentralized network that is the US health care system and how important it is to include emergency management in this network. By aligning the overarching incentives of opposing health care organizations, emergency management can become resilient to up-and-coming changes in reimbursement, staffing, and network ownership. Coalitions must grasp the opportunity created by changes in value-based purchasing and impending Centers for Medicare and Medicaid Services emergency management rules to engage payers, physicians, and executives. Hope and faith in doing good is no longer enough for preparedness and health care coalitions; understanding how physicians are employed and health care is delivered and paid for is now necessary. Incentivizing preparedness through value-based compensation systems will become the new standard for emergency management. PMID:26878308

  17. Management of hypertension emergencies.

    PubMed

    Elliott, William J

    2003-12-01

    Although they have become less common, hypertensive emergencies occur with an incidence of approximately 1 to 2/100,000 people per year. Our knowledge about this problem, its pathophysiology, risk factors, and appropriate treatment options has expanded during the past decade. A hypertensive emergency can be declared when an elevated blood pressure is associated with acute target-organ damage. Rapid evaluation and treatment (typically with an intravenously administered agent) should be instituted, usually in an intensive care unit setting, and the patient should be observed carefully during acute blood-pressure lowering. When properly treated, the prognosis for these patients is not nearly as dismal as it was more than 60 years ago, and the initial level of function of target organs (brain, heart, kidneys) is more indicative of an emergency than the actual level of blood pressure. Therapeutic options include the time-tested sodium nitroprusside (which has toxic metabolic products and is contraindicated in pregnancy, tobacco amblyopia, and Leber's optic atrophy); fenoldopam mesylate; and nicardipine. When properly treated, "malignant hypertension" need be considered malignant no longer. PMID:14594569

  18. Emergency management logistics must become emergency supply chain management.

    PubMed

    Young, Richard R; Peterson, Matthew R

    2014-01-01

    Much has been written about how emergency management (EM) needs to look to the future regarding issues of resource management (monetary, human, and material). Constraints on budgets are ongoing and the staffing of emergency response activities is often difficult because volunteers have little to no training. The management of material resources has also been a challenge because 1) the categories of material vary by the type of emergency, 2) the necessary quantities of material are often not located near the ultimate point of need, and 3) the transportation assets are rarely available in the form and quantity required to allow timely and effective response. The logistics and resource management functions of EM (what we refer to as EM logistics) have been largely reactive, with little to no pre-event planning for potential demand. We applied the Supply Chain Operational Reference (SCOR) model to EM logistics in an effort to transform it to an integrated and scalable system of physical, information, and financial flows into which are woven the functions of sourcing, making, delivering, and returning, with an overarching planning function that transcends the organizational boundaries of participants. The result is emergency supply chain management, which embraces many more participants who share in a larger quantity of more useful information about the resources that need to be deployed when responding to and recovering from emergency events. PMID:24828913

  19. Emergency Management Standards and Schools

    ERIC Educational Resources Information Center

    National Clearinghouse for Educational Facilities, 2009

    2009-01-01

    This publication discusses emergency management standards for school use and lists standards recommended by FEMA's National Incident Management System (NIMS). Schools are encouraged to review these standards carefully and to adopt, where applicable, those that meet their needs. The lists of standards, resources, and references contained herein…

  20. Nothing prepared me to manage AIDS.

    PubMed

    Banas, G E

    1992-01-01

    Articles and seminars about AIDS in the workplace are not adequate preparation for the genuine problems faced by actual managers in real organizations. There are no easy, win-win solutions to the impossible dilemmas AIDS presents, only various forms of damage control and, at best, more or less humane compromises. Gary Banas knows. Over a period of four years, two of his direct reports developed AIDS, and he watched them suffer through debility, slowly deteriorating performance, and eventual death. He also watched the gradual decline of their subordinates' productivity and morale. He found that, to different degrees, both men refused to acknowledge their illness and their decreasing organizational effectiveness. One of them resisted the author's efforts to give him an easier job at no loss in salary. Both insisted on confidentiality long after the rumor mill had identified their problem. In the course of these two consecutive ordeals, Banas discovered that AIDS patients fall into no single, neat category. AIDS is not an issue but a disease, and the people who get it are human beings first and victims second. He also learned that AIDS affects everyone around the sick individual and that almost every choice a manager makes will injure someone. Finally, he came to understand that while managers have an unequivocal obligation to treat AIDS-afflicted employees with compassion and respect, they have an equally unequivocal obligation to keep their organizations functioning. "Don't let anyone kid you," Banas warns. "When you confront AIDS in the workplace, you will face untenable choices that seem to pit your obligation to humanity against your obligation to your organization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10119719

  1. Paper or plastic? Simulation based evaluation of two versions of a cognitive aid for managing pediatric peri-operative critical events by anesthesia trainees: evaluation of the society for pediatric anesthesia emergency checklist.

    PubMed

    Watkins, Scott C; Anders, Shilo; Clebone, Anna; Hughes, Elisabeth; Zeigler, Laura; Patel, Vikram; Shi, Yaping; Shotwell, Matthew S; McEvoy, Matthew; Weinger, Matthew B

    2016-06-01

    Cognitive aids (CA), including emergency manuals and checklists, are tools designed to assist users in prioritizing and performing complex tasks during time sensitive, high stress situations (Marshall in Anesth Analgesia 117(5):1162-1171, 2013; Marshall and Mehra in Anaesthesia 69(7):669-677, 2014). The society for pediatric anesthesia (SPA) has developed a series of emergency checklists tailored for use by pediatric perioperative teams that cover a wide range of intraoperative critical events (Shaffner et al. in Anesth Analgesia 117(4):960-979, 2013). In this study, we evaluated user preferences for a CA (SPA checklist) using two different presentation formats, paper and electronic, during management of simulated critical events. Anesthesia trainees managed the simulated critical events under one of three randomized conditions: (1) memory alone, (2) with a paper version of the CA, (3) with an electronic version of the CA. Following participation in the simulated critical events, participants were asked to complete a survey regarding their experience using the different versions of the CA. The percentage of favorable responses for each format of the CA was compared using a mixed effects proportional odds model. There were 143 simulated events managed by 89 anesthesia trainees. Approximately one out of three trainees (electronic 29 %, paper 30 %) assigned to use the CA chose not to use it and completed the scenario from memory alone. The survey was completed by 68 % of participants, 58 % of trainees preferred the paper version and 35 % preferred the electronic version. All survey responses that reached statistical significance favored the paper version. In this study, anesthesia trainees had a favorable opinion of the content and perceived clinical relevance of both versions of the CA. In both quantitative and qualitative analysis, the paper version of the CA was preferred over the electronic version by participants. Despite overall favorable responses to the

  2. Hypertensive emergencies: diagnosis and management.

    PubMed

    Phillips, Robert A; Greenblatt, Jonathan; Krakoff, Lawrence R

    2002-01-01

    The treatment of hypertension is preventive medicine. This principle applies in the emergency room as well as the clinic. However, there are crucial contrasts between these two care settings related to specific goals of management for real emergencies and nonemergency conditions. In the emergency room, rapid triage is necessary to separate those who can safely be sent home for future clinic assessment from those who require immediate interventions including short stays in 24-hour observation units or hospitalization for more serious problems. This review focuses on decisions related to hypertension management in the emergency room and over brief periods of observation and treatment. Strategy is supported by evidence-based considerations whenever possible. Where outcome studies are not available, we rely on the rationale derived from relevant clinical research. PMID:12138413

  3. Intelligent situation assessment and response aiding in flight emergencies

    NASA Technical Reports Server (NTRS)

    Hudlicka, Eva; Corker, Kevin; Cramer, Nichael; Young, David; Baron, Sheldon

    1989-01-01

    A knowledge-based pilot aiding system which performs situation assessment and response aiding is described. The system uses a causal model of the flight domain to both simulate the effects of identified failures on flight and to derive responses during emergencies. The model represents information at two levels of abstraction: Boolean, which simply states whether a subsystem or aircraft component is normal or abnormal, and qualitative, which expresses the subsystem or component status as one of several qualitative values, such as increasing, decreasing, or stable.

  4. Emergency management: An annotated bibliography

    SciTech Connect

    Not Available

    1988-03-01

    Training Resources and Data Exchange (TRADE) is an organization designed to increase communication and exchange of ideas, information, and resources among US Department of Energy contractors and DOE personnel. Oak Ridge Associated Universities, located in Oak Ridge, Tennessee, manages TRADE for the DOE. The Emergency Preparedness Special Interest Group (EP SIG) is a group formed within TRADE for emergency preparedness coordinators and trainers to share information about emergency preparedness training and other EP resources. This bibliography was prepared for the EP SIG as a resource for EP training and planning activities.

  5. Optimization Techniques for College Financial Aid Managers

    ERIC Educational Resources Information Center

    Bosshardt, Donald I.; Lichtenstein, Larry; Palumbo, George; Zaporowski, Mark P.

    2010-01-01

    In the context of a theoretical model of expected profit maximization, this paper shows how historic institutional data can be used to assist enrollment managers in determining the level of financial aid for students with varying demographic and quality characteristics. Optimal tuition pricing in conjunction with empirical estimation of…

  6. Computer-Aided Corrosion Program Management

    NASA Technical Reports Server (NTRS)

    MacDowell, Louis

    2010-01-01

    This viewgraph presentation reviews Computer-Aided Corrosion Program Management at John F. Kennedy Space Center. The contents include: 1) Corrosion at the Kennedy Space Center (KSC); 2) Requirements and Objectives; 3) Program Description, Background and History; 4) Approach and Implementation; 5) Challenges; 6) Lessons Learned; 7) Successes and Benefits; and 8) Summary and Conclusions.

  7. Intelligent Pilot Aids for Flight Re-Planning in Emergencies

    NASA Technical Reports Server (NTRS)

    Pritchett, Amy R.

    2002-01-01

    Experimental studies were conducted with pilots to investigate the attributes of automation that would be appropriate for aiding pilots in emergencies. The specific focus of this year was on methods of mitigating automation brittleness. Brittleness occurs when the automatic system is used in circumstances it was not designed for, causing it to choose an incorrect action or make an inaccurate decision for the situation. Brittleness is impossible to avoid since it is impossible to predict every potential situation the automatic system will be exposed to over its life. However, operators are always ultimately responsible for the actions and decisions of the automation they are monitoring or using, which means they must evaluate the automation's decisions and actions for accuracy. As has been pointed out, this is a difficult thing for human operators to do. There have been various suggestions as to how to aid operators with this evaluation. In the study described in this report we studied how presentation of contextual information about an automatic system's decision might impact the ability of the human operators to evaluate that decision. This study focused on the planning of emergency descents. Fortunately, emergencies (e.g., mechanical or electrical malfunction, on-board fire, and medical emergency) happen quite rarely. However, they can be catastrophic when they do. For all predictable or conceivable emergencies, pilots have emergency procedures that they are trained on, but those procedures often end with 'determine suitable airport and land as quickly as possible.' Planning an emergency descent to an unplanned airport is a difficult task, particularly under the time pressures of an emergency. Automatic decision aids could be very efficient at the task of determining an appropriate airport and calculating an optimal trajectory to that airport. This information could be conveyed to the pilot through an emergency descent procedure listing all of the actions

  8. [In-hospital emergency management].

    PubMed

    Jantzen, Tanja; Fischer, Matthias; Müller, Michael P; Seewald, Stephan; Wnent, Jan; Gräsner, Jan-Thorsten

    2013-06-01

    5-10% of in-hospital patients are affected by adverse events, 10% of these requiring CPR. Standardized in-hospital emergency management may improve results, including reduction of mortality, hospital stay and cost. Early warning scores and clinical care outreach teams may help to identify patients at risk and should be combined with standard operation procedure and consented alarm criteria. These teams of doctors and nurses should be called for all in hospital emergencies, providing high-end care and initiate ICU measures at bedside. In combination with standard means of documentation assessment and evaluation--including entry in specific registers--the quality of in-hospital emergency management and patient safety could be improved. PMID:23828085

  9. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false First Aid Kits and Emergency Medical Kits A... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Pt. 121, App. A Appendix A to Part 121—First Aid Kits and Emergency Medical Kits Approved first-aid kits, at least one approved emergency medical kit,...

  10. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false First Aid Kits and Emergency Medical Kits A... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Pt. 121, App. A Appendix A to Part 121—First Aid Kits and Emergency Medical Kits Approved first-aid kits, at least one approved emergency medical kit,...

  11. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false First Aid Kits and Emergency Medical Kits A... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Pt. 121, App. A Appendix A to Part 121—First Aid Kits and Emergency Medical Kits Approved first-aid kits, at least one approved emergency medical kit,...

  12. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false First Aid Kits and Emergency Medical Kits A... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Pt. 121, App. A Appendix A to Part 121—First Aid Kits and Emergency Medical Kits Approved first-aid kits, at least one approved emergency medical kit,...

  13. 14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false First Aid Kits and Emergency Medical Kits A... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Pt. 121, App. A Appendix A to Part 121—First Aid Kits and Emergency Medical Kits Approved first-aid kits, at least one approved emergency medical kit,...

  14. Current Management of Surgical Oncologic Emergencies

    PubMed Central

    Bosscher, Marianne R. F.; van Leeuwen, Barbara L.; Hoekstra, Harald J.

    2015-01-01

    Objectives For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed. Method A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days. Results In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%. Conclusion In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy. PMID:25933135

  15. Standardized emergency management system and response to a smallpox emergency.

    PubMed

    Kim-Farley, Robert J; Celentano, John T; Gunter, Carol; Jones, Jessica W; Stone, Rogelio A; Aller, Raymond D; Mascola, Laurene; Grigsby, Sharon F; Fielding, Jonathan E

    2003-01-01

    The smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox. A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring

  16. Quantifying effectiveness in emergency management.

    PubMed

    Weaver, John Michael

    2014-01-01

    This study looked at the relationship between the Departments of Defense (DOD) and Homeland Security (DHS). Moreover, it reviewed the interface between their two subordinate organizations (Northern Command under DOD and the Federal Emergency Management Agency under DHS) with primacy over domestic disasters. Understanding the importance of intergovernmental relations (IGRs), the article dissected the interrelatedness of these organizations regarding hurricanes and the subsequent involvement of federal preparation and response efforts. The informal networked relationships were evaluated using regression analysis focusing on secondary sources of data and several variables. The vitality of collaborative networks is grounded in literature and has been espoused by Waugh and Streib in the world of emergency management; this study expanded on their premise. PMID:25350357

  17. Pediatric Ingestions: Emergency Department Management.

    PubMed

    Tarango Md, Stacy M; Liu Md, Deborah R

    2016-04-01

    Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs. Evidence regarding the evaluation and management of common pediatric ingestions is comprised largely of case reports and retrospective studies. This issue provides a review of these studies as well as consensus guidelines addressing the initial resuscitation, diagnosis, and treatment of common pediatric ingestions. Also discussed are current recommendations for decontamination, administration of antidotes for specific toxins, and management of ingested foreign bodies. PMID:27104813

  18. Uncertainty management in intelligent design aiding systems

    NASA Technical Reports Server (NTRS)

    Brown, Donald E.; Gabbert, Paula S.

    1988-01-01

    A novel approach to uncertainty management which is particularly effective in intelligent design aiding systems for large-scale systems is presented. The use of this approach in the materials handling system design domain is discussed. It is noted that, during any point in the design process, a point value can be obtained for the evaluation of feasible designs; however, the techniques described provide unique solutions for these point values using only the current information about the design environment.

  19. Awareness of emergency management of dental trauma

    PubMed Central

    Namdev, Ritu; Jindal, Ayushi; Bhargava, Smriti; Bakshi, Lokesh; Verma, Reena; Beniwal, Disha

    2014-01-01

    Aim: Traumatic dental injuries frequently occur in society and may occur at home. The ultimate prognosis of an avulsed tooth occurring in a child may depend on the parents’ knowledge of appropriate emergency measures. This study is aimed at evaluating the awareness level of a sample of Indian (Rohtak, Haryana) parents in the management of dental trauma. Materials and Methods: A total of 1500 parents were surveyed using a self-administered structured questionnaire. The questionnaire was divided into three parts. The tabulated data were statistically analyzed using the Chi-square test. Result: This study indicated a low level of knowledge regarding tooth avulsion and replantation procedures to be followed in emergency. The residing area and age of parent did not affect the knowledge and awareness of parents. Moreover, well-educated parents also had very little or no information about dental trauma first-aid. The lack of significance in correct answers between those with and without such experience indicated that past experience did not seem to have increase the knowledge of the correct emergency procedures. Very little or no information about tooth avulsion and replantation had been given to most of them. Conclusion: Dental injury prevention and management should be recognized as a major public health issue and adequate resources to be allocated for research in this area. Educational programs to improve the knowledge and awareness among the parents have to be implemented. PMID:25395768

  20. Food aid in emergencies and public health nutrition.

    PubMed

    Bhatia, Rita; Thorne-Lyman, Andrew

    2003-01-01

    HUNGER LEAVES SCARS: The visible kind may be born by the survivors of famine. Less visible, but all the more damaging, are the long-term effects of hunger that run through families through generations. Hunger passed from mother to child represents a ruinous inheritance. It marks a cycle of hunger that transcends generations, unless the cycle is broken. Food aid provided at crucial times in the lives of women and infants represents an investment for future. Thus, in contrast to former conceptions of food aid as an exclusively life-saving vehicle, modern aims of food aid also include preventing increases in the prevalence of malnutrition and asset depletion. Mass migration and food shortages have been responsible for most deaths following civil conflicts around the world. The most visible form of migration occurs when people cross international borders. The reasons for the flight of refugees and internally displaced persons are generally same; war, civil strife, and persecution. "NUTRITIONAL GATEWAYS": Finally, the importance of timely and sustained delivery of adequate food aid adequate in quality and quantity to people in dire need during the emergency is paramount. Food aid is the most direct means for conveying nutritional benefits: the time frame is often limited, sustainability is not an issue. However, in the case of drought victims, refugees or displaced people, the nutritional situation and the actions needed are more complex. In many situations people arrive are often in very bad state. While high prevalence of malnutrition is associated with inadequate food rations, in some situation malnutrition developed primarily because of the high incidence of diarrhoeal diseases. The synergism between high malnutrition and increased incidence of communicable diseases explains much of excess mortality seen in refugee and displaced persons. PMID:15806950

  1. 75 FR 55341 - Recovery Policy, RP 9523.6, Mutual Aid Agreements for Public Assistance and Fire Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... Assistance and Fire Management Assistance AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice of... comments on Recovery Policy, RP 9523.6, Mutual Aid Agreements for Public Assistance and Fire...

  2. Emergency Management Instruction. Instructor's Guide for Grades 7-9.

    ERIC Educational Resources Information Center

    North Carolina State Div. of Emergency Management, Raleigh.

    Emergency Management education seeks to give students basic information about natural and man-made disasters, preparedness procedures, and survival techniques. The intent of this guide is to aid teachers in presenting disaster survival instruction in the junior high school grades. The materials are designed to supplement existing curricula, where…

  3. Management of gynecologic oncology emergencies

    SciTech Connect

    Harwood-Nuss, A.L.; Benrubi, G.I.; Nuss, R.C.

    1987-08-01

    Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient. 28 references.

  4. Bleeding varices: 1. Emergency management.

    PubMed Central

    Hanna, S S; Warren, W D; Galambos, J T; Millikan, W J

    1981-01-01

    The aim of the emergency management of bleeding varices is to stop the hemorrhage nonoperatively if possible, avoiding emergency shunt surgery, an operation that has a higher mortality than elective shunt surgery. Patients with an upper gastrointestinal hemorrhage should undergo endoscopy immediately to verify the diagnosis of bleeding varices. They can then be categorized according to whether they stop bleeding spontaneously (group 1), continue to bleed slowly (group 2) or continue to bleed rapidly (group 3). Group 1 patients are discussed in the second part of this two-part series. Group 2 patients are initially treated with vasopressin given intravenously; those who fail to respond should undergo emergency angiography and receive vasopressin intra-arterially. If this fails, patients at low surgical risk should undergo urgent shunt surgery; those at high risk do better with endoscopic sclerotherapy. Group 3 patients are also given an intravenous infusion of vasopressin. Patients at low surgical risk who continue to bleed then receive tamponade with a Sengstaken--Blakemore tube. If this fails, they undergo emergency creation of an H-shaped mesocaval shunt. Patients at high surgical risk who fail to respond to vasopressin given intravenously are next treated intra-arterially. If this fails they are given either endoscopic or transhepatic sclerotherapy. PMID:7006779

  5. Managing hypopituitarism in emergency departments.

    PubMed

    Welsh, Jeanette

    2015-10-01

    Healthcare professionals manage patients with a vast range of conditions, but often specialise and acquire expertise in specific disease processes. Emergency and pre-hospital clinicians care for patients with various conditions for short periods of time, so have less opportunity to become familiar with more unusual conditions, yet it is vital that they have some knowledge and understanding of these. Patients with rare conditions can present at emergency departments with common complaints, but the effect of their original diagnosis on the presenting complaint may be overlooked or underestimated. This article uses a case study to describe the experience of one patient who presented with vomiting, but who also had hypopituitarism and therefore required specific management she did not at first receive. The article describes hypopituitarism and the initial management of patients with this condition who become unwell, and discusses how the trust responded to the patient's complaint to improve patient safety and care. It has been written with the full participation and consent of the patient and her husband. PMID:26451942

  6. Epilepsy emergencies: diagnosis and management.

    PubMed

    Foreman, Brandon; Hirsch, Lawrence J

    2012-02-01

    Seizures and status epilepticus are epilepsy emergencies with high morbidity and mortality. Early treatment is crucial, and the identification of an underlying etiology informs both continued treatment and prognosis. Many patients have underdiagnosed nonconvulsive seizures or nonconvulsive status epilepticus, particularly the comatose or critically ill. Timely EEG can be useful for diagnosis, management, optimizing treatment response, and determining prognosis in these patients. Refractory conditions can be quite complicated with limited evidence-based guidance, but treatment should not be restricted by nihilism even in the most prolonged cases, especially if there is not widespread irreversible brain injury. PMID:22284053

  7. Earth sciences and emergency management

    USGS Publications Warehouse

    Andrews, R.

    1990-01-01

    As understanding of California's earthquake risk had increased over the past decade, there has been a concurrent expansion of interactions between emergency management professionals and earth scientists. The effort have resulted not from a formal plan-though the U.S National Earthquake Hazards Reduction Program has provided much of the support for scientific advances since 1977-but from interactions focused on specific projects. three examples stand out, perhaps suggesting how mutually beneficial exchanges can simultaneously enhance science and public safety. 

  8. Information Systems Coordinate Emergency Management

    NASA Technical Reports Server (NTRS)

    2012-01-01

    The rescue crews have been searching for the woman for nearly a week. Hurricane Katrina devastated Hancock County, the southernmost point in Mississippi, and the woman had stayed through the storm in her beach house. There is little hope of finding her alive; the search teams know she is gone because the house is gone. Late at night in the art classroom of the school that is serving as the county s emergency operations center, Craig Harvey is discussing the search with the center s commander. Harvey is the Chief Operating Officer of a unique company called NVision Solutions Inc., based at NASA s Stennis Space Center in Bay St. Louis, only a couple of miles away. He and his entire staff have set up a volunteer operation in the art room, supporting the emergency management efforts using technology and capabilities the company developed through its NASA partnerships. As he talks to the commander, Harvey feels an idea taking shape that might lead them to the woman s location. Working with surface elevation data and hydrological principles, Harvey creates a map showing how the floodwaters from the storm would have flowed along the topography of the region around the woman s former home. Using the map, search crews find the woman s body in 15 minutes. Recovering individuals who have been lost is a sad reality of emergency management in the wake of a disaster like Hurricane Katrina in 2005. But the sooner answers can be provided, the sooner a community s overall recovery can take place. When damage is extensive, resources are scattered, and people are in dire need of food, shelter, and medical assistance, the speed and efficiency of emergency operations can be the key to limiting the impact of a disaster and speeding the process of recovery. And a key to quick and effective emergency planning and response is geographic information. With a host of Earth-observing satellites orbiting the globe at all times, NASA generates an unmatched wealth of data about our ever

  9. The Changing Role of Financial Aid and Enrollment Management.

    ERIC Educational Resources Information Center

    Kurz, Kathy A.

    1995-01-01

    Explores common institutional strategies for pricing, awarding aid, and controlling the growth of aid budgets in light of changing recruitment practices. Concludes by discussing the new services that aid offices must provide to meet their new challenges effectively. Discusses net tuition revenue goals to enhance effective management of resources.…

  10. Management of Student Aid: A Guide for Presidents.

    ERIC Educational Resources Information Center

    El-Khawas, Elaine

    A guide offering a quick review of principles, decisions, and responsibilities in financial aid management has been developed to aid presidents, trustees, and senior administrators of colleges and universities. The handbook stresses the possible implications of aid for enrollment, financial stability, and institutional mission. Topics that are…

  11. Social Media's New Role in Emergency Management

    SciTech Connect

    Ethan Huffman; Sara Prentice

    2008-03-01

    As technology continues to evolve, emergency management organizations must adapt to new ways of responding to the media and public. This paper examines a brief overview of social media's new role in emergency management. This includes definitions of social media, the benefits of utilizing social media, examples of social media being used and finally a discussion of how agencies, such as Department of Energy national laboratories, can begin including social media in their emergency management plans.

  12. The management of overseas emergencies.

    PubMed

    Thomas, Michael John Glyn

    2007-03-01

    Grave shortages of blood occur in over 80% of the countries in the world. These result from cultural taboos against donation, inadequate funding of the local transfusion service, high incidence of transfusion transmissible diseases, and rarity of a particular blood group, such as Rhesus negative in Asia, or any combination of these factors. Someone visiting such a country, requiring a transfusion, may, by receiving local blood, deprive the local community of a scarce resource. To resolve this problem the Blood Care Foundation has developed a fast reliable service to provide blood to travellers in emergency from countries where supplies are more abundant. Standard operating procedures (SOPs) to cover all aspects of sourcing blood and transfusion equipment, quality control and the requesting and transporting of blood to the patient within the shortest possible time have been produced. Five sourcing blood banks (BBs), 3 satellite BBs and over 200 transfusion support points have been established. Alarm centre medical and administrative staff and anaesthetists, who act as blood couriers have been trained. The methods of requesting blood in an emergency have been integrated with major medical assistance companies. By co-operating with a major refrigeration manufacturer, a transport box has been designed and tested, which can maintain a temperature of 2-8 degrees C for over 120h. In addition a rabies service has recently been introduced where supplies of rabies immunoglobulin and/or vaccine are taken by trained couriers to the person who has been bitten. As well as preserving the local blood supply, local health services are helped in 2 ways. Blood, transfusion fluids and equipment, when they have 20% of their shelf life remaining, are donated to local hospitals. Secondly, when the Quality Assurance Manager visits locations, he helps train the local transfusion staff, thereby helping them to improve their own service. PMID:17298918

  13. Helpful Hints for School Emergency Management: Emergency "Go-Kits"

    ERIC Educational Resources Information Center

    Hill, Tara

    2006-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. The Office of Safe and Drug-Free Schools (OSDFS) encourages schools to consider emergency management in the context of its four phases: mitigation and prevention, preparedness, response, and recovery. The preparedness phase…

  14. HIV/AIDS managed care program.

    PubMed

    Bartlett, J G

    2000-01-01

    Approximately one-half of all patients with HIV infection who are under care have Medicaid as the third party payor. Unlike Medicare, Medicaid is a state-specific program that has huge variations in reimbursement strategies. Multiple studies have shown that care for persons with AIDS is about $20,000/year, but reimbursement through various state Medicaid programs varies about $100/m/m to $2800/m/m despite the fact that expectations for care are identical. Hopkins has a major commitment to persons with HIV infection with a program that now includes 30 faculty members and a support staff of 170. With the introduction of mandatory managed care for Medicaid recipients in July, 1997, we were confronted with the issue of substantial downsizing with abandonment of over half of our patients, or learning the transition to managed care. This has been a steep learning curve involving negotiations with the state Medicaid office, reorganization of our clinic, careful scrutiny of our database regarding resource utilization and cost, education of providers, and longitudinal collection of new information and integration of the rapid changes in the field. In the process of this transition, we learned that there are precious few resources to provide guidance and that there is a perceived need for assistance by HIV providers throughout the country. Consequently, we have now established the "HIV Managed Care Network" with substantial funding from diverse sources to support education, data collection, and public policy review. It is premature to evaluate performance since most of these activities have just begun, but we expect that this Network will serve as a demonstration model for methods to deal with chronic diseases under managed care. PMID:10881336

  15. Managing rural emergency department overcrowding.

    PubMed

    Van Vonderen, Mary L

    2008-01-01

    Emergency department visits reached more than 115 million in 2005, a 30% increase over the past decade. Although much has been written regarding these numbers, little attention has been focused on the impact of overcrowding and volume increases on rural emergency departments. Rural emergency departments face challenges unlike their urban counterparts that make implementation of current overcrowding strategies difficult or impossible. This article addresses these challenges and suggests strategies specific to the needs of rural emergency departments. PMID:18820558

  16. Emergency Management Guidelines for Telepsychiatry

    PubMed Central

    Hilty, Donald M.; Yellowlees, Peter

    2007-01-01

    Objective Telepsychiatry, in the form of live-interactive videoconferencing, is an emerging application for emergency psychiatric assessment and treatment, can improve the quality and quantity of mental health services, particularly for rural, remote and isolated populations. Despite the potential of emergency telepsychiatry, the literature has been fairly limited in this area. Method Drawing on the combined clinical and administrative experiences of its authors this article reviews the common administrative, legal/ethical and clinical issues that arise in emergency telepsychiatry. Results An initial set of guidelines for emergency telepsychiatry is presented to generate further discussion to assist those who are considering establishing general telepsychiatry and/or emergency telepsychiatry services. Conclusion The practices and techniques of emergency telepsychiatry are relatively new and require further examination, modification and refinement so that they may be fully utilized within comprehensive mental health service systems. PMID:17484936

  17. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Emergency medical assistance; first-aid. 75.1713 Section 75.1713 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Miscellaneous § 75.1713 Emergency medical assistance; first-aid....

  18. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in...

  19. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in...

  20. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in...

  1. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Emergency medical assistance; first-aid. 75.1713 Section 75.1713 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Miscellaneous § 75.1713 Emergency medical assistance; first-aid....

  2. Managing hospital emergency power testing programs.

    PubMed

    Stymiest, D L

    1997-04-01

    All hospitals must have an emergency power testing program that includes generator load testing and emergency power supply system maintenance. This document examines a management program that uses lessons learned from an emergency power testing program to improve the hospital's facilities and training. PMID:10166993

  3. Educating Emergency Managers About Weather -Related Hazards

    NASA Astrophysics Data System (ADS)

    Spangler, T. C.; Johnson, V.

    2006-12-01

    The most common crises that emergency managers face are those related to hazardous weather - snowstorms, floods, hurricanes, heat waves, tornadoes, etc. However, man-made disasters, such as accidental releases of hazardous substances or terrorist acts, also often have a weather component. For example, after the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, emergency managers were concerned that thunderstorms in the area might cause the building to collapse, putting rescuers in further danger. Training emergency managers to recognize the importance of weather in disaster planning and response has been a small but important focus of the COMET Program's educational development effort. Topics addressed in COMET training modules that are pertinent to emergency management include fire weather, hurricanes, flood events, and air contaminant dispersion. Additionally, the module entitled Anticipating Hazardous Weather and Community Risk provides an overview of basic meteorological processes, describes a broad range of weather phenomenon, and then addresses what forecast products are available to emergency managers to assess a threat to their community. In many of the modules, learners are presented with scenarios that give them the opportunity to practice decision-making in hazardous weather situations. We will demonstrate some of those scenarios and discuss how training can be used to model good emergency management skills. We will discuss ways to communicate with the emergency management community and provide examples of how distance learning can be used to educate and train emergency managers.

  4. Implementing emergency manuals: can cognitive aids help translate best practices for patient care during acute events?

    PubMed

    Goldhaber-Fiebert, Sara N; Howard, Steven K

    2013-11-01

    In this article, we address whether emergency manuals are an effective means of helping anesthesiologists and perioperative teams apply known best practices for critical events. We review the relevant history of such cognitive aids in health care, as well as examples from other high stakes industries, and describe why emergency manuals have a role in improving patient care during certain events. We propose 4 vital elements: create, familiarize, use, and integrate, necessary for the widespread, successful development, and implementation of medical emergency manuals, using the specific example of the perioperative setting. The details of each element are presented, drawing from the medical literature as well as from our combined experience of more than 30 years of observing teams of anesthesiologists managing simulated and real critical events. We emphasize the importance of training clinicians in the use of emergency manuals for education on content, format, and location. Finally, we discuss cultural readiness for change, present a system example of successful integration, and highlight the importance of further research on the implementation of emergency manuals. PMID:24108251

  5. Applying business intelligence innovations to emergency management.

    PubMed

    Schlegelmilch, Jeffrey; Albanese, Joseph

    2014-01-01

    The use of business intelligence (BI) is common among corporations in the private sector to improve business decision making and create insights for competitive advantage. Increasingly, emergency management agencies are using tools and processes similar to BI systems. With a more thorough understanding of the principles of BI and its supporting technologies, and a careful comparison to the business model of emergency management, this paper seeks to provide insights into how lessons from the private sector can contribute to the development of effective and efficient emergency management BI utilisation. PMID:25193454

  6. Helpful Hints for School Emergency Management: Steps for Developing a School Emergency Management Plan

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. The U.S. Department of Education's Office of Safe and Drug-Free Schools strongly encourages schools and school districts to develop emergency management plans within the context of the four phases of emergency management:…

  7. Intelligent Pilot Aids for Flight Re-Planning in Emergencies

    NASA Technical Reports Server (NTRS)

    Pritchett, Amy R.; Ockerman, Jennifer

    2005-01-01

    Effective and safe control of an aircraft may be difficult or nearly impossible for a pilot following an unexpected system failure. Without prior training, the pilot must ascertain on the fly those changes in both manual control technique and procedures that will lead to a safe landing of the aircraft. Sophisticated techniques for determining the required control techniques are now available. Likewise, a body of literature on pilot decision making provides formalisms for examining how pilots approach discrete decisions framed as the selection between options. However, other aspects of behavior, such as the task of route planning and guidance, are not as well studied. Not only is the pilot faced with possible performance changes to the aircraft dynamics, but he or she is also tasked to create a plan of actions that will effectively take the aircraft down to a safe landing. In this plan, the many actions that the pilot can perform are closely intertwined with the trajectory of the aircraft, making it difficult to accurately predict the final outcome. Coupled with the vast number of potential actions to be taken, this problem may seem intractable. This is reflected in the lack of a pre-specified procedure capable of giving pilots the ability to find a resolution for this task. This report summarizes a multi-year effort to examine methods to aid pilots in planning an approach and arrival to an airport following an aircraft systems failure. Ultimately, we hypothesize that automatic assistance to pilots can be provided in real-time in the form of improving pilot control of a damaged aircraft and providing pilots with procedural directives suitable for critical flight conditions; such systems may also benefit pilot training and procedure design. To achieve this result, a systematic, comprehensive research program was followed, building on prior research. This approach included a pencil-and-paper study with airline pilots examining methods of representing a flight route in

  8. Going ... going ... gone? Federal Emergency Management Agency.

    PubMed

    Gresham, R

    1994-01-01

    Bashing the Federal Emergency Management Agency (FEMA) has become routine among EMS providers. The time has come for the agency's day of reckoning. Here's a look at the Congressional bills designed to build a better FEMA. PMID:10131244

  9. Social media best practices in emergency management.

    PubMed

    Siskey, Ashley; Islam, Tanveer

    2016-01-01

    Social media platforms have become popular as means of communications in emergency management. Many people use social media sites such as Facebook and Twitter on a daily basis including during disaster events. Emergency management agencies (EMAs) need to recognize the value of not only having a presence on social media but also actively engaging stakeholders and the public on these sites. However, identifying best practices for the use of social media in emergency management is still in its infancy. The objective of this article is to begin to create or further define best practices for emergency managers to use social media sites particularly Facebook and Twitter in four key areas: 1) implementation, 2) education, 3) collaboration, and 4) communication. A list of recommendations of best practices is formulated for each key area and results from a nationwide survey on the use of social media by county EMAs are discussed in this article. PMID:27108920

  10. Evaluation of a stand-alone computer-aided detection system for acute intra-cranial hemorrhage in emergency environments

    NASA Astrophysics Data System (ADS)

    Fernandez, James; Deshpande, Ruchi; Wang, Ximing; Liu, Brent; Brazaitis, Michael; Munter, Fletcher; Liu, Margaret

    2011-03-01

    Acute intra-cranial hemorrhage (AIH) may result from traumatic brain injury (TBI). Successful management of AIH depends heavily on the speed and accuracy of diagnosis. Timely diagnosis in emergency environments in both civilian and military settings is difficult primarily due to severe time restraints and lack of resources. Often, diagnosis is performed by emergency physicians rather than trained radiologists. As a result, added support in the form of computer-aided detection (CAD) would greatly enhance the decision-making process and help in providing faster and more accurate diagnosis of AIH. This paper discusses the implementation of a CAD system in an emergency environment, and its efficacy in aiding in the detection of AIH.

  11. Comprehensive management of hypertensive emergencies and urgencies.

    PubMed

    Mansoor, George A; Frishman, William H

    2002-01-01

    Despite advances in chronic hypertension management, hypertensive emergencies and urgencies remain as serious complications. Much of this relates to poor compliance with effective antihypertensive management. Hypertensive emergencies and urgencies can also be seen as the initial manifestations of hypertension in pregnancy and in the perioperative period. Multiple classes of intravenous antihypertensive drugs are available to treat hypertensive emergencies, and specific agents may have an advantage in a given clinical situation. Orally active agents are used to treat hypertensive urgencies, and include clonidine, angiotensin-converting enzyme inhibitors, and labetalol. Most patients respond to drug therapy, but problems may arise related to a rapid normalization of blood pressure. PMID:12441013

  12. Aggressive Management of Surgical Emergencies

    PubMed Central

    Bengmark, Stig

    2006-01-01

    Increasing evidence suggests that two factors significantly influence outcome in a surgical emergency – premorbid health and the degree of inflammation during the first 24 h following trauma. Repeat observations suggest that the depth of post-trauma immunoparalysis reflects the height of early inflammatory response. Administration to surgical emergencies, as was routine in the past, of larger amounts of fluid and electrolytes, fat, sugar and nutrients seems counterproductive as it increases immune dysfunction, impairs resistance to disease and, in fact, increases morbidity. Instead, strong efforts should be made to limit the obvious superinflammation, which occurs during the first 24 h after trauma and, thereby, reduce the subsequent immuno-paralysis. paralysis. Several approaches show efficacy in limiting early superinflammation such as strict control of blood glucose, avoida nce of stored blood when possible, supply of antioxidants, live lactic acid bacteria and plant fibres. This review focuses mainly on use of live lactic acid bacteria and plant fibres, often called synbiotics. Encouraging experience is reported from clinical trials in liver transplantation, severe pancreatitis and extensive trauma. Immediate control of inflammation by enteral nutrition and supply of antioxidants, lactic acid bacteria and fibres is facilitated by feeding tubes, introduced as early as possible on arrival at the hospital. PMID:17132308

  13. Computer Aided Management for Information Processing Projects.

    ERIC Educational Resources Information Center

    Akman, Ibrahim; Kocamustafaogullari, Kemal

    1995-01-01

    Outlines the nature of information processing projects and discusses some project management programming packages. Describes an in-house interface program developed to utilize a selected project management package (TIMELINE) by using Oracle Data Base Management System tools and Pascal programming language for the management of information system…

  14. The President's Emergency Plan for AIDS Relief: Report on Education

    ERIC Educational Resources Information Center

    US Department of State, 2006

    2006-01-01

    For too many children, education has been a casualty of the HIV/AIDS pandemic. Yet schooling remains an essential element of a robust individual and societal future, and partnerships with the education sector provide important opportunities to fight back against the pandemic. The United States Government (USG) supports efforts to address the…

  15. AIDS on Campus: Emerging Issues for College and University Administrators.

    ERIC Educational Resources Information Center

    Steinbach, Sheldon Elliot

    Legal information concerning Acquired Immune Deficiency Syndrome (AIDS) that college presidents may find helpful in establishing policies and procedures is provided in a paper by the general counsel of the American Council on Education. Sources of medical information, including the American College Health Association, hotlines, and federal…

  16. Health Emergency 2003: The Spread of Drug-Related AIDS and Hepatitis C among African American and Latinos. Health Emergency Series.

    ERIC Educational Resources Information Center

    Day, Dawn

    This report is the fifth in a series detailing the impact of the injection-related AIDS epidemic on African Americans and Latinos. Ten chapters include: (1) "Health Emergency: The Spread of AIDS among African Americans Who Inject Drugs"; (2) "Health Emergency: The Spread of AIDS Among Latinos Who Inject Drugs"; (3) "A Neglected Opportunity: Drug…

  17. Emergency strategies and trends in the management of liver trauma.

    PubMed

    Jiang, Hongchi; Wang, Jizhou

    2012-09-01

    The liver is the most frequently injured organ during abdominal trauma. The management of hepatic trauma has undergone a paradigm shift over the past several decades, with mandatory operation giving way to nonoperative treatment. Better understanding of the mechanisms and grade of liver injury aids in the initial assessment and establishment of a management strategy. Hemodynamically unstable patients should undergo focused abdominal sonography for trauma, whereas stable patients may undergo computed tomography, the standard examination protocol. The grade of liver injury alone does not accurately predict the need for operation, and nonoperative management is rapidly becoming popular for high-grade injuries. Hemodynamic instability with positive focused abdominal sonography for trauma and peritonitis is an indicator of the need for emergent operative intervention. The damage control concept is appropriate for the treatment of major liver injuries and is associated with significant survival advantages compared with traditional prolonged surgical techniques. Although surgical intervention for hepatic trauma is not as common now as it was in the past, current trauma surgeons should be familiar with the emergency surgical skills necessary to manage complex hepatic injuries, such as packing, Pringle maneuver, selective vessel ligation, resectional debridement, and parenchymal sutures. The present review presents emergency strategies and trends in the management of liver trauma. PMID:22673827

  18. Computer aided differential diagnosis in emergency situations (CADDIES) system

    SciTech Connect

    NOEL,WILLIAM P.

    2000-03-01

    This report presents an idea for a portable computerized differential diagnosis tool that could be utilized by a health care provider during an emergency situation. This radio frequency, networked, menu driven system would analyze various patient assessment parameters and make recommendations regarding possible diagnoses/treatment options outside the scope of suspicion of the health care provider. This system would serve as a repository for initial epidemiological data and assist the health care provider with spotting emerging trends.

  19. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  20. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  1. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  2. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  3. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  4. Management of cardiac emergencies in small animals.

    PubMed

    DeFrancesco, Teresa C

    2013-07-01

    Cardiac emergencies are life-threatening conditions that must be diagnosed quickly to avoid delays in therapy. A timely and accurate diagnosis leads to early relief of symptoms and improved survival. This article provides both a comprehensive review and updated management recommendations for common cardiac emergencies in dogs and cats. Specifically, the article confers updates for the efficient clinical recognition of decompensated cardiac patients, including focused echocardiography, cardiac biomarkers, and electrocardiogram interpretation. This article also reviews the latest recommendations for the treatment of heart failure (including the use of pimobendan) and the management of arrhythmias, pericardial effusion, and aortic thromboembolism. PMID:23747262

  5. Strategies for managing a busy emergency department.

    PubMed

    Campbell, Samuel G; Sinclair, Douglas E

    2004-07-01

    In a time of increased patient loads and emergency department (ED) exit block, the need for strategies to manage patient flow in the ED has become increasingly important. In March 2002 we contacted all 1282 members of the Canadian Association of Emergency Physicians and asked them to delineate strategies for enhancing ED patient flow and ED productivity without increasing stress levels, reducing care standards or compromising patient safety. Thirty physicians responded. Their suggested flow management strategies, which ranged from clinical decision-making to communication to choreography of time, space and personnel, are summarized here. PMID:17382005

  6. Helping Community College Students Cope with Financial Emergencies: Lessons from the Dreamkeepers and Angel Fund Emergency Financial Aid Programs

    ERIC Educational Resources Information Center

    Geckeler, Christian

    2008-01-01

    Lumina Foundation for Education created the Dreamkeepers and Angel Fund Emergency Financial Aid Programs to assist community college students who are at risk of dropping out because of unexpected financial crises. Both programs are multiyear pilot projects that began in 2005 and are administered by Scholarship America and the American Indian…

  7. 76 FR 52731 - Notice of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... open to the public. The meeting will be hosted by the Office of the U.S. Global AIDS Coordinator, Ambassador Eric Goosby, who leads implementation of the President's Emergency Plan for AIDS Relief...

  8. 77 FR 55891 - Notice of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-11

    ... of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... public. The meeting will be hosted by the Office of the U.S. Global AIDS Coordinator, and led by Ambassador Eric Goosby, who leads implementation of the President's Emergency Plan for AIDS Relief...

  9. 75 FR 78338 - Notice of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-15

    ... of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory Board will meet on January 6-7, 2011 at the St.... Global AIDS Coordinator, Ambassador Eric Goosby, who leads implementation of the President's...

  10. 75 FR 60846 - Notice of Intent To Establish the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-01

    ... of Intent To Establish the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory Board, hereinafter referred to as ``the Board.'' The Board serves the Global AIDS Coordinator (``the Coordinator'') in a solely...

  11. Home Health Management Aide. Final Report.

    ERIC Educational Resources Information Center

    Mincemoyer, Betty Jane

    The report describes a demonstration project to provide a course of study at the senior high level in home health management for the academically handicapped. The course consisted of practice in nursing skills, home management and laboratory work in food preparation techniques, the family, and child care. Activities included field trips,…

  12. Emerging pattern mining to aid toxicological knowledge discovery.

    PubMed

    Sherhod, Richard; Judson, Philip N; Hanser, Thierry; Vessey, Jonathan D; Webb, Samuel J; Gillet, Valerie J

    2014-07-28

    Knowledge-based systems for toxicity prediction are typically based on rules, known as structural alerts, that describe relationships between structural features and different toxic effects. The identification of structural features associated with toxicological activity can be a time-consuming process and often requires significant input from domain experts. Here, we describe an emerging pattern mining method for the automated identification of activating structural features in toxicity data sets that is designed to help expedite the process of alert development. We apply the contrast pattern tree mining algorithm to generate a set of emerging patterns of structural fragment descriptors. Using the emerging patterns it is possible to form hierarchical clusters of compounds that are defined by the presence of common structural features and represent distinct chemical classes. The method has been tested on a large public in vitro mutagenicity data set and a public hERG channel inhibition data set and is shown to be effective at identifying common toxic features and recognizable classes of toxicants. We also describe how knowledge developers can use emerging patterns to improve the specificity and sensitivity of an existing expert system. PMID:24873983

  13. Risk management of international trade: emergency preparedness.

    PubMed

    Torres, A; David, M J; Bowman, Q P

    2002-12-01

    Emergency preparedness and management are among the most important and critical issues facing animal health in the world today. The goals of a country for an animal health emergency management (AHEM) system should include the following: --being prepared to detect and manage an outbreak of a foreign animal disease --preventing the introduction of foreign and emerging animal pathogens --having an appropriate response system for control and eradication of the disease --having a system for recovery from animal health emergencies, including natural disasters. An AHEM system can no longer be limited to a single organisation within a country. In the event of a serious threat to the animal agriculture of a country, broader and more comprehensive participation is required. If not properly planned for, animal health emergencies can rapidly become national disasters. Therefore, it is essential that the central government of a country work towards these goals through partnerships with other Federal and State/Provincial/District organisations, academic institutions and national animal industries. PMID:12523689

  14. Hanford emergency management plan - release 15

    SciTech Connect

    CARPENTER, G.A.

    1999-07-19

    The Hanford emergency management plan for the US Department of Energy Richland, WA and Office of River Protection. The program was developed in accordance with DOE Orders as well as Federal and State regulations to protect workers and public health and safety.

  15. Special Population Planner for Emergency Management

    2003-04-17

    The SPP is a tool for use by emergency management agencies in creating plans for possible events requiring their attention. It incorporates extensive data including those on special needs populations so that this segment of the population will be considered in general plans.

  16. Emergency management in the early phase.

    PubMed

    Crick, M; McKenna, T; Buglova, E; Winkler, G; Martincic, R

    2004-01-01

    An overview of response management in the early phase of an emergency at a nuclear installation is provided from a systems approach. This starts with the recognition of response goals, and using detailed analyses of threats, past experience, international law and principles, a response strategy is developed. The process is illustrated for the case of severe accidents at pressurized water reactors (PWRs) and identifies the need for and nature of: emergency classification based on plant conditions, notification, radiological monitoring and assessment strategies, operational criteria for implementing protective action decisions and management of public information. From the strategy detailed, functional and infrastructure requirements can be defined. The paper also presents some reflections on the key differences between response to emergencies arising from accidents and those arising from deliberate acts; on the preparedness and response capabilities of States, highlighting areas where generic improvements are needed and how best to achieve that. PMID:15238649

  17. Current diagnosis and management of hypertensive emergency.

    PubMed

    Haas, Andrew R; Marik, Paul E

    2006-01-01

    The appropriate and timely evaluation and treatment of patients with severely elevated blood pressure is essential to avoid serious adverse outcomes. Most importantly, the distinction between a hypertensive emergency (crisis) and urgency needs to be made. A sudden elevation in systolic (SBP) and/or diastolic blood pressure (DBP) that is associated with acute end organ damage (cardiovascular, cerebrovascular, or renal) is defined as a hypertensive crisis or emergency. In contrast, acute elevation in SBP and/or DBP not associated with evidence of end organ damage is defined as hypertensive urgency. In patients with a hypertensive emergency, blood pressure control should be attained as expeditiously as possible with parenteral medications to prevent ongoing and potentially permanent end organ damage. In contrast, with hypertensive urgency, blood pressure control can be achieved with the use of oral medications within 24-48 hours. This paper reviews the management of hypertensive emergencies. PMID:17150051

  18. Using social media for disaster emergency management

    NASA Astrophysics Data System (ADS)

    Wang, Y. D.; Wang, T.; Ye, X. Y.; Zhu, J. Q.; Lee, J.

    2016-06-01

    Social media have become a universal phenomenon in our society (Wang et al., 2012). As a new data source, social media have been widely used in knowledge discovery in fields related to health (Jackson et al., 2014), human behaviour (Lee, 2014), social influence (Hong, 2013), and market analysis (Hanna et al., 2011). In this paper, we report a case study of the 2012 Beijing Rainstorm to investigate how emergency information was timely distributed using social media during emergency events. We present a classification and location model for social media text streams during emergency events. This model classifies social media text streams based on their topical contents. Integrated with a trend analysis, we show how Sina-Weibo fluctuated during emergency events. Using a spatial statistical analysis method, we found that the distribution patterns of Sina-Weibo were related to the emergency events but varied among different topics. This study helps us to better understand emergency events so that decision-makers can act on emergencies in a timely manner. In addition, this paper presents the tools, methods, and models developed in this study that can be used to work with text streams from social media in the context of disaster management.

  19. Software Schedules Missions, Aids Project Management

    NASA Technical Reports Server (NTRS)

    2008-01-01

    NASA missions require advanced planning, scheduling, and management, and the Space Agency has worked extensively to develop the programs and software suites necessary to facilitate these complex missions. These enormously intricate undertakings have hundreds of active components that need constant management and monitoring. It is no surprise, then, that the software developed for these tasks is often applicable in other high-stress, complex environments, like in government or industrial settings. NASA work over the past few years has resulted in a handful of new scheduling, knowledge-management, and research tools developed under contract with one of NASA s partners. These tools have the unique responsibility of supporting NASA missions, but they are also finding uses outside of the Space Program.

  20. Management Aids and Procedures for Strategic Planning. Staff Report.

    ERIC Educational Resources Information Center

    Cope, Robert G.

    Management aids required in strategic planning are divided into three categories: (1) assessing the environment, (2) providing a process for reaching decisions, and (3) presenting criteria to evaluate strategic decisions. A model for scanning the environment has four dimensions that concern economic, social, knowledge-technology, and public policy…

  1. ARAC: A support capability for emergency managers

    SciTech Connect

    Pace, J.C.; Sullivan, T.J.; Baskett, R.L.

    1995-08-01

    This paper is intended to introduce to the non-radiological emergency management community the 20-year operational history of the Atmospheric Release Advisory Capability (ARAC), its concept of operations, and its applicability for use in support of emergency management decision makers. ARAC is a centralized federal facility for assessing atmospheric releases of hazardous materials in real time, using a robust suite of three-dimensional atmospheric transport and diffusion models, extensive geophysical and source-description databases, automated meteorological data acquisition systems, and experienced staff members. Although originally conceived to respond to nuclear accidents, the ARAC system has proven to be extremely adaptable, and has been used successfully during a wide variety of nonradiological hazardous chemical situations. ARAC represents a proven, validated, operational support capability for atmospheric hazardous releases.

  2. [Emergency room management of contaminated patients].

    PubMed

    Strohm, P C; Hammer, T O; Kopp, K; Knobloch, V; Alawadi, K; Bannasch, H; Köstler, W; Zipfel, E; Südkamp, N P

    2008-06-01

    Accidents with the risk of exposure to hazardous nuclear, biological, or chemical materials are rare. Most emergency rooms are not familiar with the management of contaminated patients after this kind of incident. There are also ambiguous cases concerning the contamination status of the patient. The medical attendance should be performed carefully and under special security arrangements until a hazard for third persons can be excluded. The security arrangements should protect both (medical) personnel and third persons. Early medical treatment combined with decontamination should be the aim. Based on the case of a contaminated patient who was brought to our emergency department after an explosion of a fog grenade with red phosphorus, we discuss our management concept and the current literature. PMID:18066517

  3. Building public confidence in emergency management.

    PubMed

    Pearce, Tony

    2016-01-01

    Over the years the State of Victoria has suffered many disasters, some of them resulting in extensive community, economic and environmental loss. A number of significant events, including the 2009 Victorian bushfires, major flood events in 2010-11 and their subsequent inquiries have resulted in the biggest overhaul of Victoria's emergency management arrangements since 1983. One significant element of the new arrangements is the inclusion of an entity whose role it is to assure the emergency management arrangements at the system level--the first time such a role has existed. This paper will describe the reform programme currently underway in Victoria, as well as the governance and structural arrangements that have been put in place, before detailing the assurance processes that are being implemented. PMID:26897618

  4. An In-Depth Study of Emergency School Aid Act (ESAA) Schools: 1974-1975.

    ERIC Educational Resources Information Center

    Wellisch, Jean B.; And Others

    The 1974-75 in-depth study was designed and conducted as an exploratory investigation of program and contextual factors related to achievement. The study was conducted in conjunction with the National Evaluation of the Emergency School Aid Act (ESAA). The analysis of school success was guided by a conceptual model that identified four key…

  5. Application of expert systems in project management decision aiding

    NASA Technical Reports Server (NTRS)

    Harris, Regina; Shaffer, Steven; Stokes, James; Goldstein, David

    1987-01-01

    The feasibility of developing an expert systems-based project management decision aid to enhance the performance of NASA project managers was assessed. The research effort included extensive literature reviews in the areas of project management, project management decision aiding, expert systems technology, and human-computer interface engineering. Literature reviews were augmented by focused interviews with NASA managers. Time estimation for project scheduling was identified as the target activity for decision augmentation, and a design was developed for an Integrated NASA System for Intelligent Time Estimation (INSITE). The proposed INSITE design was judged feasible with a low level of risk. A partial proof-of-concept experiment was performed and was successful. Specific conclusions drawn from the research and analyses are included. The INSITE concept is potentially applicable in any management sphere, commercial or government, where time estimation is required for project scheduling. As project scheduling is a nearly universal management activity, the range of possibilities is considerable. The INSITE concept also holds potential for enhancing other management tasks, especially in areas such as cost estimation, where estimation-by-analogy is already a proven method.

  6. Chlorophyll Meters Aid Plant Nutrient Management

    NASA Technical Reports Server (NTRS)

    2009-01-01

    On December 7, 1972, roughly 5 hours and 6 minutes after launch, the crew of Apollo 17 took one of history s most famous photographs. The brilliant image of the fully illuminated Earth, the African and Antarctic continents peering out from behind swirling clouds, came to be known as the Blue Marble. Today, Earth still sometimes goes by the Blue Marble nickname, but as the satellites comprising NASA s Earth Observing System (EOS) scan the planet daily in ever greater resolutions, it is often the amount of green on the planet that is a focus of researchers attention. Earth s over 400,000 known plant species play essential roles in the planet s health: They absorb carbon dioxide and release the oxygen we breathe, help manage the Earth s temperature by absorbing and reflecting sunlight, provide food and habitats for animals, and offer building materials, medication, and sustenance for humans. As part of NASA s efforts to study our own planet along with the universe around it, the Agency s EOS satellites have been accumulating years of valuable data about Earth s vegetation (not to mention its land features, oceans, and atmosphere) since the first EOS satellite launched in 1997. Among the powerful sensors used is the Moderate Resolution Imaging Spectroradiometer (MODIS) on board the NASA Terra and Aqua satellites. MODIS sweeps the entire Earth every few days, beaming back information gathered across 36 bands of visible and infrared light, yielding images that let scientists track how much of Earth is green over the course of seasons and years. Monitoring the density and distribution of vegetation on Earth provides a means of determining everything from the impact of natural and human-induced climate change to the potential outbreak of disease. (Goddard Space Flight Center and U.S. Department of Defense researchers have determined, for example, that vegetation density can be used to pinpoint regions of heavy rainfall in Africa regions ripe for outbreaks of rainfall

  7. Cognitive Aids in Medicine Assessment Tool (CMAT): preliminary validation of a novel tool for the assessment of emergency cognitive aids.

    PubMed

    Evans, D; McCahon, R; Barley, M; Norris, A; Khajuria, A; Moppett, I

    2015-08-01

    Applying human factors principles to the design of clinical emergency guidelines is important. The UK Civil Aviation Authority uses a Checklist Assessment Tool for evaluating the content and usability of emergency drills before introduction into service on aircraft. We hypothesised that this model could be used to develop a generic medical tool. A three-stage modified Delphi process was used to adapt the above tool for use in designing medical emergency guidelines. The resulting Cognitive aids in Medicine Assessment Tool was then used to score and rank seven published difficult airway guidelines; the scores were used to assess its validity and reliability. Pearson's rank coefficient between these scores and scores from independent assessors was 0.89 (p = 0.007). Internal consistency, as assessed by Cronbach's alpha, was 0.74, 0.96 and 0.72 for the tool's three constituent domains of physical characteristics, content and layout/format, respectively. Inter-rater reliability, as assessed by Cohen's kappa, ranged from 0.33 to 0.72. The adoption of our tool has the potential to improve the usability of medical emergency guidelines. PMID:25758401

  8. 77 FR 70874 - Notice of Charter Renewal of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ... of Charter Renewal of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory Board SUMMARY: The Office of the U.S. Global AIDS Coordinator (S/GAC) announces the charter renewal of... Office of the U.S. Global AIDS Coordinator, and led by Ambassador Eric Goosby, who leads...

  9. 78 FR 31626 - Notice of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ... of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... will be hosted by the Office of the U.S. Global AIDS Coordinator, and led by Dr. Amy DuBois, who is the.... The Board serves the Global AIDS Coordinator in a solely advisory capacity concerning...

  10. 78 FR 33144 - Notice of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-03

    ... of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... will be hosted by the Office of the U.S. Global AIDS Coordinator, and led by Dr. Amy DuBois, who is the.... The Board serves the Global AIDS Coordinator in a solely advisory capacity concerning...

  11. 14 CFR 121.333 - Supplemental oxygen for emergency descent and for first aid; turbine engine powered airplanes...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... and for first aid; turbine engine powered airplanes with pressurized cabins. 121.333 Section 121.333... for emergency descent and for first aid; turbine engine powered airplanes with pressurized cabins. (a... passenger cabin occupants. (3) For first-aid treatment of occupants who for physiological reasons...

  12. 14 CFR 121.333 - Supplemental oxygen for emergency descent and for first aid; turbine engine powered airplanes...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... and for first aid; turbine engine powered airplanes with pressurized cabins. 121.333 Section 121.333... for emergency descent and for first aid; turbine engine powered airplanes with pressurized cabins. (a... passenger cabin occupants. (3) For first-aid treatment of occupants who for physiological reasons...

  13. 14 CFR 121.333 - Supplemental oxygen for emergency descent and for first aid; turbine engine powered airplanes...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and for first aid; turbine engine powered airplanes with pressurized cabins. 121.333 Section 121.333... for emergency descent and for first aid; turbine engine powered airplanes with pressurized cabins. (a... passenger cabin occupants. (3) For first-aid treatment of occupants who for physiological reasons...

  14. 14 CFR 121.333 - Supplemental oxygen for emergency descent and for first aid; turbine engine powered airplanes...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... and for first aid; turbine engine powered airplanes with pressurized cabins. 121.333 Section 121.333... for emergency descent and for first aid; turbine engine powered airplanes with pressurized cabins. (a... passenger cabin occupants. (3) For first-aid treatment of occupants who for physiological reasons...

  15. 14 CFR 121.333 - Supplemental oxygen for emergency descent and for first aid; turbine engine powered airplanes...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and for first aid; turbine engine powered airplanes with pressurized cabins. 121.333 Section 121.333... for emergency descent and for first aid; turbine engine powered airplanes with pressurized cabins. (a... passenger cabin occupants. (3) For first-aid treatment of occupants who for physiological reasons...

  16. Integrated Safety, Environmental, & Emergency Management Systems (ISEEMS)

    SciTech Connect

    Silver, R.; Langwell, G.; Thomas, C.; Coffing, S.

    1996-05-01

    Sandia`s Risk Management and NEPA Department recognized the need for hazard and environmental data analysis and management to support the line managers` need to know, understand, manage and document the hazards inherent in their facilities and activities. ISEEMS (Integrated Safety, Environmental, & Emergency Management System) was developed in response to this need. ISEEMS takes advantage of the fact that there is some information needed for the NEPA process that is also needed for the safety documentation process. The ISEEMS process enables Sandia to identify and manage hazards and environmental concerns at a level of effort commensurate with the hazards themselves by adopting a necessary and sufficient (graded) approach to compliance. The Preliminary Hazard Screening module of ISEEMS determines the facility or project activity hazard classification and facility designation. ISEEMS` geo-referenced icon allows immediate, visual integration of hazard information across geographic boundaries resulting in significant information compression. At Sandia, ISEEMS runs on the Sandia Internal Restricted Network, in an MS-Windows environment on standard PC hardware. The possibility of transporting ISEEMS to a ``WEB-like`` environment is being explored.

  17. Computer-Aided Evaluation of Forage Management: Forage Manager.

    ERIC Educational Resources Information Center

    Panciera, M. T.; And Others

    1993-01-01

    Presents the Forage Manager spreadsheet, developed as a forage management teaching tool to integrate agronomic, livestock, and cost data to demonstrate the impact of forage management on livestock production costs. Teaching applications, examples involving agronomic data and conventional agronomic evaluation, and limitations of the program are…

  18. 78 FR 55326 - Notice of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-10

    ... of Public Meeting of the President's Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory... is open to the public. The meeting will be hosted by the Office of the U.S. Global AIDS Coordinator, and led by Ambassador Eric Goosby, who leads implementation of the President's Emergency Plan for...

  19. Computer-Aided Nodule Assessment and Risk Yield Risk Management of Adenocarcinoma: The Future of Imaging?

    PubMed

    Foley, Finbar; Rajagopalan, Srinivasan; Raghunath, Sushravya M; Boland, Jennifer M; Karwoski, Ronald A; Maldonado, Fabien; Bartholmai, Brian J; Peikert, Tobias

    2016-01-01

    Increased clinical use of chest high-resolution computed tomography results in increased identification of lung adenocarcinomas and persistent subsolid opacities. However, these lesions range from very indolent to extremely aggressive tumors. Clinically relevant diagnostic tools to noninvasively risk stratify and guide individualized management of these lesions are lacking. Research efforts investigating semiquantitative measures to decrease interrater and intrarater variability are emerging, and in some cases steps have been taken to automate this process. However, many such methods currently are still suboptimal, require validation and are not yet clinically applicable. The computer-aided nodule assessment and risk yield software application represents a validated tool for the automated, quantitative, and noninvasive tool for risk stratification of adenocarcinoma lung nodules. Computer-aided nodule assessment and risk yield correlates well with consensus histology and postsurgical patient outcomes, and therefore may help to guide individualized patient management, for example, in identification of nodules amenable to radiological surveillance, or in need of adjunctive therapy. PMID:27568149

  20. Emerging Contaminant Issues, Including Management Of Emerging Contaminants In Wastewater

    EPA Science Inventory

    Emerging contaminants are receiving increasing media and scientific attention. These chemicals are sometimes referred to as compounds of emerging concern or trace organic compounds, and include several groups of chemicals including endocrine disrupting compounds (EDCs), and pha...

  1. Computer Simulation for Emergency Incident Management

    SciTech Connect

    Brown, D L

    2004-12-03

    This report describes the findings and recommendations resulting from the Department of Homeland Security (DHS) Incident Management Simulation Workshop held by the DHS Advanced Scientific Computing Program in May 2004. This workshop brought senior representatives of the emergency response and incident-management communities together with modeling and simulation technologists from Department of Energy laboratories. The workshop provided an opportunity for incident responders to describe the nature and substance of the primary personnel roles in an incident response, to identify current and anticipated roles of modeling and simulation in support of incident response, and to begin a dialog between the incident response and simulation technology communities that will guide and inform planned modeling and simulation development for incident response. This report provides a summary of the discussions at the workshop as well as a summary of simulation capabilities that are relevant to incident-management training, and recommendations for the use of simulation in both incident management and in incident management training, based on the discussions at the workshop. In addition, the report discusses areas where further research and development will be required to support future needs in this area.

  2. Emergency management of acute abdomen in children.

    PubMed

    Balachandran, Binesh; Singhi, Sunit; Lal, Sadhna

    2013-03-01

    Acute abdomen can be defined as a medical emergency in which there is sudden and severe pain in abdomen with accompanying signs and symptoms that focus on an abdominal involvement. It accounts for about 8 % of all children attending the emergency department. The goal of emergency management is to identify and treat any life-threatening medical or surgical disease condition and relief from pain. In mild cases often the cause is gastritis or gastroenteritis, colic, constipation, pharyngo-tonsilitis, viral syndromes or acute febrile illnesses. The common surgical causes are malrotation and Volvulus (in early infancy), intussusception, acute appendicitis, and typhoid and ischemic enteritis with perforation. Lower lobe pneumonia, diabetic ketoacidosis and acute porphyria should be considered in patients with moderate-severe pain with little localizing findings in abdomen. The approach to management in ED should include, in order of priority, a rapid cardiopulmonary assessment to ensure hemodynamic stability, focused history and examination, surgical consult and radiologic examination to exclude life threatening surgical conditions, pain relief and specific diagnosis. In a sick patient the initial steps include rapid IV access and normal saline 20 ml/kg (in the presence of shock/hypovolemia), adequate analgesia, nothing per oral/IV fluids, Ryle's tube aspiration and surgical consultation. An ultrasound abdomen is the first investigation in almost all cases with moderate and severe pain with localizing abdominal findings. In patients with significant abdominal trauma or features of pancreatitis, a Contrast enhanced computerized tomography (CECT) abdomen will be a better initial modality. Continuous monitoring and repeated physical examinations should be done in all cases. Specific management varies according to the specific etiology. PMID:23456644

  3. The effect of two cognitive aid designs on team functioning during intra-operative anaphylaxis emergencies: a multi-centre simulation study.

    PubMed

    Marshall, S D; Sanderson, P; McIntosh, C A; Kolawole, H

    2016-04-01

    This multi-centre repeated measures study was undertaken to determine how contrasting designs of cognitive aids affect team performance during simulated intra-operative anaphylaxis crises. A total of 24 teams consisting of a consultant anaesthetist, an anaesthetic trainee and anaesthetic assistant managed three simulated intra-operative anaphylaxis emergencies. Each team was assigned at random to a counterbalanced order of: no cognitive aid; a linear cognitive aid; and a branched cognitive aid, and scored for team functioning. Scores were significantly higher with a linear compared with either a branched version of the cognitive aid or no cognitive aid for 'Team Overall Behavioural Performance', difference between study groups (F-value) 5.8, p = 0.01. Aggregate scores were higher with the linear compared with the branched aid design (p = 0.03). Cognitive aids improve co-ordination of the team's activities and support team members to verbalise their actions. A linear design of cognitive aid improves team functioning more than a branched design. PMID:26792648

  4. [Hygiene is not cleanliness. For a new definition of hygiene promotion in emergency humanitarian aid].

    PubMed

    Larose, L

    2001-03-01

    Following the Kosovo crisis, this paper questions the contents of hygiene kits to be distributed to refugees, the definition of hygiene and the hygiene promotion practises in emergency aid work. Hygiene promotion cannot be reduced to cleanness promotion. We have to consider refugees' psychosocial needs and trauma as well as the problems of refugees settlement as a community and of community mobilisation to conceive programmes meeting population's needs and demands. Hygiene promotion should include systematic attempts to implement community services by volunteer refugees. One has to be careful also that the financial mechanisms of aid do not pervert programmation. PMID:11525045

  5. Multiattribute risk analysis in nuclear emergency management.

    PubMed

    Hämäläinen, R P; Lindstedt, M R; Sinkko, K

    2000-08-01

    Radiation protection authorities have seen a potential for applying multiattribute risk analysis in nuclear emergency management and planning to deal with conflicting objectives, different parties involved, and uncertainties. This type of approach is expected to help in the following areas: to ensure that all relevant attributes are considered in decision making; to enhance communication between the concerned parties, including the public; and to provide a method for explicitly including risk analysis in the process. A multiattribute utility theory analysis was used to select a strategy for protecting the population after a simulated nuclear accident. The value-focused approach and the use of a neutral facilitator were identified as being useful. PMID:11051070

  6. The configuration management program for the Emergency Management Support System

    SciTech Connect

    Probasco, K M; Stephan, E G

    1991-08-01

    Emergency response software is used increasingly by the US Department of Energy's (DOE's) Emergency Management Project (EMP) personnel at Hanford Site. This software must be reliable, of high quality, and capable of performing critical functions to support assessment of actual or potential consequences of any hazardous accidents onsite or events having potential offsite impacts. To better control the software and ensure its suitability for use as a tool to protect employees, the public, and environment, a method for specifying and certifying its capabilities and documenting its development and implementation was needed. A team of EMP staff, composed of personnel from Pacific Northwest Laboratory (PNL) and Boeing Computer Services- Richland (BCSR) under the direction of PNL EMP, responded to this need by developing a software configuration management program (CMP). This report documents the development of the CMP, including the strategies upon which the CMP is based, and describes the program as it has been implemented for EMS System software. The program relies on the integration of its three primary elements: the configuration management staff, tools, and process. Configuration management staff run the program, using specially designed configuration management forms to guide, document, and track the life cycle of the software. The configuration management process itself is reflected in the instructive forms and summarized in flowcharts representing each phase of the process -- from requirements specification through implementation and maintenance. 7 refs., 9 figs., 1 tab.

  7. DeMAID/GA an Enhanced Design Manager's Aid for Intelligent Decomposition

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1996-01-01

    Many companies are looking for new tools and techniques to aid a design manager in making decisions that can reduce the time and cost of a design cycle. One tool is the Design Manager's Aid for Intelligent Decomposition (DeMAID). Since the initial public release of DeMAID in 1989, much research has been done in the areas of decomposition, concurrent engineering, parallel processing, and process management; many new tools and techniques have emerged. Based on these recent research and development efforts, numerous enhancements have been added to DeMAID to further aid the design manager in saving both cost and time in a design cycle. The key enhancement, a genetic algorithm (GA), will be available in the next public release called DeMAID/GA. The GA sequences the design processes to minimize the cost and time in converging a solution. The major enhancements in the upgrade of DeMAID to DeMAID/GA are discussed in this paper. A sample conceptual design project is used to show how these enhancements can be applied to improve the design cycle.

  8. Emerging haemostatic agents and patient blood management.

    PubMed

    Tanaka, Kenichi A; Kor, Daryl J

    2013-03-01

    The transfusion of allogeneic blood products has been considered as a life-saving procedure for patients suffering from major traumatic injury and those who are undergoing major surgery. The safety of blood products has improved in terms of infectious complications over the last three decades due to advanced donor screening procedures and tests. Nevertheless, non-infectious complications including a blood-type mismatch, volume overload and immunologic and non-immunologic reactions to blood products can adversely affect clinical outcomes. It is thus important to implement a patient-specific strategy in diagnosing bleeding cause(s) and optimising haemostatic therapy. This strategy is an integral part of patient blood management applicable to many perioperative patients. Recent advances in the haemostatic management and transfusion include better understanding of the pathomechanisms of coagulopathy, availability of point-of-care coagulation monitoring and introductions of pathogen-inactivated plasma and factor concentrates as well as recombinant coagulation factors. Understanding the indications and limitations of conventional haemostatic therapy, and potential indications and complications relating to emerging haemostatic agents, is important for perioperative physicians. In this article, we discuss current issues related to allogeneic plasma products and emerging biological haemostatic agents and techniques. Further, we review the mechanisms of action and available preclinical or clinical data for each therapeutic agent. PMID:23590923

  9. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

    PubMed Central

    2013-01-01

    Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and

  10. Improving acute medical management: Junior Doctor Emergency Prescription Cards

    PubMed Central

    Hutton, Joe; Gingell, Megan; Hutchinson, Lisa

    2016-01-01

    Doctors commencing Foundation Year (FY) training face many stresses and challenges. FY doctors are often the first point of contact for acutely unwell and deteriorating patients. Trust guidelines are used to aid acute medical management. Accessing guidelines is often fraught with barriers. Evidence suggests aide-memoire cards can provide easier access to guidelines and management pathways. We aimed to improve prescribing accuracy and efficiency of FY doctors for acute medical conditions within Gloucestershire trust by improving access to and usability of trust guidelines. Questionnaires were distributed to FY doctors to identify acute medical conditions to include on the emergency prescription cards (EPCs). Two small double-sided cards were created containing bullet pointed trust guidelines for: hyper/hypokalaemia, status epilepticus, diabetic emergencies, arrhythmias, myocardial infarction, acute asthma, pulmonary oedema, anaphylaxis and a ward-round checklist. Feedback was used to improve EPCs prior to distribution. Pre (N=53) and post-intervention (N=46) written questionnaires were completed by FY doctors. These assessed acute clinical management including use of guidance, confidence in management, speed of prescribing and EPC “usability”. To assess prescribing accuracy, prescriptions for acute medical conditions were reviewed pre (N=8) and post-intervention (N=12). The EPCs were well received (80% quite/very useful) and found “easy to use” (83%). The introduction of EPCs increased guidance use (pre-intervention 58.8%, post-intervention 71.7%), increased confidence (pre-intervention 79%, post-intervention 89%) and significantly improved prescribing speed (p=0.05). There was a significant correlation with confidence and prescribing speed (p = 0.023). The accuracy of prescribed doses improved (pre-intervention 62.5%, post-intervention 87.5% accurate) as did details regarding route / additional required information (pre-intervention 75%, post

  11. Supporting Community Emergency Management Planning Through a Geocollaboration Software Architecture

    NASA Astrophysics Data System (ADS)

    Schafer, Wendy A.; Ganoe, Craig H.; Carroll, John M.

    Emergency management is more than just events occurring within an emergency situation. It encompasses a variety of persistent activities such as planning, training, assessment, and organizational change. We are studying emergency management planning practices in which geographic communities (towns and regions) prepare to respond efficiently to significant emergency events. Community emergency management planning is an extensive collaboration involving numerous stakeholders throughout the community and both reflecting and challenging the community’s structure and resources. Geocollaboration is one aspect of the effort. Emergency managers, public works directors, first responders, and local transportation managers need to exchange information relating to possible emergency event locations and their surrounding areas. They need to examine geospatial maps together and collaboratively develop emergency plans and procedures. Issues such as emergency vehicle traffic routes and staging areas for command posts, arriving media, and personal first responders’ vehicles must be agreed upon prior to an emergency event to ensure an efficient and effective response. This work presents a software architecture that facilitates the development of geocollaboration solutions. The architecture extends prior geocollaboration research and reuses existing geospatial information models. Emergency management planning is one application domain for the architecture. Geocollaboration tools can be developed that support community-wide emergency management planning and preparedness. This chapter describes how the software architecture can be used for the geospatial, emergency management planning activities of one community.

  12. Emerging Technologies: Biosecurity and Consequence Management Implications

    NASA Astrophysics Data System (ADS)

    Perkins, Dana; Nordmann, Brian

    The natural outbreaks of disease and pandemics are transnational threats that create international challenges when detection and containment are not timely due to scarce human and material resources. Whether the cause of those outbreaks is natural or intentional in origin, the main goal of consequence management operations is to save lives. The consequence management process is a continuum of inter-connected phases such as planning, preparation, response, and recovery. The rapid advances of life sciences and the emergence of dual-use technologies such as synthetic biology and nanotechnology pose additional challenges in terms of planning for the unknown potential threats whether they may be synthetic microorganisms with unpredictable dissemination patterns or nanoscale-manipulated biological agents evading current detection capabilities. The US National Strategy for Countering Biological Threats is emphasizing prevention while continuing to support the national preparedness goals and response/recovery capabilities. The recent policies, guidelines, and recommendations on overhauling the biological risk management in the United States are a proactive stance to a rapidly changing global environment. They include optimization of the current oversight frameworks and active engagement of the industry and academia in order to reduce the risk that individuals with ill intent may exploit the commercial application of nucleic acid synthesis technology to access genetic material derived from or by encoding Biological Select Agents or Toxins. We are also actively seeking to increase our knowledge of health effects of various types of nanomaterials, and how to assess, control, and prevent harmful exposure, taking into consideration the numerous gaps that currently exist with regard to the distinct behavior of nanoparticles compared to the same chemical or material at "macro-scale". Fundamentally, a biological incident, whether it is of natural, accidental, or deliberate origin

  13. Lessons learned in public health emergency management: personal reflections.

    PubMed

    Kizer, K W

    2000-01-01

    Multiple environmental, ecological, and socio-political forces are converging to increase the occurrence of both natural and technological disasters. Ten forces are of most concern in this regard. These are: 1) global warming, with its consequent weather extremes and climate changes; 2) continued rapid human population growth and concomitant increased urbanization; 3) decreased bio-diversity and consequent ecological fragility; 4) deforestation and loss of natural habitat for animal species, with resultant greater overlap of human and animal habitats, human exposure to animal pathogens, and other ecological perturbations; 5) increased technological development throughout the world (especially in developing countries with their typically immature safety programs); 6) globalization and increased population mobility; 7) sub-national religious and ethnic conflicts, and their potential for conflict escalation and large scale displacement of populations; 8) the collapse of several major countries and consequent unraveling of national identity and social order; 9) the rise of terrorism; and 10) dramatic advances in the science and technology of computing, communications, biotechnology, and genomics. This paper describes 10 lessons learned relative to the public health aspects of emergency management, especially as they pertain to disasters. 1) Planning pays; 2) A bad situation can be made worse by inappropriate responses; 3) Most life saving interventions will occur before the disaster happens and immediately afterwards by local action; 4) Public health emergency management is not a democratic process; 5) Psychological impacts are usually greater than anticipated; 6) Communications and information management are vital, but often are the weak link in the response chain; 7) Collaboration and partnerships are essential; 8) Unsolicited volunteers and aid are inevitable and must be planned for and managed; 9) Never assume anything, and always expect the unexpected; and 10

  14. Emergency management of ureteral stones: Recent advances

    PubMed Central

    Osorio, Luis; Lima, Estêvão; Autorino, Riccardo; Marcelo, Filinto

    2008-01-01

    Most ureteral stones can be observed with reasonable expectation of uneventful stone passage. When an active ureteral stone treatment is warranted, the best procedure to choose is dependent on several factors, besides stone size and location, including operators’ experience, patients’ preference, available equipment and related costs. Placement of double-J stent or nephrostomy tube represents the classical procedures performed in a renal colic due to acute ureteral obstruction when the conservative drug therapy does not resolve the symptoms. These maneuvers are usually followed by ureteroscopy or extracorporeal shockwave lithotripsy, which currently represent the mainstay of treatment for ureteral stones. In this review paper a literature search was performed to identify reports dealing with emergency management of renal colic due to ureteral stones. The main aspects related to this debated issue are analyzed and the advantages and disadvantages of each treatment option are carefully discussed. PMID:19468497

  15. Emergency Management of Hypertension in Children

    PubMed Central

    Singh, Dinesh; Akingbola, Olugbenga; Yosypiv, Ihor; El-Dahr, Samir

    2012-01-01

    Systemic arterial hypertension in children has traditionally been thought to be secondary in origin. Increased incidence of risk factors like obesity, sedentary life-styles, and faulty dietary habits has led to increased prevalence of the primary arterial hypertension (PAH), particularly in adolescent age children. PAH has become a global epidemic worldwide imposing huge economic constraint on health care. Sudden acute increase in systolic and diastolic blood pressure can lead to hypertensive crisis. While it generally pertains to secondary hypertension, occurrence of hypertensive crisis in PAH is however rare in children. Hypertensive crisis has been further subclassified depending on presence or absence of end-organ damage into hypertensive emergency or urgency. Both hypertensive emergencies and urgencies are known to cause significant morbidity and mortality. Increasing awareness among the physicians, targeted at investigation of the pathophysiology of hypertension and its complications, better screening methods, generation, and implementation of novel treatment modalities will impact overall outcomes. In this paper, we discuss the etiology, pathogenesis, and management of hypertensive crisis in children. An extensive database search using keywords was done to obtain the information. PMID:22577545

  16. Clinical decision aids for chest pain in the emergency department: identifying low-risk patients

    PubMed Central

    Alley, William; Mahler, Simon A

    2015-01-01

    Chest pain is one of the most common presenting complaints in the emergency department, though only a small minority of patients are subsequently diagnosed with acute coronary syndrome (ACS). However, missing the diagnosis has potential for significant morbidity and mortality. ACS presentations can be atypical, and their workups are often prolonged and costly. In order to risk-stratify patients and better direct the workup and care given, many decision aids have been developed. While each may have merit in certain clinical settings, the most useful aid in the emergency department is one that finds all cases of ACS while also identifying a substantial subset of patients at low risk who can be discharged without stress testing or coronary angiography. This review describes several of the chest pain decision aids developed and studied through the recent past, starting with the thrombolysis in myocardial infarction (TIMI) risk score and Global Registry of Acute Coronary Events (GRACE) scores, which were developed as prognostic aids for patients already diagnosed with ACS, then subsequently validated in the undifferentiated chest pain population. Asia-Pacific Evaluation of Chest Pain Trial (ASPECT); Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins (ADAPT); North American Chest Pain Rule (NACPR); and History, Electrocardiogram, Age, Risk factors, Troponin (HEART) score have been developed exclusively for use in the undifferentiated chest pain population as well, with improved performance compared to their predecessors. This review describes the relative merits and limitations of these decision aids so that providers can determine which tool fits the needs of their clinical practice setting. PMID:27147894

  17. The expanding role of civil society in the global HIV/AIDS response: what has the President's Emergency Program For AIDS Relief's role been?

    PubMed

    Coutinho, Alex; Roxo, Uchechi; Epino, Henry; Muganzi, Alex; Dorward, Emily; Pick, Billy

    2012-08-15

    Civil society has been part of the HIV/AIDS response from the very beginning of the epidemic, often becoming engaged before national governments. Traditional roles of civil society--advocacy, activism, serving as government watchdog, and acting as community caretaker--have been critical to the response. In addition, civil society organizations (CSOs) play an integral part in providing world-class HIV prevention and treatment services and helping to ensure continuity of care. The President's Emergency Program for AIDS Relief (PEPFAR) has significantly increased the global scale-up of combination antiretroviral therapy reaching for more than 5 million people in developing countries, as well as implementation of effective evidence-based combination prevention approaches. PEPFAR databases in 5 countries and annual reports from a centrally managed initiative were mined and analyzed to determine the numbers and types of CSOs funded by PEPFAR over a 5-year period (2006-2011). Data are also presented from Uganda showing the overall resource growth in CSO working for HIV. Case studies document the evolution of 3 indigenous CSOs that increased the capacity to implement activities with PEPFAR funding. A legacy of PEPFAR has been the growth of civil society to address social and health issues as well as recognition by governments that partnerships with beneficiaries and civil society result in better outcomes. Scale-up of the global response could not have happened without the involvement of civil society and people living with HIV. This game changing partnership to jointly tackle the problems that countries face may well be the greatest benefit emerging from the HIV epidemic. PMID:22797737

  18. Emergency management training program: Guide to good practice

    SciTech Connect

    Not Available

    1991-07-01

    The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate components of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager`s point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.

  19. 22 CFR 214.3 - A.I.D. Advisory Committee Management Officer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false A.I.D. Advisory Committee Management Officer. 214.3 Section 214.3 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADVISORY COMMITTEE MANAGEMENT General § 214.3 A.I.D. Advisory Committee Management Officer. The Advisory Committee Management Officer is responsible to the Administrator...

  20. Management of acute diarrhea in emergency room.

    PubMed

    Dekate, Parag; Jayashree, M; Singhi, Sunit C

    2013-03-01

    Acute diarrhea is the second leading cause of under-five mortality in India. It is defined as the passage of frequent watery stools (>3/24 h). Recent change in consistency of stools is more important than frequency. Acute diarrhea is caused by variety of viral, bacterial and parasitic agents. The common ones are: Rotavirus, E. coli, Shigella, Cholera, and Salmonella. Campylobacter jejuni, Giardia and E. histolytica are also not uncommon. The most important concern in management of acute diarrhea in Emergency room (ER) is fluid and electrolyte imbalances and treatment of underlying infection, wherever applicable. It includes, initial stabilization (identification and treatment of shock), assessment of hydration and rehydration therapy, recognition and treatment of electrolyte imbalance, and use of appropriate antimicrobials wherever indicated. For assessment of hydration clinical signs are generally reliable; however, in severely malnourished children sunken eyes and skin turgor are unreliable. Oral Rehydration Therapy is the cornerstone of management of dehydration. Intravenous fluids are not routinely recommended except in cases of persistent vomiting and/or shock. Majority of cases can be managed in ER and at home. Hospitalization is indicated in infants <3 mo, children with severe dehydration, severe malnutrition, toxic look, persistent vomiting and suspected surgical abdomen. Supplementations with zinc and probiotics have been shown to reduce severity and duration of diarrhea; however evidence does not support the use of antisecretary, antimotility and binding agents. Education of parents about hand hygiene, safe weaning and safe drinking water etc., can help in reducing incidence of this important health problem in the country. PMID:23192407

  1. Code orange: Towards transformational leadership of emergency management systems.

    PubMed

    Caro, Denis H J

    2015-09-01

    The 21(st) century calls upon health leaders to recognize and respond to emerging threats and systemic emergency management challenges through transformative processes inherent in the LEADS in a caring environment framework. Using a grounded theory approach, this qualitative study explores key informant perspectives of leaders in emergency management across Canada on pressing needs for relevant systemic transformation. The emerging model points to eight specific attributes of transformational leadership central to emergency management and suggests that contextualization of health leadership is of particular import. PMID:26135294

  2. Emergency management training program: Guide to good practice

    SciTech Connect

    Not Available

    1991-07-01

    The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate components of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager's point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.

  3. Los Alamos National Laboratory emergency management plan. Revision 1

    SciTech Connect

    Ramsey, G.F.

    1998-07-15

    The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents, transportation accidents, electrical accidents, and natural disasters.

  4. Improving HIV/AIDS Knowledge Management Using EHRs

    PubMed Central

    Malmberg, Erik D.; Phan, Thao M.; Harmon, Glynn; Nauert, Richard F.

    2012-01-01

    Background A primary goal for the development of EHRs and EHR-related technologies should be to facilitate greater knowledge management for improving individual and community health outcomes associated with HIV / AIDS. Most of the current developments of EHR have focused on providing data for research, patient care and prioritization of healthcare provider resources in other areas. More attention should be paid to using information from EHRs to assist local, state, national, and international entities engaged in HIV / AIDS care, research and prevention strategies. Unfortunately the technology and standards for HIV-specific reporting modules are still being developed. Methods: A literature search and review supplemented by the author’s own experiences with electronic health records and HIV / AIDS prevention strategies will be used. This data was used to identify both opportunities and challenges for improving public health informatics primarily through the use of latest innovations in EHRs. Qualitative analysis and suggestions are offered for how EHRs can support knowledge management and prevention strategies associated with HIV infection. Results: EHR information, including demographics, medical history, medication and allergies, immunization status, and other vital statistics can help public health practitioners to more quickly identify at-risk populations or environments; allocate scarce resources in the most efficient way; share information about successful, evidenced-based prevention strategies; and increase longevity and quality of life. Conclusion: Local, state, and federal entities need to work more collaboratively with NGOs, community-based organizations, and the private sector to eliminate barriers to implementation including cost, interoperability, accessibility, and information security. PMID:23569643

  5. Cellular Interactions and Signaling in NeuroAIDS: Emerging Issues Colloquium

    PubMed Central

    Al-Harthi, Lena; Buch, Shilpa; Geiger, Jonathan D.; Gendelman, Howard E.; He, Johnny; Jordan-Sciutto, Kelly L.; Kolson, Dennis L.; Rappaport, Jay; Roy, Sabita; Zheng, Jialin; Fox, Howard S.

    2014-01-01

    On May 23, 2013 scientific leaders in the neuroAIDS community met at the University of Nebraska Medical Center to discuss cellular interaction and signaling for the third annual human immunodeficiency virus and neuroAIDS colloquium. The meeting continues a series of contemporary scientific issues related to how virus effects the nervous system. In 2011 the focus was on animal models and in 2012 in biomarkers. Here, our 2013 meeting featured ten presentations from outstanding scientists examining how inter- and intra-cellular processes contribute to neuropathogenesis. Talks highlighted emerging issues, findings, and potential therapies, followed by a panel discussion in which controversies in the field and gaps in our current knowledge were identified. The panel discussion was transcribed into the article and published as a field perspective. A link is available where all of the presentations and the concluding discussion can be seen and heard. PMID:24789373

  6. Emergency mental health management in bioterrorism events.

    PubMed

    Benedek, David M; Holloway, Harry C; Becker, Steven M

    2002-05-01

    The United States has not suffered significant psychosocial or medical consequences from the use of biological weapons within its territories. This has contributed to a "natural" state of denial at the community level. This denial could amplify the sense of crisis, anxiety, fear, chaos, and disorder that would accompany such a bioterrorist event. A key part of primary prevention involves counteracting this possibility before an incident occurs. Doing so will require realistic information regarding the bioterrorism threat followed by the development of a planned response and regular practice of that response. Unlike in natural disasters or other situations resulting in mass casualties, emergency department physicians or nurses and primary care physicians (working in concert with epidemiologic agencies), rather than police, firemen, or ambulance personnel, will be most likely to first identify the unfolding disaster associated with a biological attack. Like community leaders, this group of medical responders must be aware of its own susceptibility to mental health sequelae and performance decrement as the increasing demands of disaster response outpace the availability of necessary resources. A bioterrorist attack will necessitate treatment of casualties who experience neuropsychiatric symptoms and syndromes. Although symptoms may result from exposure to infection with specific biological agents, similar symptoms may result from the mere perception of exposure or arousal precipitated by fear of infection, disease, suffering, and death. Conservative use of psychotropic medications may reduce symptoms in exposed and uninfected individuals, as may cognitive-behavioral interventions. Clear, consistent, accessible, reliable, and redundant information (received from trusted sources) will diminish public uncertainty about the cause of symptoms that might otherwise prompt persons to seek unnecessary treatment. Training and preparation for contingencies experienced in an

  7. The President's Emergency Plan for AIDS Relief: from successes of the emergency response to challenges of sustainable action.

    PubMed

    Merson, Michael H; Curran, James W; Griffith, Caroline Hope; Ragunanthan, Braveen

    2012-07-01

    The President's Emergency Plan for AIDS Relief (PEPFAR) has made a major contribution to the reduction of the global HIV/AIDS burden. The program initially focused on rapidly scaling up treatment and prevention services in fifteen low-income countries, then transitioned to an approach that emphasizes sustainability, defined as the capacity to maintain program services after financial, managerial, and technical assistance from the United States and other external donors essentially ceases. Today, PEPFAR continues to expand its HIV prevention, treatment, and care activities while also supporting capacity-building initiatives, coordination efforts, and implementation science. The latter is research focused on improving service delivery, maximizing cost-effectiveness, and achieving public health impact. Recent advances in both scientific knowledge and the provision of prevention, treatment, and care services have bred cautious optimism about greatly reducing the spread of HIV. However, success will require a substantial increase in resources, strengthened health systems, renewed commitment to HIV prevention, and well-financed efforts to develop an effective HIV vaccine. PMID:22778326

  8. Aiding the environment: the Australian Development Agency's experience of implementing an environmental management system

    SciTech Connect

    Keen, Meg . E-mail: meg.keen@anu.edu.au; Sullivan, Marjorie

    2005-08-15

    Aid agencies, like commercial businesses, are increasingly concerned with incorporating sound environmental management into their operations. Different approaches are being used to integrate sustainability into development assistance to ensure that environmental impacts are assessed and managed. One approach being used by AusAID, the Australian aid agency, is to implement an environmental management system (EMS) across program and project areas. This paper examines how AusAID has adapted the EMS approach to suit aid agency operations, and some of the lessons from the Australian experience.

  9. Quality assurance measurement for emergency management

    SciTech Connect

    Pawlowski, M.S.

    1993-12-31

    Under the Federal Civil Defense Act of 1950, as amended, the Federal Emergency Management Agency (FEMA) is charged with maintenance of a nationwide inventory of 4.3 million radiological instruments procured and granted by the federal government to state and local governments. These instruments are used by trained state Radiological Response Team Members, first responders, and critical workers to support the population from a national security or large-scale peacetime radiological disaster, e.g., Chernobyl, Three Mile Island, Satellite Reentry, etc. The inventory is maintained through a network of 100% federally funded state maintenance and calibration facilities, with overall technical guidance and standardization provided by the FEMA Radiological Instrumentation Test Facility. The system used to support maintenance and standardized calibration of the inventory consists of CDV-794 Radiation Calibrator (High Range), CDV-765 Model 2 Gamma Transfer Standard, CDV-790 Model 1 Calibrator (Low Range), and Dosimeter Transfer Standards. Past studies have indicated the {open_quotes}Readiness{close_quotes} and {open_quotes}Reliability{close_quotes} of the inventory to meet mission requirements based upon a standardized system of maintenance and calibration. FEMA has just initiated a new instrument Readiness and Reliability study with the State of Ohio Radiological Instrument Maintenance and Calibration Program to provide data to reassess the capability of the current inventory to support all types of peacetime and national security missions.

  10. Special event planning for the emergency manager.

    PubMed

    Gaynor, Peter T

    2009-11-01

    In the domain of emergency management and homeland security there is a lack of a formal planning process at the local level when it comes to special event planning. The unique nature of special event planning demands an understanding of the planning process for both traditional and non-traditional planning partners. This understanding will make certain that local governments apply due diligence when planning for the safety of the public. This paper offers a practical roadmap for planning at the local level. It will address those 'special events' that are beyond routine local events but not of a sufficient scale to be granted National Special Security Event status. Due to the infrequency of 'special events' in most communities, it is imperative that deliberate planning takes place. Upon conclusion, the reader will be able to construct a planning process tailored to the needs of their community, guide both traditional and non-traditional planning partners through the planning process, determine priorities, explore alternatives, plan for contingencies, conduct a confirmation brief, facilitate operations and assemble an after-action report and improvement plan. PMID:20378490

  11. Managing Pediatric Pain in the Emergency Department.

    PubMed

    Bailey, Benoit; Trottier, Evelyne D

    2016-08-01

    Far more attention is now given to pain management in children in the emergency department (ED). When a child arrives, pain must be recognized and evaluated using a pain scale that is appropriate to the child's development and regularly assessed to determine whether the pain intervention was effective. At triage, both analgesics and non-pharmacological strategies, such as distraction, immobilization, and dressing should be started. For mild pain, oral ibuprofen can be administered if the child has not received it at home, whereas ibuprofen and paracetamol are suitable for moderate pain. For patients who still require pain relief, oral opioids could be considered; however, many EDs have now replaced this with intranasal fentanyl, which allows faster onset of pain relief and can be administered on arrival pending either intravenous access or definitive care. Intravenous opioids are often required for severe pain, and paracetamol or ibuprofen can still be considered for their likely opioid-sparing effects. Specific treatment should be used for patients with migraine. In children requiring intravenous access or venipuncture, non-pharmacological and pharmacological strategies to decrease pain and anxiety associated with needle punctures are mandatory. These strategies can also be used for laceration repairs and other painful procedures. Despite the gaps in knowledge, pain should be treated with the most up-to-date evidence in children seen in EDs. PMID:27260499

  12. [Emergency treatment and management of anaphylaxis].

    PubMed

    Brockow, K; Ring, J

    2013-02-01

    Anaphylaxis, the maximal manifestation of an immediate allergic reaction, is a life-threatening systemic reaction. The immediate therapy is chosen according to the clinical manifestations and new German guidelines are in preparation. Required measures include immediate removal of allergen, adequate positioning, assessment of severity and organ involvement and activation of emergency medical services. In anaphylaxis with primarily cardiovascular involvement, epinephrine is the treatment of choice and given together with volume substitution, oxygen, H(1)-antihistamines and corticosteroids. Obstruction of the airways is treated with intramuscular and inhaled epinephrine, or alternatively β(2)-sympathicomimetics, and oxygen. Abdominal or cutaneous involvement, such as generalized urticaria, usually can be treated with intravenous H(1)-antihistamines, glucocorticoids and surveillance. In patients with anaphylaxis, the elicitor of the reaction has to be diagnosed by allergy testing. Patients with sustained risk for anaphylaxis should receive a self-medication kit and should be educated about behavioral patterns needed for prophylaxis and therapy of anaphylactic reactions. Patient educational intervention increases knowledge about anaphylaxis, and practical competence and thus, is a basis of a successful management of anaphylaxis. PMID:23385622

  13. Management of Children Using Cochlear Implants and Hearing Aids.

    ERIC Educational Resources Information Center

    Ching, Teresa Y. C.; Psarros, Colleen; Incerti, Paula; Hill, Mandy

    2001-01-01

    Four case studies identify six factors affecting successful use of a hearing aid with a cochlear implant: duration of hearing aid use prior to implantation, amount of residual hearing in the non-implanted ear, educational and listening demands, cosmetic issues, hearing aid rejection, and extended period of non-use of hearing aid. (Contains…

  14. Action Guide for Emergency Management at Institutions of Higher Education

    ERIC Educational Resources Information Center

    Office of Safe and Drug-Free Schools, US Department of Education, 2010

    2010-01-01

    This "Action Guide for Emergency Management at Higher Education Institutions" has been developed to give higher education institutions a useful resource in the field of emergency management. It is intended for community colleges, four-year colleges and universities, graduate schools, and research institutions associated with higher education…

  15. Comprehensive emergency management: Evacuating threatened populations. Topical report

    SciTech Connect

    Perry, R.W.

    1983-01-01

    The structure of emergency management is outlined and emergency management tasks including mitigation and preparedness activities, are addressed. Four actors in the emergency management system are described: local governments, state governments, Federal government, and private organizations. Man-made and natural disasters are compared and human response to three emergency situations is described: (1) the nuclear reaction incident at Three Mile Island, (2) the May 18, 1980 eruption of Mt. St. Helens volcano, and (3) a riverine flood. Citizen response comparisons among these disaster events is focused on: (1) the source and credibility of evacuation warnings; and (2) citizen evacuation decisions. Information is supplied on the way citizens make decisions in emergencies, social-psychological responses to emergencies, the context of evacuation planning in hazard management, and strategies for enhancing citizen compliance with evacuation warnings.

  16. The Design Manager's Aid for Intelligent Decomposition (DeMAID)

    NASA Technical Reports Server (NTRS)

    Rogers, James L.

    1994-01-01

    Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed, the proposed system can be decomposed to identify its hierarchical structure. The design manager's aid for intelligent decomposition (DeMAID) is a knowledge based system for ordering the sequence of modules and identifying a possible multilevel structure for design. Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save considerable money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined.

  17. Municipal resilience: A paradigm shift in emergency and continuity management.

    PubMed

    Solecki, Greg; Luchia, Mike

    More than a decade of emergency and continuity management vision was instrumental in providing the unprecedented level of response and recovery from the great flood of 2013. Earlier assessments, planning and validation promulgated development of corporate continuity, emergency and contingency plans along with tactical, strategic and recovery operations centres that all led to a reliable emergency management model that will continue to provide the backbone for municipal resilience. PMID:26642170

  18. The symphony of the damned: racial discourse, complex political emergencies and humanitarian aid.

    PubMed

    Duffield, M

    1996-09-01

    This paper concerns the manner in which the West is responding to protracted political crises beyond its borders. It examines the conceptual world-view that aid agencies bring to complex emergencies and which shapes action. The paper provides an analysis of developmentalism. That is, the currently dominant idea of development which is an adapted form of multiculturalism. It is based on the empowerment of cultural differences and the relativisation of progress. As a variant of multiculturalism, developmentalism is part of Western racial discourse. In terms of understanding conflict, it establishes a mirror-image relationship with new rascist ideas premised on cultural pluralism inevitably leading to social breakdown, violence and anarchy. To the contrary, with its functional view of social harmony, libertine developmentalism claims that even unresolved political crisis constitutes a development opportunity. Developmentalism, like culturalism generally, is incapable of analysing power. It therefore cannot understand the effects and significance of its own organisational forms. Moreover, since the absence of power translates into operational neutrality in a war zone, it is also unable to analyse the nature of new political formations emerging in the global periphery. That is, the so-called weak or failed states, warlords and so on. This functional ignorance has allowed a widespread incorporation of humanitarian aid into the fabric of political violence. Developmentalism is an essential underpinning for the growing organisational accommodation to ongoing conflict and eroding standards of justice and accountability. PMID:8854455

  19. Municipal Emergency Management System: a strategy towards information and managing resources

    NASA Astrophysics Data System (ADS)

    Pacheco, J.

    2009-04-01

    The Azores archipelago is located in the North Atlantic Ocean, on a complex geological setting where the North American, Eurasian and African plates meet. Throughout its history the geological and meteorological hazards have been the most significant and had cause thousands of deaths and extensive damages. To prepare and mitigate the impact of catastrophic events there are emergency plans to guide the authorities and to instruct the population. However, a key point on the effectiveness of any emergency plan is the efficiency on getting the relevant information from the existing plans and conveying quality information to the operational teams and to the population. To address this issue the Municipal Emergency Management System was designed as a modular software with a core database and two different applications; one back-office to input and manage data and one front-end to query the database. The database is installed in a server and the system runs over an Intranet or the Internet, allowing its management and query to be done anywhere. The information on the system comprises two sets of data: (a) static data, regarding guidelines from the official Municipal Emergency Plan and a broad characterization of the county that does not need to be updated frequently (geography, geomorphology, climatology and the main hazards to consider) and (b) dynamic information, concerning data that requires regular updating such as available resources, administrative officials, pertinent private organisations etc.. All dynamic data in the core database is organised in three layers: (1) administrative organisations with geographical expression (such as province or district), (2) entities with capability to provide aid on provisions, accommodations, health, infrastructures, construction, transportation and security (public services, non-governmental organisations, enterprises or individual persons) and (3) operative information (applicable laws, tasks of each operative structure of the

  20. A Self-Instructional Course in Student Financial Aid Administration. Module 17--Evaluation of Student Aid Management: Self-Evaluation, Audit, and Program Review. Second Edition.

    ERIC Educational Resources Information Center

    Washington Consulting Group, Inc., Washington, DC.

    The 17th module in the 17-module self-instructional course on student financial aid administration discusses the evaluation of student aid management in terms of self-evaluation, audit, and program review. The full course offers a systematic introduction to the management of federal financial aid programs authorized by Title IV of the Higher…

  1. Steps for Developing a School Emergency Management Plan. Helpful Hints for School Emergency Management. Volume 2, Issue 1

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    The U.S. Department of Education's Office of Safe and Drug-Free Schools strongly encourages schools and school districts to develop emergency management plans within the context of the four phases of emergency management: prevention, mitigation, preparedness, response and recovery. In addition, schools should collaborate closely with police, fire…

  2. Diagnosis and management of environmental thoracic emergencies.

    PubMed

    Tourigny, Paul D; Hall, Chris

    2012-05-01

    Physiologic sequelae from increasing ambient pressure in underwater activities, decreasing ambient pressure while at altitude, or the consequences of drowning present a unique set of challenges to emergency physicians. In addition, several environmental toxins cause significant respiratory morbidity, whether they be pulmonary irritants, simple asphyxiants, or systemic toxins. It is important for emergency physicians to understand the pathophysiology of these illnesses as well as to apply this knowledge to the clinical arena either in the prehospital setting or in the emergency department. Current treatment paradigms and controversies within these regimens are discussed. PMID:22487116

  3. The Vortex: a universal 'high-acuity implementation tool' for emergency airway management.

    PubMed

    Chrimes, N

    2016-09-01

    Factors influencing performance during emergency airway management can be broadly divided into issues with preparation and those with implementation. Effective design of resources that provide guidance on management requires consideration of the context in which they are to be used. Many of the major airway guidelines do not specify whether they are intended to be used during preparation or implementation and may not take the context for use into account in their design. This can produce tools which may be not only ineffective but actively disruptive to team function in an emergency. The Vortex is a novel, simple, and predominantly visually based cognitive aid, which has been specifically designed to be used in real time during airway emergencies to support team function and target recognized failings in airway crisis management. Unlike the major algorithms, which are context specific, the Vortex is flexible enough for the same tool to be applied to any circumstance in which airway management takes place, independent of context, patient type, or the intended airway device. This makes the same tool suitable for use by emergency physicians, intensivists, paramedical staff, and anaesthetists. The Vortex contains many of the recognized features of an ideal cognitive tool and may be effective in reducing implementation errors in emergency airway management. Experimental evidence is required to establish this. PMID:27440673

  4. HIV/AIDS Case Managers and Client HIV Status Disclosure: Perceived Client Needs, Practices, and Services

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Klein, Susan J.; Kalichman, Moira O.; O'Connell, Daniel A.; Freedman, Jay A.; Eaton, Lisa; Cain, Demetria

    2007-01-01

    People living with HIV/AIDS often need assistance in deciding whether or how to disclose their HIV status to others, and case managers are in a unique position to offer this assistance. The current study surveyed 223 case managers providing services to people living with HIV/AIDS in New York State. The survey was conducted anonymously, and case…

  5. Conflicts between managed care organizations and emergency departments in California.

    PubMed Central

    Johnson, L A; Derlet, R W

    1996-01-01

    To control costs, managed care organizations have begun to restrict the use of hospital emergency departments by their enrollees. They are doing this by educating enrollees, providing better access to 24-hour urgent care, denying preauthorizations for care for some patients who do present to emergency departments, and retrospectively denying payment for certain patients who use emergency services. Changing traditional use of emergency departments has resulted in conflicts between managed care organizations and these departments. Because federal law mandates access to emergency care for all persons, disagreements occur over the precise definition of an emergency medical condition. In addition, conflicts occur over the scope and payment for the medical screening examination required by federal law of persons presenting to an emergency department. Finally, issues arise related to the safety of patients who present to emergency departments and request care but are denied care because the managed care organization does not authorize the visit. Recent legislation in California has attempted to reconcile differences between managed care practices and federal and state laws; however, areas of continued conflict need to be resolved to prevent possible adverse consequences for patients actually needing emergency care. PMID:8775727

  6. Open source GIS for HIV/AIDS management

    PubMed Central

    Vanmeulebrouk, Bas; Rivett, Ulrike; Ricketts, Adam; Loudon, Melissa

    2008-01-01

    Background Reliable access to basic services can improve a community's resilience to HIV/AIDS. Accordingly, work is being done to upgrade the physical infrastructure in affected areas, often employing a strategy of decentralised service provision. Spatial characteristics are one of the major determinants in implementing services, even in the smaller municipal areas, and good quality spatial information is needed to inform decision making processes. However, limited funds, technical infrastructure and human resource capacity result in little or no access to spatial information for crucial infrastructure development decisions at local level. This research investigated whether it would be possible to develop a GIS for basic infrastructure planning and management at local level. Given the resource constraints of the local government context, particularly in small municipalities, it was decided that open source software should be used for the prototype system. Results The design and development of a prototype system illustrated that it is possible to develop an open source GIS system that can be used within the context of local information management. Usability tests show a high degree of usability for the system, which is important considering the heavy workload and high staff turnover that characterises local government in South Africa. Local infrastructure management stakeholders interviewed in a case study of a South African municipality see the potential for the use of GIS as a communication tool and are generally positive about the use of GIS for these purposes. They note security issues that may arise through the sharing of information, lack of skills and resource constraints as the major barriers to adoption. Conclusion The case study shows that spatial information is an identified need at local level. Open source GIS software can be used to develop a system to provide local-level stakeholders with spatial information. However, the suitability of the technology

  7. Sexualised space, sexual networking & the emergence of AIDS in Rakai, Uganda.

    PubMed

    Kuhanen, Jan

    2010-03-01

    This paper argues that the outbreak of the epidemic of AIDS in Rakai, Uganda, in the early 1980s was a consequence of economic change, leading to the erosion of conventional cultural checks on juvenile, female and male sexuality and the emergence and growth of sexualised spaces and sexual networking in a few remote rural hubs of economic activity which exhibited a different sexual culture from the surrounding countryside. The trading hubs developed dense local and regional sexual networks which enabled HIV to spread quickly among the "risk groups" and local people of the busiest trading towns and villages. The high degree of sexual mixing in these hubs opened up new routes for HIV to infect the general population. This paper, which shows the importance of understanding the role of the aggravated economic disparities and changing sexual culture in the onset and spread of the HIV and AIDS epidemic in Rakai, Uganda, is primarily based on in-depth interviews and focus group discussions and on the analysis of newspapers, unofficial and official documents and academic studies. PMID:19884035

  8. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Federal Emergency Management... 62 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND... OF CLAIMS Pt. 62, App. A Appendix A to Part 62—Federal Emergency Management Agency, Federal...

  9. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Federal Emergency Management... 62 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND... OF CLAIMS Pt. 62, App. A Appendix A to Part 62—Federal Emergency Management Agency, Federal...

  10. Prehospital emergency trauma care and management.

    PubMed

    Kerby, Jeffrey D; Cusick, Marianne V

    2012-08-01

    Prehospital care of the trauma patient is continuing to evolve; however, the principles of airway maintenance, hemorrhage control, and appropriate resuscitative maneuvers remain central to the role of the emergency medical care provider. Recent changes in the regulations for research in emergency settings will allow randomized trials to proceed to test new devices, drugs, and resuscitative strategies in the prehospital environment. The creation of prehospital research networks will provide the appropriate infrastructure to greatly facilitate the development of new protocols and the execution of large-scale randomized trials with the potential to change current prehospital practice. PMID:22850149

  11. A Survey on Hong Kong Secondary School Students' Knowledge of Emergency Management of Dental Trauma

    PubMed Central

    Young, Cecilia; Wong, Kin Yau; Cheung, Lim K.

    2014-01-01

    Objectives To investigate Hong Kong secondary school students' knowledge of emergency management of dental trauma. Method A questionnaire survey on randomly selected secondary school students using cluster sampling. Results Only 36.6% (209/571) of the respondents were able to correctly identify the appropriate place for treatment of dental injury. 55.2% of the respondents knew the suitable time for treatment. Only 24.7% of the respondents possessed the knowledge of how to correctly manage fractured teeth. Only 23.6% of them knew how to manage displaced teeth. 62.5% of them correctly answered that knocked-out deciduous teeth should not be replanted to the original position, but few of them (23.6%) knew that permanent teeth should be replanted. Moreover, 37.1% of the respondents correctly identified at least one of the appropriate media for storing a knocked-out tooth. First-aid training and acquisition of dental injury information from other sources were significant factors that positive responses from these questions would lead to higher scores. Conclusion Hong Kong secondary school students' knowledge of emergency management of dental trauma is considered insufficient. An educational campaign in secondary schools dedicated to students is recommended. Prior first-aid training and acquisition of dental injury information from other sources positively relate to the level of knowledge. Dental trauma emergency management is recommended to be added to first-aid publications and be taught to students and health professionals.Trial Registration: Hong Kong Clinical Trial Centre HKCTR-1344 PMID:24400088

  12. Chemical Biological Emergency Management Information System

    2004-06-15

    CB-EMIS is designed to provide information and analysis to transit system operators and emergency responders in the event of a chemical attack on a subway system. The software inforporates detector data, video images, train data, meteorological data, and above- and below-ground plume dispersion models, hight of the liquid level.

  13. Challenges for lupus management in emerging countries.

    PubMed

    Tazi Mezalek, Zoubida; Bono, Wafaa

    2014-06-01

    In emerging countries, systemic lupus erythematosus (SLE) has been associated with several unfavorable outcomes including disease activity, damage accrual, work disability and mortality. Poor socioeconomic status (SES) and lack of access to healthcare, especially in medically underserved communities, may be responsible for many of the observed disparities. Diagnostic delay of SLE or for severe organ damages (renal involvement) have a negative impact on those adverse outcomes in lupus patients who either belong to minority groups or live in emerging countries. Longitudinal and observational prospective studies and registries may help to identify the factors that influence poor SLE outcomes in emerging countries. Infection is an important cause of mortality and morbidity in SLE, particularly in low SES patients and tuberculosis appears to be frequent in SLE patients living in endemic areas (mainly emerging countries). Thus, tuberculosis screening should be systematically performed and prophylaxis discussed for patients from these areas. SLE treatment in the developing world is restricted by the availability and cost of some immunosuppressive drugs. Moreover, poor adherence has been associated to bad outcomes in lupus patients with a higher risk of flares, morbidity, hospitalization, and poor renal prognosis. Low education and the lack of money are identified as the main barrier to improve lupus prognosis. Newer therapeutic agents and new protocols had contributed to improve survival in SLE. The use of corticoid-sparing agents (hydroxychloroquine, methotrexate, azathioprine and mycophenolate mofetif) is one of the most useful strategy; availability of inexpensive generics may help to optimize access to these medications. PMID:24857588

  14. Increasing access and support for emergency management higher education programs.

    PubMed

    Cwiak, Carol L

    2014-01-01

    The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs. PMID:25350356

  15. How do emergency managers use social media platforms?

    PubMed

    Bennett, DeeDee M

    2014-01-01

    Social media platforms are increasingly becoming a useful tool for victims, humanitarians, volunteers, and the general public to communicate during disasters. Research has shown that there are multiple advantages to using social media and the applicability of these platforms crosses several different types of disasters (human-caused, natural, and terrorist) here in the United States and abroad. However, some emergency management agencies have been reluctant to use social media as one of their many communications tools. In this study, the usefulness of social media for emergency management was examined over a 30-day period following a series of tornadoes. Using an observational approach, the public posts disseminated from an emergency management agency were analyzed to determine how two social media platforms were used. The findings show how emergency management agencies could leverage the connectedness of social media to reach victims and make unlikely partnerships. PMID:25062826

  16. Keeping a tight grip on the reins: donor control over aid coordination and management in Bangladesh.

    PubMed

    Buse, K

    1999-09-01

    A long-standing consensus that aid coordination should be owned by recipient authorities has been eclipsed by accord on the desirability of recipient management of aid along-side domestic resources. Nonetheless, in many low and lower-middle income countries, donors remain remarkably uncoordinated; where attempts at coordination are made, they are often donor-driven, and only a small proportion of aid is directly managed by recipients. This paper draws on evidence from an in-depth review of aid to the health sector in Bangladesh to analyze the systems by which external resources are managed. Based on interviews with key stakeholders, a questionnaire survey and analysis of documentary sources, the factors constraining the government from assuming a more active role in aid management are explored. The results suggest that donor perceptions of weak government capacity, inadequate accountability and compromised integrity only partially account for the propensity for donor leadership. Equally important is the consideration that aid coordination has a markedly political dimension. Stakeholders are well aware of the power, influence and leverage which aid coordination confers, an awareness which colours the desire of some stakeholders to lead aid coordination processes, and conditions the extent and manner by which others wish to be involved. It is argued that recipient management of external aid is dependent on major changes in the attitudes and behaviours of recipients and donors alike. PMID:10621239

  17. Quality function deployment in emergency planning and management

    SciTech Connect

    Schaub, D.; Tufekci, S.

    1995-12-31

    Quality Function Deployment (QFD) is an engineering tool for organizing and ranking information into matrix form in order to understand the attributes or actions that are needed to achieve a common goal, and to align cross-functional teams strategically to quickly and efficiently meet that common goal. Although this tool has been used primarily in the manufacturing world for product or process planning, it can easily and effectively be applied at various levels within the emergency planning/response environment as an aid to prioritize critical resources. Applications will be discussed at the personal or user level, local emergency response level, state and federal levels. By utilizing QFD, these entities will be better able to address emergency situations. QFD can also be a cornerstone to continuously improve readiness to handle the crucial time just prior to, and just after, the emergency occurs.

  18. The Role of Spatial Information Systems in Environmental Emergency Management.

    ERIC Educational Resources Information Center

    Mondschein, Lawrence G.

    1994-01-01

    Reviews the use of spatial data and information technology by environmental managers and emergency responders. Discussion includes environmental legislation, the Toxic Chemical Release Inventory (TRI) database, public access to environmental information, information standardization problems, emergency response software development and a case study…

  19. MS ANTWERPEN: Emergency Management Training for Low-Risk Environments

    ERIC Educational Resources Information Center

    Strohschneider, Stefan; Gerdes, Jurgen

    2004-01-01

    Emergency management training programs have been developed mostly for trainees from high-risk environments such as aviation or the chemical industry. This article describes a training program for staff members from low-risk environments such as hospitals or hotels, where the awareness of potential dangers is usually low and emergency plans are…

  20. Recommendations for Emergency Management Planning for School Facilities.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    Numerous events, such as hurricanes, floods, and tornadoes, constitute a natural disaster for public schools. Human-caused disasters include hazardous-material emergencies, civil riots, fires, and nuclear accidents. This document contains emergency-management planning guidelines, developed by the Texas Education Agency, to help local school…

  1. Emergency management: Implementing a new strategy

    SciTech Connect

    Indelicato, G.

    1997-09-01

    Many of the problems resulting from a release incident stem from lack of preparation for such incidents; lack of control and coordination of the activities performed during the incident response; and mistaken assumptions regarding responsibility for the clean up. One unique approach to this type of situation addresses these and other issues thereby facilitating the primary objectives of cost control and incident closure. The Arrowhead Concept{reg_sign} to emergency response separates a release incident into two main phases: response phase and resolution phase. Each phase has three stages or activities. The response phase is the part of the incident that is typically performed under emergency conditions; it is urgent and fast-paced, with the need for a lot of decisions to be made without a lot of information. This phase is broken down into three concurrent activities: initial communication and coordination; release containment and control (abatement); and regulatory notification and negotiation.

  2. United States global health policy: HIV/AIDS, maternal and child health, and The President's Emergency Plan for AIDS Relief (PEPFAR).

    PubMed

    Leeper, Sarah C; Reddi, Anand

    2010-09-10

    The Obama administration has unveiled a new 6-year, $63 billion Global Health Initiative. In addition to the reauthorization of the President's Emergency Plan for AIDS Relief (PEPFAR) to fund HIV/AIDS, tuberculosis, and malaria, the plan also supports maternal and child health (MCH) initiatives that are rooted in a proposal known as the Mother and Child Campaign. The architects of the Obama administration's Global Health Initiative recommend funding the Mother and Child Campaign at the expense of future funding increases for PEPFAR. The idea that differing global health initiatives must compete with each other lacks not only ethical legitimacy but also scientific merit. We believe that MCH need not to be framed in opposition to PEPFAR. Confronting illness in isolation - whether by funding PEPFAR at the expense of programs that target MCH or vice versa - cannot be our way forward. Given the intimate connection between HIV/AIDS and MCH, we affirm supporting PEPFAR and MCH programs together. We argue that policies that de-emphasize PEPFAR threaten to undermine, rather than support, MCH in countries with high HIV/AIDS prevalence. PEPFAR has directly and indirectly supported the care and treatment of other milieu specific diseases, including those afflicting mothers and children, bringing about broad benefits to the primary healthcare systems of recipient countries. We advocate the vertical integration of MCH initiatives into PEPFAR in order to create a comprehensive approach to addressing MCH against the global backdrop of HIV/AIDS. PMID:20606571

  3. The aging of the AIDS epidemic: emerging legal and public health issues for elderly persons living with HIV/AIDS.

    PubMed

    Waysdorf, Susan L

    2002-01-01

    As as the elderly population continues to grow, so does a subgroup of that population--elderly persons living with HIV infection and AIDS. In her article, Professor Waysdorf, a nationally recognized AIDS law expert who has taught, published, and practiced in this area for over a decade, introduces statistics and studies that show just how quickly the HIV/AIDS-infected elderly population is growing. She analyzes which groups within the elderly population are hit hardest by this epidemic, paying particular attention to women and minority groups. The article also considers how much larger these subgroups will become in the following years. Professor Waysdorf then examines existing and proposed legislation that may help this population address the health and legal concerns it faces every day. She recommends additional measures that governmental, medical, professional, and social service agencies can take to further address the needs of the HIV/AIDS infected elderly population. Professor Waysdorf concludes that while some legal safeguards do exist, much more is needed to protect these individuals. PMID:15586460

  4. Updating and Maintaining School Emergency Management Plans. Helpful Hints for School Emergency Management. Volume 2, Issue 3, 2007

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. Developing and implementing comprehensive, multi-hazard emergency management plans is an ongoing process that must be consistently reinforced and strengthened. Opportunities for reviewing, strengthening and updating…

  5. Approaches to emergency management teaching at the master's level.

    PubMed

    Alexander, David

    2013-01-01

    Training and education enable emergency managers to deal with complex situations, create durable networks of people with appropriate expertise, and ensure that knowledge is utilized to improve resilience in the face of disaster risk. Although there is a discrete literature on emergency management training, few attempts have been made to create an overview that discusses the key issues and proposes a standardized approach. This article examines the nature of training and education in emergency and disaster management. It analyzes the composition and requirements of courses at the master's degree level, which is considered to be the most appropriate tier for in-depth instruction in this field. This article defines "training" and "education" in the context of emergency management courses. It reviews the developing profile of the emergency manager in the light of training requirements. This article examines the question of whether emergency management is a branch of management science or whether it is something distinct and separate. Attention is given to the composition of a core curriculum and to the most appropriate pedagogical forms of delivering it. The article reviews the arguments for and against standardization of the curriculum and describes some of the pedagogical methods for delivering courses. Briefly, it considers the impact on training and education of new pedagogic methods based on information technology. It is concluded that the master's level is particularly suited to emergency and crisis management education, as it enables students to complement the in-depth knowledge they acquired in their disciplinary first degrees with a broader synthetic approach at the postgraduate level. Some measures of standardization of course offerings are desirable, in favor of creating a core curriculum that will ensure that essential core knowledge is imparted. Education and training in this field should include problem-solving approaches that enable students to learn

  6. Emergency department management of nerve agent exposure.

    PubMed

    Pfaff, B L

    1998-01-01

    Nerve agents are toxic chemicals developed for use by the military, but used by terrorists against civilian populations. As threats of terrorism increase, it is possible that health care providers will be confronted with multiple victims of nerve agent exposure. Nerve agents are highly toxic forms of organophosphate poisons that potentially could cause harm to anyone who comes in contact. Emergency personnel need to be familiar with the agents, know how to prepare for encountering and treating victims, and know how to protect all people involved from further poisoning. PMID:9855972

  7. Operation Windshield and the simplification of emergency management.

    PubMed

    Andrews, Michael

    2016-01-01

    Large, complex, multi-stakeholder exercises are the culmination of years of gradual progression through a comprehensive training and exercise programme. Exercises intended to validate training, refine procedures and test processes initially tested in isolation are combined to ensure seamless response and coordination during actual crises. The challenges of integrating timely and accurate situational awareness from an array of sources, including response agencies, municipal departments, partner agencies and the public, on an ever-growing range of media platforms, increase information management complexity in emergencies. Considering that many municipal emergency operations centre roles are filled by staff whose day jobs have little to do with crisis management, there is a need to simplify emergency management and make it more intuitive. North Shore Emergency Management has accepted the challenge of making emergency management less onerous to occasional practitioners through a series of initiatives aimed to build competence and confidence by making processes easier to use as well as by introducing technical tools that can simplify processes and enhance efficiencies. These efforts culminated in the full-scale earthquake exercise, Operation Windshield, which preceded the 2015 Emergency Preparedness and Business Continuity Conference in Vancouver, British Columbia. PMID:26897621

  8. Developing Higher Education Programs in Emergency Management: Ghana's Experience

    ERIC Educational Resources Information Center

    Yakubu, Mariama Bisongu

    2013-01-01

    Ghana is highly vulnerable and threatened by several hazards and has sought ways of minimizing impacts of hazards events over time including demonstrating an interest in developing an emergency management training and an higher education degree program. Yet, as of 2013, the country has not developed a disaster management training program or a…

  9. RYAN WHITE COMPREHENSIVE AIDS RESOURCES EMERGENCY (CARE) ACT OF 1990 OR CARE ACT DATA REPORT (CADR) SYSTEM

    EPA Science Inventory

    The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act is Federal legislation that addresses the unmet health needs of persons living with HIV disease (PLWH) by funding primary health care and support services that enhance access to and retention in care.

  10. Emergency managers as change agents: recognizing the value of management, leadership, and strategic management in the disaster profession.

    PubMed

    Urby, Heriberto; McEntire, David A

    2015-01-01

    This article discusses the influence of management theory, some principles of leadership, four strategic management considerations, that are applied to emergency management, allow emergency managers to transform their followers, organizations, and communities at large. The authors argue that in the past there has been little recognition of the value, or application, of these three areas of emphasis in the disaster profession. Using more of these principles, emergency managers may transform into transformational change agents who make a difference in their followers' lives, who themselves transform other people and improve emergency management. PMID:25779898

  11. The United States President's Emergency Plan for AIDS Relief: a story of partnerships and smart investments to turn the tide of the global AIDS pandemic.

    PubMed

    Goosby, Eric; Dybul, Mark; Fauci, Anthony S; Fauci, Anthony A; Fu, Joe; Walsh, Thomas; Needle, Richard; Bouey, Paul

    2012-08-15

    The United States President's Emergency Plan for AIDS Relief (PEPFAR) has played a key leadership role in the global response to the HIV/AIDS pandemic. PEPFAR was inspired by the principles of the historic Monterrey Consensus (United Nations. Monterrey Consensus on Financing for Development, Monterrey, Mexico, March 18-22, 2002. New York: United Nations; 2002. Available at: http://www.un.org/esa/ffd/monterrey/MonterreyConsensus.pdf. Accessed April 21, 2012), which changed the underlying conceptual framework for international development, and therefore global health--a shift from paternalism to partnership that begins with country ownership and requires good governance, a results-based approach, and engagement of all sectors of society. PEPFAR began with a focus on the growing emergency of the HIV/AIDS pandemic by rapidly expanding HIV services, building clinical capacity, implementing strategic information systems, and building a coalition of partners to lead the response. Within the first years of implementation, there was a shift to sustainability, including the advent of Partnership Frameworks. The PEPFAR reauthorization in 2008 codified into law, the evolution in policies and programs for the next phase of implementation. In 2011 alone, PEPFAR supported nearly 4 million people on treatment, supported programs that provided more than 1.5 million HIV-positive pregnant women with antiretroviral drugs to prevent HIV transmission to their children, and supported HIV testing for more than 40 million people. This article provides an overview of how smart investments and partnerships across sectors and US agencies have helped achieve unprecedented results in increasing HIV/AIDS services and engaging partner countries and organizations in sharing the responsibility for an AIDS-free generation. PMID:22797740

  12. Acute pain management curriculum for emergency medicine residency programs.

    PubMed

    Motov, Sergey M; Marshall, John P

    2011-10-01

    Pain is the most common reason people visit emergency departments (EDs); this implies that emergency physicians (EPs) should be experts in managing acute painful conditions. The current trend in the literature, however, demonstrates that EPs possess inadequate knowledge and lack formal training in acute pain management. The purpose of this article is to create a formal educational curriculum that would assist emergency medicine (EM) residents in proper assessment and treatment of acute pain, as well as in providing a solid theoretical and practical knowledge base for managing acute pain in the ED. The authors propose a series of lectures, case-oriented study groups, practical small group sessions, and class-specific didactics with the goal of enhancing the theoretical and practical knowledge of acute pain management in the ED. PMID:21692900

  13. Case studies of emergency management of screwworm.

    PubMed

    Reichard, R

    1999-04-01

    Screwworm myiasis, caused by infestation of even minor wounds by the obligative parasitic larval stages of the New World screwworm (NWS) (Cochliomyia hominivorax) or Old World screwworm (OWS) (Chrysomya bezziana) flies, is a major cause of livestock morbidity and mortality in tropical and sub-tropical regions of the world. The two parasites occur in different hemispheres but are remarkably homologous. Animal health emergencies result from the invasion of new territories by the parasites or, in the case of NWS, reinfestation of areas from which the parasite had been eradicated after great effort and expense. The author reviews the biology of the parasites and the effects of screwworm, in addition to prevention of infestation upon the introduction of animals. Examples of three programmes or events are described. The first is the eradication of previously exotic NWS from an epizootic in Libya before the parasite spread to become enzootic in the Mediterranean Basin and eventually other areas of the Eastern Hemisphere. The second example reviews the serious consequences of the extension of the range of OWS into Iraq where conditions at the time were favourable for propagation and unfavourable for control. The third example describes the NWS programme strategy in North and Central America which, for forty years, has been to progressively achieve eradication and then protection of areas from north to south on that continent, employing the sterile insect technique (SIT). Outbreaks in areas where screwworm has already been eradicated divert costly programme resources and slow progress southwards, and are considered emergencies. Some problems encountered and the solutions found during the height of the eradication programme in Mexico are described. Although to date eradication of screwworms has only been accomplished with the application of SIT, this technique alone will not eradicate the pest. The author describes other elements which are required to control or eradicate

  14. AIDS in the Workplace: A Training for Managers and Supervisors. District of Oregon.

    ERIC Educational Resources Information Center

    Tyree, Jimmy L.

    This document provides a summary of "AIDS in the Workplace for Court Managers," a 3-hour seminar that was presented to the District of Oregon. The document begins with a summary of the seminar goals and objectives, which included the following: reduce fears and anxieties about HIV/AIDS in the workplace; provide information about the fundamentals…

  15. Enrollment Management and Financial Aid Part Two: A Public Policy Perspective

    ERIC Educational Resources Information Center

    Hossler, Don; Kalsbeek, David

    2008-01-01

    In our previous essay, we considered the role of institutional financial aid and the practice of enrollment management. In that essay we explored the use of financial aid as a tool to enhance equity increase prestige, as a revenue enhancement tool and as a means to shape institutional image in the various markets that comprise our diverse system…

  16. Industrial ecology: an emerging management science.

    PubMed Central

    Piasecki, B

    1992-01-01

    Pollution is a complex equation, compounded by population, rate of consumption, and toxic emissions per unit of resource consumed. This article defines industrial ecology as a management science that focuses a corporation's expertise on the third variable. Thus, industrial ecology is involved with changing the efficiency of machines, not just changing the law or a firm's compliance strategy. This article also explores how this emphasis allows a profoundly different orientation than the end-of-the-pipe regulatory approach of the last 20 yr. PMID:11607271

  17. The role of strategic planning in emergency management

    SciTech Connect

    Douglas, N.B.; Harrison, G.T.

    1995-12-31

    Rapid technology development, competition for resources, and an increasing awareness of the global community are but a few of the many forces and trends affecting today`s Emergency Management Organizations. Implementing a continuous Strategic Planning process helps an Emergency Management Organization to formulate responses to issues such as those stated above. By continuously monitoring the forces and trends in its environment, the organization is able to succinctly identify its strategic issues and subsequently frame an appropriate infrastructure of goals, objectives, and strategies. Strategic Planning also holds significant potential for the emergency management community at large. The wide range of expertise and the inherent dependencies between Emergency Management Organizations at all levels of government -- including the local, national, and international arenas -- makes the emergency management community an ideal candidate to capitalize on the benefits resulting from joint strategic planning. The identification of common issues, priorities, and requirements provides the foundation for increased resource and information sharing, as well as the formulation of strategic partnerships between organizations to battle common threats.

  18. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. PMID:21051258

  19. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (MACINTOSH VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  20. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (SUN VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  1. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (MACINTOSH VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  2. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (SUN VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  3. Fritz Reiche and the Emergency Committee in Aid of Displaced Foreign Scholars

    NASA Astrophysics Data System (ADS)

    Bederson, Benjamin

    2005-12-01

    I discuss the family background and early life of the German theoretical physicist Fritz Reiche (1883 1969) in Berlin; his higher education at the University of Berlin under Max Planck (1858 1947); his subsequent work at the University of Breslau with Otto Lummer (1860 1925); his return to Berlin in 1911, where he completed his Habilitation thesis in 1913, married Bertha Ochs the following year, became a friend of Albert Einstein (1879 1955), and worked during and immediately after the Great War. In 1921 he was appointed as ordentlicher Professor of Theoretical Physics at the University of Breslau and worked there until he was dismissed in 1933. He spent the academic year 1934 1935 as a visiting professor at the German University in Prague and then returned to Berlin, where he remained until, with the crucial help of his friend Rudolf Ladenburg (1882 1952) and vital assistance of the Emergency Committee in Aid of Displaced Foreign Scholars, he, his wife Bertha, and their daughter Eve were able to emigrate to the United States in 1941 (their son Hans had already emigrated to England in 1939).From 1941 1946 he held appointments at the New School for Social Research in New York, the City College of New York, and Union College in Schenectady, New York, and then was appointed as an Adjunct Professor of Physics at New York University, where his contract was renewed year-by-year until his retirement in 1958.

  4. Some considerations for mass casualty management in radiation emergencies.

    PubMed

    Hopmeier, Michael; Abrahams, Jonathan; Carr, Zhanat

    2010-06-01

    Radiation emergencies are rather new to humankind, as compared to other types of emergencies such as earthquakes, floods, or hurricanes. Fortunately, they are rare, but because of that, planning for response to large-scale radiation emergencies is least understood. Along with the specific technical aspects of response to radiation emergencies, there are some general guiding principles of responding to mass casualty events of any nature, as identified by the World Health Organization in its 2007 manual for mass casualty management systems. The paper brings forward such general considerations as applicable to radiation mass casualty events, including (1) clear lines of communication; (2) scalability of approach; (3) whole-of-health approach; (4) knowledge based approach; and (5) multisectoral approach. Additionally, some key considerations of planning for mass casualty management systems are discussed, namely, health systems surge capacity and networking, risk and resources mapping, and others. PMID:20445382

  5. Emergency department management of seizures in pediatric patients.

    PubMed

    Santillanes, Genevieve; Luc, Quyen

    2015-03-01

    Seizures account for 1% of all emergency department visits for children, and the etiologies range from benign to life-threatening. The challenge for emergency clinicians is to diagnose and treat the life-threatening causes of seizures while avoiding unnecessary radiation exposure and painful procedures in patients who are unlikely to have an emergent pathology. When treating patients in status epilepticus, emergency clinicians are also faced with the challenge of choosing anticonvulsant medications that will be efficacious while minimizing harmful side effects. Unfortunately, evidence to guide the evaluation and management of children presenting with new and breakthrough seizures and status epilepticus is limited. This review summarizes available evidence and guidelines on the diagnostic evaluation of first-time, breakthrough, and simple and complex febrile seizures. Management of seizures in neonates and seizures due to toxic ingestions is also reviewed. PMID:25799698

  6. Emerging electromembrane technologies in hazardous management

    SciTech Connect

    Grebenyuk, V.D.; Grebenyuk, O.V.

    1995-12-31

    A new generalized index of ecological estimation of different technological process is suggested. It is the number of salt equivalents which contaminate environment when a production unit is making. The quantity of salt equivalent have been calculated not only as necessary amount for the technological process by itself, but as amount of energy and different materials for an entire technology. The estimation of different methods of water treatment is shown. The electrodialysis is the most ecological method of water desalination in comparison with others. This conclusion was spreaded on other electromembrane technologies in hazardous management. Such as: (1) Brackish water desalination, (2) Acid rain prevention, (3) Recuperation of pure heavy metals from rinse galvanic water.

  7. Managing marine disease emergencies in an era of rapid change.

    PubMed

    Groner, Maya L; Maynard, Jeffrey; Breyta, Rachel; Carnegie, Ryan B; Dobson, Andy; Friedman, Carolyn S; Froelich, Brett; Garren, Melissa; Gulland, Frances M D; Heron, Scott F; Noble, Rachel T; Revie, Crawford W; Shields, Jeffrey D; Vanderstichel, Raphaël; Weil, Ernesto; Wyllie-Echeverria, Sandy; Harvell, C Drew

    2016-03-01

    Infectious marine diseases can decimate populations and are increasing among some taxa due to global change and our increasing reliance on marine environments. Marine diseases become emergencies when significant ecological, economic or social impacts occur. We can prepare for and manage these emergencies through improved surveillance, and the development and iterative refinement of approaches to mitigate disease and its impacts. Improving surveillance requires fast, accurate diagnoses, forecasting disease risk and real-time monitoring of disease-promoting environmental conditions. Diversifying impact mitigation involves increasing host resilience to disease, reducing pathogen abundance and managing environmental factors that facilitate disease. Disease surveillance and mitigation can be adaptive if informed by research advances and catalysed by communication among observers, researchers and decision-makers using information-sharing platforms. Recent increases in the awareness of the threats posed by marine diseases may lead to policy frameworks that facilitate the responses and management that marine disease emergencies require. PMID:26880835

  8. Martin Marietta Paducah Gaseous Diffusion Plant comprehensive earthquake emergency management program

    SciTech Connect

    Not Available

    1990-02-28

    Recognizing the value of a proactive, integrated approach to earthquake preparedness planning, Martin Marietta Energy Systems, Inc. initiated a contract in June 1989 with Murray State University, Murray, Kentucky, to develop a comprehensive earthquake management program for their Gaseous Diffusion Plant in Paducah, Kentucky. The overall purpose of the program is to mitigate the loss of life and property in the event of a major destructive earthquake. The program includes four distinct (yet integrated) components: an emergency management plan, with emphasis on the catastrophic earthquake; an Emergency Operations Center Duty Roster Manual; an Integrated Automated Emergency Management Information System (IAEMIS); and a series of five training program modules. The PLAN itself is comprised of four separate volumes: Volume I -- Chapters 1--3; Volume II -- Chapters 4--6, Volume III -- Chapter 7, and Volume IV -- 23 Appendices. The EOC Manual (which includes 15 mutual aid agreements) is designated as Chapter 7 in the PLAN and is a stand alone'' document numbered as Volume III. This document, Volume I, provides an introduction, summary and recommendations, and the emergency operations center direction and control.

  9. A Risk Management Architecture for Emergency Integrated Aircraft Control

    NASA Technical Reports Server (NTRS)

    McGlynn, Gregory E.; Litt, Jonathan S.; Lemon, Kimberly A.; Csank, Jeffrey T.

    2011-01-01

    Enhanced engine operation--operation that is beyond normal limits--has the potential to improve the adaptability and safety of aircraft in emergency situations. Intelligent use of enhanced engine operation to improve the handling qualities of the aircraft requires sophisticated risk estimation techniques and a risk management system that spans the flight and propulsion controllers. In this paper, an architecture that weighs the risks of the emergency and of possible engine performance enhancements to reduce overall risk to the aircraft is described. Two examples of emergency situations are presented to demonstrate the interaction between the flight and propulsion controllers to facilitate the enhanced operation.

  10. Active management of food allergy: an emerging concept.

    PubMed

    Anagnostou, Katherine; Stiefel, Gary; Brough, Helen; du Toit, George; Lack, Gideon; Fox, Adam T

    2015-04-01

    IgE-mediated food allergies are common and currently there is no cure. Traditionally, management has relied upon patient education, food avoidance and the provision of an emergency medication plan. Despite this, food allergy can significantly impact on quality of life. Therefore, in recent years, evolving research has explored alternative management strategies. A more active approach to management is being adopted, which includes early introduction of potentially allergenic foods, anticipatory testing, active monitoring, desensitisation to food allergens and active risk management. This review will discuss these areas in turn. PMID:25378378

  11. Precision Information Environments Envisioning the future of emergency management

    SciTech Connect

    2010-04-01

    Researchers at Pacific Northwest National Laboratory are developing future work environments for the emergency management community called Precision Information Environments (or PIEs). PIEs will provide tailored access to information and decision support capabilities in a system that supports the multiple user roles, contexts, and phases of emergency management, planning, and response. This video gives you a look at one vision for the future. To view an annotated version that describes each of the technology concepts you'll see as well as the end user needs that motivated them and the research challenges that must be addressed to make them a reality visit http://precisioninformation.org.

  12. Handling Emergency Management in [an] Object Oriented Modeling Environment

    NASA Technical Reports Server (NTRS)

    Tokgoz, Berna Eren; Cakir, Volkan; Gheorghe, Adrian V.

    2010-01-01

    It has been understood that protection of a nation from extreme disasters is a challenging task. Impacts of extreme disasters on a nation's critical infrastructures, economy and society could be devastating. A protection plan itself would not be sufficient when a disaster strikes. Hence, there is a need for a holistic approach to establish more resilient infrastructures to withstand extreme disasters. A resilient infrastructure can be defined as a system or facility that is able to withstand damage, but if affected, can be readily and cost-effectively restored. The key issue to establish resilient infrastructures is to incorporate existing protection plans with comprehensive preparedness actions to respond, recover and restore as quickly as possible, and to minimize extreme disaster impacts. Although national organizations will respond to a disaster, extreme disasters need to be handled mostly by local emergency management departments. Since emergency management departments have to deal with complex systems, they have to have a manageable plan and efficient organizational structures to coordinate all these systems. A strong organizational structure is the key in responding fast before and during disasters, and recovering quickly after disasters. In this study, the entire emergency management is viewed as an enterprise and modelled through enterprise management approach. Managing an enterprise or a large complex system is a very challenging task. It is critical for an enterprise to respond to challenges in a timely manner with quick decision making. This study addresses the problem of handling emergency management at regional level in an object oriented modelling environment developed by use of TopEase software. Emergency Operation Plan of the City of Hampton, Virginia, has been incorporated into TopEase for analysis. The methodology used in this study has been supported by a case study on critical infrastructure resiliency in Hampton Roads.

  13. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... under the WYO (Write Your Own) Program. 44 CFR part 62, appendix B. These data shall be validated/edited... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Federal Emergency Management... 62 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF...

  14. DeMAID/GA USER'S GUIDE Design Manager's Aid for Intelligent Decomposition with a Genetic Algorithm

    NASA Technical Reports Server (NTRS)

    Rogers, James L.

    1996-01-01

    Many companies are looking for new tools and techniques to aid a design manager in making decisions that can reduce the time and cost of a design cycle. One tool that is available to aid in this decision making process is the Design Manager's Aid for Intelligent Decomposition (DeMAID). Since the initial release of DEMAID in 1989, numerous enhancements have been added to aid the design manager in saving both cost and time in a design cycle. The key enhancement is a genetic algorithm (GA) and the enhanced version is called DeMAID/GA. The GA orders the sequence of design processes to minimize the cost and time to converge to a solution. These enhancements as well as the existing features of the original version of DEMAID are described. Two sample problems are used to show how these enhancements can be applied to improve the design cycle. This report serves as a user's guide for DeMAID/GA.

  15. Infant Trauma Management in the Emergency Department: An Emergency Medicine Simulation Exercise

    PubMed Central

    Mathieson, Sarah; Whalen, Desmond

    2015-01-01

    In a trauma situation, it is essential that emergency room physicians are able to think clearly, make decisions quickly and manage patients in a way consistent with their injuries. In order for emergency medicine residents to adequately develop the skills to deal with trauma situations, it is imperative that they have the opportunity to experience such scenarios in a controlled environment with aptly timed feedback. In the case of infant trauma, sensitivities have to be taken that are specific to pediatric medicine. The following describes a simulation session in which trainees were tasked with managing an infantile patient who had experienced a major trauma as a result of a single vehicle accident. The described simulation session utilized human patient simulators and was tailored to junior (year 1 and 2) emergency medicine residents. PMID:26487992

  16. Infant Trauma Management in the Emergency Department: An Emergency Medicine Simulation Exercise.

    PubMed

    Mathieson, Sarah; Whalen, Desmond; Dubrowski, Adam

    2015-01-01

    In a trauma situation, it is essential that emergency room physicians are able to think clearly, make decisions quickly and manage patients in a way consistent with their injuries. In order for emergency medicine residents to adequately develop the skills to deal with trauma situations, it is imperative that they have the opportunity to experience such scenarios in a controlled environment with aptly timed feedback. In the case of infant trauma, sensitivities have to be taken that are specific to pediatric medicine. The following describes a simulation session in which trainees were tasked with managing an infantile patient who had experienced a major trauma as a result of a single vehicle accident. The described simulation session utilized human patient simulators and was tailored to junior (year 1 and 2) emergency medicine residents. PMID:26487992

  17. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    ERIC Educational Resources Information Center

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

    2013-01-01

    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  18. Seeking Accountability through State-Appointed Emergency District Management

    ERIC Educational Resources Information Center

    Arsen, David; Mason, Mary L.

    2013-01-01

    Michigan's Local Government and School District Accountability Act of 2011 empowers the governor to appoint emergency managers (EMs) in financially troubled school districts. EMs assume all powers of the superintendent and school board. They can reshape academic programs, nullify labor contracts, and open and close schools. This article analyzes…

  19. EMERGING TECHNOLOGIES FOR THE MANAGEMENT AND UTILIZATION OF LANDFILL GAS

    EPA Science Inventory

    The report gives information on emerging technologies that are considered to be commercially available (Tier 1), currently undergoing research and development (Tier 2), or considered as potentially applicable (Tier 3) for the management of landfill gas (LFG) emissions or for the ...

  20. Testicular torsion and the acute scrotum: current emergency management.

    PubMed

    Ta, Anthony; D'Arcy, Frank T; Hoag, Nathan; D'Arcy, John P; Lawrentschuk, Nathan

    2016-06-01

    The acute scrotum is a challenging condition for the treating emergency physician requiring consideration of a number of possible diagnoses including testicular torsion. Prompt recognition of torsion and exclusion of other causes may lead to organ salvage, avoiding the devastating functional and psychological issues of testicular loss and minimizing unnecessary exploratory surgeries. This review aims to familiarize the reader with the latest management strategies for the acute scrotum, discusses key points in diagnosis and management and evaluates the strengths and drawbacks of history and clinical examination from an emergency perspective. It outlines the types and mechanisms of testicular torsion, and examines the current and possible future roles of labwork and radiological imaging in diagnosis. Emergency departments should be wary of younger males presenting with the acute scrotum. PMID:26267075

  1. Optimising the management of pulmonary arterial hypertension patients: emergency treatments.

    PubMed

    Delcroix, M; Naeije, R

    2010-09-01

    Pulmonary arterial hypertension (PAH) is a rare and potentially fatal disease whose management is usually restricted to a few specialised centres. As patients do not necessarily live in the neighbourhood of these centres, daily care and emergencies have to be delegated to first and second lines. Treatment guidelines do not usually provide recommendations for acute emergency situations as evidence is scarce. This short review provides a description of our therapeutic protocols based on available data. A model of transmural organisation of care for PAH patients, currently applied in Belgium, is described. Thereafter, based on an analysis of the reasons of death in the PAH population, a review of the main emergencies is provided. Cardiac arrest and resuscitation, decompensated right heart failure, respiratory failure, arrhythmia, pericardial effusion, haemoptysis, surgery and drug-related adverse events will be discussed successively. Case reports showing the precariousness of PAH patients will enforce our thesis of the need for optimal patient management organisation. PMID:20956193

  2. Remote sensing as an aid for marsh management

    NASA Technical Reports Server (NTRS)

    Ragan, J. G.; Green, J. H.

    1973-01-01

    NASA aerial photography, primarily color infrared and color positive transparencies, is used in a study of marsh management practices and in comparing managed and unmanaged marsh areas. Weir locations for tidal control are recommended.

  3. Data management for Computer-Aided Engineering (CAE)

    NASA Technical Reports Server (NTRS)

    Bryant, W. A.; Smith, M. R.

    1984-01-01

    Analysis of data flow through the design and manufacturing processes has established specific information management requirements and identified unique problems. The application of data management technology to the engineering/manufacturing environment addresses these problems. An overview of the IPAD prototype data base management system, representing a partial solution to these problems, is presented here.

  4. New Jersey's EMS response to Superstorm Sandy: a case study of the emergency management assistance compact.

    PubMed

    Clancy, Terry; Christensen, Kenneth; Cortacans, Henry P

    2014-06-01

    In the United States, understanding the Emergency Management Assistance Compact (EMAC) is critical to responding to a natural disaster or manmade event. Recently, the State of New Jersey responded to Superstorm Sandy and implemented the EMAC system by requesting ambulances to aid in the Emergency Medical Services response. New Jersey's response to Superstorm Sandy was unprecedented in that this storm affected the entire state and EMS community. New Jersey's EMS community and infrastructure were impacted greatly, despite years of planning and preparation for such an event. Once received, out-of-state EMS resources were integrated into New Jersey's emergency management and EMS systems. In this report, each phase of the EMAC in New Jersey is explored, from how the response was coordinated to how it ultimately was executed. The state coordinated its response on multiple levels and, as such, tested the practical applicability of the EMAC process and employed best practices and solutions to issues that arose. These best practices and solutions may prove invaluable for any state or territory that may activate the EMAC system for emergency medical service resources. PMID:24844291

  5. Martin Marietta Paducah Gaseous Diffusion Plant comprehensive earthquake emergency management program

    SciTech Connect

    Not Available

    1990-02-28

    Recognizing the value of a proactive, integrated approach to earthquake preparedness planning, Martin Marietta Energy Systems, Inc. initiated a contract in June 1989 with Murray State University, Murray, Kentucky, to develop a comprehensive earthquake management program for their Gaseous Diffusion Plant in Paducah, Kentucky (PGDP -- Subcontract No. 19P-JV649V). The overall purpose of the program is to mitigate the loss of life and property in the event of a major destructive earthquake. The program includes four distinct (yet integrated) components: an emergency management plan, with emphasis on the catastrophic earthquake; an Emergency Operations Center Duty Roster Manual; an Integrated Automated Emergency Management Information System (IAEMIS); and a series of five training program modules. The PLAN itself is comprised of four separate volumes: Volume I -- Chapters 1--3; Volume II -- Chapters 4--6, Volume III -- Chapter 7, and Volume IV -- 23 Appendices. The EOC Manual (which includes 15 mutual aid agreements) is designated as Chapter 7 in the PLAN and is a stand alone'' document numbered as Volume III. This document, Volume II, discusses methodology, engineering and environmental analyses, and operational procedures.

  6. Martin Marietta Paducah Gaseous Diffusion Plant comprehensive earthquake emergency management program

    SciTech Connect

    Not Available

    1990-02-28

    Recognizing the value of a proactive, integrated approach to earthquake preparedness planning, Martin Marietta Energy Systems, Inc. initiated a contract in June 1989 with Murray State University, Murray, Kentucky, to develop a comprehensive earthquake management program for their Gaseous Diffusion Plant in Paducah, Kentucky (PGDP -- Subcontract No. 19P-JV649V). The overall purpose of the program is to mitigate the loss of life and property in the event of a major destructive earthquake. The program includes four distinct (yet integrated) components: (1) an emergency management plan with emphasis on the catas trophic earthquake; (2) an Emergency Operations Center Duty Roster Manual; (3) an Integrated Automated Emergency Management Information System (IAEMIS); and (4) a series of five training program modules. The PLAN itself is comprised of four separate volumes: Volume I -- Chapters 1--3; Volume II -- Chapters 4--6; Volume III -- Chapter 7; and Volume IV -- 23 Appendices. The EOC Manual (which includes 15 mutual aid agreements) is designated as Chapter 7 in the PLAN and is this document numbered as Volume III.

  7. Martin Marietta Paducah Gaseous Diffusion Plant comprehensive earthquake emergency management program

    SciTech Connect

    Not Available

    1990-02-28

    Recognizing the value of a proactive, integrated approach to earthquake preparedness planning, Martin Marietta Energy Systems, Inc, initiated a contract in June 1989 with Murray State University, Murray, Kentucky, to develop a comprehensive earthquake management program for their Gaseous Diffusion Plant in Paducah, Kentucky (PGDP--Subcontract No. 19P-JV649V). The overall purpose of the program is to mitigate the loss of life and property in the event of a major destructive earthquake. The program includes four distinct (yet integrated) components: (1) an emergency management plan, with emphasis on the catas trophic earthquake, (2) an Emergency Operations Center Duty Roster Manual, (3) an Integrated Automated Emergency Management Information System (IAEMIS), and (4) a series of five training program modules. The PLAN itself is comprised of four separate volumes: Volume I--Chapters 1--3; Volume II--Chapters 4--6, Volume III--Chapter 7, and Volume IV--23 Appendices. The EOC Manual (which includes 15 mutual aid agreements) is designated as Chapter 7 in the PLAN and is a stand alone'' document numbered as Volume III. This document, Volume IV contains the appendices to this report.

  8. Pilot decision making in a computer-aided flight management situation

    NASA Technical Reports Server (NTRS)

    Chu, Y. Y.; Rouse, W. B.

    1978-01-01

    An experimental representation of a computer-aided multi-task flight management situation has been developed. A computer aiding program was implemented to serve as a back-up decision maker. An experiment was conducted with a balanced design of several subject runs for different workload levels. This was achieved using three levels of subsystem event arrival rates, three levels of control task involvement, and three levels of availability of computer aiding. Experimental results compared quite favorably with those from a computer simulation which employed a queueing model. It was shown that the aiding had enhanced system performance as well as subjective ratings, and that the adaptive aiding policy further reduced subsystem delay.

  9. The application of supply chain management principles to emergency management logistics: An empirical study.

    PubMed

    Peterson, Matthew R; Young, Richard R; Gordon, Gary A

    2016-01-01

    Key elements of supply chain theory remain relevant to emergency management (EM) logistics activities. The Supply Chain Operations Reference model can also serve as a useful template for the planning, organizing, and execution of EM logistics. Through a series of case studies (developed through intensive survey of organizations and individuals responsible for EM), the authors identified the extent supply chain theory is being adopted and whether the theory was useful for emergency logistics managers. The authors found several drivers that influence the likelihood of an organization to implement elements of supply chain management: the frequency of events, organizational resources, population density, range of events, and severity of the disaster or emergency. PMID:27575640

  10. Emerging concepts in the management of acute retinal necrosis.

    PubMed

    Wong, Robert William; Jumper, J Michael; McDonald, H Richard; Johnson, Robert N; Fu, Arthur; Lujan, Brandon J; Cunningham, Emmett T

    2013-05-01

    Acute retinal necrosis (ARN), also known as Kirisawa-type uveitis, is an uncommon condition caused by infection of the retina by one of the herpes family of viruses, most typically varicella zoster virus or herpes simplex virus and less commonly cytomegalovirus. Clinical diagnosis can be challenging and is often aided by PCR-based analysis of ocular fluids. Treatment typically involves extended use of one or more antiviral agents. Long term retinal detachment risk is high. We review the literature on ARN and present an approach to the diagnosis and management of this serious condition. PMID:23235944

  11. Hazardous Materials Management and Emergency Response training Center needs assessment

    SciTech Connect

    McGinnis, K.A.; Bolton, P.A.; Robinson, R.K.

    1993-09-01

    For the Hanford Site to provide high-quality training using simulated job-site situations to prepare the 4,000 Site workers and 500 emergency responders for known and unknown hazards a Hazardous Materials Management and Emergency Response Training Center is needed. The center will focus on providing classroom lecture as well as hands-on, realistic training. The establishment of the center will create a partnership among the US Department of Energy; its contractors; labor; local, state, and tribal governments; and Xavier and Tulane Universities of Louisiana. This report presents the background, history, need, benefits, and associated costs of the proposed center.

  12. The use of emergency manuals in perioperative crisis management: a cautious approach.

    PubMed

    Szabo, Ashley; August, David A; Klainer, Suzanne; Miller, Andrew D; Kaye, Alan D; Raemer, Daniel B; Urman, Richard D

    2015-01-01

    When an unexpected perioperative crisis arises, simulation studies have suggested that the use of an emergency manual (EM) may offset the large cognitive load involved in crisis management, facilitating the efficient performance of key steps in treatment. However, little is known about how well EMs will translate into actual practice and what is required to use them optimally. While EMs are a promising tool in the management of perioperative critical events, more research is needed to define best practices and their limitations. In the interim, cautious use of these cognitive aids is recommended, especially when the diagnosis is not straightforward, falls "in between" sections of the EM, or falls outside of the EM itself. Further research should focus on the efficacy of EMs as measured by the percentage of critical steps correctly performed by their users in scenarios that do not closely mirror one of the listed EM scenarios from the beginning or as the situation evolves. PMID:26062310

  13. Emergence and Persistence of CXCR4-Tropic HIV-1 in a Population of Men from the Multicenter AIDS Cohort Study

    PubMed Central

    Shepherd, James C.; Jacobson, Lisa P.; Qiao, Wei; Jamieson, Beth D.; Phair, John P.; Piazza, Paolo; Quinn, Thomas C.; Margolick, Joseph B.

    2009-01-01

    We examined the emergence of CXCR4 (i.e., X4) tropism in 67 male human immunodeficiency virus type 1 (HIV-1) seroconverters from the Multicenter AIDS Cohort Study (MACS) who were selected to reflect the full spectrum of rates of HIV-1 disease progression. A mean of 10 serial samples per donor were evaluated by a laboratory-validated, commercially available assay to determine phenotypic coreceptor use. A total of 52% of men had dual- or mixed-tropic HIV-1 detected at 1 or more of the time points tested. Use of X4 by HIV-1 was detected more frequently among men who developed AIDS (defined as a CD4+ T cell count of < 200 cells/μL and/or an AIDS-defining illness)≤11 years after seroconversion than among those who did not (P = .005), as well as among men who exhibited a total T cell count decline (i.e., a CD3+ inflection point), compared with those who did not (P = .03). For men in whom both X4 virus and an inflection point were detected, emergence of X4 virus preceded the inflection point by a median of 0.83 years. The median CD4+ T cell count at first detection of X4 viruses before the onset of AIDS was 475 cells/μL. We conclude that HIV-1 variants that used X4 frequently emerged at high CD4+ T cell counts and may contribute to the decrease in T cell numbers during late HIV-1 infection. PMID:18783316

  14. Conceptualizing the cross-cultural gaps in managing international aid: HIV/AIDS and TB project delivery in Southern Africa.

    PubMed

    Jackson, Terence

    2011-01-01

    There appears to be a gap between the billions of dollars inputted into fighting HIV/AIDS and TB and outcomes. This in part can be attributed to the lack of attention in International Development to managing programmes and projects within complex levels of cross-cultural interactions. International Development often ignores management issues, yet Management Studies is left wanting through a lack of engagement with development issues including the fight against disease and poverty. This paper attempts to link these two disciplines towards mutual benefit, through a critical cross-cultural approach. It provides contextualization of international development policies/strategies; conceptualization of dominant paradigms; structural analysis of how a programme/project fits into the global governance structure; analysis of complexities and levels of cross-cultural interaction and their consequences and the process and implications of knowledge transfer across cultural distances. It concludes with implications for policy and practice, as well as what is needed from cross-disciplinary research. This includes how feedback loops can be strengthened from local to global, how indigenous knowledge may be better understood and integrated, how power relations within the global governance structure could be managed, how cross-cultural interaction could be better understood, and how knowledge transfer/sharing should be critically managed. PMID:20957771

  15. Ocular Injuries: New Strategies In Emergency Department Management.

    PubMed

    Messman, Anne M

    2015-11-01

    Ocular injuries are common in the emergency department, and they are the most frequent cause of noncongenital monocular blindness in children and adults. This review provides evidence-based recommendations for the diagnosis, treatment, and disposition of patients with all types of ocular trauma, including pain management, the use of antibiotics, cycloplegics, steroids, antifibrinolytics, and patching. Bedside ocular ultrasound has profoundly expanded diagnostic capability, particularly for the multiply injured patient, and routine management and disposition of patients with corneal abrasions has evolved significantly as well. Diagnosis and management of patients with retrobulbar hemorrhage is discussed in detail, with resources for performing vision-saving lateral canthotomy. Systematic evaluation and management of ocular trauma patients will ensure these patients have the best chance for a favorable final visual outcome. PMID:26466300

  16. GNSS-based network positioning technology for cooperative emergency management

    NASA Astrophysics Data System (ADS)

    Wu, Caicong; Chu, Tianxing; Tang, Anning; Su, Huaihong

    2009-06-01

    Personal digital assistant (PDA) with built-in GPS chip begins to be used for city management and emergency response management nowadays. The intelligent terminal can be used for event recording, multimedia (photo, audio, and video) capturing, wireless communication, GPS positioning and navigation. In the near future, PDA would take place of the vehicle GPS monitoring terminal to provide more functions and convenient. This article organizes the PDA of the same team for emergency response event into an integrated network through wireless communication so that each terminal can see each other on the map, including the vehicle GPS monitoring terminals. All of the terminals should send its GPS position and collected information to the emergency response center (ERC) through GPRS with a customized protocol. Then the center would create the socket connection to push the neighbors' location and common or special information to the others in the team according to the terminal's requirement and its authorities, and the leader or commander could send commands and messages to all of the underling members also. The GNSS based positioning and communication network organizes the dispersive emergency response personnel handheld with PDA and vehicles equipped with vehicle GPS monitoring terminal into an organic and cooperative network, each member in the network can see where its colleagues are, so as to seek for the help or support and exchange information in real time without calling which avoids exposure to the tracked objects. The Compass-1 satellite positioning and communication terminal is also used for personnel and vehicle positioning and message reporting. Altay is selected as the demonstration area. The prototype emergency management system is established for the local public security bureau and well validates the terminals and network function.

  17. Social Networking for Emergency Management and Public Safety

    SciTech Connect

    Lesperance, Ann M.; Olson, Jarrod; Godinez, Melanie A.

    2010-08-31

    On March 10, 2010 the workshop titled Social Networking for Emergency Management and Public Safety was held in Seattle, WA. The objective of this workshop was to showcase ways social media networking technologies can be used to support emergency management and public safety operations. The workshop highlighted the current state of social networking and where this dynamic engagement is heading, demonstrated some of the more commonly used technologies, highlighted case studies on how these tools have been used in a variety of jurisdictions and engaged the private sector on how these tools might serve as a conduit for two way communication between with the public sector to address regional recovery issues and decision making.

  18. An intelligent flight-management aid for procedure execution

    NASA Technical Reports Server (NTRS)

    Hammer, J. M.

    1984-01-01

    A computer program is described that contains a model of the procedures used in the operation of a twin engine aircraft. This program, by comparing the model to the aircraft state, can determine when a procedure (or checklist) should be or is invoked and when each step (detectable by a change in the aircraft state) is completed. Thus, the program tracks the flight crew's procedure execution through changes in the aircraft state. Data were used for evaluation from an earlier experiment on a Link GAT-II simulator. The program had been able to identify practically all of the errors identified by human judges as well as locate some missed by them. It is felt that this model could significantly aid flight crews.

  19. Extreme Space Weather Impact: An Emergency Management Perspective

    NASA Astrophysics Data System (ADS)

    MacAlester, Mark H.; Murtagh, William

    2014-08-01

    In 2010, the Department of Homeland Security's Federal Emergency Management Agency (FEMA) partnered with the National Oceanic and Atmospheric Administration's Space Weather Prediction Center (SWPC) to investigate the potential for extreme space weather conditions to impact National Security/Emergency Preparedness communications—those communications vital to a functioning government and to emergency and disaster response—in the United States. Given the interdependencies of modern critical infrastructure, the initial systematic review of academic research on space weather effects on communications expanded to other critical infrastructure sectors, federal agencies, and private sector organizations. While the effort is ongoing, and despite uncertainties inherent with this hazard, FEMA and the SWPC did draw some conclusions. If electric power remains available, an extreme space weather event will result in the intermittent loss of HF and similar sky wave radio systems, minimal direct impact to public safety line-of-sight radio and commercial cellular services, a relatively small loss of satellite services as a percentage of the total satellite fleet, interference or intermittent loss of satellite communications and GPS navigation and timing signals, and no first-order impact to consumer electronic devices. Vulnerability of electric power to an extreme geomagnetic storm remains the primary concern from an emergency management perspective, but actual impact is not well understood at present. A discussion of potential impacts to infrastructure from the loss of electric power from any hazard is provided using the 2011 record tornado outbreak in Alabama as an example.

  20. Technology-aided programs for post-coma patients emerged from or in a minimally conscious state

    PubMed Central

    Lancioni, Giulio E.; Singh, Nirbhay N.; O’Reilly, Mark F.; Sigafoos, Jeff; Olivetti Belardinelli, Marta; Buonocunto, Francesca; D’Amico, Fiora; Navarro, Jorge; Lanzilotti, Crocifissa; Ferlisi, Gabriele; Denitto, Floriana

    2014-01-01

    Post-coma persons in a minimally conscious state (MCS) or emerged/emerging from such state (E-MCS), who are affected by extensive motor impairment and lack of speech, may develop an active role and interact with their environment with the help of technology-aided intervention programs. Although a number of studies have been conducted in this area during the last few years, new evidence about the efficacy of those programs is warranted. These three studies were an effort in that direction. Study I assessed a technology-aided program to enable six MCS participants to access preferred environmental stimulation independently. Studies II and III assessed technology-aided programs to enable six E-MCS participants to make choices. In Study II, three of those participants were led to choose among leisure and social stimuli, and caregiver interventions automatically presented to them. In Study III, the remaining three participants were led to choose (a) among general stimulus/intervention options (e.g., songs, video-recordings of family members, and caregiver interventions); and then (b) among variants of those options. The results of all three studies were largely positive with substantial increases of independent stimulation access for the participants of Study I and independent choice behavior for the participants of Studies II and III. The results were analyzed in relation to previous data and in terms of their implications for daily contexts working with MCS and E-MCS persons affected by multiple disabilities. PMID:25538593

  1. Technology-aided programs for post-coma patients emerged from or in a minimally conscious state.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Olivetti Belardinelli, Marta; Buonocunto, Francesca; D'Amico, Fiora; Navarro, Jorge; Lanzilotti, Crocifissa; Ferlisi, Gabriele; Denitto, Floriana

    2014-01-01

    Post-coma persons in a minimally conscious state (MCS) or emerged/emerging from such state (E-MCS), who are affected by extensive motor impairment and lack of speech, may develop an active role and interact with their environment with the help of technology-aided intervention programs. Although a number of studies have been conducted in this area during the last few years, new evidence about the efficacy of those programs is warranted. These three studies were an effort in that direction. Study I assessed a technology-aided program to enable six MCS participants to access preferred environmental stimulation independently. Studies II and III assessed technology-aided programs to enable six E-MCS participants to make choices. In Study II, three of those participants were led to choose among leisure and social stimuli, and caregiver interventions automatically presented to them. In Study III, the remaining three participants were led to choose (a) among general stimulus/intervention options (e.g., songs, video-recordings of family members, and caregiver interventions); and then (b) among variants of those options. The results of all three studies were largely positive with substantial increases of independent stimulation access for the participants of Study I and independent choice behavior for the participants of Studies II and III. The results were analyzed in relation to previous data and in terms of their implications for daily contexts working with MCS and E-MCS persons affected by multiple disabilities. PMID:25538593

  2. Emergency management and homeland security: Exploring the relationship.

    PubMed

    Kahan, Jerome H

    2015-01-01

    In the years after the 9/11 tragedy, the United States continues to face risks from all forms of major disasters, from potentially dangerous terrorist attacks to catastrophic acts of nature. Professionals in the fields of emergency management and homeland security have responsibilities for ensuring that all levels of government, urban areas and communities, nongovernmental organizations, businesses, and individual citizens are prepared to deal with such hazards though actions that reduce risks to lives and property. Regrettably, the overall efficiency and effectiveness of the nation's ability to deal with disasters is unnecessarily challenged by the absence of a common understanding on how these fields are related in the workforce and educational arenas. Complicating matters further is the fact that neither of these fields has developed agreed definitions. In many ways, homeland security and emergency management have come to represent two different worlds and cultures. These conditions can have a deleterious effect on preparedness planning for public and private stakeholders across the nation when coordinated responses among federal, state, and local activities are essential for dealing with consequential hazards. This article demonstrates that the fields of emergency management and homeland security share many responsibilities but are not identical in scope or skills. It argues that emergency management should be considered a critical subset of the far broader and more strategic field of homeland security. From analytically based conclusions, it recommends five steps that be taken to bring these fields closer together to benefit more from their synergist relationship as well as from their individual contributions. PMID:26750811

  3. Acute carbon monoxide poisoning: Emergency management and hyperbaric oxygen therapy

    SciTech Connect

    Severance, H.W.; Kolb, J.C.; Carlton, F.B.; Jorden, R.C.

    1989-10-01

    An ice storm in February 1989 resulted in numerous incidences of carbon monoxide poisoning in central Mississippi secondary to exposure to open fires in unventilated living spaces. Sixteen cases were treated during this period at the University of Mississippi Medical Center and 6 received Hyperbaric Oxygen therapy. These 6 cases and the mechanisms of CO poisoning are discussed and recommendations for emergency management are reviewed.10 references.

  4. Management of hypertensive emergencies: implications for the critical care nurse.

    PubMed

    Schulenburg, Margaret

    2007-01-01

    Hypertensive emergencies are characterized by acute blood pressure elevations and potential for end organ damage. The critical care nurse must understand the pathophysiology to appreciate the therapeutic management and complications associated with the devastating clinical event. Stroke, renal damage and failure, retinopathy, aortic dissection, and encephalopathy are among the sequelae of severe hypertensive episodes. Intravenous medications are the treatment of choice to lower the blood pressure without risking hypoperfusion of the brain and other vital organs. PMID:17356350

  5. Visualizing Diurnal Population Change in Urban Areas for Emergency Management

    SciTech Connect

    Kobayashi, Tetsuo; Medina, Richard M; Cova, Thomas

    2011-01-01

    There is an increasing need for a quick, simple method to represent diurnal population change in metropolitan areas for effective emergency management and risk analysis. Many geographic studies rely on decennial U.S. Census data that assume that urban populations are static in space and time. This has obvious limitations in the context of dynamic geographic problems. The U.S. Department of Transportation publishes population data at the transportation analysis zone level in fifteen-minute increments. This level of spatial and temporal detail allows for improved dynamic population modeling. This article presents a methodology for visualizing and analyzing diurnal population change for metropolitan areas based on this readily available data. Areal interpolation within a geographic information system is used to create twenty-four (one per hour) population surfaces for the larger metropolitan area of Salt Lake County, Utah. The resulting surfaces represent diurnal population change for an average workday and are easily combined to produce an animation that illustrates population dynamics throughout the day. A case study of using the method to visualize population distributions in an emergency management context is provided using two scenarios: a chemical release and a dirty bomb in Salt Lake County. This methodology can be used to address a wide variety of problems in emergency management.

  6. Visualizing diurnal population change in urban areas for emergency management.

    PubMed

    Kobayashi, Tetsuo; Medina, Richard M; Cova, Thomas J

    2011-01-01

    There is an increasing need for a quick, simple method to represent diurnal population change in metropolitan areas for effective emergency management and risk analysis. Many geographic studies rely on decennial U.S. Census data that assume that urban populations are static in space and time. This has obvious limitations in the context of dynamic geographic problems. The U.S. Department of Transportation publishes population data at the transportation analysis zone level in fifteen-minute increments. This level of spatial and temporal detail allows for improved dynamic population modeling. This article presents a methodology for visualizing and analyzing diurnal population change for metropolitan areas based on this readily available data. Areal interpolation within a geographic information system is used to create twenty-four (one per hour) population surfaces for the larger metropolitan area of Salt Lake County, Utah. The resulting surfaces represent diurnal population change for an average workday and are easily combined to produce an animation that illustrates population dynamics throughout the day. A case study of using the method to visualize population distributions in an emergency management context is provided using two scenarios: a chemical release and a dirty bomb in Salt Lake County. This methodology can be used to address a wide variety of problems in emergency management. PMID:21491706

  7. NNSA/NV Consequence Management Capabilities for Radiological Emergency Response

    SciTech Connect

    D. R. Bowman

    2002-10-01

    The U.S. Department of Energy's National Nuclear Security Administration Nevada Operations Office (NNSA/NV) provides an integrated Consequence Management (CM) response capability for the (NNSA) in the event of a radiological emergency. This encompasses planning, technical operations, and home team support. As the lead organization for CM planning and operations, NNSA/NV coordinates the response of the following assets during the planning and operational phases of a radiological accident or incident: (1) Predictive dispersion modeling through the Atmospheric Release Advisory Capability (ARAC) at Lawrence Livermore National Laboratory (LLNL) and the High Consequence Assessment Group at Sandia National Laboratories (SNL); (2) Regional radiological emergency assistance through the eight Radiological Assistance Program (RAP) regional response centers; (3) Medical advice and assistance through the Radiation Emergency Assistance Center/Training Site (REAC/TS) in Oak Ridge, Tennessee; (4) Aerial radiological mapping using the fixed-wing and rotor-wing aircraft of the Aerial Measuring System (AMS); (5) Consequence Management Planning Teams (CMPT) and Consequence Management Response Teams (CMRT) to provide CM field operations and command and control. Descriptions of the technical capabilities employed during planning and operations are given below for each of the elements comprising the integrated CM capability.

  8. [Pre-hospital management of adults with life-threatening emergencies].

    PubMed

    Wattel, Francis; Dubois, François

    2012-01-01

    , fewer voluntary firemen, hospital reorganization, tight funding, difficulties of medical dispatching, and the varying skills of "first-on-the-scene "emergency workers. Grievances include late emergency responses, inappropriate medical care, and dispatching to the wrong facility. This raises the question of equal opportunity for all in a country with widely varying geographic features and population density. Improvement in the system's efficiency will require a series of objectives to be met in varied and complementary--Enhanced functional coordination, by speeding up the deployment of the ANTARES digital radio-frequency transmission network (Adaptation Nationale des Transmissions Aux Risques Et aux Secours).--Implementation of a network of emergency services with varying degrees of emergency healthcare management related to the technical nature of the facilities. Three levels of emergency healthcare must be made available: level 1 is provided by local hospitals, level 2 includes support facilities available in general hospitals (not necessarily the nearest hospital), and level 3 provides specialized healthcare in large and/or training hospitals with specialized departments. Life-threatening emergency situations are to be handled by level 2 or 3 facilities. Specific facilities must be selected as reference centers. In France, the ARS (Agences Régionales de Santé) is in charge of this procedure, as it provide funding for healthcare continuity--Reducing inequalities in access to emergency care. This will involve improving the network of SDIS brigades, making local medical facilities more responsive, delegating more medical procedures, on-site telemedicine, providing more helicopters equipped with healthcare facilities, more automated external defibrillators, and more dedicated neuro-vascular units.--First aid training must be made widely available. The French National Academy of Medicine has approved ten recommendations regarding organization and facilities. PMID

  9. 76 FR 2908 - Nonprofit Management LLC and Jeremy Ryan Claeys; Analysis of Proposed Consent Order To Aid Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... Nonprofit Management LLC and Jeremy Ryan Claeys; Analysis of Proposed Consent Order To Aid Public Comment... or unfair methods of competition. The attached Analysis to Aid Public Comment describes both the... following Analysis to Aid Public Comment describes the terms of the consent agreement, and the...

  10. Risk management: application of early warning systems to emergency plans

    NASA Astrophysics Data System (ADS)

    Garcia, C.; Sterlacchini, S.; Pasuto, A.; de Amicis, M.

    2009-04-01

    Warning System and emergency plans are two fundamental elements of risk management and governance, but unfortunately, most of the times, they are developed independently one from the other, as sequential steps not necessary linked. The main goal of this research is to develop a methodology for applying Early Warning Systems - Community Based to the emergency plan using the results of social surveys and quantitative risk assessment, taking into account the administrative structure and the planning system of the study area, as well as the legislative obligations of each entity involved in the risk governance and emergency management. Using a integrative scientific and social approach to natural hazards the research aim to contribute to fill the gap between scientists, policy makers, stakeholders and community. Initially applied in Comunità Montana Valtellina di Tirano, Italy, the methodology involves the application of two comprehensive surveys. The first is addressed to stakeholders (including policy makers, emergency managers, emergency volunteers, consultants and scientists) in order to determine their needs, points of view, concerns and constraints. The second survey is addressed specifically to local community to assess risk perception, awareness, needs, capacity and level of trust towards stakeholders, besides asking for their willingness to participate in future risk communication activities. The Early Warning System developed includes all the stages of the early warning process (hazard evaluation and forecasting; warning and dissemination and public response) and would be based on a multidisciplinary partnership that takes into account the different actors involved in the risk management in order to accomplish a more reliable and credible result, including an emergency plan specifically designed for each study area. After evaluating the results of the surveys, information and education campaigns will be developed with the objective of reducing vulnerability

  11. Ideologies of aid, practices of power: lessons for Medicaid managed care.

    PubMed

    Nelson, Nancy L

    2005-03-01

    The articles in this special issue teach valuable lessons based on what happened in New Mexico with the shift to Medicaid managed care. By reframing these lessons in broader historical and cultural terms with reference to aid programs, we have the opportunity to learn a great deal more about the relationship between poverty, public policy, and ideology. Medicaid as a state and federal aid program in the United States and economic development programs as foreign aid provide useful analogies specifically because they exhibit a variety of parallel patterns. The increasing concatenation of corporate interests with state and nongovernmental interests in aid programs is ultimately producing a less centralized system of power and responsibility. This process of decentralization, however, is not undermining the sources of power behind aid efforts, although it does make the connections between intent, planning, and outcome less direct. Ultimately, the devolution of power produces many unintended consequences for aid policy. But it also reinforces the perspective that aid and the need for it are nonpolitical issues. PMID:15789629

  12. The AFFORD Clinical Decision Aid To Identify Emergency Department Patients With Atrial Fibrillation At Low Risk For 30-Day Adverse Events

    PubMed Central

    Barrett, Tyler W.; Storrow, Alan B.; Jenkins, Cathy A.; Abraham, Robert L.; Liu, Dandan; Miller, Karen F.; Moser, Kelly M.; Russ, Stephan; Roden, Dan M.; Harrell, Frank E.; Darbar, Dawood

    2015-01-01

    There is wide variation in the management of emergency department (ED) patients with atrial fibrillation (AF). We aimed to derive and internally validate the first prospective, ED-based clinical decision aid to identify patients with AF at low risk for 30-day adverse events. We performed a prospective cohort study at a university-affiliated, tertiary-care, ED. Patients were enrolled from June 9, 2010 to February 28, 2013 and followed for 30 days. We enrolled a convenience sample of ED patients presenting with symptomatic AF. Candidate predictors were based on ED data available in the first two hours. The decision aid was derived using model approximation (preconditioning) followed by strong bootstrap internal validation. We utilized an ordinal outcome hierarchy defined as the incidence of the most severe adverse event within 30 days of the ED evaluation. Of 497 patients enrolled, stroke and AF-related death occurred in 13 (3%) and 4 (<1%) patients, respectively. The decision aid included the following: age, triage vitals (systolic blood pressure, temperature, respiratory rate, oxygen saturation, supplemental oxygen requirement); medical history (heart failure, home sotalol use, prior percutaneous coronary intervention, electrical cardioversion, cardiac ablation, frequency of AF symptoms); ED data (2 hour heart rate, chest radiograph results, hemoglobin, creatinine, and brain natriuretic peptide). The decision aid’s c-statistic in predicting any 30-day adverse event was 0.7 (95% CI, 0.65, 0.76). In conclusion, among ED patients with AF, AFFORD provides the first evidence based decision aid for identifying patients who are at low risk for 30-day adverse events and candidates for safe discharge. PMID:25633190

  13. Implementation of state assistance program for training and education in emergency management--Federal Emergency Management Agency. Final rule.

    PubMed

    1981-01-01

    This rule sets forth a description of the FEMA training and education assistance program to the States. The program functions through State Cooperative Agreements and is designed to further comprehensive emergency management training including emergency preparedness planning, hazard mitigation, and disaster response and recovery. In response to State and local expressed needs, FEMA was formed to coordinate and manage all disaster planning and response in one Agency. The combined training responsibilities of predecessor agencies are now being administered by the Training and Education Office of FEMA using the State Cooperative Agreements and Regional Support Contracts as the vehicle to meet individual State training needs. This rule defines the objectives and elements of the program, the funding approach, and the State application/proposal. PMID:10249532

  14. Management of Complications Following Emergency and Elective Surgery for Diverticulitis

    PubMed Central

    Holmer, Christoph; Kreis, Martin E.

    2015-01-01

    Background The clinical spectrum of sigmoid diverticulitis (SD) varies from asymptomatic diverticulosis to symptomatic disease with potentially fatal complications. Sigmoid colectomy with restoration of continuity has been the prevailing modality for treating acute and recurrent SD, and is often performed as a laparoscopy-assisted procedure. For elective sigmoid colectomy, the postoperative morbidity rate is 15-20% whereas morbidity rates reach up to 30% in patients who undergo emergency surgery for perforated SD. Some of the more common and serious surgical complications after sigmoid colectomy are anastomotic leaks and peritonitis, wound infections, small bowel obstruction, postoperative bleeding, and injuries to the urinary tract structures. Regarding the management of complications, it makes no difference whether the complication is a result of an emergency or an elective procedure. Methods The present work gives an overview of the management of complications in the surgical treatment of SD based on the current literature. Results To achieve successful management, early diagnosis is mandatory in cases of deviation from the normal postoperative course. If diagnostic procedures fail to deliver a correlate for the clinical situation of the patient, re-laparotomy or re-laparoscopy still remain among the most important diagnostic and/or therapeutic principles in visceral surgery when a patient's clinical status deteriorates. Conclusion The ability to recognize and successfully manage complications is a crucial part of the surgical treatment of diverticular disease and should be mastered by any surgeon qualified in this field. PMID:26989382

  15. Managing dyslipidemia in HIV/AIDS patients: challenges and solutions

    PubMed Central

    Husain, Nazik Elmalaika OS; Ahmed, Mohamed H

    2015-01-01

    Human immunodeficiency virus (HIV) is a chronic disease associated with dyslipidemia and insulin resistance. In addition, the administration of combination antiretroviral therapy is associated with an increase in the incidence of metabolic risk factors (insulin resistance, lipoatrophy, dyslipidemia, and abnormalities of fat distribution in HIV patients). HIV dyslipidemia is a common problem, and associated with an increase in incidence of cardiovascular disease. Further challenges in the management of HIV dyslipidemia are the presence of diabetes and metabolic syndrome, nonalcoholic fatty liver disease, hypothyroidism, chronic kidney disease, the risk of diabetes associated with statin administration, age and ethnicity, and early menopause in females. Dyslipidemia in patients with HIV is different from the normal population, due to the fact that HIV increases insulin resistance and HIV treatment not only may induce dyslipidemia but also may interact with lipid-lowering medication. The use of all statins (apart from simvastatin and lovastatin) is safe and effective in HIV dyslipidemia, and the addition of ezetimibe, fenofibrate, fish oil, and niacin can be used in statin-unresponsive HIV dyslipidemia. The management of dyslipidemia and cardiovascular disease risks associated with HIV is complex, and a certain number of patients may require management in specialist clinics run by specialist physicians in lipid disorders. Future research is needed to address best strategies in the management of hyperlipidemia with HIV infection. PMID:25565897

  16. Graphic visualization of program performance aids management review

    NASA Technical Reports Server (NTRS)

    Eisenhart, G. N.

    1967-01-01

    Chart technique /PERTREE/ which displays the essential status elements of a PERT system in a vertical flow array, of high graphic quality, enables visual review by management of program performance. Since the display is versatile, it can accommodate any aspect of the program which the presenter wishes to accent.

  17. Enrollment Management and Financial Aid: Seeking a Strategic Integration

    ERIC Educational Resources Information Center

    Kalsbeek, David H.; Hossler, Donald

    2008-01-01

    Enrollment management has become an important leadership function on many college and university campuses. It is also attracting critical attention here and abroad among observers of the system of postsecondary education. With this essay, the authors continue a series that examines policies and practices that are central to campus-based efforts to…

  18. Management of Hepatic Rupture Diagnosed after an Emergency Cesarean Section

    PubMed Central

    Damiani, Gianluca Raffaello; Merola, Viviana; Barnaba, Mario; Landi, Stefano; Cormio, Gennaro; Pellegrino, Antonio

    2014-01-01

    A careful management of hepatic capsular rupture, with massive hemoperitoneum which occurred 14 hours after an emergency cesarean section at 36 weeks of gestation, is meticulously reported. The grade of hepatic involvement varies from minor capsular laceration to extensive parenchymal rupture. Our management involved a combination of surgical interventions and aggressive supportive care. The patient was discharged after 53 days and 4 laparotomies and an unsuccessful attempt of superselective artery embolization. Ultrasound after 40 days from the last surgery showed uniform hepatic parenchyma free of focal lesions. Due to the rarity and the unpredictability nature of this devastating event we believe necessary to report our experience, reinforcing the importance of the postsurgery management. PMID:25254049

  19. Management of atrial fibrillation in the emergency department.

    PubMed

    Crozier, I; Melton, I; Pearson, S

    2003-04-01

    Abstract Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is a frequent cause for presentation to the emergency department. With an understanding of the pathophysiology and types of AF, efficient and effective management strategies for AF can be formulated. Patients with paroxysmal AF will often revert spontaneously and can initially be managed on an outpatient basis, unless an antiarrhythmic is commenced. In patients with AF and severe underlying heart disease, the management is primarily directed at the underlying heart disease, supplemented with rate-controlling measures, and prevention of thromboembolic complications. In patients with persistent AF good rate control, early cardioversion and initiation of an antiarrhythmic are likely to reduce the risk of recurrence. PMID:12680985

  20. Federal Emergency Management Information system (FEMIS) data management guide. Version 1.2

    SciTech Connect

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L.; Johnson, S.M.; Loveall, R.M.; Winters, C.

    1996-05-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Chemical and Biological Defense Command. The FEMIS Data Management Guide provides the background, as well as the operations and procedures needed to generate and maintain the data resources in the system. Database administrators, system administrators, and general users can use this guide to manage the data files and database that support the administrative, user-environment, database management, and operational capabilities of FEMIS. This document provides a description of the relational and spatial information present in FEMIS. It describes how the data was assembled, how it is loaded, and how it is managed while the system is in operation.

  1. HIV/AIDS as a Chronic Disease: Emergence from the Plague Model.

    ERIC Educational Resources Information Center

    Beaudin, Christy L.; Chambre, Susan M.

    1996-01-01

    Examines the social, biological, and political forces that changed the public policy conception of HIV/AIDS from an acute epidemic to a chronic illness. Provides an overview of the institutional and social responses to the disease. Discusses and defines characteristics of the chronic illness and plague models. (MJP)

  2. Reverse quality management: developing evidence-based best practices in health emergency management.

    PubMed

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management. PMID:16622359

  3. Integrated Safety, Environmental and Emergency Management System (ISEEMS)

    SciTech Connect

    Silver, R.; Langwell, G.; Thomas, C.; Coffing, S.

    1996-05-01

    The Risk Management and NEPA (National Environmental Policy Act) Department of Sandia National Laboratories/New Mexico (SNL/NM) recognized the need for hazard and environmental data analysis and management to support the line managers` need to know, understand, manage and document the hazards in their facilities and activities. The Integrated Safety, Environmental, and Emergency Management System (ISEEMS) was developed in response to this need. SNL needed a process that would quickly and easily determine if a facility or project activity contained only standard industrial hazards and therefore require minimal safety documentation, or if non-standard industrial hazards existed which would require more extensive analysis and documentation. Many facilities and project activities at SNL would benefit from the quick screening process used in ISEEMS. In addition, a process was needed that would expedite the NEPA process. ISEEMS takes advantage of the fact that there is some information needed for the NEPA process that is also needed for the safety documentation process. The ISEEMS process enables SNL line organizations to identify and manage hazards and environmental concerns at a level of effort commensurate with the hazards themselves by adopting a necessary and sufficient (graded) approach to compliance. All hazard-related information contained within ISEEMS is location based and can be displayed using on-line maps and building floor plans. This visual representation provides for quick assimilation and analysis.

  4. Smartphone applications to aid weight loss and management: current perspectives.

    PubMed

    Sutton, Elizabeth F; Redman, Leanne M

    2016-01-01

    The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or "apps" along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to "self-digitize" and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials. PMID:27486338

  5. Smartphone applications to aid weight loss and management: current perspectives

    PubMed Central

    Sutton, Elizabeth F; Redman, Leanne M

    2016-01-01

    The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or “apps” along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to “self-digitize” and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials. PMID:27486338

  6. Is emergency management an integrated element of business continuity management? A case study with security professionals in Western Australia.

    PubMed

    Frohde, Kenny; Brooks, David J

    2014-01-01

    Emergency management (EM) and business continuity management (BCM) frameworks incorporate various strategic and operational measures. Defined within a number of national and international standards and guidelines, such concepts may be integrated within one another to provide increased resilience to disruptive events. Nevertheless, there is a degree of dispute regarding concept integration among security and EM professionals and bodies of knowledge. In line with cognitive psychology exemplar-based concepts, such disputes may be associated with a lack of precision in communality in the approach to EM and BCM. This paper presents a two-stage study, where stage 1 critiqued national and international literature and stage 2 applied semi-structured interviews with security managers in Western Australia. Findings indicate the existence of contradictory views on EM and its integration within BCM. As such, this study concludes that EM is considered a vital component of BCM by the majority of security managers. However, there is broader dispute regarding its degree of integration. Understanding the underpinnings of such disputes will aid in raising the standards and application of professionalism within security, EM and BCM domains, supporting clarification and definition of professional boundaries. PMID:25193457

  7. The Film as Visual Aided Learning Tool in Classroom Management Course

    ERIC Educational Resources Information Center

    Altinay Gazi, Zehra; Altinay Aksal, Fahriye

    2011-01-01

    This research aims to investigate the impact of the visual aided learning on pre-service teachers' co-construction of subject matter knowledge in teaching practice. The study revealed the examination of film as an active cognizing and learning tool in classroom management course within teacher education programme. Within the framework of action…

  8. Data Management Standards in Computer-aided Acquisition and Logistic Support (CALS)

    NASA Technical Reports Server (NTRS)

    Jefferson, David K.

    1990-01-01

    Viewgraphs and discussion on data management standards in computer-aided acquisition and logistic support (CALS) are presented. CALS is intended to reduce cost, increase quality, and improve timeliness of weapon system acquisition and support by greatly improving the flow of technical information. The phase 2 standards, industrial environment, are discussed. The information resource dictionary system (IRDS) is described.

  9. The Role of Social Entrepreneurship in HIV/AIDS Management across the Education Sector in Kenya

    ERIC Educational Resources Information Center

    Ayiro, Laban P.

    2010-01-01

    Purpose: The overall purpose of this study is to identify key entrepreneurial variables in the realm of social entrepreneurship that may contribute to enhancing impact mitigation of HIV/AIDS. In addition, the study seeks to establish which of the correlations between the entrepreneurial variables and management of response of impact mitigation of…

  10. Functional Specifications for Computer Aided Training Systems Development and Management (CATSDM) Support Functions. Final Report.

    ERIC Educational Resources Information Center

    Hughes, John; And Others

    This report provides a description of a Computer Aided Training System Development and Management (CATSDM) environment based on state-of-the-art hardware and software technology, and including recommendations for off the shelf systems to be utilized as a starting point in addressing the particular systematic training and instruction design and…

  11. Strengthening the Federal Emergency Management Agency's disaster response capabilities.

    PubMed

    Cannon, Glenn M

    2008-04-01

    The Federal Emergency Management Agency's (FEMA) Disaster Operations Directorate provides the core federal response capability to save lives and to protect property in US communities that have been overwhelmed by the impact of a major disaster or emergency. The directorate executes its mission through three main programme areas: operational direction, command and control; operational teams; and operational planning. Based on lessons learned from years of disaster response experience, FEMA is now taking a more proactive and collaborative approach with its partners. This paper discusses how FEMA is placing a greater emphasis on response operations and strengthening capabilities across the full range of operational and support missions by comprehensively revamping its disaster operations model; enhancing its headquarters and regional operations centres; enhancing its headquarters and regional operational planning capabilities; and addressing catastrophic disaster planning and related critical preparedness issues. PMID:21339114

  12. Emergency Management Students' Perceptions of the Use of WebEOC[R] to Support Authentic Learning

    ERIC Educational Resources Information Center

    Johnson, Thomas

    2012-01-01

    This study investigates the use of software technology that is used by emergency management professionals to create an authentic learning environment in emergency and disaster management courses in the classroom. Participants were 235 upper-level students enrolled in residential and online emergency and disaster management courses at a mid-sized…

  13. Inhaled Foreign Bodies In Pediatric Patients: Proven Management Techniques In The Emergency Department.

    PubMed

    Maraynes, Megan; Agoritsas, Konstantinos

    2015-10-01

    Foreign body inhalation affects thousands of children every year, and it remains a significant cause of morbidity and mortality in children. Inhaled organic or inorganic foreign bodies can become lodged in the posterior nasopharynx, larynx, trachea, or bronchi. Presentation of foreign body inhalation can range from nonspecific respiratory symptoms to respiratory failure associated with a choking episode. In this issue, an in-depth review of the etiology, pathophysiology, diagnosis, and treatment of inhaled foreign bodies is presented. Risk factors for foreign body inhalation and clinical clues to diagnosis, as well as emergent management of inhaled foreign bodies are reviewed. A systematic approach, as described in this issue, will aid in timely and accurate diagnosis and treatment of inhaled foreign bodies, thereby limiting future complications and morbidity. PMID:26510331

  14. Emergency department management of patients internally contaminated with radioactive material.

    PubMed

    Kazzi, Ziad; Buzzell, Jennifer; Bertelli, Luiz; Christensen, Doran

    2015-02-01

    After a radiation emergency that involves the dispersal of radioactive material, patients can become externally and internally contaminated with 1 or more radionuclides. Internal contamination can lead to the delivery of harmful ionizing radiation doses to various organs and tissues or the whole body. The clinical consequences can range from acute radiation syndrome to the long-term development of cancer. Estimating the amount of radioactive material absorbed into the body can guide the management of patients. Treatment includes, in addition to supportive care and long term monitoring, certain medical countermeasures like Prussian blue, calcium diethylenetriamine pentaacetic acid (DTPA) and zinc DTPA. PMID:25455668

  15. Emergency department management of patients internally contaminated with radioactive material

    DOE PAGESBeta

    Kazzi, Ziad; Buzzell, Jennifer; Bertelli, Luiz; Christensen, Doran

    2014-11-15

    After a radiation emergency that involves the dispersal of radioactive material, patients can become externally and internally contaminated with one or more radionuclides. Internal contamination can lead to the delivery of harmful ionizing radiation doses to various organs and tissues or the whole body. The clinical consequences can range from acute radiation syndrome (ARS) to the long term development of cancer. Estimating the amount of radioactive material absorbed into the body can guide the management of patients. Treatment includes, in addition to supportive care and long term monitoring, certain medical countermeasures like Prussian blue, Calcium DTPA and Zinc DTPA.

  16. Emergent properties of proteostasis in managing cystic fibrosis.

    PubMed

    Balch, William E; Roth, Daniela M; Hutt, Darren M

    2011-02-01

    Cystic fibrosis (CF) is a consequence of defective recognition of the multimembrane spanning protein cystic fibrosis conductance transmembrane regulator (CFTR) by the protein homeostasis or proteostasis network (PN) (Hutt and Balch (2010). Like many variant proteins triggering misfolding diseases, mutant CFTR has a complex folding and membrane trafficking itinerary that is managed by the PN to maintain proteome balance and this balance is disrupted in human disease. The biological pathways dictating the folding and function of CFTR in health and disease are being studied by numerous investigators, providing a unique opportunity to begin to understand and therapeutically address the role of the PN in disease onset, and its progression during aging. We discuss the general concept that therapeutic management of the emergent properties of the PN to control the energetics of CFTR folding biology may provide significant clinical benefit. PMID:21421917

  17. Targeted temperature management in emergency medicine: current perspectives

    PubMed Central

    Hunter, Benton R; Ellender, Timothy J

    2015-01-01

    Landmark trials in 2002 showed that therapeutic hypothermia (TH) after out-of-hospital cardiac arrest due to ventricular tachycardia or ventricular fibrillation resulted in improved likelihood of good neurologic recovery compared to standard care without TH. Since that time, TH has been frequently instituted in a wide range of cardiac arrest patients regardless of initial heart rhythm. Recent evidence has evaluated how, when, and to what degree TH should be instituted in cardiac arrest victims. We outline early evidence, as well as recent trials, regarding the use of TH or targeted temperature management in these patients. We also provide evidence-based suggestions for the institution of targeted temperature management/TH in a variety of emergency medicine settings. PMID:27147892

  18. Identification and Management of Information Problems by Emergency Department Staff

    PubMed Central

    Murphy, Alison R.; Reddy, Madhu C.

    2014-01-01

    Patient-care teams frequently encounter information problems during their daily activities. These information problems include wrong, outdated, conflicting, incomplete, or missing information. Information problems can negatively impact the patient-care workflow, lead to misunderstandings about patient information, and potentially lead to medical errors. Existing research focuses on understanding the cause of these information problems and the impact that they can have on the hospital’s workflow. However, there is limited research on how patient-care teams currently identify and manage information problems that they encounter during their work. Through qualitative observations and interviews in an emergency department (ED), we identified the types of information problems encountered by ED staff, and examined how they identified and managed the information problems. We also discuss the impact that these information problems can have on the patient-care teams, including the cascading effects of information problems on workflow and the ambiguous accountability for fixing information problems within collaborative teams. PMID:25954457

  19. Federal Emergency Management Information System (FEMIS) Data Management Guide for FEMIS Version 1.4.6

    SciTech Connect

    Angel, L.K.; Bower, J.C.; Burnett, R.A.; Downing, T.R.; Fangman, P.M.; Hoza, M.; Johnson, D.M.; Johnson, S.M.; Loveall, R.M.; Millard, W.D.; Schulze, S.A.; Wood, B.M.

    1999-06-29

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are corrected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication data distribution and notification functionality necessary to operate FEMIS in a networked, client/server environment.

  20. Borderline Personality Disorder in the Emergency Department: Good Psychiatric Management.

    PubMed

    Hong, Victor

    2016-01-01

    Patients with borderline personality disorder (BPD) are high utilizers of psychiatric emergency services and present unique challenges in that setting. Frequently advised to visit an emergency department (ED) if safety is in question, their experiences once there often do not have beneficial effects. Issues specific to patients with BPD in the ED include volatile interactions with staff, repeat visits, concerns about safety (and liability), and disposition. Emergency department staff attitudes toward these patients are frequently negative when compared to patients with other diagnoses, and can detrimentally affect outcomes and perpetuate stigma regarding BPD. These attitudes are often due to lack of education and training about how to understand, approach, and treat the patient with BPD. The limited literature regarding the treatment of BPD in the ED offers few guidelines. This article presents an approach based on Good Psychiatric Management that can reduce negative reactions by ED staff and make ED visits more effective and less harmful. Relevant principles include psychoeducation, the reinforcement of the connection between symptoms and interpersonal stressors, and employment of an active, authentic therapeutic stance. Training ED staff in these principles could lead to attitudinal changes, reduced stigma, and potentially improved outcomes. PMID:27603743

  1. Patient-related barriers to pain management in ambulatory AIDS patients.

    PubMed

    Breitbart, W; Passik, S; McDonald, M V; Rosenfeld, B; Smith, M; Kaim, M; Funesti-Esch, J

    1998-05-01

    A number of studies have demonstrated that pain is dramatically undertreated among patients with AIDS and that opioids in particular are rarely prescribed. To date, however, there has been no systematic attempt to examine patient-related barriers to the management of pain in AIDS. This study examines potential patient-related barriers to pain management in patients with AIDS using the Barriers Questionnaire (Ward et al., Pain, 52 (1993) 319-324), and assesses gender, racial, and other demographic differences in the endorsement of these barriers. We surveyed 199 ambulatory patients with AIDS, recruited from numerous sites in New York City, as part of an ongoing study of pain and quality of life in ambulatory AIDS patients. In addition to obtaining demographic and medical data, we administered a number of self-report questionnaires including the Brief Pain Inventory (BPI), the Brief Symptom Index (BSI), the Beck Depression Inventory (BDI), and the Memorial Symptom Assessment Scale (MSAS). Barriers to pain management were assessed using a modified version of the Barriers Questionnaire (BQ), including the original 27 questions from this self-report instrument along with an additional 12 items developed for an AIDS population. Results indicated that the most frequently endorsed BQ items were those concerning the addiction potential of pain medications and physical discomfort associated with opioid administration (e.g. injections) or side effects (e.g. nausea, constipation). There were no associations between age, gender, or HIV transmission risk factor and total scores on the BQ; however, Caucasian patients endorsed significantly fewer BQ items than did non-Caucasian patients and years of education was negatively correlated with BQ scores. Scores on the BQ were also significantly correlated with number of physical symptoms (MSAS) and scores on several self-report measures of psychological distress (the BSI Global Distress Index, BDI total scores). Patient

  2. Recognition and management of seizures in children in emergency departments.

    PubMed

    Caplan, Edward; Dey, Indranil; Scammell, Andrea; Burnage, Katy; Paul, Siba Prosad

    2016-09-01

    Seizure is defined as 'a sudden surge of electrical activity in the brain, which usually affects how a person appears or acts for a short time'. Children who have experienced seizures commonly present to emergency departments (EDs), and detailed history taking will usually help differentiate between epileptic and non-epileptic events. ED nurses are often the first health professionals to manage children with seizures, and this is best done by following the ABCDE approach. Treatment involves termination of seizures with anticonvulsants, and children may need other symptomatic management. Seizures in children can be an extremely distressing experience for parents, who should be supported and kept informed by experienced ED nurses. Nurses also play a vital role in educating parents on correct administration of anticonvulsants and safety advice. This article discusses the aetiology, clinical presentation, diagnosis and management of children with seizures, with particular emphasis on epilepsy. It includes two reflective case studies to highlight the challenges faced by healthcare professionals managing children who present with convulsions. PMID:27615348

  3. Sustainable risk management of emerging contaminants in municipal wastewaters.

    PubMed

    Martin, O V; Voulvoulis, N

    2009-10-13

    The presence of emerging contaminants in municipal wastewaters, particularly endocrine-disrupting compounds such as oestrogenic substances, has been the focus of much public concern and scientific attention in recent years. Due to the scientific uncertainty still surrounding their effects, the Precautionary Principle could be invoked for the interim management of potential risks. Therefore, precautionary prevention risk-management measures could be employed to reduce human exposure to the compounds of concern. Steroid oestrogens are generally recognized as the most significant oestrogenically active substances in domestic sewage effluent. As a result, the UK Environment Agency has championed a 'Demonstration Programme' to investigate the potential for removal of steroid oestrogens and alkylphenol ethoxylates during sewage treatment. Ecological and human health risks are interdependent, and ecological injuries may result in increased human exposures to contaminants or other stressors. In this context of limiting exposure to potential contaminants, examining the relative contribution of various compounds and pathways should be taken into account when identifying effective risk-management measures. In addition, the explicit use of ecological objectives within the scope of the implementation of the EU Water Framework Directive poses new challenges and necessitates the development of ecosystem-based decision tools. This paper addresses some of these issues and proposes a species sensitivity distribution approach to support the decision-making process related to the need and implications of sewage treatment work upgrade as risk-management measures to the presence of oestrogenic compounds in sewage effluent. PMID:19736227

  4. Emergency management of disasters involving livestock in developing countries.

    PubMed

    Heath, S E; Kenyon, S J; Zepeda Sein, C A

    1999-04-01

    Different disasters have similar consequence on the health and welfare of livestock. Numerous geophysical disasters can exacerbate epizootics, resulting in the deaths of many animals and the reduction of production efficiency. These disasters also present a considerable threat of spoilage of processed foods, endangering public health. Furthermore, large-scale disasters involving animals can modify the long-term stability of national economies, the environment and social structures. The authors discuss the vulnerability of the livestock industry to natural disasters and the impact of floods, droughts and transboundary diseases and pests on national economies. Examples are given on how some losses can be avoided, evaluated and compensated. The role of the veterinarian is presented in relation to work conducted by other relief organisations in cases of emergency. In developing countries, mitigation programmes should focus on strengthening global animal health services. Preparedness needs to be community based, with education provided in a timely manner. Effective recovery from disasters should be based on mitigation programmes, including international trade and mutual aid agreements between neighbouring countries to supply appropriate goods and environmentally and culturally appropriate breeds of livestock. Disaster relief for the care of livestock should be recognised as a form of humanitarian assistance, given the benefits to be derived for public health and the socio-economic implications of successful intervention. PMID:10190219

  5. [Paediatric emergencies; example of the management of winter epidemics].

    PubMed

    Mercier, Jean-Christophe; Bellettre, Xavier; Lejay, Émilie; Desmarest, Marie; Titomanlio, Luigi

    2015-01-01

    Every year, epidemics of viral bronchiolitis and gastroenteritis occur with a significant increase in the number of visits (by a factor 1.8) and hospitalisations that can over-exceed bed capacity leading to transfer sick children to other hospitals. This kind of hospital 'crisis' is not limited to paediatrics, big cities or western nations. It is a worldwide worrying problem. Because our hospital sits in the Northern districts of Paris where a large community of m.ncants lives in poverty, our number of visits is high (mean 250 per day), and winter epidemics further jeopardise the difficult equilibrium achieved between quality management and waiting times. Thus, we have taken various initiatives in terms of organisation of the paediatric emergency department and other wards, including a "fast track" clinic, the opening of beds dedicated to winter epidemics, the institution of a "bed manager" in order to more easily find a bed, and a larger use of home hospitalisations. Furthermore, we created a specific committee which may decide on various indicators of tension whether it is necessary to cancel programmed hospitalisations or surgery.in order to resolve the emergency crisis. This kind of organisation can serve as a model for other hospitals facing winter epidemics crises. PMID:25842428

  6. Emergency planning and management in health care: priority research topics

    PubMed Central

    Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

    2014-01-01

    Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making. PMID:25013721

  7. D Geo-Information Requirements for Disaster and Emergency Management

    NASA Astrophysics Data System (ADS)

    Demir Ozbek, E.; Zlatanova, S.; Ates Aydar, S.; Yomralioglu, T.

    2016-06-01

    A conceptual approach is proposed to define 3D geo-information requirement for different types of disasters. This approach includes components such as Disaster Type-Sector-Actor-Process-Activity-Task-Data. According to disaster types processes, activities, tasks, sectors, and responsible and operational actors are derived. Based on the tasks, the needed level of detail for 3D geo-information model is determined. The levels of detail are compliant with the 3D international standard CityGML. After a brief introduction on the disaster phases and geo-information requirement for actors to perform the tasks, the paper discusses the current situation of disaster and emergency management in Turkey and elaborates on components of conceptual approach. This paper discusses the 3D geo-information requirements for the tasks to be used in the framework of 3D geo-information model for Disaster and Emergency Management System in Turkey. The framework is demonstrated for an industrial fire case in Turkey.

  8. [Management of adult abdominal pain in the Emergency Room].

    PubMed

    Chiche, L; Roupie, E; Delassus, P

    2006-01-01

    Abdominal pain is a commonplace reason for surgical consultation in the emergency department and is the the most common symptom which the digestive surgeon on-call must evaluate. He must understand the pathophysiologic basis of visceral pain and referred pain in order to appreciate its diverse manifestations. Abdominal pain can stem from many causes intestinal and non-intestinal, medical and surgical. Evaluation and management in the emergency department must be rapid and pragmatic; clinical history and physical examination should define the gravity of the case, direct the first diagnostic procedures and complementary examinations, and guide the therapeutic direction. Ultrasonography is a quick and effective diagnostic procedure in the diagnosis of biliary, urologic, and gynecologic pathologies; it can be useful for other digestive problems as well. The new generation spiral CT scanner gives excellent definition of digestive and vascular pathologies. The initial evaluation and management of the acute abdomen may determine the prognosis of the patient; it should lead to prompt symptomatic relief and to a well-directed treatment appropriate to the diagnosis. PMID:16609646

  9. Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol

    PubMed Central

    Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

    2013-01-01

    Introduction Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. Methods and analysis To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. Ethics and dissemination This protocol has been approved by the CSSS Alphonse–Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific

  10. Federal Emergency Management Information System (FEMIS) Data Management Guide Version 1.3

    SciTech Connect

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L.; Hoza, M.; Johnson, S.M.; Loveall, R.M.; Millard, W.D.; Winters, C.; Wood, B.M.

    1996-12-01

    FEMIS is an emergency management planning and analysis tool that is being developed under the direction of the US Army Chemical and Biological Defense Command. FEMIS is designed to help civilian emergency management personnel to plan for and support their responses to a chemical-releasing event at a military chemical stockpile. This guide provides the background as well as the operations and procedures needed to generate and maintain the data resources in the system. Database administrators, system administrators, and general users can use this guide to manage the datafiles and database. This document provides a description of the relational and spatial information present in FEMIS. It describes how the data was assembled, loaded, and managed while the system is in operation.

  11. The emerging epidemic of HIV infection and AIDS in Asia and the Pacific.

    PubMed

    Kaldor, J M; Sittitrai, W; John, T J; Kitamura, T

    1994-01-01

    The countries of Asia in 1988 did not seem to be at great risk of sharing in the virtually global HIV/AIDS epidemic. HIV transmission was not occurring on a large scale in those countries and no dominant pattern of transmission had been established. That situation has, however, dramatically changed such that Asia and the Pacific are now fully part and parcel of the global pandemic. Indeed, Australia and New Zealand were among the first developed countries to record high rates of AIDS incidence during the early 1980s, while Thailand had documented alarming increases in HIV seroprevalence by 1988. In New Zealand and Australia, sex between men was quickly established as the dominant route of transmission, with IV drug use remaining a rare mode. IV drug use appears to have been the major transmission route in southern China, northern Malaysia, and northern Myanmar, while heterosexual transmission dominates in the majority of Asian and Pacific countries. Tuberculosis is the major opportunistic infection in the countries of Asia and a fungal pathogen of increasing importance in the region, Penicillium marneffei, had not been associated with HIV infection until the virus reached Asia. Some governments have been slow to respond, yet others including Australia and Thailand have implemented comprehensive national strategies. Many community level prevention activities are ongoing. Despite these activities and some important successes, HIV infection and its related social, economic, and political consequences continue to threaten Asia and the Pacific. PMID:7857551

  12. A Sigh of Relief: The First-Aid Handbook for Childhood Emergencies.

    ERIC Educational Resources Information Center

    Green, Martin I.

    This manual contains tips on preventing childhood accidents and instructions for handling those accidents which do occur. Part One outlines ways of preventing accidents involving the home, infant equipment, toys, school, cars, bicycles, playgrounds, sports, hiking, camping, and water; it also provides blank forms for a family's emergency medical…

  13. The depressed patient and suicidal patient in the emergency department: evidence-based management and treatment strategies.

    PubMed

    Chang, Bernard; Gitlin, David; Patel, Ronak

    2011-09-01

    There are approximately 12 million emergency department (ED) visits related to mental health/substance abuse annually. Approximately 650,000 patients are evaluated annually for suicide attempts. Evidence to guide the management and treatment of depression and suicidal ideation in the ED is limited. A large variation exists in the quality of care provided due to the lack of standardized guidelines aiding emergency clinicians. Depression ften manifests as unexplained somatic complaints, adding to the challenge of making this diagnosis in the ED. Recognition of depression by emergency clinicians has proved poor. Suicide is associated with multiple risk factors, of which a prior history of suicide attempts is the single strongest predictor. A systematic approach is required in the ED to identify patients with or at risk of having depression, and screening tools may offer utility to identify high-risk patients. PMID:22164363

  14. Management of Fever in Postpneumococcal Vaccine Era: Comparison of Management Practices by Pediatric Emergency Medicine and General Emergency Medicine Physicians

    PubMed Central

    Goldman, David L.; Avner, Jeffrey R.

    2014-01-01

    Background. The primary objective of this study was to compare management practices of general emergency physicians (GEMPs) and pediatric emergency medicine physicians (PEMPs) for well-appearing young febrile children. Methods. We retrospectively reviewed the charts of well-appearing febrile children aged 3–36 months who presented to a large urban children's hospital (PED), staffed by PEMPs, or a large urban general emergency department (GED), staffed by GEMPs. Demographics, immunization status, laboratory tests ordered, antibiotic usage, and final diagnoses were collected. Results. 224 cases from the PED and 237 cases from the GED were reviewed. Children seen by PEMPs had significantly less CXRs (23 (10.3%) versus 51 (21.5%), P = 0.001) and more rapid viral testing done (102 (45%) versus 40 (17%), P < 0.0001). A diagnosis of a viral infection was more common in the PED, while a diagnosis of bacterial infection (including otitis media) was more common in the GED. More GED patients were prescribed antibiotics (41% versus 27%, P = 0.002), while more PED patients were treated with oseltamivir (6.7% versus 0.4%, P < 0.001). Conclusions. Our findings identify important differences in the care of the young, well-appearing febrile child by PEMPs and GEMPs and highlight the need for standardization of care. PMID:24982807

  15. Effects of Acupuncture at the Yintang and the Chengjiang Acupoints on Cardiac Arrhythmias and Neurocardiogenic Syncope in Emergency First Aid.

    PubMed

    Fabrin, Saulo; Soares, Nayara; Pezarezi Yoshimura, Daiana; Hallak Regalo, Simone Cecilio; Donizetti Verri, Edson; de Freitas Vianna, Jacqueline Rodrigues; Gatti Regueiro, Eloisa Maria; Torres da Silva, Josie Resende

    2016-02-01

    This study evaluated the effectiveness of YinTang and ChengJiang acupoints on patients with cardiac arrhythmia and neurocardiogenic syncope in emergency first aid. A 45 year old woman underwent acupuncture. She had a previous history of a valvuloplasty for rheumatic disease and two acute myocardial infarctions, followed by four catheterizations and an angioplasty. Needling of the YinTang acupoint and stimulation of the ChengJiang acupoint through acupressure were performed for 20 minutes soon after syncope and during tachycardia, hypertension, tachypnea, and precordial pain, without any effect on peripheral oxygen saturation (SpO2) or the glycemic index. Data were analyzed comparatively by using the following parameters at rest, during syncope, and at 1 minute and 10 minutes after an emergency acupuncture procedure: blood pressure; heart rate; SpO2; and respiratory rate. We found that acupuncture at YinTang and ChenJiang acupoints induced cardiovascular responses, increased the limits of the body's homeostasis, and normalized the patient's condition in the case of syncope. Acupuncture using a combination of ChengJiang and YinTang acupoints had an immediate effect on the autonomic nervous system and on maintaining homeostasis and energy balance in the body. Although this technique was effective, the patient was still referred to the Emergency Room. PMID:26896074

  16. HIV/AIDS and lipodystrophy: Implications for clinical management in resource-limited settings

    PubMed Central

    Finkelstein, Julia L; Gala, Pooja; Rochford, Rosemary; Glesby, Marshall J; Mehta, Saurabh

    2015-01-01

    Introduction Lipodystrophy is a term used to describe a metabolic complication of fat loss, fat gain, or a combination of fat loss and gain, which is associated with some antiretroviral (ARV) therapies given to HIV-infected individuals. There is limited research on lipodystrophy in low- and middle-income countries, despite accounting for more than 95% of the burden of HIV/AIDS. The objective of this review was to evaluate the prevalence, pathogenesis and prognosis of HIV-related lipoatrophy, lipohypertrophy and mixed syndrome, to inform clinical management in resource-limited settings. Methods We conducted a structured literature search using MEDLINE electronic databases. Relevant MeSH terms were used to identify published human studies on HIV and lipoatrophy, lipohypertrophy, or mixed syndrome in low-, low-middle- and upper-middle-income countries through 31 March 2014. The search resulted in 5296 articles; after 1599 studies were excluded (958 reviews, 641 non-human), 3697 studies were extracted for further review. After excluding studies conducted in high-income settings (n=2808), and studies that did not meet inclusion criteria (n=799), 90 studies were included in this review. Results and Discussion Of the 90 studies included in this review, only six were from low-income countries and eight were from lower middle-income economies. These studies focused on lipodystrophy prevalence, risk factors and side effects of antiretroviral therapy (ART). In most studies, lipodystrophy developed after the first six months of therapy, particularly with the use of stavudine. Lipodystrophy is associated with increased risk of cardiometabolic complications. This is disconcerting and anticipated to increase, given the rapid scale-up of ART worldwide, the increasing number and lifespan of HIV-infected patients on long-term therapy, and the emergence of obesity and non-communicable diseases in settings with extensive HIV burden. Conclusions Lipodystrophy is common in resource

  17. Federal Emergency Management Information System (FEMIS) data management guide, version 1.4.5

    SciTech Connect

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L.

    1998-06-26

    The Federal Emergency Management Information System (FEMIS) information resources are described in this FEMIS Data Management Guide. To comprehend what types of data are present, where the data is located, and how it is managed during the life span of the system, a basic understanding of the FEMIS architecture is necessary. The system is being developed by Pacific Northwest National Laboratory (PNNL) and is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). The capability to connect to remote CSEPP sites and share information will be present in a future release. Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide efficient EOC-wide services. Each EOC is interconnected to other EOCs via telecommunications links. FEMIS is a client/server system where much of the application software is located in the client PC. This client software integrates the FEMIS application, government furnished dispersion and evacuation models, and Commercial-Off-The-Shelf (COTS) software tools such as the ArcView geographic information system (GIS) and Microsoft Project (electron planning). A UNIX server provides data management services, ARC/INFO GIS capabilities, evacuation (Evac) modeling, electron main (E-mail), and meteorological (Met) input processing. A PC communication utility is available to interface with external subsystems. At this time, the weather collection system (Handar Met System) is the only external subsystem.

  18. Structural and functional photoacoustic molecular tomography aided by emerging contrast agents

    PubMed Central

    Nie, Liming

    2015-01-01

    Photoacoustic tomography (PAT) can offer structural, functional and molecular contrasts at scalable observation level. By ultrasonically overcoming the strong optical scattering, this imaging technology can reach centimeters penetration depth while retaining high spatial resolution in biological tissue. Recent extensive research has been focused on developing new contrast agents to improve the imaging sensitivity, specificity and efficiency. These emerging materials have substantially accelerated PAT applications in signal sensing, functional imaging, biomarker labeling and therapy monitoring etc. Here, the potentials of different optical probes as PAT contrast agents were elucidated. We first describe the instrumental embodiments and the measured functional parameters, then focus on emerging contrast agent-based PAT applications, and finally discuss the challenges and prospects. PMID:24967718

  19. Research on Group Decision-Making Mechanism of Internet Emergency Management

    NASA Astrophysics Data System (ADS)

    Xie, Kefan; Chen, Gang; Qian, Wu; Shi, Zhao

    With the development of information technology, internet has become a popular term and internet emergency has an intensive influence on people's life. This article offers a short history of internet emergency management. It discusses the definition, characteristics, and factor of internet emergency management. A group decision-making mechanism of internet emergency is presented based on the discussion. The authors establish a so-called Rough Set Scenario Flow Graphs (RSSFG) of group decision-making mechanism of internet emergency management and make an empirical analysis based on the RSSFG approach. The experimental results confirm that this approach is effective in internet emergency decision-making.

  20. Personal Emergency Response Systems--Communication Technology Aids Elderly and Their Families.

    ERIC Educational Resources Information Center

    Dibner, Andrew S.

    Personal response systems (PRS) bring immediate help to aged and disabled persons at home at the touch of a button. The PRS user wears a tiny radio transmitter as a pendant or a bracelet and can send a telephone signal from any part of the home to a 24-hour emergency center when help is needed. This study examined research on the Lifeline system,…

  1. Federal Emergency Management Information System (FEMIS). Data Management Guide, FEMIS: Phase 1, Version 1.1u

    SciTech Connect

    Burnett, R.A.; Johnson, D.M.; Johnson, S.M.

    1995-06-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the U.S. Army Chemical and Biological Defense Command. The FEMIS Data Management Guide provides the background, as well as the operations and procedures needed to generate and maintain the data resources in the system.

  2. Idiopathic ulcers as an oral manifestation in pediatric patients with AIDS: multidisciplinary management.

    PubMed

    Martinez-Sandoval, B; Ceballos-Hernández, H; Téllez-Rodríguez, J; Xochihua-Díaz, L; Durán-Ibarra, G; Pozos-Guillen, A J

    2012-01-01

    HIV infection is a major global health problem affecting developing and developed countries alike. HIV infection is associated with multiple oral lesions, some of which are of value in diagnosing the disease. The aim of this report is to describe the clinical manifestations and their multidisciplinary management, in a 6-year-old girl with AIDS. The findings of this case report indicate that, it is essential to be familiar with the early oral manifestations of AIDS in order to understand the patient's dental health needs, apply preventive methods, control caries, and understand the value of oral lesions as diagnostic markers of disease progression in children with HIV infection. A multidisciplinary management is fundamental. PMID:23342569

  3. Enhancements to the Design Manager's Aide for Intelligent Decomposition (DeMaid)

    NASA Technical Reports Server (NTRS)

    Rogers, James L.; Barthelemy, Jean-Francois M.

    1992-01-01

    This paper discusses the addition of two new enhancements to the program Design Manager's Aide for Intelligent Decomposition (DeMAID). DeMAID is a knowledge-based tool used to aid a design manager in understanding the interactions among the tasks of a complex design problem. This is done by ordering the tasks to minimize feedback, determining the participating subsystems, and displaying them in an easily understood format. The two new enhancements include (1) rules for ordering a complex assembly process and (2) rules for determining which analysis tasks must be re-executed to compute the output of one task based on a change in input to that or another task.

  4. Enhancements to the Design Manager's Aide for Intelligent Decomposition (DeMAID)

    NASA Technical Reports Server (NTRS)

    Rogers, James L.; Barthelemy, Jean-Francois M.

    1992-01-01

    This paper discusses the addition of two new enhancements to the program Design Manager's Aide for Intelligent Decomposition (DeMAID). DeMAID is a knowledge-based tool used to aid a design manager in understanding the interactions among the tasks of a complex design problem. This is done by ordering the tasks to minimize feedback, determining the participating subsystems, and displaying them in an easily understood format. The two new enhancements include (1) rules for ordering a complex assembly process and (2) rules for determining which analysis tasks must be re-executed to compute the output of one task based on a change in input to that or another task.

  5. Effectiveness of the Chest Pain Choice decision aid in emergency department patients with low-risk chest pain: study protocol for a multicenter randomized trial

    PubMed Central

    2014-01-01

    Background Chest pain is the second most common reason patients visit emergency departments (EDs) and often results in very low-risk patients being admitted for prolonged observation and advanced cardiac testing. Shared decision-making, including educating patients regarding their 45-day risk for acute coronary syndrome (ACS) and management options, might safely decrease healthcare utilization. Methods/Design This is a protocol for a multicenter practical patient-level randomized trial to compare an intervention group receiving a decision aid, Chest Pain Choice (CPC), to a control group receiving usual care. Adults presenting to five geographically and ethnically diverse EDs who are being considered for admission for observation and advanced cardiac testing will be eligible for enrollment. We will measure the effect of CPC on (1) patient knowledge regarding their 45-day risk for ACS and the available management options (primary outcome); (2) patient engagement in the decision-making process; (3) the degree of conflict patients experience related to feeling uninformed (decisional conflict); (4) patient and clinician satisfaction with the decision made; (5) the rate of major adverse cardiac events at 30 days; (6) the proportion of patients admitted for advanced cardiac testing; and (7) healthcare utilization. To assess these outcomes, we will administer patient and clinician surveys immediately after each clinical encounter, obtain video recordings of the patient-clinician discussion, administer a patient healthcare utilization diary, analyze hospital billing records, review the electronic medical record, and conduct telephone follow-up. Discussion This multicenter trial will robustly assess the effectiveness of a decision aid on patient-centered outcomes, safety, and healthcare utilization in low-risk chest pain patients from a variety of geographically and ethnically diverse EDs. Trial registration NCT01969240. PMID:24884807

  6. Impact of HIV-1 tropism on the emergence of non-AIDS events in HIV-infected patients receiving fully suppressive antiretroviral therapy

    PubMed Central

    Maffongelli, Gaetano; Alteri, Claudia; Gentilotti, Elisa; Bertoli, Ada; Ricciardi, Alessandra; Malagnino, Vincenzo; Svicher, Valentina; Santoro, Maria M.; Dori, Luca; Perno, Carlo F.; Andreoni, Massimo; Sarmati, Loredana

    2016-01-01

    Objective: The impact of HIV-1 tropism on the emergence of non-AIDS events was evaluated in a cohort of 116 antiretroviral therapy (ART) responder patients. Methods: The patients were followed for the emergence of hypertension, renal impairment, metabolic and bone disorders (defined as non-AIDS events) each 8 weeks at standard visits. A V3 plasma sequence genotype analysis was performed at the time of ART initiation and the geno2pheno algorithm with the results that defines the false-positive rate (FPR) was used to infer HIV tropism. The associations between the non-AIDS events and the FPR at baseline were evaluated using the χ2 test for trend. A Cox-regression analysis using the counting process formulation of Andersen and Gill was performed to define whether the emergence of non-AIDS events was correlated to FPR. Results: The prevalence of at least one non-AIDS event resulted higher in patients with a FPR below 10% than in patients with a R5 virus (P = 0.033). Patients with a FPR below 5.0% most frequently developed non-AIDS events during ART (P = 0.01). A higher prevalence of patients with at least two AIDS events was found in the group of patients with a FPR below 5.0% with respect to the others (P < 0.001). At multivariate Cox-regression analysis, having an X4 virus and age were independently associated with a higher probability of non-AIDS event development. Conclusion: This study shows that an X4 virus, particularly a FPR less than 5%, is related to non-AIDS events development. Further studies are warranted to understand the mechanisms underlying this phenomenon. PMID:26595543

  7. Urinary Tract Infections: Current and Emerging Management Strategies

    PubMed Central

    Barber, Amelia E.; Norton, J. Paul; Spivak, Adam M.; Mulvey, Matthew A.

    2013-01-01

    Acute cystitis is one of the most commonly encountered bacterial infections and is responsible for substantial morbidity and high medical costs in the United States and across the globe. Though generally considered to be self-limiting and easily treated with antibiotics, urinary tract infections (UTIs) are often incompletely resolved by antibiotic therapy and frequently recur. This is in part due to the ability of uropathogenic bacteria to invade, replicate, and persist within host epithelial cells. The biological complexity of these infections combined with a dramatic rise in antibiotic-resistant pathogens highlight the need for alternative therapies. In this review we examine current management strategies for UTIs, as well as emerging treatments, including novel compounds that block bacterial interactions with the urothelium and vaccines focused on preventing both acute and recurrent infections. PMID:23645845

  8. A bed management strategy for overcrowding in the emergency department.

    PubMed

    Barrett, Lynn; Ford, Suzanne; Ward-Smith, Peggy

    2012-01-01

    In 2006, the Institute of Medicine cited growing visit volumes, hospital closures, financial pressures, and operational inefficiencies as the principal reasons for emergency department (ED) overcrowding and called for regulatory measures to resolve the problem. A Midwest medical center with 59,000 annual ED visits instituted a bed management strategy to decrease the need to board, or hold, admitted hospital patients in the ED awaiting transfer to an inpatient care unit. This strategy was successful in improving the hold time from an average of 216 minutes to 103 minutes, or by 52%. This allowed the staff at the hospital to care for an additional 2,936 patients. During this same time, the overall hospital mortality decreased by 0.07% and patient satisfaction scores improved 1%. The greatest outcome from this intervention was realized in the potential revenue increase of over $2 million. PMID:22558725

  9. Transient Global Amnesia: Emergency Department Evaluation And Management.

    PubMed

    Faust, Jeremy Samuel; Nemes, Andreea

    2016-08-01

    Transient global amnesia is a clinically distinct syndrome characterized by the acute inability to form new memories. It can last up to 24 hours. The diagnosis is dependent on eliminating other more serious etiologies including toxic ingestions, acute strokes, complex partial seizures, and central nervous system infections. Transient global amnesia confers no known long-term risks; however, when abnormal signs or symptoms are present, they take precedence and guide the formulation of a differential diagnosis and investigation. In witnessed transient global amnesia with classic features, a minimalist approach is reasonable, avoiding overtesting, inappropriate medication, and medical interventions in favor of observation, ensuring patient safety, and reassuring patients and their families. This review provides a detailed framework for distinguishing transient global amnesia from its dangerous mimics and managing its course in the emergency department. PMID:27416582

  10. Emergency presentation and management of acute severe asthma in children

    PubMed Central

    Øymar, Knut; Halvorsen, Thomas

    2009-01-01

    Acute severe asthma is one of the most common medical emergency situations in childhood, and physicians caring for acutely ill children are regularly faced with this condition. In this article we present a summary of the pathophysiology as well as guidelines for the treatment of acute severe asthma in children. The cornerstones of the management of acute asthma in children are rapid administration of oxygen, inhalations with bronchodilators and systemic corticosteroids. Inhaled bronchodilators may include selective b2-agonists, adrenaline and anticholinergics. Additional treatment in selected cases may involve intravenous administration of theophylline, b2-agonists and magnesium sulphate. Both non-invasive and invasive ventilation may be options when medical treatment fails to prevent respiratory failure. It is important that relevant treatment algorithms exist, applicable to all levels of the treatment chain and reflecting local considerations and circumstances. PMID:19732437

  11. Enhanced risk management by an emerging multi-agent architecture

    NASA Astrophysics Data System (ADS)

    Lin, Sin-Jin; Hsu, Ming-Fu

    2014-07-01

    Classification in imbalanced datasets has attracted much attention from researchers in the field of machine learning. Most existing techniques tend not to perform well on minority class instances when the dataset is highly skewed because they focus on minimising the forecasting error without considering the relative distribution of each class. This investigation proposes an emerging multi-agent architecture, grounded on cooperative learning, to solve the class-imbalanced classification problem. Additionally, this study deals further with the obscure nature of the multi-agent architecture and expresses comprehensive rules for auditors. The results from this study indicate that the presented model performs satisfactorily in risk management and is able to tackle a highly class-imbalanced dataset comparatively well. Furthermore, the knowledge visualised process, supported by real examples, can assist both internal and external auditors who must allocate limited detecting resources; they can take the rules as roadmaps to modify the auditing programme.

  12. Psychological first aid training for Lebanese field workers in the emergency context of the Syrian refugees in Lebanon.

    PubMed

    Akoury-Dirani, Leyla; Sahakian, Tina S; Hassan, Fahed Y; Hajjar, Ranya V; El Asmar, Khalil

    2015-11-01

    The Syrian refugee crisis in Lebanon required a fast and efficient comprehensive rescue strategy. Professionals working in emergency response were neither prepared to provide psychological first aid nor prepared to screen for mental health disorders in child refugees. This article examines the efficacy of a national training program in psychological first aid (PFA) to enhance the readiness of mental health field workers in the Syrian refugee response. Participant (N = 109) were recruited from Lebanese ministries and nongovernmental organizations. They received a 2.5-day training on PFA and on screening for mental health disorders in children. Their knowledge and perceived readiness were assessed before the training, immediately after the training, and 1 month after the training using 2 evaluation forms. Evaluation Form A was a multiple choice questionnaire composed of 20 questions and created on the basis of the content of the training, and Evaluation Form B was a Likert-type scale of 20 items created based on the core components of PFA. The data of 60 participants were analyzed. The results showed a significant increase in knowledge and readiness, specifically on the components related to the principles and techniques of PFA. PMID:25866960

  13. Therapeutic Management of Familial Hypercholesterolemia: Current and Emerging Drug Therapies.

    PubMed

    Patel, Roshni S; Scopelliti, Emily M; Savelloni, Julie

    2015-12-01

    Familial hypercholesterolemia (FH) is a genetic disorder characterized by significantly elevated low-density lipoprotein cholesterol (LDL-C) concentrations that result from mutations of the LDL receptor, apolipoprotein B (apo B-100), and proprotein convertase subtilisin/kexin type 9 (PCSK9). Early and aggressive treatment can prevent premature atherosclerotic cardiovascular disease in these high-risk patients. Given that the cardiovascular consequences of FH are similar to typical hypercholesterolemia, traditional therapies are utilized to decrease LDL-C levels. Patients with FH should receive statins as first-line treatment; high-potency statins at high doses are often required. Despite the use of statins, additional treatments are often necessary to achieve appropriate LDL-C lowering in this patient population. Novel drug therapies that target the pathophysiologic defects of the condition are continuously emerging. Contemporary therapies including mipomersen (Kynamro, Genzyme), an oligonucleotide inhibitor of apo B-100 synthesis; lomitapide (Juxtapid, Aegerion), a microsomal triglyceride transfer protein inhibitor; and alirocumab (Praluent, Sanofi-Aventis/Regeneron) and evolocumab (Repatha, Amgen), PCSK9 inhibitors, are currently approved by the U.S. Food and Drug Administration for use in FH. This review highlights traditional as well as emerging contemporary therapies with supporting clinical data to evaluate current recommendations and discuss the future direction of FH management. PMID:26684558

  14. The application of Firefly algorithm in an Adaptive Emergency Evacuation Centre Management (AEECM) for dynamic relocation of flood victims

    NASA Astrophysics Data System (ADS)

    ChePa, Noraziah; Hashim, Nor Laily; Yusof, Yuhanis; Hussain, Azham

    2016-08-01

    Flood evacuation centre is defined as a temporary location or area of people from disaster particularly flood as a rescue or precautionary measure. Gazetted evacuation centres are normally located at secure places which have small chances from being drowned by flood. However, due to extreme flood several evacuation centres in Kelantan were unexpectedly drowned. Currently, there is no study done on proposing a decision support aid to reallocate victims and resources of the evacuation centre when the situation getting worsens. Therefore, this study proposes a decision aid model to be utilized in realizing an adaptive emergency evacuation centre management system. This study undergoes two main phases; development of algorithm and models, and development of a web-based and mobile app. The proposed model operates using Firefly multi-objective optimization algorithm that creates an optimal schedule for the relocation of victims and resources for an evacuation centre. The proposed decision aid model and the adaptive system can be applied in supporting the National Security Council's respond mechanisms for handling disaster management level II (State level) especially in providing better management of the flood evacuating centres.

  15. Can preferences in information processing aid in understanding suicide risk among emerging adults?

    PubMed

    Cramer, Robert J; Bryson, Claire N; Gardner, Brett O; Webber, Wesley B

    2016-07-01

    The present study evaluated emerging adult (n = 192 college students) preferences in information processing (PIP), defined by the need for affect (NFA) and need for cognition (NFC), as they may be associated with suicide risk. The following were direct indicators of elevated suicide risk: presence of lifetime exposure to suicide (i.e., lifetime yes/no), elevated depressive symptoms, and greater NFA avoidance. Two different interactions resulted in elevated suicide risk: high depressive symptoms and high NFA avoidance, and high NFC and high NFA. Present results concerning PIP hold the potential to inform suicide risk assessment and prevention efforts among young adults. PMID:27007001

  16. Building capacity for HIV/AIDS program leadership and management in Uganda through mentored Fellowships

    PubMed Central

    Matovu, Joseph K.B.; Wanyenze, Rhoda K.; Mawemuko, Susan; Wamuyu-Maina, Gakenia; Bazeyo, William; Olico-Okui; Serwadda, David

    2011-01-01

    Background Around the world, health professionals and program managers are leading and managing public and private health organizations with little or no formal management and leadership training and experience. Objective To describe an innovative 2-year, long-term apprenticeship Fellowship training program implemented by Makerere University School of Public Health (MakSPH) to strengthen capacity for leadership and management of HIV/AIDS programs in Uganda. Implementation process The program, which began in 2002, is a 2-year, full-time, non-degree Fellowship. It is open to Ugandan nationals with postgraduate training in health-related disciplines. Enrolled Fellows are attached to host institutions implementing HIV/AIDS programs and placed under the supervision of host institution and academic mentors. Fellows spend 75% of their apprenticeship at the host institutions while the remaining 25% is dedicated to didactic short courses conducted at MakSPH to enhance their knowledge base. Achievements Overall, 77 Fellows have been enrolled since 2002. Of the 57 Fellows who were admitted between 2002 and 2008, 94.7% (54) completed the Fellowship successfully and 50 (92.3%) are employed in senior leadership and management positions in Uganda and internationally. Eighty-eight percent of those employed (44/54) work in institutions registered in Uganda, indicating a high level of in-country retention. Nineteen of the 20 Fellows who were admitted between 2009 and 2010 are still undergoing training. A total of 67 institutions have hosted Fellows since 2002. The host institutions have benefited through staff training and technical expertise from the Fellows as well as through grant support to Fellows to develop and implement innovative pilot projects. The success of the program hinges on support from mentors, stakeholder involvement, and the hands-on approach employed in training. Conclusion The Fellowship Program offers a unique opportunity for hands-on training in HIV/AIDS

  17. Nanostructured Delivery Systems: Augmenting the Delivery of Antiretroviral Drugs for Better Management of HIV/AIDS.

    PubMed

    Singh, Gurinder; Pai, Roopa S; Mustafa, Sanaul

    2015-01-01

    In the last two decades, HIV-1, the retrovirus associated with acquired immunodeficiency syndrome (AIDS), is globally one of the primary causes of morbidity and mortality. Unfortunately, existing approaches for interventions are not able to suppress the progression of infection due to this virus. Of the many obstacles, viral entry into the mono-nuclear phagocyte system encompassing monocytes/macrophages and dendritic cells is a major concern. Viral infection is also responsible for the subsequent distribution of the virus into various tissues throughout the organism. Tremendous progress has been made during the past few years to diagnose and treat patients with HIV/AIDS infection, yet much remains to be done. Recommended treatment involves long-term and multiple drug therapy that causes severe side effects. With almost 12% of the world population suffering from HIV/AIDS, better management of this global threat is highly desired. Nanostructured delivery systems hold promise for improving the situation. Such systems can facilitate the uptake of antiretroviral drugs, causing a considerable improvement in HIV/AIDS therapy. Nanoscale systems have intriguing potential to drastically improve existing HIV/AIDS diagnosis and treatment platforms. Nanosystems constitute a wide range of systems varying from polymeric nanoparticles, to solid-lipid nanoparticles, liposomes, micro- and nanoemulsions, dendrimers, and self-nanoemulsifying systems. Improved bioavailability, solubility, stability, and biocompatibility make them an ideal choice for delivery of antiretroviral drugs. The present review initially describes an updated bird's-eye view account of the literature. Then, we provide a relatively sententious overview on updated patents of recent nanostructured delivery systems for antiretroviral drugs. Finally, we discuss low-cost therapy (such as antioxidants and immune modulators) for the treatment and prevention of HIV/AIDS. PMID:26559551

  18. Regulation of human sexual behaviour, sex revolution and emergence of AIDS: a historical perspective.

    PubMed

    Singh, A

    1997-01-01

    No Society in the World permits fully free sexual behaviour. All societies utilize a variety of ways for regulation of sexual behaviour. This has been happening since antiquity. Culture also affects sexual behaviour. In western civilization there was a healthly outlook towards sexuality during Greco-Roman era. In Indian civilization also human sexuality was considered an inseparable part of life and was given a higher place in human life. Many treatises on human sexuality were written. Sex was considered as an art and was given an exalted status through the medium of sculpture work in temples of Konark & Khajuraho. But in Christian civilization sexual acts and related areas were considered immoral, debasing, dirty and abhoring. Sex-related ideas/thoughts were considered immoral in Churches and were given low status in society. Rapidly occurring social changes in 20th century- World wars I & II, urbanization, modernization, industrialization, women emancipation and strong reaction to unprecedented suppression of 19th century suppression of sexuality led to advent of sexual revolution in America & other western countries. Liberal-sex spread throughout the society. Sexual promiscuity, prostitution, homosexuality, group-sex were socially accepted on a wide scale. Presumably as a result of these tendencies a disease like AIDS has now spread from America to the whole world. Present article is an effort of analysis of historical perspective of this problem. PMID:12575704

  19. A 'principled' approach to complex emergencies: testing a new aid delivery model in the Nuba mountains.

    PubMed

    Pantuliano, Sara

    2005-06-01

    This paper provides an analysis of the Nuba Mountains Programme Advancing Conflict Trans-formation (NMPACT) as an example of an operational response in a complex emergency that innovatively addressed an incipient food security crisis. NMPACT is notable for having brought together an array of actors around a common principled agenda and for being the only operational programme in the Sudan to which both warring parties subscribed during the conflict. The key features of the programme are presented and the main innovative elements are reviewed, including the role of the principles of engagement and the 'political humanitarianism' of NMPACT. The paper looks at how NMPACT broke from traditional externally driven responses to food insecurity, and, drawing on lessons from Operation Lifeline Sudan, adopted an approach that focuses on capacity building, sustainable agriculture and market revitalisation, alongside conflict transformation and peace-building. The limitations of the model are also assessed, and preliminary lessons regarding its replication in other complex emergency contexts are presented. PMID:15910677

  20. Channelopathies - emerging trends in the management of inherited arrhythmias.

    PubMed

    Chockalingam, Priya; Mizusawa, Yuka; Wilde, Arthur Am

    2015-01-01

    In spite of their relative rarity, inheritable arrhythmias have come to the forefront as a group of potentially fatal but preventable cause of sudden cardiac death in children and (young) adults. Comprehensive management of inherited arrhythmias includes diagnosing and treating the proband and identifying and protecting affected family members. This has been made possible by the vast advances in the field of molecular biology enabling better understanding of the genetic underpinnings of some of these disease groups, namely congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome. The ensuing knowledge of the genotype-phenotype correlations enables us to risk-stratify, prognosticate and treat based on the genetic test results. The various diagnostic modalities currently available to us, including clinical tools and genetic technologies, have to be applied judiciously in order to promptly identify those affected and to spare the emotional burden of a potentially lethal disease in the unaffected individuals. The therapeutic armamentarium of inherited arrhythmias includes pharmacological agents, device therapies and surgical interventions. A treatment strategy keeping in mind the risk profile of the patients, the local availability of drugs and the expertise of the treating personnel is proving effective. While opportunities for research are numerous in this expanding field of medicine, there is also tremendous scope for incorporating the emerging trends in managing patients and families with inherited arrhythmias in the Indian subcontinent. PMID:25852242

  1. Emergent aquatics: stand establishment, management, and species screening

    SciTech Connect

    Pratt, D.C.; Andrews, N.J.; Dubbe, D.R.; Garver, E.G.; Penko, M.; Read, P.E.; Zimmerman, E.S.

    1982-11-01

    Several emergent aquatic species have been identified as potential biomass crops, including Typha spp. (cattail), Scirpus spp. (rush), Sparganium spp. (bur reed), and Phragmites (reed). This report discusses first year results from studies of stand establishment and management, Typha nutrient requirements, wetland species yield comparisons, and Typha micropropagation. In a comparison of the relative effectiveness of seed, seedlings, and rhizomes for stand establishment, rhizomes appeared to be more consistent and productive under a wire variety of conditions. Both rhizomes and seedling established plots grew successfully on excavated peatland sites. First season results from a multiyear fertilizer rate experiment indicate that fertilizer treatment resulted in significantly increased tissue nutrient concentrations which should carry over into subsequent growing seasons. Shoot density and belowground dry weight were also significantly increased by phosphorus + potassium and potassium applications, respectively. First season yields of selected wetland species from managed paddies generally were comparable to yields reported from natural stands. Several particularly productive clones of Typha spp. have been identified. A method of establishing Typha in tissue culture is described.

  2. [General principles of wound management in emergency departments].

    PubMed

    Zacher, M T; Högele, A M; Hanschen, M; von Matthey, F; Beer, A-K; Gebhardt, F; Biberthaler, P; Kanz, K-G

    2016-04-01

    Wound management is one of the major tasks in emergency departments. The surrounding intact skin but not the wound itself should be disinfected before starting definitive wound treatment. Hair should first be removed by clipping to 1-2 mm above the skin with scissors or clippers as shaving the area with a razor damages the hair follicles and increases the risk of wound infections. Administration of local anesthetics should be performed directly through the exposed edges of the wound. After wound examination, irrigation is performed with Ringer's solution, normal saline or distilled water. The next step is débridement of contaminated and devitalized tissue. There are several wound closure techniques available, including adhesive tapes, staples, tissue adhesives and numerous forms of sutures. Management of specific wounds requires particular strategies. A bleeding control problem frequently occurs with scalp lacerations. Superficial scalp lacerations can be closed by alternative wound closure methods, for example by twisting and fixing hair and the use of tissue adhesives, i.e. hair apposition technique (HAT). For strongly bleeding lacerations of the scalp, the epicranial aponeurosis should be incorporated into the hemostasis. Aftercare varies depending on both the characteristics of the wound and those of the patient and includes adequate analgesia as well as minimizing the risk of infection. Sufficient wound aftercare starts with the treating physician informing the patient about the course of events, potential complications and providing relevant instructions. PMID:27059794

  3. Channelopathies - Emerging Trends in The Management of Inherited Arrhythmias

    PubMed Central

    Chockalingam, Priya; Mizusawa, Yuka; Wilde, Arthur A.M.

    2016-01-01

    In spite of their relative rarity, inheritable arrhythmias have come to the forefront as a group of potentially fatal but preventable cause of sudden cardiac death in children and (young) adults. Comprehensive management of inherited arrhythmias includes diagnosing and treating the proband and identifying and protecting affected family members. This has been made possible by the vast advances in the field of molecular biology enabling better understanding of the genetic underpinnings of some of these disease groups, namely congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome. The ensuing knowledge of the genotype-phenotype correlations enables us to risk-stratify, prognosticate and treat based on the genetic test results. The various diagnostic modalities currently available to us, including clinical tools and genetic technologies, have to be applied judiciously in order to promptly identify those affected and to spare the emotional burden of a potentially lethal disease in the unaffected individuals. The therapeutic armamentarium of inherited arrhythmias includes pharmacological agents, device therapies and surgical interventions. A treatment strategy keeping in mind the risk profile of the patients, the local availability of drugs and the expertise of the treating personnel is proving effective. While opportunities for research are numerous in this expanding field of medicine, there is also tremendous scope for incorporating the emerging trends in managing patients and families with inherited arrhythmias in the Indian subcontinent. PMID:25852242

  4. 76 FR 78227 - Notice of Request for Extension of Approval of an Information Collection; Emergency Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-16

    ... Collection; Emergency Management Response System AGENCY: Animal and Plant Health Inspection Service, USDA... Emergency Management Response System. DATES: We will consider all comments that we receive on or before... Management Response System, contact Dr. Steven Finch, Senior Staff Veterinarian, Preparedness and...

  5. A Quantitative Study of Critical Thinking Skills amongst Local Emergency Managers

    ERIC Educational Resources Information Center

    Peerbolte, Stacy L.

    2010-01-01

    Emergency managers must be able to think critically to identify and anticipate situations, solve problems, and make judgments and decisions to effectively and efficiently assume and manage risks. An assessment of the extent to which local emergency managers are able to think critically has not yet been conducted. Based in systems theory and the…

  6. Forecasting daily attendances at an emergency department to aid resource planning

    PubMed Central

    Sun, Yan; Heng, Bee Hoon; Seow, Yian Tay; Seow, Eillyne

    2009-01-01

    Background Accurate forecasting of emergency department (ED) attendances can be a valuable tool for micro and macro level planning. Methods Data for analysis was the counts of daily patient attendances at the ED of an acute care regional general hospital from July 2005 to Mar 2008. Patients were stratified into three acuity categories; i.e. P1, P2 and P3, with P1 being the most acute and P3 being the least acute. The autoregressive integrated moving average (ARIMA) method was separately applied to each of the three acuity categories and total patient attendances. Independent variables included in the model were public holiday (yes or no), ambient air quality measured by pollution standard index (PSI), daily ambient average temperature and daily relative humidity. The seasonal components of weekly and yearly periodicities in the time series of daily attendances were also studied. Univariate analysis by t-tests and multivariate time series analysis were carried out in SPSS version 15. Results By time series analyses, P1 attendances did not show any weekly or yearly periodicity and was only predicted by ambient air quality of PSI > 50. P2 and total attendances showed weekly periodicities, and were also significantly predicted by public holiday. P3 attendances were significantly correlated with day of the week, month of the year, public holiday, and ambient air quality of PSI > 50. After applying the developed models to validate the forecast, the MAPE of prediction by the models were 16.8%, 6.7%, 8.6% and 4.8% for P1, P2, P3 and total attendances, respectively. The models were able to account for most of the significant autocorrelations present in the data. Conclusion Time series analysis has been shown to provide a useful, readily available tool for predicting emergency department workload that can be used to plan staff roster and resource planning. PMID:19178716

  7. Prevalence and clinical management of cytomegalovirus retinitis in AIDS patients in shanghai, china

    PubMed Central

    2011-01-01

    Background Cytomegalovirus retinitis is a common AIDS-associated illness, leading to blindness in up to 30% of patients. This study was to investigate the prevalence and clinical management of the cytomegalovirus retinitis associated with AIDS in a large municipality of China. Methods Clinical and laboratory data from 23 cytomegalovirus retinitis patients (35 eyes) out of 303 hospitalized AIDS individuals in a single medical center were analyzed retrospectively. Two of 23 patients were diagnosed cytomegalovirus retinitis just before hospitalization without anti-CMV therapy. Ganciclovir combined with the high active anti-retroviral therapy was installed for treatment of cytomegalovirus retinitis after diagnosis was confirmed. The data were analyzed by specialists and statistics was also applied. Results The prevalence of cytomegalovirus retinitis in hospitalized AIDS patients was 7.6% in this study. The level of CD4+ T lymphocytes was correlated well with the occurrence of cytomegalovirus retinitis, showing 16.8% (19/113) (95% confidence interval: 10.4,25.0), 5.4% (3/56) (95% confidence interval: 1.1,14.9), and 1.4% (1/69) (95% confidence interval: 0.0,7.8) occurrence in the patients with CD4+ T lymphocyte counts < 50, 50~99, and 100~199 cells/μl, respectively. The mean CD4+ T lymphocyte counts was 31.7 ± 38.6 cells/μl in 23 AIDS patients with cytomegalovirus retinitis. Median CD4+ T lymphocyte count is 20 cells/μl with inter-quartile range as (5, 36). Seven patients died (11 eyes) and 16 patients (24 eyes) survived. The proportion of blindness and low vision in eyes infected with cytomegalovirus retinitis respectively was 20.8% (5/24) and 29.2% (7/24) when they were diagnosed in survivors. The ganciclovir therapy was effective in 16 patients (24 eyes). Clinical recovery of cytomegalovirus retinitis was 41.7% (10/24) and clinical improvement 58.3% (14/24). After anti-CMV treatment, the proportion of blindness or low vision was 16.7% (4/24). Conclusions The AIDS

  8. An attempt at the computer-aided management of HIV infection

    NASA Astrophysics Data System (ADS)

    Ida, A.; Oharu, Y.; Sankey, O.

    2007-07-01

    The immune system is a complex and diverse system in the human body and HIV virus disrupts and destroys it through extremely complicated but surprisingly logical process. The purpose of this paper is to make an attempt to present a method for the computer-aided management of HIV infection process by means of a mathematical model describing the dynamics of the host pathogen interaction with HIV-1. Treatments for the AIDS disease must be changed to more efficient ones in accordance with the disease progression and the status of the immune system. The level of progression and the status are represented by parameters which are governed by our mathematical model. It is then exhibited that our model is numerically stable and uniquely solvable. With this knowledge, our mathematical model for HIV disease progression is formulated and physiological interpretations are provided. The results of our numerical simulations are visualized, and it is seen that our results agree with medical aspects from the point of view of antiretroviral therapy. It is then expected that our approach will take to address practical clinical issues and will be applied to the computer-aided management of antiretroviral therapies.

  9. Emerging issues with diagnosis and management of fungal infections in solid organ transplant recipients.

    PubMed

    Farmakiotis, D; Kontoyiannis, D P

    2015-05-01

    Invasive fungal infections (IFIs) are being increasingly recognized in solid organ transplant (SOT) recipients, and delayed diagnosis can lead to graft loss and death. Therefore, there is a low threshold for prophylaxis and early initiation of empiric antifungal treatment, in this patient population. Meanwhile, the increasing consumption of antifungals is associated with high cost, medication toxicities and the emergence of resistance in Candida species, all of which call for rational use of antifungal agents. The implementation of fungal biomarkers, molecular diagnostic methods and direct detection of volatile fungal metabolites in breath samples could lead to faster diagnosis, early appropriate treatment and improved clinical outcomes, but also aid in the de-escalation of antifungal treatment. Those novel diagnostic modalities need to be validated specifically in SOT recipients. Infectious diseases consultation can contribute to optimization of care through prompt initiation and appropriate modification of antifungal treatment, management of medication toxicities and drug-drug interactions, as well as source control. In this review, we conceptually summarize recent advances in the diagnosis and management of IFI in SOT recipients, and highlight the importance of early diagnostic tools and good stewardship of antifungal drugs. PMID:25655091

  10. Moving Beyond Screening: How Emergency Departments Can Help Extinguish the HIV/AIDS Epidemic

    PubMed Central

    Menchine, Michael; Zhou, Michael; Lotfipour, Shahram; Chakravarthy, Bharath

    2016-01-01

    While great strides have been made in diagnostic and treatment strategies, human immunodeficiency virus (HIV) remains a major public health epidemic. The Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report article, “Vital Signs: HIV Diagnosis, Care, and Treatment Among Persons Living with HIV – United States, 2011,” highlights current areas of concern regarding HIV diagnosis and care. The CDC estimates that 1.2 million people in the U.S. are living with HIV. Of them, 86% have received a diagnosis (14% remain undiagnosed and unaware), but only 40% are engaged in care and a mere 30% are virally suppressed. Emergency departments (EDs) can play a major role in combatting the HIV epidemic through regular screening and facilitating linkage to chronic HIV care. Universal opt-out screening as recommended by the CDC in 2006 has been shown to be effective but expensive, and has not been widely implemented in EDs nationwide. Cost-effective models and a renewed commitment from ED providers are needed to enhance ED-based HIV containment strategies. PMID:26973737

  11. [Automatic data processing for organisational aid to blood donor centers in emergency hospitals].

    PubMed

    Kretschmer, V; Haase, H; Pönighaus, K H

    1977-06-01

    A test model of a computer-off-line system at the Community Hospital Blood Bank in Herford collecting approximately 3.000 units of blood annually is described. The computer system presented, now in operation for more than one year, has proven its value for general blood bank administration by its time-saving effect and the optimalized documentation of donor- and blood-related data. The computer system described is particularly recommended for smaller, hospital-based blood transfusion services. Its introduction is even justified in institutions preparing less than 5.000 units of blood per year. Prerequisite for an economical operation of the computer system is the participation of the hospital management in other computer activities, i.e. book-keeping, accounting etc. PMID:880375

  12. Experimental evaluation of an interactive information processing aid for an emergency poison center.

    PubMed

    Robertson, C K

    1981-07-01

    In the recent literature, many studies have addressed the evaluation of the user interface in interactive systems. However, there are few theoretically based methodologies for this purpose. This study is an attempt to develop a methodology for examining the complex division of information processing labor between user and computer. A special concern was the computer-naive user searching for information using a self-teaching system. Our test bed was an emergency poison information center whose functioning depended on fast, accurate processing of patient and antidote data by a nurse. We augmented the nurses' traditional information support--a manual card file and reference books--with an interactive software system which summarized and suggested inferences from data on past successful treatment of patients. Analysis of recordings of user comments and user-system interactions showed that: (1) the support system should be more robust and have more "reasoning" power; and (2) the users' expressed information needs changed after the new support was introduced. From the results, we abstracted elements of an effective naive user-support system division of labor: (1) the support system should "actively" help the user's error recovery; (2) the system should have a sufficient knowledge base to allow "intelligent" conversation about the problem domain; and (3) the support system should allow the user to reconceptualize his information problem as his environment changes. Our method of recording user-system interactions and verbal protocols was time consuming, but did yield significant insight into the user-system division of labor. Also, considering the poison center as a living system, analysis of processing by the nurse and the traditional, the new, or an envisioned information support system showed that a highly dispersed associator and effective internal transducer promoted the functioning of the entire group. PMID:7247908

  13. Emergency School Aid Hearings Before a Subcommittee of the Committee on Appropriations, United States Senate, Ninety-Fourth Congress. Second Session. Special Hearing.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Appropriations.

    The purpose of these hearings was to hear testimony on an amendment to the Emergency School Aid Act proposed by Senator Jackson. This amendment would provide 50 million dollars in discretionary funds to the Commissioner of Education. These funds could be used in areas having special problems with school integration. Testimony was given on the…

  14. Technology-Aided Leisure and Communication Opportunities for Two Post-Coma Persons Emerged from a Minimally Conscious State and Affected by Multiple Disabilities

    ERIC Educational Resources Information Center

    Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa; Oliva, Doretta

    2013-01-01

    This study assessed technology-aided programs for helping two post-coma persons, who had emerged from a minimally conscious state and were affected by multiple disabilities, to (a) engage with leisure stimuli and request caregiver's procedures, (b) send out and listen to text messages for communication with distant partners, and (c) combine…

  15. An Assessment of Emergency School Aid Act (ESAA) Program Operations. Volume I: The Targeting of ESAA Grants and Grant Funds, and Volume II: The Focus of ESAA Projects.

    ERIC Educational Resources Information Center

    Smith, Stephen M.

    As part of a larger study, volume I of this report describes the results of analyses of the extent to which Emergency School Aid Act (ESAA) program grants and grant funds have been focused on school districts with desegregation-related needs. Also described is the extent to which the Act, regulations, and program processes influence the focusing…

  16. Automatic search of geospatial features for disaster and emergency management

    NASA Astrophysics Data System (ADS)

    Zhang, Chuanrong; Zhao, Tian; Li, Weidong

    2010-12-01

    Although the fast development of OGC (Open Geospatial Consortium) WFS (Web Feature Service) technologies has undoubtedly improved the sharing and synchronization of feature-level geospatial information across diverse resources, literature shows that there are still apparent limitations in the current implementation of OGC WFSs. Currently, the implementation of OGC WFSs only emphasizes syntactic data interoperability via standard interfaces and cannot resolve semantic heterogeneity problems in geospatial data sharing. To help emergency responders and disaster managers find new ways of efficiently searching for needed geospatial information at the feature level, this paper aims to propose a framework for automatic search of geospatial features using Geospatial Semantic Web technologies and natural language interfaces. We focus on two major tasks: (1) intelligent geospatial feature retrieval using Geospatial Semantic Web technologies; (2) a natural language interface to a geospatial knowledge base and web feature services over the Semantic Web. Based on the proposed framework we implemented a prototype. Results show that it is practical to directly discover desirable geospatial features from multiple semantically heterogeneous sources using Geospatial Semantic Web technologies and natural language interfaces.

  17. A randomized controlled trial testing the efficacy of an HIV/AIDS symptom management manual.

    PubMed

    Wantland, Dean J; Holzemer, William L; Moezzi, Shahnaz; Willard, Suzanne S; Arudo, John; Kirksey, Kenn M; Portillo, Carmen J; Corless, Inge B; Rosa, María E; Robinson, Linda L; Nicholas, Patrice K; Hamilton, Mary Jane; Sefcik, Elizabeth F; Human, Sarie; Rivero, Marta M; Maryland, Mary; Huang, Emily

    2008-09-01

    This study investigates whether using an HIV/AIDS symptom management manual with self-care strategies for 21 common symptoms, compared to a basic nutrition manual, had an effect on reducing symptom frequency and intensity. A 775-person, repeated measures, randomized controlled trial was conducted over three months in 12 sites from the United States, Puerto Rico, and Africa to assess the relationship between symptom intensity with predictors for differences in initial symptom status and change over time. A mixed model growth analysis showed a significantly greater decline in symptom frequency and intensity for the group using the symptom management manual (intervention) compared to those using the nutrition manual (control) (t=2.36, P=0.018). The models identified three significant predictors for increased initial symptom intensities and in intensity change over time: (1) protease inhibitor-based therapy (increased mean intensity by 28%); (2) having comorbid illness (nearly twice the mean intensity); and (3) being Hispanic receiving care in the United States (increased the mean intensity by 2.5 times). In addition, the symptom manual showed a significantly higher helpfulness rating and was used more often compared to the nutrition manual. The reduction in symptom intensity scores provides evidence of the need for palliation of symptoms in individuals with HIV/AIDS, as well as symptoms and treatment side effects associated with other illnesses. The information from this study may help health care providers become more aware of self-management strategies that are useful to persons with HIV/AIDS and help them to assist patients in making informed choices. PMID:18400461

  18. Effectiveness and Comparison of Various Audio Distraction Aids in Management of Anxious Dental Paediatric Patients

    PubMed Central

    Johri, Nikita; Khan, Suleman Abbas; Singh, Rahul Kumar; Chadha, Dheera; Navit, Pragati; Sharma, Anshul; Bahuguna, Rachana

    2015-01-01

    Background Dental anxiety is a widespread phenomenon and a concern for paediatric dentistry. The inability of children to deal with threatening dental stimuli often manifests as behaviour management problems. Nowadays, the use of non-aversive behaviour management techniques is more advocated, which are more acceptable to parents, patients and practitioners. Therefore, this present study was conducted to find out which audio aid was the most effective in the managing anxious children. Aims and Objectives The aim of the present study was to compare the efficacy of audio-distraction aids in reducing the anxiety of paediatric patients while undergoing various stressful and invasive dental procedures. The objectives were to ascertain whether audio distraction is an effective means of anxiety management and which type of audio aid is the most effective. Materials and Methods A total number of 150 children, aged between 6 to 12 years, randomly selected amongst the patients who came for their first dental check-up, were placed in five groups of 30 each. These groups were the control group, the instrumental music group, the musical nursery rhymes group, the movie songs group and the audio stories group. The control group was treated under normal set-up & audio group listened to various audio presentations during treatment. Each child had four visits. In each visit, after the procedures was completed, the anxiety levels of the children were measured by the Venham’s Picture Test (VPT), Venham’s Clinical Rating Scale (VCRS) and pulse rate measurement with the help of pulse oximeter. Results A significant difference was seen between all the groups for the mean pulse rate, with an increase in subsequent visit. However, no significant difference was seen in the VPT & VCRS scores between all the groups. Audio aids in general reduced anxiety in comparison to the control group, and the most significant reduction in anxiety level was observed in the audio stories group

  19. Incident Management Systems and Building Emergency Management Capacity during the 2014-2016 Ebola Epidemic - Liberia, Sierra Leone, and Guinea.

    PubMed

    Brooks, Jennifer C; Pinto, Meredith; Gill, Adrienne; Hills, Katherine E; Murthy, Shivani; Podgornik, Michelle N; Hernandez, Luis F; Rose, Dale A; Angulo, Frederick J; Rzeszotarski, Peter

    2016-01-01

    Establishing a functional incident management system (IMS) is important in the management of public health emergencies. In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC established the Emergency Management Development Team (EMDT) to coordinate technical assistance for developing emergency management capacity in Guinea, Liberia, and Sierra Leone. EMDT staff, deployed staff, and partners supported each country to develop response goals and objectives, identify gaps in response capabilities, and determine strategies for coordinating response activities. To monitor key programmatic milestones and assess changes in emergency management and response capacities over time, EMDT implemented three data collection methods in country: coordination calls, weekly written situation reports, and an emergency management dashboard tool. On the basis of the information collected, EMDT observed improvements in emergency management capacity over time in all three countries. The collaborations in each country yielded IMS structures that streamlined response and laid the foundation for long-term emergency management programs.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html). PMID:27389463

  20. Crash Injury Management for Traffic Law Enforcement Officers; Emergency Medical Services; Course Guide.

    ERIC Educational Resources Information Center

    Cleven, Arlene M.

    The course guide has been prepared to aid in planning and conducting a training program in emergency medical care for first responders to traffic accidents (expected to be patrolling law enforcement officers). This document contains a detailed description of the training program; suggestions for course planning including class size, scheduling…

  1. Effective Behavior Management in Preschool Classrooms and Children's Task Orientation: Enhancing Emergent Literacy and Language Development

    ERIC Educational Resources Information Center

    Dobbs-Oates, Jennifer; Kaderavek, Joan N.; Guo, Ying; Justice, Laura M.

    2011-01-01

    This study investigated the relations among preschool teachers' behavior management, children's task orientation, and children's emergent literacy and language development, as well as the extent to which task orientation moderated the relation between teachers' behavior management and children's emergent literacy and language development.…

  2. Emergency Management Standards for NCAA Division I-A Football Stadia

    ERIC Educational Resources Information Center

    Hoogstra, Joshua R.

    2012-01-01

    In the best of times, emergency managers of athletic event venues struggle with the responsibilities of venue security. The possibility of terrorist threats exacerbates the situation, especially when security threats can involve a critical mass of spectators at an event. Emergency managers at the National Collegiate Athletic Association (NCAA)…

  3. Like a Hurricane: A Citation Analysis of Emergency Management Scholarly Literature

    ERIC Educational Resources Information Center

    Noe, Jennifer; Furay, Julia

    2013-01-01

    This bibliometric study used citation analysis to uncover citing characteristics in the burgeoning academic field of emergency management. Of the 281 degree programs listed by the Federal Emergency Management Agency nationwide, those at community colleges accounted for 17% of the total. Using the interdisciplinary database of Academic Search…

  4. Hepatocellular carcinoma: natural history, current management, and emerging tools

    PubMed Central

    Tinkle, Christopher L; Haas-Kogan, Daphne

    2012-01-01

    Hepatocellular carcinoma (HCC) is the most common primary liver tumor and represents the third-leading cause of cancer-related death in the world. The incidence of HCC continues to increase worldwide, with a unique geographic, age, and sex distribution. The most important risk factor associated with HCC is liver cirrhosis, with the majority of cases caused by chronic infection with hepatitis B (HBV) and C (HCV) viruses and alcohol abuse, although nonalcoholic fatty liver disease is emerging as an increasingly important cause. Primary prevention in the form of HBV vaccination has led to a significant decrease in HBV-related HCC, and initiation of antiviral therapy appears to reduce the incidence of HCC in patients with chronic HBV or HCV infection. Additionally, the use of ultrasonography enables the early detection of small liver tumors and forms the backbone of recommended surveillance programs for patients at high risk for the development of HCC. Cross-sectional imaging studies, including computed tomography and magnetic resonance imaging, represent further noninvasive techniques that are increasingly employed to diagnose HCC in patients with cirrhosis. The mainstay of potentially curative therapy includes surgery – either resection or liver transplantation. However, most patients are ineligible for surgery, because of either advanced disease or underlying liver dysfunction, and are managed with locoregional and/or systemic therapies. Randomized controlled trials have demonstrated a survival benefit with both local therapies, either ablation or embolization, and systemic therapy in the form of the multikinase inhibitor sorafenib. Despite this, median survival remains poor and recurrence rates significant. Further advances in our understanding of the molecular pathogenesis of HCC hold promise in improving the diagnosis and treatment of this highly lethal cancer. PMID:22904613

  5. Teaching wilderness first aid in a remote First Nations community: the story of the Sachigo Lake Wilderness Emergency Response Education Initiative

    PubMed Central

    Born, Karen; Orkin, Aaron; VanderBurgh, David; Beardy, Jackson

    2012-01-01

    Objective To understand how community members of a remote First Nations community respond to an emergency first aid education programme. Study design A qualitative study involving focus groups and participant observation as part of a community-based participatory research project, which involved the development and implementation of a wilderness first aid course in collaboration with the community. Methods Twenty community members participated in the course and agreed to be part of the research focus groups. Three community research partners validated and reviewed the data collected from this process. These data were coded and analysed using open coding. Results Community members responded to the course in ways related to their past experiences with injury and first aid, both as individuals and as members of the community. Feelings of confidence and self-efficacy related access to care and treatment of injury surfaced during the course. Findings also highlighted how the context of the remote First Nations community influenced the delivery and development of course materials. Conclusions Developing and delivering a first aid course in a remote community requires sensitivity towards the response of participants to the course, as well as the context in which it is being delivered. Employing collaborative approaches to teaching first aid can aim to address these unique needs. Though delivery of a first response training programme in a small remote community will probably not impact the morbidity and mortality associated with injury, it has the potential to impact community self-efficacy and confidence when responding to an emergency situation. PMID:23110258

  6. Emergency management communication on university Web sites: A 7-year study.

    PubMed

    Brown, Kelly L; Holguin, Gina; Scott, Tara Halbrook

    2016-01-01

    In the last several years, disasters-both manmade and natural-have taken their toll on college campuses. Extant research shows that college campuses have greatly increased their emergency management efforts. One area in which colleges and universities have made strides is emergency management communication. There has been some research examining emergency management communication across campuses, but there is still much to learn. This research fills a gap in this area by investigating the use of university Web sites to disseminate emergency management information to the university stakeholders. Data were gathered in 2007 and 2014 from the Web sites of public, 4-year universities in Indiana. The results show that universities are using the Internet to communicate emergency management information to their stakeholders. Among the most common categories of information available on the Web sites are links to other agencies, university response information, and threat levels. Implications for future research are discussed. PMID:27575641

  7. Facility management of computer-aided design, drafting/manufacturing systems (CADD/M)

    SciTech Connect

    Norton, F.J.

    1980-09-23

    Interactive Computer-Aided Design Drafting/Manufacturing systems have been installed in thousands of companies, applying CADD/M capabilities to many applications. This has been done with varying degrees of success even among companies with identical applications. Investigation of individual companies reveals a gap between the capabilities of CADD/M systems and the actual usage by industry of those capabilities. This company usage often determines the degree of success or failure of an interactive graphics facility and is largely controlled by management. The responsibilities of the interactive graphics facility managemant team are explained in detail. Proper management of a CADD/M facility is more critical to the success or failure of the facility than any other factor.

  8. Effect of Structured Teaching Programme on Knowledge of School Teachers regarding First Aid Management in Selected Schools of Bangalore.

    PubMed

    De, Piyali

    2014-01-01

    Safe childhood is the foundation of a good future. Children face different kinds of accidents at school premises while playing. Prevention of these accidents and their management is essential. A study was therefore conducted among school teachers at Anekal Taluk, Bangalore to make them aware about different accidents of children at school premises and their first aid management. The sample consisted of 30 primary and higher primary school teachers selected by convenience sampling technique. The analysis showed that improvement of knowledge occurred after administering structured teaching programme (STP) on first aid management. Nursing professionals can benefit from the study result at the area of community, administration, research and education. PMID:26182823

  9. A randomized controlled trial of an HIV/AIDS Symptom Management Manual for depressive symptoms.

    PubMed

    Eller, Lucille S; Kirksey, Kenn M; Nicholas, Patrice K; Corless, Inge B; Holzemer, William L; Wantland, Dean J; Willard, Suzanne S; Robinson, Linda; Hamilton, Mary Jane; Sefcik, Elizabeth F; Moezzi, Shahnaz; Mendez, Marta Rivero; Rosa, Maria; Human, Sarie

    2013-01-01

    Abstract Depressive symptoms are highly prevalent, underdiagnosed, and undertreated in people living with HIV/AIDS (PLWH), and are associated with poorer health outcomes. This randomized controlled trial examined the effects of the HIV/AIDS Symptom Management Manual self-care symptom management strategies compared with a nutrition manual on depressive symptoms in an international sample of PLWH. The sample consisted of a sub-group (N=222) of participants in a larger study symptom management study who reported depressive symptoms. Depressive symptoms of the intervention (n=124) and control (n=98) groups were compared over three months: baseline, one-month, and two-months. Use and effectiveness of specific strategies were examined. Depressive symptom frequency at baseline varied significantly by country (χ (2) 12.9; p=0.04). Within the intervention group there were significant differences across time in depressive symptom frequency [F(2, 207) = 3.27, p=0.05], intensity [F(2, 91) = 4.6, p=0.01], and impact [F(2, 252) = 2.92, p= 0.05), and these were significantly lower at one month but not at two months, suggesting that self-care strategies are effective in reducing depressive symptoms, however effects may be short term. Most used and most effective self-care strategies were distraction techniques and prayer. This study suggests that people living with HIV can be taught and will employ self-care strategies for management of depressive symptoms and that these strategies are effective in reducing these symptoms. Self-care strategies are noninvasive, have no side-effects, and can be readily taught as an adjunct to other forms of treatment. Studies are needed to identify the most effective self-care strategies and quantify optimum dose and frequency of use as a basis for evidence-based practice. PMID:22880943

  10. Towards a better management of complex emergencies through crisis management meta-modelling.

    PubMed

    Lauras, Matthieu; Truptil, Sébastien; Bénaben, Frédérick

    2015-10-01

    Managing complex emergency situations is a challenging task, mainly due to the heterogeneity of the partners involved and the critical nature of such events. Whatever approach is adopted to support this objective, one unavoidable issue is knowledge management. In the context of our research project, gathering, formalising and exploiting all the knowledge and information about a given crisis situation is a critical requirement. This paper presents some research results concerning this specific topic: from a theoretical point of view, the generic dimensions of crisis characterisation are defined, while from a technical point of view, we describe a software solution able to collect that knowledge (based on meta-models and ontologies). This is used to confront the characteristics of the situation (context) with characteristics of the resources (relief system) in order to design a suitable response. Finally, an illustrative example concerning a crash between a tanker truck and a train is described. PMID:25754216

  11. Emergency management in health: key issues and challenges in the UK

    PubMed Central

    2012-01-01

    Background Emergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. However, deficiencies in NHS emergency planning were identified and the evidence-base that underpins it is questionable. Inconsistencies in terminologies and concepts also exist. Different models of emergency management exist internationally but the optimal system is unknown. This study examines the evidence-base and evidence requirements for emergency planning in the UK health context. Methods The study involved semi-structured interviews with key stakeholders and opinion leaders. Purposive sampling was used to obtain a breadth of views from various agencies involved in emergency planning and response. Interviews were then analysed using a grounded approach using standard framework analysis techniques. Results We conducted 17 key informant interviews. Interviewees identified greater gaps in operational than technical aspects of emergency planning. Social and behavioural knowledge gaps were highlighted with regards to how individuals and organisations deal with risk and behave in emergencies. Evidence-based approaches to public engagement and for developing community resilience to disasters are lacking. Other gaps included how knowledge was developed and used. Conflicting views with regards to the optimal configuration and operation of the emergency management system were voiced. Conclusions Four thematic categories for future research emerged: (i) Knowledge-base for emergency management: Further exploration is needed of how knowledge is acquired, valued, disseminated, adopted and retained. (ii) Social and behavioural issues: Greater understanding of how individuals approach risk and behave in emergencies is required. (iii) Organisational issues in emergencies: Several conflicting organisational issues were identified; value of planning versus plans, flexible versus standardized procedures, top-down versus bottom-up engagement, generic versus

  12. Collection and Dissemination of Volcanic Hazard Information for Emergency Managers

    NASA Astrophysics Data System (ADS)

    Mouginis-Mark, P. J.; Horton, K. A.; Garbeil, H.

    2010-12-01

    At the companion AGU special session in 2000, we predicted a significant future increase in the use of volcanic hazard information by emergency managers, such as the Pacific Disaster Center (PDC). Improvements in digital elevation models for volcanoes, the understanding of plume eruption dynamics, lava flow emplacement, and dome growth would all contribute to more accurate estimations of the likely damage and area affected. Automated "event detection algorithms" based on remote monitoring sensors, and on more frequent high resolution satellite coverage, were expected to provide quantitative data that would be distributed to the disaster management community via user-interactive web pages tailored to their geographic region of interest and the on-going style of volcanism. This year's activity at Iceland's Eyjafjallajokull volcano highlighted the need for a wide diversity of remote sensing capabilities around the world. It became clear that airline officials and trans-Atlantic flyers required detailed regional information that was often unavailable from the suite of orbital sensors. Contrast this with the wealth of orbital data, from more than a dozen different spacecraft, that was collected daily over the Gulf Oil Spill in mid-2010, and used for near real-time deployment of ships and coastal crews dealing with the event. So what has limited the use of remote sensing data for volcano hazard assessment? There have been some remote sensing successes. The on-going eruption of Halema'uma'u has prompted the development of an array of FLYSPEC SO2 measurement instruments that will be deployed downwind of the vent in order to provide better monitoring and prediction of hazardous conditions for the USGS Hawaiian Volcano Observatory and the Hawaii Volcanoes National Park. This array will provide high resolution, real-time measurement of SO2 flux from the vent during the daylight hours. However, this is a ground-based capability, rather than orbital. One of the inhibitors to

  13. DeMAID: A Design Manager's Aide for Intelligent Decomposition user's guide

    NASA Technical Reports Server (NTRS)

    Rogers, James L.

    1989-01-01

    A design problem is viewed as a complex system divisible into modules. Before the design of a complex system can begin, the couplings among modules and the presence of iterative loops is determined. This is important because the design manager must know how to group the modules into subsystems and how to assign subsystems to design teams so that changes in one subsystem will have predictable effects on other subsystems. Determining these subsystems is not an easy, straightforward process and often important couplings are overlooked. Moreover, the planning task must be repeated as new information become available or as the design specifications change. The purpose of this research is to develop a knowledge-based tool called the Design Manager's Aide for Intelligent Decomposition (DeMAID) to act as an intelligent advisor for the design manager. DeMaid identifies the subsystems of a complex design problem, orders them into a well-structured format, and marks the couplings among the subsystems to facilitate the use of multilevel tools. DeMAID also provides the design manager with the capability of examining the trade-offs between sequential and parallel processing. This type of approach could lead to a substantial savings or organizing and displaying a complex problem as a sequence of subsystems easily divisible among design teams. This report serves as a User's Guide for the program.

  14. Policy initiatives for electric-utility load management in AID-assisted countries

    SciTech Connect

    Not Available

    1990-08-01

    The demand for electricity has been growing at a rate of over 7 percent per year, on average, for developing countries (in contrast, demand has been rising by less than 3% annually in the United States). While developing nations have traditionally relied on building new power plants to satisfy their increasing needs for electricity, the strategy has proven to be expensive, consuming over one-quarter of their development budgets and over a quarter of their foreign borrowings. Load management, whereby an electric utility modifies its customers' demand characteristics, offers developing countries an alternative for reducing the need to construct new generating capacity and for better utilizing their existing supply facilities. To mitigate the problems associated with high energy growth rates, especially in the power sector, the lack of investment capital for the electricity sector, and the growing concern for environmental hazards including global climate change, the Office of Energy promotes energy efficiency, the role of private power and other supply options to ensure sustainable development. In view of these objectives, the report examines the rationale for load management in the electricity sector and summarizes the positive U.S. experience with these techniques. Additionally, it recommends a strategy for achieving energy efficiency via load management. Lastly, it recommends to A.I.D. a method for identifying priority Agency-assisted countries as candidates for load management assistance.

  15. Emergency department evaluation and management of foot and ankle pain.

    PubMed

    Wedmore, Ian; Young, Scott; Franklin, Jill

    2015-05-01

    Foot and ankle injuries are a frequent cause for a visit to the Emergency Department. A thorough evaluation and treatment of these injuries needs to be an area of in-depth familiarity for the Emergency Medicine physician. The key to proper evaluation is first a history and physical examination that focuses on determining what, if any, imaging is required. Subsequently, a focused history, physical examination, and imaging will then determine if an injury is stable or unstable, requiring operative intervention. PMID:25892727

  16. Supporting command and control training functions in the emergency management domain using cognitive systems engineering.

    PubMed

    Ntuen, Celestine A; Balogun, Obafemi; Boyle, Edward; Turner, Amy

    The design and implementation of MERMAIDS, a computer-based training system in the domain of emergency command and control, is described. The research investigates the use of cognitive systems engineering and information management tools for modelling and representing training knowledge of emergency system operators. We propose a decision-centric human-computer interface as a new method of supporting computer-based modelling in the domain of emergency systems. Several interacting themes in information management relevant to emergency response planning are discussed. PMID:17008263

  17. Awareness in Primary School Teachers regarding Traumatic Dental Injuries in Children and Their Emergency Management: A Survey in South Jaipur

    PubMed Central

    Syed, Ather Ahmed; Chaturvedi, Shefali; Goenka, Puneet; Sharma, Swati

    2016-01-01

    ABSTRACT Introduction: Trauma to primary and permanent teeth and their supporting structures is one of the most common dental problems seen in children. The prognosis of traumatized teeth depends on timely attention with prompt and appropriate treatment, which often relies on knowledge of the teachers who may be present at the place of accidents. Thus, the aim of this study was to evaluate via a questionnaire the knowledge level of primary school teachers in South Jaipur regarding dental trauma. Design: Questionnaire survey. Materials and methods: A self-designed questionnaire was administered to 300 primary school teachers from 20 randomly selected private and semi-aided schools of South Jaipur. Results: A total of 278 teachers responded to the survey. The collected data were subjected to statistical analysis. It was found that most of the respondents had accepted poor knowledge regarding dental trauma, with a mean knowledge of 10.56 ± 2.58. Conclusion: This study highlighted inadequate knowledge regarding emergency management of traumatic dental injuries, and teachers felt the need for training in the management of dental trauma as part of their training program. How to cite this article: Nirwan M, Syed AA, Chaturvedi S, Goenka P, Sharma S. Awareness in Primary School Teachers regarding Traumatic Dental Injuries in Children and Their Emergency Management: A Survey in South Jaipur. Int J Clin Pediatr Dent 2016;9(1):62-66. PMID:27274158

  18. Management of Chronic Diseases in Sub-Saharan Africa: Cross-Fertilisation between HIV/AIDS and Diabetes Care

    PubMed Central

    van Olmen, Josefien; Schellevis, François; Van Damme, Wim; Kegels, Guy; Rasschaert, Freya

    2012-01-01

    There is growing attention for chronic diseases in sub-Saharan Africa (SSA) and for bridges between the management of HIV/AIDS and other (noncommunicable) chronic diseases. This becomes more urgent with increasing numbers of people living with both HIV/AIDS and other chronic conditions. This paper discusses the commonalities between chronic diseases by reviewing models of care, focusing on the two most dominant ones, diabetes mellitus type 2 (DM2) and HIV/AIDS. We argue that in order to cope with care for HIV patients and diabetes patients, health systems in SSA need to adopt new strategies taking into account essential elements of chronic disease care. We developed a “chronic dimension framework,” which analyses the “disease dimension,” the “health provider dimension,” the patient or “person dimension,” and the “environment dimension” of chronic diseases. Applying this framework to HIV/AIDS and DM2 shows that it is useful to think about management of both in tandem, comparing care delivery platforms and self-management strategies. A literature review on care delivery models for diabetes and HIV/AIDS in SSA revealed potential elements for cross-fertilisation: rapid scale-up approaches through the public health approach by simplification and decentralisation; community involvement, peer support, and self-management strategies; and strengthening health services. PMID:23209477

  19. Human-resources strategies for managing HIV/AIDS: the case of the South African forestry industry.

    PubMed

    Gow, Jeff; Grant, Bligh

    2010-09-01

    Previous work has focused on HIV prevalence among forestry workers and the impact of HIV/AIDS on the sustainability of forest resources. Following a review of work examining the impacts of HIV/AIDS on the South African economy, this article presents original qualitative research examining the responses of company management to the HIV epidemic across a range of enterprises in the South African forestry industry, including large companies, contractors and cooperatives. At the level of the enterprise, management occupies a critical nexus, at which the intersecting requirements of complex government legislation, the wellbeing of workers and the demands of the business must be met. The research demonstrates that large forestry companies tend to provide only a small fraction of their workforces with HIV/AIDS education, prevention or treatment services, as they have essentially outsourced the requirement through the use of labour-supply contractors who, by and large, provide workers with scant HIV/AIDS-related programmes or benefits. Moreover, the extent to which the different types of forestry enterprises incorporate the management of HIV/AIDS in the workforce with the management of the business is highly variable, and in most instances falls short of legislative requirements that have been in place for over a decade. The implications of this for the forestry industry in South Africa are acute. PMID:25860632

  20. Enhancing the Relevance of Incident Management Systems in Public Health Emergency Preparedness: A Novel Conceptual Framework.

    PubMed

    Bochenek, Richard; Grant, Moira; Schwartz, Brian

    2015-08-01

    We outline a conceptual framework developed to meet the needs of public health professionals in the province of Ontario for incident management system-related education and training. By using visual models, this framework applies a public health lens to emergency management, introducing concepts relevant to public health and thereby shifting the focus of emergency preparedness from a strict "doctrine" to a more dynamic and flexible approach grounded in the traditional principles of incident management systems. These models provide a foundation for further exploration of the theoretical foundations for public health emergency preparedness in practice. PMID:25991506

  1. Getting into the brain: Potential of nanotechnology in the management of NeuroAIDS.

    PubMed

    Nair, Madhavan; Jayant, Rahul Dev; Kaushik, Ajeet; Sagar, Vidya

    2016-08-01

    In spite of significant advances in antiretroviral (ARV) therapy, the elimination of human immunodeficiency virus (HIV) reservoirs from the periphery and the central nervous system (CNS) remains a formidable task. The incapability of ARV to go across the blood-brain barrier (BBB) after systemic administration makes the brain one of the dominant HIV reservoirs. Thus, screening, monitoring, and elimination of HIV reservoirs from the brain remain a clinically daunting and key task. The practice and investigation of nanomedicine possesses potentials for therapeutics against neuroAIDS. This review highlights the advancements in nanoscience and nanotechnology to design and develop specific size therapeutic cargo for efficient navigation across BBB so as to recognize and eradicate HIV brain reservoirs. Different navigation and drug release strategies, their biocompatibility and efficacy with related challenges and future prospects are also discussed. This review would be an excellent platform to understand nano-enable multidisciplinary research to formulate efficient nanomedicine for the management of neuroAIDS. PMID:26944096

  2. Managing external resources in Mozambique: building new aid relationships on shifting sands?

    PubMed

    Pavignani, E; Durão, J R

    1999-09-01

    The Mozambican health sector is recovering from war and general disruption. This massive endeavour is supported by several donor agencies, which contribute a substantial proportion of national health expenditure. The final years of the war and the transition period have seen an extreme fragmentation of the health sector. To correct it, serious efforts to coordinate the plethora of aid agencies and related external inputs have taken place. This paper reviews the actors present on the Mozambican health scene and their interactions. The existing aid management mechanisms are described and their effectiveness appraised. The factors affecting both the process and its outcomes are analyzed. Given the prevailing complexity, this research presents a number of tentative conclusions. First, the evidence suggests that coordination efforts have paid off. However, progress has required intense and sustained work. Incremental approaches, where donor demands are progressively raised as the system is strengthened, have been crucial. The initiative has come mainly from donors, with the Ministry of Health receptive and reactive. When the recipient administration has been able to take advantage of donor initiatives, success has ensued. Individual people have been crucial in shaping the process. Critical factors contributing to positive developments on both sides of the donor-recipient relationship have been frankness, risk-taking and a long-term perspective. PMID:10621241

  3. Management of hearing aid assembly by urban-dwelling hearing-impaired adults in a developed country: implications for a self-fitting hearing aid.

    PubMed

    Convery, Elizabeth; Keidser, Gitte; Hartley, Lisa; Caposecco, Andrea; Hickson, Louise; Meyer, Carly

    2011-12-01

    A self-fitting hearing aid, designed to be assembled and programmed without audiological or computer support, could bring amplification to millions of people in developing countries, who remain unaided due to the lack of a local, professional, audiological infrastructure. The ability to assemble and insert a hearing aid is fundamental to the successful use of a self-fitting device. In this study, the management of such tasks was investigated. Eighty older, urban-dwelling, hearing-impaired adults in a developed country were asked to follow a set of written, illustrated instructions to assemble two slim-fit behind-the-ear hearing aids. Participants were allowed to access assistance with the task from an accompanying partner. A range of personal and audiometric variables was measured through the use of structured questionnaires and standardized tests of health literacy, cognitive function, and manual dexterity. The results showed that 99% of participants were able to complete the hearing aid assembly task, either on their own or with assistance. Health literacy, or the ability to read and understand health-related text, and gender most strongly influenced participants' ability to complete the assembly task independently and accurately. Higher levels of health literacy were associated with an increased likelihood of independent and successful task completion. Male participants were more likely to complete the task on their own, while female participants were more likely to assemble the device without errors. The results of this study will inform future work regarding development of educational material for the self-fitting hearing aid as well as candidacy for such a device. PMID:22200734

  4. Modeling and managing urban water demand through smart meters: Benefits and challenges from current research and emerging trends

    NASA Astrophysics Data System (ADS)

    Cominola, A.; Giuliani, M.; Castelletti, A.; Piga, D.; Rizzoli, A. E.

    2015-12-01

    Urban population growth, climate and land use change are expected to boost residential water demand in urban contexts in the next decades. In such a context, developing suitable demand-side management strategies is essential to meet future water demands, pursue water savings, and reduce the costs for water utilities. Yet, the effectiveness of water demand management strategies (WDMS) relies on our understanding of water consumers' behavior, their consumption habits, and the water use drivers. While low spatial and temporal resolution water consumption data, as traditionally gathered for billing purposes, hardly support this understanding, the advent of high-resolution, smart metering technologies allowed for quasi real-time monitoring water consumption at the single household level. This, in turn, is advancing our ability in characterizing consumers' behavior, modeling, and designing user-oriented residential water demand management strategies. Several water smart metering programs have been rolled-out in the last two decades worldwide, addressing one or more of the following water demand management phases: (i) data gathering, (ii) water end-uses characterization, (iii) user modeling, (iv) design and implementation of personalized WDMS. Moreover, the number of research studies in this domain is quickly increasing and big economic investments are currently being devoted worldwide to smart metering programs. With this work, we contribute the first comprehensive review of more than 100 experiences in the field of residential water demand modeling and management, and we propose a general framework for their classification. We revise consolidated practices, identify emerging trends and highlight the challenges and opportunities for future developments given by the use of smart meters advancing residential water demand management. Our analysis of the status quo of smart urban water demand management research and market constitutes a structured collection of information

  5. Network-aware scalable video monitoring system for emergency situations with operator-managed fidelity control

    NASA Astrophysics Data System (ADS)

    Al Hadhrami, Tawfik; Nightingale, James M.; Wang, Qi; Grecos, Christos

    2014-05-01

    In emergency situations, the ability to remotely monitor unfolding events using high-quality video feeds will significantly improve the incident commander's understanding of the situation and thereby aids effective decision making. This paper presents a novel, adaptive video monitoring system for emergency situations where the normal communications network infrastructure has been severely impaired or is no longer operational. The proposed scheme, operating over a rapidly deployable wireless mesh network, supports real-time video feeds between first responders, forward operating bases and primary command and control centers. Video feeds captured on portable devices carried by first responders and by static visual sensors are encoded in H.264/SVC, the scalable extension to H.264/AVC, allowing efficient, standard-based temporal, spatial, and quality scalability of the video. A three-tier video delivery system is proposed, which balances the need to avoid overuse of mesh nodes with the operational requirements of the emergency management team. In the first tier, the video feeds are delivered at a low spatial and temporal resolution employing only the base layer of the H.264/SVC video stream. Routing in this mode is designed to employ all nodes across the entire mesh network. In the second tier, whenever operational considerations require that commanders or operators focus on a particular video feed, a `fidelity control' mechanism at the monitoring station sends control messages to the routing and scheduling agents in the mesh network, which increase the quality of the received picture using SNR scalability while conserving bandwidth by maintaining a low frame rate. In this mode, routing decisions are based on reliable packet delivery with the most reliable routes being used to deliver the base and lower enhancement layers; as fidelity is increased and more scalable layers are transmitted they will be assigned to routes in descending order of reliability. The third tier

  6. Oxygenation via a Biventricular Assist Device for Emergency Airway Management.

    PubMed

    Howitt, Samuel Henry; Stirling, Sarah; Krysiak, Piotr; Pate, Bryce; Maybauer, Marc Oliver

    2016-05-01

    A 56-year-old man receiving mechanical circulatory support via a biventricular assist device suffered an airway emergency secondary to bleeding into the airway. An improvised solution to gain control of the airway in the short term was devised, and an oxygenator was inserted into the circuit, providing an alternative means of gas exchange while definitive control of the airway was achieved. This case changed practice in our institution, where we now make contingency plans for emergency oxygenator insertion into the circuits of all patients with a biventricular assist device who show any sign of airway hemorrhage. PMID:27136082

  7. Creating a strategic plan for configuration management using computer aided software engineering (CASE) tools

    SciTech Connect

    Smith, P.R.; Sarfaty, R.

    1993-05-01

    This paper provides guidance in the definition, documentation, measurement, enhancement of processes, and validation of a strategic plan for configuration management (CM). The approach and methodology used in establishing a strategic plan is the same for any enterprise, including the Department of Energy (DOE), commercial nuclear plants, the Department of Defense (DOD), or large industrial complexes. The principles and techniques presented are used world wide by some of the largest corporations. The authors used industry knowledge and the areas of their current employment to illustrate and provide examples. Developing a strategic configuration and information management plan for DOE Idaho Field Office (DOE-ID) facilities is discussed in this paper. A good knowledge of CM principles is the key to successful strategic planning. This paper will describe and define CM elements, and discuss how CM integrates the facility`s physical configuration, design basis, and documentation. The strategic plan does not need the support of a computer aided software engineering (CASE) tool. However, the use of the CASE tool provides a methodology for consistency in approach, graphics, and database capability combined to form an encyclopedia and a method of presentation that is easily understood and aids the process of reengineering. CASE tools have much more capability than those stated above. Some examples are supporting a joint application development group (JAD) to prepare a software functional specification document and, if necessary, provide the capability to automatically generate software application code. This paper briefly discusses characteristics and capabilities of two CASE tools that use different methodologies to generate similar deliverables.

  8. Management Education in Emerging Economies: The Impossible Dream?

    ERIC Educational Resources Information Center

    Napier, N. K.; Harvey, Michael; Usui, Kengo

    2008-01-01

    Providing management education in countries where poverty is rampant seems a contradiction in terms. Yet it may help the country to develop stronger competitiveness and economic development. The article proposes a tentative framework to show how management education might be implemented in the world's poorest countries. The proposed framework…

  9. School Management and Contingency Theory: An Emerging Perspective.

    ERIC Educational Resources Information Center

    Hanson, E. Mark

    An understanding of the "situational" characteristics of the organizational forces that influence the relationships between environmental, management, and performance variables is now coming to be seen as a key to understanding the management process itself. This paper is a synthesis of the contingency theory literature drawn from the public,…

  10. Action Guide for Emergency Management at Institutions of Higher Education

    ERIC Educational Resources Information Center

    US Department of Education, 2009

    2009-01-01

    Because of recent violent crimes, natural disasters, and other emergencies or crises, colleges and universities are convening committees and task forces to reexamine or conduct a comprehensive review of policies, procedures, and systems related to campus safety and security. As with many critical areas on the agendas of administrators, campus…

  11. Assessment and Management of Bullied Children in the Emergency Department

    PubMed Central

    Waseem, Muhammad; Ryan, Mary; Foster, Carla Boutin; Peterson, Janey

    2015-01-01

    Bullying is an important public health issue in the United States. Up to 30% of children report exposure to such victimization. Not only does it hurt bully victim, but it also negatively impacts the bully, other children, parents, school staff, and health care providers. Because bullying often presents with accompanying serious emotional and behavioral symptoms, there has been an increase in psychiatric referrals to emergency departments. Emergency physicians may be the first responders in the health care system for bullying episodes. Victims of bullying may present with nonspecific symptoms and be reluctant to disclose being victimized, contributing to the underdiagnosis and underreporting of bully victimization. Emergency physicians therefore need to have heightened awareness of physical and psychosocial symptoms related to bullying. They should rapidly screen for bullying, assess for injuries and acute psychiatric issues that require immediate attention, and provide appropriate referrals such as psychiatry and social services. This review defines bullying, examines its presentations and epidemiology, and provides recommendations for the assessment and evaluation of victims of bullying in the emergency department. PMID:23462401

  12. Incident and Emergency Medical Services Management from a Regional Perspective

    PubMed Central

    Sisiopiku, Virginia P.; Cavusoglu, Ozge

    2012-01-01

    Traffic crashes and other emergencies have impacts on traffic operations in transportation networks, often resulting in non-recurring congestion. Congestion, in turn, may impede the ability of Emergency Medical Services (EMS) to provide timely response to those in need of medical attention. The work in this paper investigated the impact of incidents of varying severity and duration on transportation network performance in the Birmingham (AL, USA) area. The intensity and extent of the impact over space and time were assessed on the basis of average speeds. The analysis of incident scenarios was performed using the Visual Interactive System for Transport Algorithms (VISTA) platform. Moreover, first responders’ travel times to the scene of the incident were collected to identify best units for responding, in an effort to improve current dispatching practices. Finally, a secondary incident on the EMS to the hospital was considered to further demonstrate the superiority of Dynamic Traffic Assignment (DTA) over traditional static assignment methods in capturing dynamically changing traffic conditions. The study findings are expected to benefit local transportation planners, traffic engineers, emergency responders, and policy makers by allowing them to assess various response strategies to major incidents and emergencies and select the ones that minimize their potential impacts. PMID:22851940

  13. Cloud-Based Data Sharing Connects Emergency Managers

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Under an SBIR contract with Stennis Space Center, Baltimore-based StormCenter Communications Inc. developed an improved interoperable platform for sharing geospatial data over the Internet in real time-information that is critical for decision makers in emergency situations.

  14. The Multi-Dimensional Nature of Emergency Communications Management

    ERIC Educational Resources Information Center

    Staman, E. Michael; Katsouros, Mark; Hach, Richard

    2009-01-01

    Within an incredibly short period--perhaps less than twenty-four months--the need for emergency preparedness has risen to a higher level of urgency than at any other time in the history of academe. Large or small, public or private, higher education institutions are seriously considering the dual problems of notification and communications…

  15. Assessment and management of bullied children in the emergency department.

    PubMed

    Waseem, Muhammad; Ryan, Mary; Foster, Carla Boutin; Peterson, Janey

    2013-03-01

    Bullying is an important public health issue in the United States. Up to 30% of children report exposure to such victimization. Not only does it hurt bully victim, but it also negatively impacts the bully, other children, parents, school staff, and health care providers. Because bullying often presents with accompanying serious emotional and behavioral symptoms, there has been an increase in psychiatric referrals to emergency departments. Emergency physicians may be the first responders in the health care system for bullying episodes. Victims of bullying may present with nonspecific symptoms and be reluctant to disclose being victimized, contributing to the underdiagnosis and underreporting of bully victimization. Emergency physicians therefore need to have heightened awareness of physical and psychosocial symptoms related to bullying. They should rapidly screen for bullying, assess for injuries and acute psychiatric issues that require immediate attention, and provide appropriate referrals such as psychiatry and social services. This review defines bullying, examines its presentations and epidemiology, and provides recommendations for the assessment and evaluation of victims of bullying in the emergency department. PMID:23462401

  16. Managing Bipolar Youths in a Psychiatric Inpatient Emergency Service

    ERIC Educational Resources Information Center

    Masi, Gabriele; Mucci, Maria; Pias, Paola; Muratori, Filippo

    2011-01-01

    Among the youths referred to our Psychiatric Inpatient Emergency Service, we focused on bipolar disorder (BD), to explore predictive elements for the outcome. Fifty-one patients (30 males, 21 females, age range 8-18 years, mean age 14.2 plus or minus 3.1 years) received a diagnosis of BD, according to historical information, prolonged…

  17. Incident and emergency medical services management from a regional perspective.

    PubMed

    Sisiopiku, Virginia P; Cavusoglu, Ozge

    2012-07-01

    Traffic crashes and other emergencies have impacts on traffic operations in transportation networks, often resulting in non-recurring congestion. Congestion, in turn, may impede the ability of Emergency Medical Services (EMS) to provide timely response to those in need of medical attention. The work in this paper investigated the impact of incidents of varying severity and duration on transportation network performance in the Birmingham (AL, USA) area. The intensity and extent of the impact over space and time were assessed on the basis of average speeds. The analysis of incident scenarios was performed using the Visual Interactive System for Transport Algorithms (VISTA) platform. Moreover, first responders' travel times to the scene of the incident were collected to identify best units for responding, in an effort to improve current dispatching practices. Finally, a secondary incident on the EMS to the hospital was considered to further demonstrate the superiority of Dynamic Traffic Assignment (DTA) over traditional static assignment methods in capturing dynamically changing traffic conditions. The study findings are expected to benefit local transportation planners, traffic engineers, emergency responders, and policy makers by allowing them to assess various response strategies to major incidents and emergencies and select the ones that minimize their potential impacts. PMID:22851940

  18. Assessment of the Temperament, Motivation, and Capability of a School System District for Emergency Management/Crisis Performance

    ERIC Educational Resources Information Center

    Hoff, Larry A.

    2009-01-01

    This study was a cross-sectional study of leadership and staff of a public school system in Georgia concerning their temperament type, emergency management motivation and emergency management knowledge in relation to Emergency Management/Crisis performance (ERCM). The study consisted of an inclusive questionnaire that contains questions on four…

  19. An ethnobotanical survey of plants used to manage HIV/AIDS opportunistic infections in Katima Mulilo, Caprivi region, Namibia

    PubMed Central

    2010-01-01

    Katima Mulilo has the highest burden of HIV/AIDS in Namibia. Due to several constraints of the antiretroviral therapy programme, HIV-infected persons still use ethnomedicines to manage AIDS-related opportunistic infections. Despite the reliance on plants to manage HIV/AIDS in Katima Mulilo, there have been no empirical studies to document the specific plant species used by traditional healers to treat AIDS-related opportunistic infections. In this study, an ethnobotanical survey was conducted to record the various plant families, species, and plant parts used to manage different HIV/AIDS-related opportunistic infections in Katima Mulilo, Caprivi region, Namibia. The results showed that a total of 71 plant species from 28 families, mostly the Combretaceae (14%), Anacardiaceae (8%), Mimosaceae (8%), and Ebanaceae (7%), were used to treat conditions such as herpes zoster, diarrhoea, coughing, malaria, meningitis, and tuberculosis. The most plant parts used were leaves (33%), bark (32%), and roots (28%) while the least used plant parts were fruits/seeds (4%). Further research is needed to isolate the plants' active chemical compounds and understand their modes of action. PMID:20831821

  20. Serum Aspergillus Galactomannan for the Management of Disseminated Histoplasmosis in AIDS

    PubMed Central

    Rivière, Sébastien; Denis, Blandine; Bougnoux, Marie-Elisabeth; Lanternier, Fanny; Lecuit, Marc; Lortholary, Olivier

    2012-01-01

    Disseminated histoplasmosis is an emerging infection in patients with cellular immune deficiency in non-endemic countries, caused by the migration from endemic regions and the development of travels. Diagnosis can be challenging in this context because rapid diagnostic tools such as Histoplasma antigen detection or appropriate molecular tools are generally unavailable, serology is often negative in immunosuppressed patients, and isolation of the fungus from cultures often takes several weeks. Here, we report the contribution of galactomannan serum detection for the management of an HIV-infected patient with disseminated histoplasmosis. PMID:22855762

  1. Information Technology Utilization in Emergency Management at Exxon Research and Engineering Company.

    ERIC Educational Resources Information Center

    Soled, E. H.; And Others

    1987-01-01

    This description of the role of the Information Services Division of Exxon Research and Engineering Division in emergency management covers the information technology developed and used for internally generated and published information, and how this information is used to prevent emergencies and deal with them should they actually occur. (EM)

  2. Emerging technological and cultural shifts advancing drylands research and management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Sustainable provisioning of ecosystem services in dryland landscapes is complicated by extreme conditions that constrain biological responses to perturbation, vast spatial and temporal complexity, and uncertainty regarding the resilience of these ecosystems to management practices and climate change...

  3. Automated external defibrillator use for in-hospital emergency management.

    PubMed

    Huschak, G; Dünnebier, A; Kaisers, U X; Huschens, B; Bercker, S

    2016-05-01

    The in-hospital spread of automated external defibrillators (AEDs) is aimed to allow for a shock-delivery within three minutes. However, it has to be questioned if the implementation of AED alone really contributes to a 'heart-safe hospital'. We performed a cohort study of 1008 in-hospital emergency calls in a university tertiary care hospital, analysing cardiopulmonary resuscitation (CPR) cases with and without AED use. In total, 484 patients (48%) had cardiac arrest and received CPR. Response time of the emergency team was 4.3 ± 4.0 minutes. Only 8% percent of the CPR cases had a shockable rhythm. In three of 43 placements a shock was delivered by the AED. There were no differences in survival between patients with CPR only and CPR with AED use. Our data do not support the use of an AED for in-hospital CPR if a professional response team is rapidly available. PMID:27246934

  4. Anesthetic Management During Emergency Surgical Ligation for Carotid Blowout Syndrome.

    PubMed

    Klein Nulent, Casper G A; de Graaff, Henri J D; Ketelaars, Rein; Sewnaik, Aniel; Maissan, Iscander M

    2016-08-15

    A 44-year-old man presented to our emergency department with a pharyngeal hemorrhage, 6 weeks after a total laryngectomy and extensive neck dissection. Immediate surgical intervention was necessary to stop massive arterial hemorrhage from the pharynx. The head and neck surgeon successfully ligated the common carotid artery during this procedure. We describe the anesthetic strategy and the thromboelastometry (ROTEM®)-guided massive transfusion protocol. PMID:27310900

  5. Severe acute malnutrition during emergencies: burden management, and gaps.

    PubMed

    Bahwere, Paluku

    2014-06-01

    Natural and man-made disasters, including floods, droughts, earthquakes, and armed conflicts, create nutrition crises. Unfortunately, the frequency and severity of such disasters have been increasing since the beginning of the 20th century, and their contribution to the burden of acute malnutrition is increasing every year. However, their contribution to the burden of acute malnutrition is underrecognized due to the ways in which global statistics are built and causes of death are reported. Fortunately, the success of the current protocol for treatment of severe acute malnutrition (SAM) and the integrated approach to treatment has created a momentum allowing expanded coverage of treatment of SAM, especially in humanitarian emergency contexts. For this progress to be maintained and accelerated, changes in nutrition information systems at the national and global levels are needed, and the persisting barriers to the expansion and integration of treatment of SAM into routine health systems need to be removed. Emergency funding approaches and objectives have to include sustaining and amplifying the achievements of the short-term palliative interventions. Nutrition programs implemented in emergency contexts have the capacity to contribute to answering priority research questions, and this capacity should be more optimally utilized. PMID:25069293

  6. Medically important venomous animals: biology, prevention, first aid, and clinical management.

    PubMed

    Junghanss, Thomas; Bodio, Mauro

    2006-11-15

    Venomous animals are a significant health problem for rural populations in many parts of the world. Given the current level of the international mobility of individuals and the inquisitiveness of travelers, clinicians and travel clinics need to be able to give advice on the prevention, first aid, and clinical management of envenoming. Health professionals often feel overwhelmed by the taxonomy of venomous animals; however, venomous animals can be grouped, using a simple set of criteria, into cnidarians, venomous fish, sea snakes, scorpions, spiders, hymenoterans, and venomous terrestrial snakes. Geographic distribution, habitats, and circumstances of accidents further reduce the range of culprits that need to be considered in any single event. Clinical management of envenomed patients relies on supportive therapy and, if available, specific antivenoms. Supplies of life-saving antivenoms are scarce, and this scarcity particularly affects rural populations in resource-poor settings. Travel clinics and hospitals in highly industrialized areas predominantly see patients with injuries caused by accidents involving marine animals: in particular, stings by venomous fish and skin damage caused by jellyfish. However, globally, terrestrial venomous snakes are the most important group of venomous animals. PMID:17051499

  7. Cognitive Aids for Role Definition (CARD) to improve interprofessional team crisis resource management: An exploratory study.

    PubMed

    Renna, Tania Di; Crooks, Simone; Pigford, Ashlee-Ann; Clarkin, Chantalle; Fraser, Amy B; Bunting, Alexandra C; Bould, M Dylan; Boet, Sylvain

    2016-09-01

    This study aimed to assess the perceived value of the Cognitive Aids for Role Definition (CARD) protocol for simulated intraoperative cardiac arrests. Sixteen interprofessional operating room teams completed three consecutive simulated intraoperative cardiac arrest scenarios: current standard, no CARD; CARD, no CARD teaching; and CARD, didactic teaching. Each team participated in a focus group interview immediately following the third scenario; data were transcribed verbatim and qualitatively analysed. After 6 months, participants formed eight new teams randomised to two groups (CARD or no CARD) and completed a retention intraoperative cardiac arrest simulation scenario. All simulation sessions were video recorded and expert raters assessed team performance. Qualitative analysis of the 16 focus group interviews revealed 3 thematic dimensions: role definition in crisis management; logistical issues; and the "real life" applicability of CARD. Members of the interprofessional team perceived CARD very positively. Exploratory quantitative analysis found no significant differences in team performance with or without CARD (p > 0.05). In conclusion, qualitative data suggest that the CARD protocol clarifies roles and team coordination during interprofessional crisis management and has the potential to improve the team performance. The concept of a self-organising team with defined roles is promising for patient safety. PMID:27294389

  8. Knowledge, attitude and practices of students about first aid epilepsy seizures management in a Northern Indian City

    PubMed Central

    Goel, Sonu; Singh, Navpreet; Lal, Vivek; Singh, Amarjeet

    2013-01-01

    Background: Knowledge about epilepsy and its management is not satisfactory among school students in developing countries. The present study was planned to ascertain the knowledge, attitude and practices (KAP) of students regarding first-aid management of epilepsy seizures in school setting. Materials and Methods: A total of 177 students of government schools of Chandigarh, a city of northern India, were taken. They were administered with a pre-tested semi-structured questionnaire (for knowledge and attitude assessment) and an observational checklist after role play (for practice assessment) on first-aid management of epilepsy. A scoring system was devised to quantify the knowledge and practices of students. Results: Seventy-one percent of them had either heard or read about epilepsy. Half of the students believed epilepsy as a hindrance to education. Ayurvedic treatment was preferred by more than half of the students; however, many believed that visit to religious places and exorcism as ways to cure epilepsy. Nearly 74% of students would call a doctor as first-aid measure for seizure in a person with epilepsy. Conclusion: We concluded that the knowledge about various aspects of epilepsy was average among school students in Chandigarh. However, there was no significant difference in knowledge, attitude and practice between students who lived in urban, urban slum and rural areas. It is recommended that first-aid management of seizures in epilepsy should be a part of school curriculum. PMID:24339575

  9. Integrated surgical emergency training plan in the internship: A step toward improving the quality of training and emergency center management

    PubMed Central

    Akhlaghi, Mohammad Reza; Vafamehr, Vajiheh; Dadgostarnia, Mohammad; Dehghani, Alireza

    2013-01-01

    training of emergency issues, increasing the teamwork, facing a variety of patients, practicing the role of general practitioners, role-playing on a real patient's bedside, having a multilateral approach to the patient, reducing the wasting time on minor wards, balancing the work and rest schedules of the interns, and better learning and satisfaction of the interns. Over 60% of the participants believed the program has the following benefits: More attention on the training plan, improving the learning of patient management, being more responsive for the training of interns, increasing operational approach to emergency patients, being more aware of the performed actions, and increasing the quality and speed of services provided to patients. The mean score assigned to the whole questionnaire of investigating the viewpoints was 37.5 out of 50. The mean score of the interns’ questionnaire was significantly more than the mean score of the assistants. Discussion: The results obtained indicated that the greatest existing consensus about this plan was the positive impact on the learning of interns in the emergency setting. Thus, it will not only increase the number of patients who the interns are managing during the internship course, but also increases the balance of their workload and they can learn and manage the emergency patients with more leisure. PMID:24520557

  10. Heatstroke, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Heatstroke, First Aid A A A Heatstroke signs and symptoms can ... specific to the earlier stages of heat illness. First Aid Guide When heatstroke is suspected, seek emergency medical ...

  11. Adult Status Epilepticus: A Review of the Prehospital and Emergency Department Management.

    PubMed

    Billington, Michael; Kandalaft, Osama R; Aisiku, Imoigele P

    2016-01-01

    Seizures are a common presentation in the prehospital and emergency department setting and status epilepticus represents an emergency neurologic condition. The classification and various types of seizures are numerous. The objectives of this narrative literature review focuses on adult patients with a presentation of status epilepticus in the prehospital and emergency department setting. In summary, benzodiazepines remain the primary first line therapeutic agent in the management of status epilepticus, however, there are new agents that may be appropriate for the management of status epilepticus as second- and third-line pharmacological agents. PMID:27563928

  12. Effects of two educational method of lecturing and role playing on knowledge and performance of high school students in first aid at emergency scene

    PubMed Central

    Hassanzadeh, Akbar; Vasili, Arezu; Zare, Zahra

    2010-01-01

    BACKGROUND: This study aimed to investigate the effects of two educational methods on students' knowledge and performance regarding first aid at emergency scenes. METHODS: In this semi-experimental study, the sample was selected randomly among male and female public high school students of Isfahan. Each group included 60 students. At first the knowledge and performance of students in first aid at emergency scene was assessed using a researcher-made questionnaire. Then necessary education was provided to the students within 10 sessions of two hours by lecturing and role playing. The students' knowledge and performance was as-sessed again and the results were compared. RESULTS: It was no significant relationship between the frequency distribution of students' age, major and knowledge and performance before the educational course in the two groups. The score of knowledge in performing CPR, using proper way to bandage, immobilizing the injured area, and proper ways of carrying injured person after the education was significantly increased in both groups. Moreover, the performance in proper way to bandage, immobilizing injured area and proper ways of carrying injured person after educational course was significantly higher in playing role group compared to lecturing group after education. CONCLUSIONS: Iran is a developing country with a young generation and it is a country with high risk of natural disasters; so, providing necessary education with more effective methods can be effective in reducing mortality and morbidity due to lack of first aid care in crucial moments. Training with playing role is suggested for this purpose. PMID:21589743

  13. Effect of insecticide management history on emergence phenology and neonicotinoid resistance in Leptinotarsa decemlineata (Coleoptera: Chrysomelidae).

    PubMed

    Huseth, A S; Groves, R L

    2013-12-01

    Emergence phenology and fitness attributes of several Colorado potato beetle, Leptinotarsa decemlineata (Say), populations were measured under field and greenhouse conditions. Anecdotal observations by producers and pest managers in many locations of the upper Midwest increasingly suggested that select populations of Colorado potato beetle were emerging over a longer period in the spring and were less sensitive to systemic neonicotinoids in cultivated potato. These changes in emergence phenology may be related to changes in systemic insecticide concentration over time. Specifically, a prolonged period of adult emergence in the spring increases the potential of low-dose chronic exposure to systemic neonicotinoid insecticides in potato. In 2010 and 2011, our objectives were twofold: 1) establish a common garden experiment to compare the emergence phenology of Colorado potato beetle populations uniquely managed with variable insecticide inputs, and 2) measure postdormancy fitness of emerged adult beetles from among these selected populations. Cumulative adult emergence was modeled with logistic regression. Results from this study found no clear evidence for direct relationships between phenology and management history or resistance. Differences in reproductive capacity, sex ratio, and body size were apparent in some instances. However, these results did not uniformly correspond to one specific form of potato pest management tested here. In this study, long-term reliance on systemic insecticides for Colorado potato beetle control did not serve as a strong predictor for variable life history for selected populations in Wisconsin. PMID:24498751

  14. Management of orthodontic emergencies in primary care - self-reported confidence of general dental practitioners.

    PubMed

    Popat, H; Thomas, K; Farnell, D J J

    2016-07-01

    Objective To determine general dental practitioners' (GDPs) confidence in managing orthodontic emergencies.Design Cross-sectional study.Setting Primary dental care.Subjects and methods An online survey was distributed to dentists practicing in Wales. The survey collected basic demographic information and included descriptions of ten common orthodontic emergency scenarios.Main outcome measure Respondents' self-reported confidence in managing the orthodontic emergency scenarios on a 5-point Likert scale. Differences between the Likert responses and the demographic variables were investigated using chi-squared tests.Results The median number of orthodontic emergencies encountered by respondents over the previous six months was 1. Overall, the self-reported confidence of respondents was high with 7 of the 10 scenarios presented scoring a median of 4 indicating that GDPs were 'confident' in their management. Statistical analysis revealed that GDPs who saw more orthodontic emergencies in the previous six months were more confident when managing the presented scenarios. Other variables such as age, gender, geographic location of practice and number of years practising dentistry were not associated with self-reported confidence.Conclusions Despite GDPs encountering very few orthodontic emergencies in primary care, they appear to be confident in dealing with commonly arising orthodontic emergency situations. PMID:27388086

  15. The German approach to emergency/disaster management.

    PubMed

    Domres, B; Schauwecker, H H; Rohrmann, K; Roller, G; Maier, G W; Manger, A

    2000-01-01

    Disaster control and disaster relief in Germany are public tasks. But the government has shifted the responsibility of the administration of these tasks to the 16 states, the so called "Lander", because the EFG is a federal republic. The same is valid for the civil defense and the civil protection in the case of military or international risks. The 16 states are also responsible for the legislation of rescue service, fire fighting service and disaster control (natural and technical disasters). Counties and district-free cities are responsible for the organisation of these services. The German system is based on the principle of subsidiary between official and private institutions. A lot of official and private relief organisations are responsible for the execution of disaster relief tasks. In Germany the following organisations exist: Official (GO): Technisches Hilfswerk (THW/Federal Technical Support Service), Feuerwehren (Fire Brigades/professionals and volunteers) Academie of Emergency Planning and Civil Defense Private (NGO): Arbeiter-Samariter-Bund Deutschland (ASB/Workers' Samaritan Association Germany), Deutsche Gesellschaft zur Rettung Schiffbruchiger (DGzRS, German Lifesaving Association), Deutsches Rotes Kreuz (DRK/German Red Cross), Johanniter-Unfall-Hilfe (JUH/St. John's Ambulance), Malteser Hilfsdienst (MEID/Maltese-Relief-Organisation). ASB, DRK, JUH and MHD are specialised in the field of rescue, medical and welfare services and medical disaster relief. 80% of the German rescue service and 95% of the German disaster medical relief are realised by these NGO's. NGO's and GO's employ more than 1.2 million volunteers and appr. 100,000 professionals. Rescue service is carried out by professionals, disaster relief by volunteers. The German constitution allows to call the federal army in case of disaster, to support the disaster relief organisations (for example: flood Oder River 1997, train-crash "ICE" 1998). In all counties and district free cities

  16. Emerging geomorphic approaches to guide river management practices

    NASA Astrophysics Data System (ADS)

    Brierley, Gary; Hooke, Janet

    2015-12-01

    Humans have been modifying river systems across much of the world for many thousands of years. Initially, piecemeal impacts inadvertently affected particular parts of landscapes. Subsequently, many rivers have been subjected to multiple layers of human disturbance, and changes have become widespread and systematic. Increasingly, human impacts reflect deliberative actions as part of river management programmes. These activities entail significant choices in determining the desirable (or acceptable) state and behavioural regime of a river. Typically, contemporary decision-making reflects negotiations among multiple stakeholders, seeking to provide balanced approaches to the management of socio-economic, cultural, and environmental values (e.g. Jähnig et al., 2011).

  17. Using Geo-Data Corporately on the Response Phase of Emergency Management

    NASA Astrophysics Data System (ADS)

    Demir Ozbek, E.; Ates, S.; Aydinoglu, A. C.

    2015-08-01

    Response phase of emergency management is the most complex phase in the entire cycle because it requires cooperation between various actors relating to emergency sectors. A variety of geo-data is needed at the emergency response such as; existing data provided by different institutions and dynamic data collected by different sectors at the time of the disaster. Disaster event is managed according to elaborately defined activity-actor-task-geodata cycle. In this concept, every activity of emergency response is determined with Standard Operation Procedure that enables users to understand their tasks and required data in any activity. In this study, a general conceptual approach for disaster and emergency management system is developed based on the regulations to serve applications in Istanbul Governorship Provincial Disaster and Emergency Directorate. The approach is implemented to industrial facility explosion example. In preparation phase, optimum ambulance locations are determined according to general response time of the ambulance to all injury cases in addition to areas that have industrial fire risk. Management of the industrial fire case is organized according to defined actors, activities, and working cycle that describe required geo-data. A response scenario was prepared and performed for an industrial facility explosion event to exercise effective working cycle of actors. This scenario provides using geo-data corporately between different actors while required data for each task is defined to manage the industrial facility explosion event. Following developing web technologies, this scenario based approach can be effective to use geo-data on the web corporately.

  18. Decision making as community adaptation: a case study of emergency managers in Oklahoma.

    PubMed

    Donner, William R

    2008-06-01

    This paper explores how emergency managers make judgments regarding long-term policy and offers a sociological account of organisational decision making within an ecological context. Discussions with emergency managers focusing on the relative merits of rainfall estimation and tornado detection served as data with which to address these issues. Among the 39 interviewees, a consensus emerged favouring tornado detection over rainfall estimation. From these findings, the paper attempts to understand why emergency managers prefer tornado detection to rainfall estimation and to develop theoretical generalisations explaining trends in these preferences. When developing long-term policy, analysis of transcripts revealed emergency managers to be most concerned with the relative uncertainty of hazards, the capabilities of technology in hazard mitigation, and how the public perceives environmental threats. Given the environmental, technological, and social concerns reflected in this reasoning, there appears to be a strong ecological context driving the need for tornado detection among emergency managers. Implications and concerns are presented in the final section. PMID:18380856

  19. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  20. Rural-Urban Disparities in Child Abuse Management Resources in the Emergency Department

    ERIC Educational Resources Information Center

    Choo, Esther K.; Spiro, David M.; Lowe, Robert A.; Newgard, Craig D.; Hall, Michael Kennedy; McConnell, Kenneth John

    2010-01-01

    Purpose: To characterize differences in child abuse management resources between urban and rural emergency departments (EDs). Methods: We surveyed ED directors and nurse managers at hospitals in Oregon to gain information about available abuse-related resources. Chi-square analysis was used to test differences between urban and rural EDs.…

  1. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  2. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 5 2013-10-01 2013-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  3. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  4. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  5. SOME EMERGING ISSUES IN WATERSHED MANAGEMENT LANDSCAPE PATTERNS SUSTAINABILITY WITH CUMULATIVE ENVIRONMENTAL CHANGE

    EPA Science Inventory

    Emerging issues in watershed management include the need to assess the effects of management activities on the time scale of several cutting rotations (>100 yrs) and on spatial sacles that consider factors impinging from beyond watershed boundaries. ong-range analysis reveals str...

  6. 76 FR 30940 - Information Collection Being Submitted to the Office of Management and Budget for Emergency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION Information Collection Being Submitted to the Office of Management and Budget for Emergency Review... of Management and Budget, via fax at 202-395-5167 or via the Internet at...

  7. How To Manage the Emerging Generational Divide in the Contemporary Knowledge-Rich Workplace.

    ERIC Educational Resources Information Center

    Novicevic, Milorad M.; Buckley, M. Ronald

    2001-01-01

    Addresses the manager's dilemmas and options in resolving emerging latent intergenerational conflict in the contemporary knowledge-rich workplace. Topics include a theoretical framework for generational divide management; the polarization in task requirements; social and environmental factors; differences in employee needs and expectations; and…

  8. 76 FR 38183 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ... Under Emergency Review by the Office of Management and Budget (OMB) Title: Evaluation of Adolescent... Training 533 1 .7 373 Princeton Center for Leadership Training (PCLT)/ 533 1 .6 320 TeenPEP Total 2468 1601... Officer for ACF, Office of Management and Budget, Paperwork Reduction Project, 725 17th Street...

  9. Emergency Management of Seizures in the School Setting

    ERIC Educational Resources Information Center

    O'Dell, Christine; O'Hara, Kathryn; Kiel, Sarah; McCullough, Kathleen

    2007-01-01

    Effective seizure management in the school setting is a critical issue for students with seizures, as well as their parents, classmates, and school personnel. The unpredictable nature of seizures and the potential outcomes of experiencing a seizure in school are sources of anxiety for students with seizures. The ability to respond appropriately to…

  10. Emerging Network Storage Management Standards for Intelligent Data Storage Subsystems

    NASA Technical Reports Server (NTRS)

    Podio, Fernando; Vollrath, William; Williams, Joel; Kobler, Ben; Crouse, Don

    1998-01-01

    This paper discusses the need for intelligent storage devices and subsystems that can provide data integrity metadata, the content of the existing data integrity standard for optical disks and techniques and metadata to verify stored data on optical tapes developed by the Association for Information and Image Management (AIIM) Optical Tape Committee.

  11. From Plutocracy to Pluralism: Managing the Emerging Technostructure.

    ERIC Educational Resources Information Center

    Heterick, Robert C., Jr.; Sanders, William H.

    1993-01-01

    Advocates the formulation of an information systems strategy for higher education in light of trends affecting the information age, including globalization, networking, restructuring, pluralism, and automation. Management strategies of leadership, responsibility, organization, and funding are discussed; and implications for instruction, outreach,…

  12. The Emergence of Management Education in Central Europe.

    ERIC Educational Resources Information Center

    Waddock, Sandra

    1997-01-01

    Management education in East Central Europe exists in a context of rapid evolution, the need to establish credibility, and contradictory demand. Programs must deal with the transition to a market economy, social versus profit orientation, lack of qualified faculty, and the need for textbooks and case material. (SK)

  13. Management of acute asthma in the emergency department.

    PubMed

    Schauer, Steven G; Cuenca, Peter J; Johnson, Jeremiah J; Ramirez, Sasha

    2013-06-01

    Asthma is primarily a clinical diagnosis that is made from a combination of historical features and clinical examination findings. The mainstay of asthma treatment includes short-acting beta agonist therapy (albuterol) and steroids. Handheld inhalers are sufficient for most inhaled therapy; all patients on inhalers should be provided with a spacer. The severity of asthma exacerbations is determined by 3 features: (1) clinical presentation, (2) peak expiratory flow rates, and (3) vital signs. Additional testing, such as chest x-ray and blood gas measurements, is reserved for select patients. Spirometry aids in the diagnosis of asthma and measurement of severity, but it is not always required, nor should it be solely relied upon to make disposition decisions. Inhaled ipratropium decreases hospitalization rates, and it should be routinely used. Levalbuterol provides little to no advantage over less-expensive racemic albuterol. Noninvasive positive pressure ventilation may be utilized in patients with moderate to severe exacerbations. Ketamine may be considered in severe exacerbations, but it should not be used routinely. Magnesium sulfate may be beneficial in severe asthma exacerbations, but routine use for mild to moderate exacerbations is not indicated. PMID:24040898

  14. The allergic emergency--management of severe allergic reactions.

    PubMed

    Werner-Busse, Alexandra; Zuberbier, Torsten; Worm, Margitta

    2014-05-01

    Anaphylaxis is characterized by the sudden onset of acute allergic symptoms involving two or more organ systems. An acute allergic emergency is a challenge for physicians due to its life-threatening potential. The incidence of anaphylactic reactions has increased in recent years. Most frequent elicitors of mast cell and primarily histamine dependent anaphylactic reactions are food, insect venom or drugs. Allergic -reactions are graded into four groups according to the classification by Ring and Messmer; grade I is defined by the onset of cutaneous symptoms only whereas grade IV is characterized by cardiovascular shock as well as cardiac and/or respiratory arrest. The treatment of allergic reactions should be guided by the severity of the reaction. Initially an intramuscular epinephrine injection into the lateral thigh should be given if cutaneous, mucosal and cardiovascular/respiratory symptoms occur. Additionally, the patient should receive intravenous antihistamines and corticosteroids. For self-treatment in the case of an allergic emergency, oral antihistamines and corticosteroids should be prescribed to the patient. PMID:24673732

  15. Psychometric Properties of a Symptom Management Self-Efficacy Scale for Women Living with HIV/AIDS

    PubMed Central

    Webel, Allison R.; Okonsky, Jennifer

    2010-01-01

    Context Many people with HIV/AIDS find it difficult to manage the symptoms of the disease, but by adopting effective symptom management behavior, they increase the potential of alleviating the burden of those symptoms. Self-efficacy is a recognized mediator of successful behavior change and is utilized by many researchers and clinicians when developing symptom management interventions. Despite this, an instrument measuring the self-efficacy of symptom management behavior specifically for people living with HIV/AIDS has not yet been made available. Objective To introduce and test the psychometric properties of the HIV Symptom Management Self-Efficacy for Women Scale (HSM-SEWS) for women with HIV/AIDS. This scale, a new 9-item measurement instrument, was modified from the Chronic Disease Self-Efficacy Scale. Methods In this study, psychometric testing focused on the reliability and validity of the HSM-SEWS instrument. Reliability was assessed using Cronbach’s alpha. Exploratory factor analysis with oblique promax rotation was used to examine validity and test hypothetical associations. Results Eighty-nine HIV-positive women were recruited and asked to complete the scale every four weeks for a total of 16 weeks. Factor analysis supported a one-factor solution explaining 93% of the variance among items. Internal consistency of the nine items was found to range from 0.83–0.93, with an overall Cronbach’s alpha of 0.92. Conclusions Psychometric analyses suggest that the HIV Symptom Management Self-Efficacy for Women Scale is a reliable and valid instrument that measures the self-efficacy of symptom management behavior in women with HIV/AIDS and can be used during interventions and in research targeting this area of health care research. PMID:21145198

  16. The use of a spatial information system in the management of HIV/AIDS in South Africa

    PubMed Central

    Busgeeth, Karishma; Rivett, Ulrike

    2004-01-01

    Background South Africa is experiencing an HIV/AIDS pandemic of shattering dimensions. The availability and provision of antiretroviral (ARV) drugs could bring relief to the situation, but the treatment is unfortunately complex with each patient being assigned a different antiretroviral therapy varying in diet-medication regiment. The context of South Africa, its variety of urban and rural settings adds to the challenge of administering and monitoring the HIV+ person throughout the treatment, which will last for the rest of their lives. The lack of physical infrastructure, reliable statistics and adequate resources hinder the efficient management of HIV/AIDS. Results The collection of reliable data will be a first step to assess the status of HIV/AIDS in communities. A number of hospitals have started this process using the conventional approach to collect information about their patients using a paper-based system. Since time is of essence in the fight against the pandemic, data exchange between various hospitals, municipalities and decision-making bodies is becoming more and more important. The logical response to such a need is a computerised system, which will collect and administer HIV/AIDS related information within the local context and allow a monitored access to the data from a number of stakeholders. Conclusions The purpose of this study was to design and develop an HIV/AIDS database, which is embedded in a Spatial Information Management System. The pilot study area is the Gugulethu township in Cape Town where more than 27% of the 325 000 residents are HIV+. It is shown that the implementation of the HIV/AIDS database and the Spatial Information Management System can play a critical role in determining where and when to intervene, improving the quality of care for HIV+ patients, increasing accessibility of service and delivering a cost-effective mode of information. PMID:15239839

  17. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.2

    SciTech Connect

    Burford, M.J.; Burnett, R.A.; Curtis, L.M.

    1996-05-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Chemical biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS system package. System administrators, database administrators, and general users can use this guide to install, configure, and maintain the FEMIS client software package. This document provides a description of the FEMIS environment; distribution media; data, communications, and electronic mail servers; user workstations; and system management.

  18. [Comparison of management of ambulatory emergency patients in the family practice and the hospital emergency center].

    PubMed

    Bovet Fritschi, Caroline; Ballmer, Peter E

    2014-06-18

    The increase in health care cost is broadly discussed in the public, either in the hospital or ambulatory setting. With the present study we compared the invoice amount generated by a first doctor's advice in the general practitioner to the one in the emergency room. In addition, we compared the diagnostic procedures used in the general practice to the one in the hospital, and whether the choice of diagnostic procedures would substantially influence the invoice amount. The invoice amount in the hospital setting was on average CHF 197.-, i. e. 134%, higher compared to the general practice. The difference in the invoice amount was largely explained by more diagnostic procedures in the hospital. Moreover, part of the higher invoice amount was generated by the extensive physical examination by doctors in the hospital. PMID:24938157

  19. How can models better aid the decision processes for the management of water resources?

    NASA Astrophysics Data System (ADS)

    Brugnach, M.; Pahl-Wostl, C.

    2007-12-01

    Despite the long history of development and use of models in policy making, there is still a poor integration between modeling and the decision process. This is influenced by several factors, such as a lack of understanding of models from policy makers, limitations in the applicability and use of models, modeller's behaviour, and a lack of stakeholder involvement in the whole modelling process. But, most relevant of all, is the fact that models are perceived as non reliable tools for policy making, due to the uncertainty associated with them and the lack of confidence this uncertainty generates. Commonly, in fields like natural resource management, and in particular water management, models are build to predict, in space or time, the state of the system to be managed (e.g. real time flood forecasting). These models are then used by policy makers as a surrogate of a real system to inform their decisions. In this view, the efficacy of a model depends on how well it can approximate reality and how much confidence policy makers can have on model's results. However, even though predictive models can be used to convey scientific argumentation that can aid decision making, these models fall short in supporting the processes of negotiation, learning, and communication, which constitute the basis for policy making. In this presentation we explore and discuss the relationship between models used in water resource management and policy making: how models can be used and how uncertainty should be treated depending on the purpose models are supposed to serve. We identify four major modeling purposes that are important for understanding and managing complex environmental systems: prediction, exploratory analysis, communication and learning, and investigate the implications of the different purposes in dealing with uncertainty. In predictive models, the presence of uncertainty is understood as a critical constraint for decision making, and as such it ought to be eliminated or

  20. Risk management in HIV/AIDS: ethical and economic issues associated with restricting HAART access only to adherent patients.

    PubMed

    Chawana, Richard; van Bogaert, Donna Knapp

    2011-01-01

    Like many other developing nations, South Africa faces the challenge of mobilising resources in response to the HIV pandemic. There is a large budget gap between the ideal and the actual amount of funding needed to achieve universal access to highly active antiretroviral therapy (HAART). In addition to financial demands, new burdens are being placed on HAART programmes with the emergence of HIV drug resistance (HIVDR). Thus, a major threat to successful HAART rollout is HIVDR due to non-adherence to HAART. The use of HAART as a primary and secondary HIV-prevention strategy could be ineffective in situations characterised by high rates of non-adherence. In this context, the research looked at issues related to adherence and non-adherence to HAART from the perspective of the provider. Using the software TreeAge Pro 2009, we developed a Markov model to project economic outcomes for a hypothetical cohort of HIV/AIDS patients on HAART. The model compared two scenarios: adherence and non-adherence to HAART. Input data for the model was obtained from existing literature on HAART uptake in South Africa. Moral arguments were analysed and managed through moral reasoning and critical thinking. Discounted lifetime costs for adherent and non-adherent HAART patients in South Africa were estimated at US$9 771 and US$14 762, respectively. The model showed the loss of 4.55 quality-adjusted life years (QALYs) for non-adherent patients, which could be otherwise gained through improved adherence. The incremental cost-effectiveness ratio (ICER) indicated that restricting HAART access only to adherent patients was the dominant strategy. We suggest that, although not a panacea, the withholding or withdrawal of treatment from non-adherent individuals as a precautionary intervention has economic and moral merit. PMID:25865513

  1. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.3

    SciTech Connect

    Burford, M.J.; Burnett, R.A.; Downing, T.R.

    1996-12-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that was developed by the (Pacific Northwest National Laboratory) (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS software package. 91 This document also contains information on the following: software installation for the FEMIS data servers, communication server, mail server, and the emergency management workstations; distribution media loading and FEMIS installation validation and troubleshooting; and system management of FEMIS users, login, privileges, and usage. The system administration utilities (tools), available in the FEMIS client software, are described for user accounts and site profile. This document also describes the installation and use of system and database administration utilities that will assist in keeping the FEMIS system running in an operational environment.

  2. Management of Pneumothorax in Emergency Medicine Departments: Multicenter Trial

    PubMed Central

    Ince, Abdulkadir; Ozucelik, Dogac Niyazi; Avci, Akkan; Nizam, Ozgur; Dogan, Halil; Topal, Mehmet Ali

    2013-01-01

    Background: Pneumothorax is common and life-threatening clinical condition which may require emergency treatment in Emergency Medicine Departments. Objectives: We aimed to reveal the epidemiological analysis of the patients admitted to the Emergency Department with pneumothorax. Material and Methods: This case-control and multi-center study was conducted in the patients treated with the diagnosis of pneumothorax between 01.01.2010-31.12.2010. Patient data were collected from hospital automation system. According to the etiology of the pneumothorax, study groups were arranged like spontaneous pneumothorax and traumatic pneumothorax. Results: 82.2% (n = 106) of patients were male and 17.8% (n = 23) of patients were female and mean age were 31.3 ± 20,2 (Minimum: 1, Maximum: 87). 68.2% (n = 88) of patients were spontaneous pneumothorax (61.36%, n=79 were primary spontaneous pneumothorax) and 31.8% (n = 41) of patients were traumatic pneumothorax (21.95% were iatrogenic pneumothorax). Main complaint is shortness of breath (52.3%, n=67) and 38% (n=49) of patients were smokers. Posteroanterior (PA) Chest X-Ray has been enough for 64.3% (n = 83) of the patients' diagnosis. Tube thoracostomy is applied to 84.5% (n = 109) of patients and surgery is applied to 9.3% (n = 12) of patients and 6.2% (n = 8) of patients were discharged with conservative treatment. Spontaneous pneumothorax showed statistically significant high recurrence compared with traumatic pneumothorax (P = 0.007). 4.65% of (n = 6) patients died. The average age of those who died (9.3 ± 19.9), statistically were significantly lower the mean age of living patients (32.4 ± 19.7) (t test, P = 0,006). 83.33% of the patients who died were neonatals and in the 0-1 years age group, and five of these patients were secondary spontaneous pneumothorax, and one of these patients were iatrogenic pneumothorax due to mechanical ventilation. Conclusions: Pneumothorax in adults can be treated by tube thoracostomy or

  3. Delirium: An Emerging Frontier in Management of Critically Ill Children

    PubMed Central

    Smith, Heidi A.B.; Fuchs, D. Catherine; Pandharipande, Pratik P.; Barr, Frederick E.; Ely, E. Wesley

    2009-01-01

    OBJECTIVES Introduce pediatric delirium and provide understanding of acute brain dysfunction with its classification and clinical presentations. Understand how delirium is diagnosed and discuss current modes of delirium diagnosis in the critically ill adult population and translation to pediatrics. Understand the prevalence and prognostic significance of delirium in the adult and pediatric critically ill population. Discuss the pathophysiology of delirium as currently understood. Provide general management guidelines for delirium. PMID:19576533

  4. Pharmacotherapy for uveitis: current management and emerging therapy

    PubMed Central

    Barry, Robert J; Nguyen, Quan Dong; Lee, Richard W; Murray, Philip I; Denniston, Alastair K

    2014-01-01

    Uveitis, a group of conditions characterized by intraocular inflammation, is a major cause of sight loss in the working population. Most uveitis seen in Western countries is noninfectious and appears to be autoimmune or autoinflammatory in nature, requiring treatment with immunosuppressive and/or anti-inflammatory drugs. In this educational review, we outline the ideal characteristics of drugs for uveitis and review the data to support the use of current and emerging therapies in this context. It is crucial that we continue to develop new therapies for use in uveitis that aim to suppress disease activity, prevent accumulation of damage, and preserve visual function for patients with the minimum possible side effects. PMID:25284976

  5. Emerging Advances in the Management of Cardiac Amyloidosis.

    PubMed

    Vranian, Michael N; Sperry, Brett W; Valent, Jason; Hanna, Mazen

    2015-11-01

    Amyloidosis is a disease in which proteins misfold, aggregate into fibrils, and deposit extracellularly disrupting organ architecture and function. There are two main types which affect the heart: light chain (AL) amyloidosis and transthyretin cardiac amyloidosis (ATTR). There is a misconception that cardiac amyloidosis has no effective treatment options. However, over the past decade, there has been extensive research and drug development. Outcomes are improving in AL amyloidosis with evolving chemotherapeutic regimens and novel monoclonal antibodies. In ATTR, therapies that decrease protein production, prevent dissociation, and promote clearance have the potential to slow or even halt a disease which is uniformly fatal. Selected patients may be candidates for heart and/or stem cell transplant and should be promptly referred to an experienced amyloid program. Herein, we discuss the emerging advances for the treatment of cardiac amyloidosis. PMID:26374453

  6. IT management and governance systems and their emergence in healthcare.

    PubMed

    Mohrmann, Gregg; Kropf, Roger

    2007-01-01

    Today's healthcare IT departments are challenged with understanding the total service demand imposed by their user communities and how much of their limited resources are available to meet that demand. This challenge is being addressed through the use of new IT management and governance (IT-MG) systems. This software supports IT governance and project and portfolio management. IT-MG is a relatively new term to healthcare; it entails reviewing and managing demand for IT services from inception to completion through the application of IT resources. These systems help save time through automated reporting and quicker delivery of services; they save money by more effectively addressing resource needs on time and on budget. The systems also reduce the number of administrative tasks through process automation; increase customer satisfaction by communicating services and deliverables more quickly and accurately; and help executives make better and more informed decisions about priorities and expectations through reporting that was previously nonexistent. This article will explore IT-MG systems and present a case study of a hospital that rapidly implemented this type of system. PMID:17299923

  7. Transforming Water Management: an Emerging Promise of Integrated Earth Observations

    NASA Astrophysics Data System (ADS)

    Lawford, R. G.

    2011-12-01

    Throughout its history, civilization has relied on technology to facilitate many of its advances. New innovations and technologies have often provided strategic advantages that have led to transformations in institutions, economies and ultimately societies. Observational and information technologies are leading to significant developments in the water sector. After a brief introduction tracing the role of observational technologies in the areas of hydrology and water cycle science, this talk explores the existing and potential contributions of remote sensing data in water resource management around the world. In particular, it outlines the steps being undertaken by the Group on Earth Observations (GEO) and its Water Task to facilitate capacity building efforts in water management using Earth Observations in Asia, Africa and Latin and Caribbean America. Success stories on the benefits of using Earth Observations and applying GEO principles are provided. While GEO and its capacity building efforts are contributing to the transformation of water management through interoperability, data sharing, and capacity building, the full potential of these contributions has not been fully realized because impediments and challenges still remain.

  8. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.4

    SciTech Connect

    Arp, J.A.; Burnett, R.A.; Downing, T.R.

    1997-11-21

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the US Army Chemical Biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS software package. This document also contains information on the following: software installation for the FEMIS data servers, communication server, mail server, and the emergency management workstations; distribution media loading and FEMIS installation validation and troubleshooting; and system management of FEMIS users, login privileges, and usage. The system administration utilities (tools), available in the FEMIS client software, are described for user accounts and site profile. This document also describes the installation and use of system and database administration utilities that will assist in keeping the FEMIS system running in an operational environment. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via telecommunications links.

  9. Conceptualization of Approaches and Thought Processes Emerging in Validating of Model in Mathematical Modeling in Technology Aided Environment

    ERIC Educational Resources Information Center

    Hidiroglu, Çaglar Naci; Bukova Güzel, Esra

    2013-01-01

    The aim of the present study is to conceptualize the approaches displayed for validation of model and thought processes provided in mathematical modeling process performed in technology-aided learning environment. The participants of this grounded theory study were nineteen secondary school mathematics student teachers. The data gathered from the…

  10. Federal Emergency Management Information System (FEMIS) system administration guide, version 1.4.5

    SciTech Connect

    Arp, J.A.; Burnett, R.A.; Carter, R.J.

    1998-06-26

    The Federal Emergency Management Information Systems (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the US Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication, data distribution, and notification functionality necessary to operate FEMIS in a networked, client/server environment. The UNIX server provides an Oracle relational database management system (RDBMS) services, ARC/INFO GIS (optional) capabilities, and basic file management services. PNNL developed utilities that reside on the server include the Notification Service, the Command Service that executes the evacuation model, and AutoRecovery. To operate FEMIS, the Application Software must have access to a site specific FEMIS emergency management database. Data that pertains to an individual EOC`s jurisdiction is stored on the EOC`s local server. Information that needs to be accessible to all EOCs is automatically distributed by the FEMIS

  11. [EMOTIONAL MANAGEMENT AND CRITICAL THINKING IN THE AID RELATIONSHIP OF THE HOLISTIC CARE OF PALLIATIVE PATIENTS].

    PubMed

    De Blas Gómez, Irene; Rodríguez García, Marta

    2015-05-01

    To care for palliative patients is essential that healthcare professionals develop emotional competencies. This means acquiring the habit of self reflection and be emphatic with other people, in order to be able to identify the personal emotions of patients, family and team. Reflection involves a continuing effort to reason about aspects of professional practice, especially on issues as complex as suffering and death. Both reflective reasoning and emotional management are vital in an Aid Relationship. For nursing healthcare professionals, to care the emotional aspects means becoming aware of their own and others feelings, and get to understand and accept to handle them properly. Nursing actions involves many qualities of social competence, such as empathy, understanding, communication skills, honesty, flexibility and adaptability to the individual needs of people cared. In the context of palliative care patients and their families all these aspects are fundamental and are part of the same philosophy. Emotional education still remains a challenge in our profession both in the initial and continuing training. PMID:26540895

  12. Management of Indigenous Plant-Microbe Symbioses Aids Restoration of Desertified Ecosystems

    PubMed Central

    Requena, Natalia; Perez-Solis, Estefania; Azcón-Aguilar, Concepción; Jeffries, Peter; Barea, José-Miguel

    2001-01-01

    Disturbance of natural plant communities is the first visible indication of a desertification process, but damage to physical, chemical, and biological soil properties is known to occur simultaneously. Such soil degradation limits reestablishment of the natural plant cover. In particular, desertification causes disturbance of plant-microbe symbioses which are a critical ecological factor in helping further plant growth in degraded ecosystems. Here we demonstrate, in two long-term experiments in a desertified Mediterranean ecosystem, that inoculation with indigenous arbuscular mycorrhizal fungi and with rhizobial nitrogen-fixing bacteria not only enhanced the establishment of key plant species but also increased soil fertility and quality. The dual symbiosis increased the soil nitrogen (N) content, organic matter, and hydrostable soil aggregates and enhanced N transfer from N-fixing to nonfixing species associated within the natural succession. We conclude that the introduction of target indigenous species of plants associated with a managed community of microbial symbionts is a successful biotechnological tool to aid the recovery of desertified ecosystems. PMID:11157208

  13. Executive summary. Consensus statement of the National AIDS Plan Secretariat, Spanish Society of Emergency Medicine and AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology on Emergency and HIV Infection.

    PubMed

    2013-01-01

    Emergency Services (ES) are the cornerstone of our health system and therefore it cannot remain indifferent to the HIV advances that have drastically changed the landscape of the disease, so, emergency specialist updating is not only necessary, it is also essential. The purpose of this paper is to support non-HIV specialist professionals in treating patients with urgent diseases resulting from HIV infection or related to it. PMID:23601917

  14. Current and emerging treatment options in the management of lupus.

    PubMed

    Jordan, Natasha; D'Cruz, David

    2016-01-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease with variable clinical manifestations. While the clearest guidelines for the treatment of SLE exist in the context of lupus nephritis, patients with other lupus manifestations such as neuropsychiatric, hematologic, musculoskeletal, and severe cutaneous lupus frequently require immunosuppression and/or biologic therapy. Conventional immunosuppressive agents such as mycophenolate mofetil, azathioprine, and cyclophosphamide are widely used in the management of SLE with current more rationalized treatment regimens optimizing the use of these agents while minimizing potential toxicity. The advent of biologic therapies has advanced the treatment of SLE particularly in patients with refractory disease. The CD20 monoclonal antibody rituximab and the anti-BLyS agent belimumab are now widely in use in clinical practice. Several other biologic agents are in ongoing clinical trials. While immunosuppressive and biologic agents are the foundation of inflammatory disease control in SLE, the importance of managing comorbidities such as cardiovascular risk factors, bone health, and minimizing susceptibility to infection should not be neglected. PMID:27529058

  15. School management and contingency theory: an emerging perspective.

    PubMed

    Hanson, E M

    1979-01-01

    In an article written for educational administrators, Hanson explains the assumptions, framework, and application of contingency theory. The author sees contingency theory as a way for organizations to adapt to uncertainty by developing a strategic plan with alternative scenarios. He urges school administrators to join businessmen and public managers in using a technique described as "the most powerful current sweeping over the organizational field." The theory assumes that: (1) a maze of goals govern the development of events; (2) different management approaches may be appropriate within the same organization; and (3) different leadership styles suit different situations. Contingency planning helps the organization to respond to uncertainty in the external environment by identifying possible events that may occur and by preparing alternative stratgies to deal with them. Hanson describes the purpose of this process as providing "a more effective match between an organization and its environment." He explains that contingency theory analyzes the internal adjustments of the organization (e.g., decision making process, structure, technology, instructional techniques) as it seeks to meet the shifting demands of its external or internal environments. According to the author, the intent of contingency theory is to establish an optimal "match" between environmental demands (and support) and the response capabilities of the organization including its structure, planning process, and leadership style. PMID:10247889

  16. Complications of bariatric surgery: Presentation and emergency management.

    PubMed

    Kassir, Radwan; Debs, Tarek; Blanc, Pierre; Gugenheim, Jean; Ben Amor, Imed; Boutet, Claire; Tiffet, Olivier

    2016-03-01

    The epidemic in obesity has led to an increase in number of so called bariatric procedures. Doctors are less comfortable managing an obese patient after bariatric surgery. Peri-operative mortality is less than 1%. The specific feature in the obese patient is that the classical signs of peritoneal irritation are never present as there is no abdominal wall and therefore no guarding or rigidity. Simple post-operative tachycardia in obese patients should be taken seriously as it is a WARNING SIGNAL. The most common complication after surgery is peritonitis due to anastomotic fistula formation. This occurs typically as an early complication within the first 10 days post-operatively and has an incidence of 1-6% after gastric bypass and 3-7% after sleeve gastrectomy. Post-operative malnutrition is extremely rare after restrictive surgery (ring, sleeve gastrectomy) although may occur after malabsorbative surgery (bypass, biliary pancreatic shunt) and is due to the restriction and change in absorption. Prophylactic cholecystectomy is not routinely carried out during the same procedure as the bypass. Superior mesenteric vein thrombosis after bariatric surgery is a diagnosis which should be considered in the presence of any postoperative abdominal pain. Initially a first etiological assessment is performed (measurement of antithrombin III and of protein C and protein S, testing for activated protein C resistance). If the least doubt is present, a medical or surgical consultation should be requested with a specialist practitioner in the management of obese patients as death rates increase with delayed diagnosis. PMID:26808323

  17. Current and emerging treatment options in the management of lupus

    PubMed Central

    Jordan, Natasha; D’Cruz, David

    2016-01-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease with variable clinical manifestations. While the clearest guidelines for the treatment of SLE exist in the context of lupus nephritis, patients with other lupus manifestations such as neuropsychiatric, hematologic, musculoskeletal, and severe cutaneous lupus frequently require immunosuppression and/or biologic therapy. Conventional immunosuppressive agents such as mycophenolate mofetil, azathioprine, and cyclophosphamide are widely used in the management of SLE with current more rationalized treatment regimens optimizing the use of these agents while minimizing potential toxicity. The advent of biologic therapies has advanced the treatment of SLE particularly in patients with refractory disease. The CD20 monoclonal antibody rituximab and the anti-BLyS agent belimumab are now widely in use in clinical practice. Several other biologic agents are in ongoing clinical trials. While immunosuppressive and biologic agents are the foundation of inflammatory disease control in SLE, the importance of managing comorbidities such as cardiovascular risk factors, bone health, and minimizing susceptibility to infection should not be neglected. PMID:27529058

  18. Management of keloids and hypertrophic scars: current and emerging options

    PubMed Central

    Gauglitz, Gerd G

    2013-01-01

    In the context of growing aesthetic awareness, a rising number of patients feel disappointed with their scars and are frequently seeking help for functional and aesthetic improvement. However, excessive scarring following surgery or trauma remains difficult to improve despite a plethora of advocated treatment strategies as frequently observed in daily clinical routine. It is thus still preferable to prevent scarring by minimizing risk factors as much as possible. Hence, it remains crucial for the physician to be aware of basic knowledge of healing mechanisms and skin anatomy, as well as an appreciation of suture material and wound closure techniques to minimize the risk of postoperative scarring. Next to existing, well known prophylactic and therapeutic strategies for the improvement of excessive scarring, this article discusses emerging techniques such as intralesional cryotherapy, intralesional 5-fluorouracil, interferon, and bleomycin. Some of them have been successfully tested in well-designed trials and already have extended or may extend the current spectrum of excessive scar treatment in the near future. Innovative options such as imiquimod 5% cream, photodynamic therapy, or botulinum toxin A may also be of certain importance; however, the data currently available is too contradictory for definite recommendations. PMID:23637546

  19. A theoretical framework for negotiating the path of emergency management multi-agency coordination.

    PubMed

    Curnin, Steven; Owen, Christine; Paton, Douglas; Brooks, Benjamin

    2015-03-01

    Multi-agency coordination represents a significant challenge in emergency management. The need for liaison officers working in strategic level emergency operations centres to play organizational boundary spanning roles within multi-agency coordination arrangements that are enacted in complex and dynamic emergency response scenarios creates significant research and practical challenges. The aim of the paper is to address a gap in the literature regarding the concept of multi-agency coordination from a human-environment interaction perspective. We present a theoretical framework for facilitating multi-agency coordination in emergency management that is grounded in human factors and ergonomics using the methodology of core-task analysis. As a result we believe the framework will enable liaison officers to cope more efficiently within the work domain. In addition, we provide suggestions for extending the theory of core-task analysis to an alternate high reliability environment. PMID:25480001

  20. Conceptual design report, Hazardous Materials Management and Emergency Response (HAMMER) Training Center

    SciTech Connect

    Kelly, K.E.

    1994-11-09

    For the next 30 years, the main activities at the US Department of Energy (DOE) Hanford Site will involve the management, handling, and cleanup of toxic substances. If the DOE is to meet its high standards of safety, the thousands of workers involved in these activities will need systematic training appropriate to their tasks and the risks associated with these tasks. Furthermore, emergency response for DOE shipments is the primary responsibility of state, tribal, and local governments. A collaborative training initiative with the DOE will strengthen emergency response at the Hanford Site and within the regional communities. Local and international labor has joined the Hazardous Materials Management and Emergency Response (HAMMER) partnership, and will share in the HAMMER Training Center core programs and facilities using their own specialized trainers and training programs. The HAMMER Training Center will provide a centralized regional site dedicated to the training of hazardous material, emergency response, and fire fighting personnel.

  1. VTOL aircraft in emergency planning and management: a model for a helipad network.

    PubMed

    Caprì, Salvatore; Ignaccolo, Matteo; Inturri, Giuseppe

    2009-03-01

    The scientific literature regarding HEMS (Helicopter Emergency Medical Service) planning lacks a method for defining optimal sites for helipads that takes into account risk distribution and hospital location. Such a method could minimise overall rescue time in emergency situations. In this paper a method that supports the decisions taken by disaster planners and managers is developed, focusing on the quantification of necessary air resources for the management of some probable calamities. Given a region characterised by a natural and non-natural disaster risk map, along with a comprehensive transport system (also characterised by a risk map), a set of emergency destinations (hospitals), a set of heliports/helipads dislocated on the territory and a number of available HEMS rotorcraft, the aim of the paper is to assess the adequacy of the VTOL/FATO (Vertical Take-Off and Landing/Final Take-Off and Landing Area) system in order to deal with a set of possible emergencies. PMID:18498369

  2. Project plan, Hazardous Materials Management and Emergency Response Training Center: Project 95L-EWT-100

    SciTech Connect

    Borgeson, M.E.

    1994-11-09

    The Hazardous Materials Management and Emergency Response (HAMMER) Training Center will provide for classroom lectures and hands-on practical training in realistic situations for workers and emergency responders who are tasked with handling and cleanup of toxic substances. The primary objective of the HAMMER project is to provide hands-on training and classroom facilities for hazardous material workers and emergency responders. This project will also contribute towards complying with the planning and training provisions of recent legislation. In March 1989 Title 29 Code of Federal Regulations Occupational Safety and Health Administration 1910 Rules and National Fire Protection Association Standard 472 defined professional requirements for responders to hazardous materials incidents. Two general types of training are addressed for hazardous materials: training for hazardous waste site workers and managers, and training for emergency response organizations.

  3. Vulnerability and risk perception in the management of HIV/AIDS: Public priorities in a global pandemic

    PubMed Central

    Tsasis, Peter; Nirupama, N.

    2008-01-01

    Understanding the way perception of risk is shaped and constructed is crucial in understanding why it has been so difficult to mitigate the spread of HIV/AIDS. This paper uses the Pressure and Release (PAR) model, used to predict the onset of natural disasters as the conceptual framework. It substitutes vulnerability and risk perception as the trigger factors in the model, in making the case that HIV/AIDS can be characterized as a slow onset disaster. The implications are that vulnerability must be managed and reduced by addressing root causes, dynamic pressures, and unsafe conditions that contribute to the HIV/AIDS pandemic. HIV/AIDS programs must be culturally appropriate and work toward influencing risk perception, while addressing social norms and values that negatively impact vulnerable populations. By impacting cultural and social expectations, individuals will be able to more readily adopt safer sex behaviors. The development of policies and programs addressing the issues in context, as opposed to individual behaviors alone, allows for effective public health intervention. This may have implications for public health measures implemented for combating the spread of HIV/AIDS. PMID:22312198

  4. Fluid assessment and management in the emergency department.

    PubMed

    Di Somma, Salvatore; Gori, Chiara Serena; Grandi, Tommaso; Risicato, Marcello Giuseppe; Salvatori, Emiliano

    2010-01-01

    Evaluation of hydration state or water homeostasis is an important component in the assessment and treatment of critically ill patients in the emergency department (ED). The main purpose of ED physicians is to immediately distinguish between normal hydrated, dehydrated and hyperhydrated states. Fluid depletion may result from renal losses and extrarenal losses (from the GI tract, respiratory system, skin, fever, sepsis, third space accumulations). Total body fluid increase can result from heart failure, kidney disease, liver disease, malignant lymphoedema or thyroid disease. In patients with fluid overload due to acute heart failure, diuretics should be given when there is evidence of systemic volume overload, in a dose up-titrated according to renal function, systolic blood pressure, and history of chronic diuretic use. The bioelectrical impedance vector analysis (BIVA) is a noninvasive technique to estimate body mass and water composition by bioelectrical impedance measurements, resistance and reactance. In patients with hyperhydration state due to heart failure, some authors showed that reactance is strongly related to BNP values and the NYHA functional classes. Other authors found a correlation between impedance and central venous pressure in critically ill patients. We have been analyzing the hydration state at admission to the ED, 24, 72 h after admission and at discharge, and found a significant and indirectly proportional correlation between BIVA hydration and the Caval index at the time of presentation to the ED and 24 and 72 h after hospital admission. Moreover, at admission we found an inverse relationship between BIVA hydration and reduced urine output that became directly proportional at 72 h. This confirms the good response to diuretic therapy with the shift of fluids from interstitial spaces. PMID:20428007

  5. An asthma management system in a pediatric emergency department

    PubMed Central

    Dexheimer, Judith W.; Abramo, Thomas J.; Arnold, Donald H.; Johnson, Kevin B.; Shyr, Yu; Ye, Fei; Fan, Kang-Hsien; Patel, Neal; Aronsky, Dominik

    2013-01-01

    Introduction Pediatric asthma exacerbations account for >1.8 million emergency department (ED) visits annually. Asthma guidelines are intended to guide time-dependent treatment decisions that improve clinical outcomes; however, guideline adherence is inadequate. We examined whether an automatic disease detection system increases clinicians' use of paper-based guidelines and decreases time to a disposition decision. Methods We evaluated a computerized asthma detection system that triggered NHLBI-adopted, evidence-based practice to improve care in an urban, tertiary care pediatric ED in a 3-month (7/09–9/09) prospective, randomized controlled trial. A probabilistic system screened all ED patients for acute asthma. For intervention patients, the system generated the asthma protocol at triage for intervention patients to guide early treatment initiation, while clinicians followed standard processes for control patients. The primary outcome measures included time to patient disposition. Results The system identified 1100 patients with asthma exacerbations, of which 704 had a final asthma diagnosis determined by a physician-established reference standard. The positive predictive value for the probabilistic system was 65%. The median time to disposition decision did not differ among the intervention (289 min; IQR = (184, 375)) and control group (288 min; IQR = (185, 375)) (p= 0.21). The hospital admission rate was unchanged between intervention (37%) and control groups (35%) (p= 0.545). ED length of stay did not differ among the intervention (331 min; IQR =(226, 581)) and control group (331 min; IQR = (222, 516)) (p = 0.568). Conclusion Despite a high level of support from the ED leadership and staff, a focused education effort, and implementation of an automated disease detection, the use of the paper-based asthma protocol remained low and time to patient disposition did not change. PMID:23218449

  6. An Author Management System and Other Computer-Based Aids to ISD.

    ERIC Educational Resources Information Center

    O'Neal, A. F.

    A brief review of some of the more important needs imposed by current and projected Department of Defense training problems is followed by descriptions of such automated aids as the LAMPS MARK III Weapons System and the Air Force's F-16 Instructional System Development (ISD) effort. These aids have been designed and developed in response to the…

  7. AIDS and Child Care: A Booklet for Child Care Workers, Management Committees and Parents.

    ERIC Educational Resources Information Center

    Fricke, Caroline; Glasson, Mark

    This booklet provides Australians with basic information about the Acquired Immune Deficiency Syndrome (AIDS). Contents cover the definiton of AIDS, ways the disease is transmitted, Human Immunodeficiency Virus (HIV) antibody testing for adults and children, variations among children infected with HIV, information that HIV is not transmitted…

  8. Nonpharmacological Interventions for Pain Management in Paramedicine and the Emergency Setting: A Review of the Literature

    PubMed Central

    Pak, Sok Cheon; Micalos, Peter S.; Maria, Sonja J.; Lord, Bill

    2015-01-01

    Paramedicine and the emergency medical services have been moving in the direction of advancing pharmaceutical intervention for the management of pain in both acute and chronic situations. This coincides with other areas of advanced life support and patient management strategies that have been well researched and continue to benefit from the increasing evidence. Even though paramedic practice is firmly focused on pharmacological interventions to alleviate pain, there is emerging evidence proposing a range of nonpharmacological options that can have an important role in pain management. This review highlights literature that suggests that paramedicine and emergency medical services should be considering the application of complementary and alternative therapies which can enhance current practice and reduce the use of pharmacological interventions. PMID:25918548

  9. Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

    PubMed Central

    2012-01-01

    Background Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies. Methods We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5%) of sub-counties, 21/42 (50.0%) parishes and 32/212 (15.1%) villages (clusters), were interviewed. Data were analysed using STATA version 10.0. Results Community pre-emergency support interventions available included community awareness creation (sensitization) while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies) included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54) and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14). Conclusions Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community sensitization by empowered

  10. A modeling and experiment framework for the emergency management in AHC transmission.

    PubMed

    Chen, Bin; Ge, Yuanzheng; Zhang, Laobing; Zhang, Yongzheng; Zhong, Ziming; Liu, Xiaocheng

    2014-01-01

    Emergency management is crucial to finding effective ways to minimize or even eliminate the damage of emergent events, but there still exists no quantified method to study the events by computation. Statistical algorithms, such as susceptible-infected-recovered (SIR) models on epidemic transmission, ignore many details, thus always influencing the spread of emergent events. In this paper, we first propose an agent-based modeling and experiment framework to model the real world with the emergent events. The model of the real world is called artificial society, which is composed of agent model, agent activity model, and environment model, and it employs finite state automata (FSA) as its modeling paradigm. An artificial campus, on which a series of experiments are done to analyze the key factors of the acute hemorrhagic conjunctivitis (AHC) transmission, is then constructed to illustrate how our method works on the emergency management. Intervention measures and optional configurations (such as the isolation period) of them for the emergency management are also given through the evaluations in these experiments. PMID:24693330

  11. Federal Emergency Management Information System (FEMIS), Installation Guide for FEMIS 1.4.6

    SciTech Connect

    Arp, J.A.; Burnett, R.A.; Carter, R.J.; Downing, T.R.; Dunkle, J.R.; Fangman, P.M.; Gackle, P.P.; Homer, B.J.; Johnson, D.M.; Johnson, R.L.; Johnson, S.M.; Loveall, R.M.; Stephan, A.J.; Millard, W.D.; Wood, B.M.

    1999-06-29

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are corrected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication data distribution and notification functionality necessary to operate FEMIS in a networked, client/server environment.

  12. Federal Emergency Management Information System (FEMIS) System Administration Guide for FEMIS Version 1.4.6

    SciTech Connect

    Arp, J.A.; Bower, J.C.; Burnett, R.A.; Carter, R.J.; Downing, T.R.; Fangman, P.M.; Gerhardstein, L.H.; Homer, B.J.; Johnson, D.M.; Johnson, R.L.; Johnson, S.M.; Loveall, R.M.; Martin, T.J.; Millard, W.D.; Schulze, S.A.; Stoops, L.R.; Tzemos, S.; Wood, B.M.

    1999-06-29

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are corrected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication data distribution and notification functionality necessary to operate FEMIS in a networked, client/server environment.

  13. Emergency!

    ERIC Educational Resources Information Center

    Geissler, Rebecca

    2006-01-01

    For generations, schools have routinely held fire drills. However, ensuring a safe learning environment is more complicated than staging an occasional drill. Schools and universities should have an integrated school safety plan, and it must address how to manage site hazards in science labs, kitchens and other building areas. It is essential for…

  14. Identification and Management of Deep Brain Stimulation Intra- and Postoperative Urgencies and Emergencies

    PubMed Central

    Morishita, Takashi; Foote, Kelly D.; Burdick, Adam P.; Katayama, Yoichi; Yamamoto, Takamitsu; Frucht, Steven J.; Okun, Michael S.

    2009-01-01

    Deep brain stimulation (DBS) has been increasingly utilized for the therapeutic treatment of movement disorders, and with the advent of this therapy more postoperative urgencies and emergencies have emerged. In this paper, we will review, identify, and suggest management strategies for both intra- and postoperative urgencies and emergencies. We have separated the scenarios into 1- surgery/procedure related, 2- hardware related, 3- stimulation induced difficulties, and 4- others. We have included ten illustrative (and actual) case vignettes to augment the discussion of each issue. PMID:19896407

  15. Emergency management and mass fatalities: who owns the dead?

    PubMed

    Crabtree, Jim

    2009-11-01

    Mass fatality incidents are always unexpected and put a sudden stress on local response agencies to cooperate and share resources to accomplish tasks that are outside their normal activities. Lines of legal authority are often conflicting when two or more agencies are statutorily in charge. Within the USA, the local coroner system is almost universally delegated as responsible for all involved tasks including body recovery, yet the coroner is almost always the smallest responding agency, with the smallest labour pool from which to draw and the least experience of formal Incident Command System (ICS) procedures at large incidents. This paper explores the many tasks required following a mass fatality incident and the necessity for pre-event written agreements to be negotiated between local, state and federal agencies to ensure that material and personnel can be readily shared and reimbursed without bureaucratic misunderstanding in order to accomplish known objectives. Also explored are potential National Incident Management System conflicts in applying unified command to situations where legal authority and level of commitment are not synonymous. PMID:20378492

  16. Bile acids: emerging role in management of liver diseases.

    PubMed

    Asgharpour, Amon; Kumar, Divya; Sanyal, Arun

    2015-10-01

    Bile acids are well known for their effects on cholesterol homeostasis and lipid digestion. Since the discovery of bile acid receptors, of which there are farnesoid X receptor (FXR), a nuclear receptor, and the plasma membrane G-protein receptor, as well as Takeda G-protein coupled receptor clone 5, further roles have been elucidated for bile acids including glucose and lipid metabolism as well as inflammation. Additionally, treatment with bile acid receptor agonists has shown a decrease in the amount of atherosclerosis plaque formation and decreased portal vascular resistance and portal hypotension in animal models. Furthermore, rodent models have demonstrated antifibrotic activity using bile acid receptor agonists. Early human data using a FXR agonist, obeticholic acid, have shown promising results with improvement of histological activity and even a reduction of fibrosis. Human studies are ongoing and will provide further information on bile acid receptor agonist therapies. Thus, bile acids and their derivatives have the potential for management of liver diseases and potentially other disease states including diabetes and the metabolic syndrome. PMID:26320013

  17. Emergent airway management in a case of fibrodysplasia ossificans progressiva

    PubMed Central

    Parekh, Uma R.; Read, Selina; Desai, Vimal; Budde, Arne O.

    2014-01-01

    Fibrodysplasia ossificans progressiva (FOP), or Stone man syndrome, is rare and one of the most disabling genetic conditions of the connective tissue due to progressive extraskeletal ossification. It usually presents in the first decade of life as painful inflammatory swellings, either spontaneously or in response to trauma, which later ossify and lead to severe disability. Progressive spinal deformity including thoracolumbar kyphoscoliosis leads to thoracic insufficiency syndrome, increasing the risk for pneumonia and right sided heart failure. We present the airway management in a 22-year-old male, diagnosed with FOP with severe disability, who required urgent airway intervention as a result of respiratory failure from pnuemonia. Tracheostomy triggers ossification and consequent airway obstruction at the tracheostomy site and laryngoscopy triggers temporomandibular joint ankylosis. Therefore, awake fiber-optic endotracheal intubation is recommended in these patients. Use of an airway endoscopy mask enabled us to simultaneously maintain non-invasive ventilation and intubate the patient in a situation where tracheostomy needed to be avoided. PMID:25425787

  18. Bile acids: emerging role in management of liver diseases

    PubMed Central

    Asgharpour, Amon; Kumar, Divya

    2016-01-01

    Bile acids are well known for their effects on cholesterol homeostasis and lipid digestion. Since the discovery of bile acid receptors, of which there are farnesoid X receptor (FXR), a nuclear receptor, and the plasma membrane G-protein receptor, as well as Takeda G-protein coupled receptor clone 5, further roles have been elucidated for bile acids including glucose and lipid metabolism as well as inflammation. Additionally, treatment with bile acid receptor agonists has shown a decrease in the amount of atherosclerosis plaque formation and decreased portal vascular resistance and portal hypotension in animal models. Furthermore, rodent models have demonstrated antifibrotic activity using bile acid receptor agonists. Early human data using a FXR agonist, obeticholic acid, have shown promising results with improvement of histological activity and even a reduction of fibrosis. Human studies are ongoing and will provide further information on bile acid receptor agonist therapies. Thus, bile acids and their derivatives have the potential for management of liver diseases and potentially other disease states including diabetes and the metabolic syndrome. PMID:26320013

  19. Current management strategies and emerging treatments for functional dyspepsia.

    PubMed

    Camilleri, Michael; Stanghellini, Vincenzo

    2013-03-01

    Functional dyspepsia refers to painful and nonpainful symptoms that are perceived to arise in the upper digestive tract but are not secondary to organic, systemic or metabolic diseases. The symptoms of this syndrome often overlap with those of GERD and IBS, making its management far from simple. If Helicobacter pylori infection is diagnosed in patients with functional dyspepsia, it should be treated. In patients with mild or intermittent symptoms, reassurance and lifestyle advice might be sufficient; in patients not responding to these measures, or in those with more severe symptoms, drug therapy should be considered. Both PPIs and prokinetics can be used in initial empirical pharmacotherapy based on symptom patterns--a PPI is more likely to be effective in the presence of retrosternal or epigastric burning or epigastric pain, whereas a prokinetic is more effective in dyspepsia with early satiation or postprandial fullness. Although combinations of PPIs and prokinetics might have additive symptomatic effects, single-drug therapy is initially preferable. Antidepressants or referral to a psychiatrist or psychotherapist can be considered in nonresponders and in those whose symptoms have a marked effect on daily functioning. Despite extensive research, functional dyspepsia treatment often remains unsatisfactory. Better characterization of dyspeptic subgroups and understanding of underlying mechanisms will enable treatment advances to be made in the future. PMID:23381190

  20. Aging with HIV: Responding to an Emerging Challenge

    MedlinePlus

    ... Stay Connected You are here Home Aging with HIV: Responding to an emerging challenge September 30, 2013 ... with HIV. New frontiers in medical management of HIV/AIDS Several NIA and NIH-wide initiatives support ...

  1. Emergency managers as community change agents: an expanded vision of the profession.

    PubMed

    Drabek, Thomas E

    2014-01-01

    Reflecting the historical evolution of attack preparedness, technological failures, and so-called natural disaster events, the profession of emergency management confronts new challenges today. In part, these reflect important cultural differences among stakeholder groups, especially local emergency managers. homeland security personnel, and those focused on public health threats and business continuity. An expanded and more strategic vision of the profession is required wherein fundamental assumption sets are placed into broader contexts. Contrary to the drift experienced in the US during the past decade, a major paradigm shift is required reflecting new orientations and program priorities. PMID:24757750

  2. Difficult Airway Response Team: A Novel Quality Improvement Program for Managing Hospital-Wide Airway Emergencies

    PubMed Central

    Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.

    2015-01-01

    Background Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. Methods We developed a quality improvement program—the Difficult Airway Response Team (DART)—to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had three core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Results Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index > 40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous

  3. Case management for frequent users of the emergency department: study protocol of a randomised controlled trial

    PubMed Central

    2014-01-01

    Background We devised a randomised controlled trial to evaluate the effectiveness and efficiency of an intervention based on case management care for frequent emergency department users. The aim of the intervention is to reduce such patients’ emergency department use, to improve their quality of life, and to reduce costs consequent on frequent use. The intervention consists of a combination of comprehensive case management care and standard emergency care. It uses a clinical case management model that is patient-identified, patient-directed, and developed to provide high intensity services. It provides a continuum of hospital- and community-based patient services, which include clinical assessment, outreach referral, and coordination and communication with other service providers. Methods/Design We aim to recruit, during the first year of the study, 250 patients who visit the emergency department of the University Hospital of Lausanne, Switzerland. Eligible patients will have visited the emergency department 5 or more times during the previous 12 months. Randomisation of the participants to the intervention or control groups will be computer generated and concealed. The statistician and each patient will be blinded to the patient’s allocation. Participants in the intervention group (N = 125), additionally to standard emergency care, will receive case management from a team, 1 (ambulatory care) to 3 (hospitalization) times during their stay and after 1, 3, and 5 months, at their residence, in the hospital or in the ambulatory care setting. In between the consultations provided, the patients will have the opportunity to contact, at any moment, the case management team. Participants in the control group (N = 125) will receive standard emergency care only. Data will be collected at baseline and 2, 5.5, 9, and 12 months later, including: number of emergency department visits, quality of life (EuroQOL and WHOQOL), health services use, and relevant costs

  4. Emergency management of the paediatric patient with generalized convulsive status epilepticus

    PubMed Central

    Friedman, JN

    2011-01-01

    The present guideline paper addresses the emergency management of generalized convulsive status epilepticus (CSE) in children and infants older than one month of age. It replaces the previous statement from 1996, and includes a new treatment algorithm and table of recommended medications, reflecting new evidence and the evolution of clinical practice over the past 15 years. The document focuses on the acute pharmacological management of CSE, but some issues regarding supportive care, diagnostic approach and treatment of refractory CSE are discussed. PMID:22294869

  5. Towards a "fourth generation" of approaches to HIV/AIDS management: creating contexts for effective community mobilisation.

    PubMed

    Campbell, Catherine; Cornish, Flora

    2010-01-01

    Many biomedical and behavioural HIV/AIDS programmes aimed at prevention, care and treatment have disappointing outcomes because of a lack of effective community mobilisation. But community mobilisation is notoriously difficult to bring about. We present a conceptual framework that maps out those dimensions of social context that are likely to support or undermine community mobilisation efforts, proposing that attention should be given to three dimensions of social context: the material, symbolic and relational. This paper has four parts. We begin by outlining why community mobilisation is regarded as a core dimension of effective HIV/AIDS management: it increases the "reach" and sustainability of programmes; it is a vital component of the wider "task shifting" agenda given the scarcity of health professionals in many HIV/AIDS-vulnerable contexts. Most importantly it facilitates those social psychological processes that we argue are vital preconditions for effective prevention, care and treatment. Secondly we map out three generations of approaches to behaviour change within the HIV/AIDS field: HIV-awareness, peer education and community mobilisation. We critically evaluate each approach's underlying assumptions about the drivers of behaviour change, to frame our understandings of the pathways between mobilisation and health, drawing on the concepts of social capital, dialogue and empowerment. Thirdly we refer to two well-documented case studies of community mobilisation in India and South Africa to illustrate our claim that community mobilisation is unlikely to succeed in the absence of supportive material, symbolic and relational contexts. Fourthly we provide a brief overview of how the papers in this special issue help us flesh out our conceptualisation of the "health enabling social environment". We conclude by arguing for the urgent need for a 'fourth generation' of approaches in the theory and practice of HIV/AIDS management, one which pays far greater

  6. Sensitivity of disease management decision aids to temperature input errors associated with out-of-canopy and reduced time-resolution measurements

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Plant disease management decision aids typically require inputs of weather elements such as air temperature. Whereas many disease models are created based on weather elements at the crop canopy, and with relatively fine time resolution, the decision aids commonly are implemented with hourly weather...

  7. Office of Federal Student Aid: Better Strategic and Human Capital Would Help Sustain Management Progress. Report to Congressional Committees. GAO-05-31

    ERIC Educational Resources Information Center

    Ashby, Cornelia M.

    2004-01-01

    In 2003, the Department of Education's Office of Federal Student Aid (FSA) managed about $60 billion in new financial aid. In 1998, the Congress designated FSA as a performance-based organization. In so doing, it specified purposes for the agency, such as to reduce program costs and increase accountability of its officials, and provided…

  8. The Con Edison Emergency Child Care Plan for Management Employees: Summary Plan Description.

    ERIC Educational Resources Information Center

    Consolidated Edison Co., Brooklyn, NY.

    This summary plan description offers guidelines for participation in a pilot program that provides short-term emergency care for children of Con Edison managers who are under 13 years old. The plan offers professional, in-home child care that can be used when usual arrangements have collapsed. The summary plan description addresses the following…

  9. Designing a HAZMAT (hazardous materials) incident management system for facilities with widely varying emergency organization structures

    SciTech Connect

    Carter, R.J.; Easterly, C.E.

    1988-01-01

    Oak Ridge National Laboratory is currently conducting a research program for the United States Air Force, the purpose of which is to assist them in their emergency planning for HAZMAT spills. This paper describes the first two tasks in the program. These tasks are oriented towards: determining the extent of the hazardous materials (HAZMAT) problem and establishing plans directed toward HAZMAT incident management.

  10. It's Not Business as Usual: New and Emerging Career in Marketing, Finance, and Management

    ERIC Educational Resources Information Center

    Miller, April J.

    2010-01-01

    There have been many changes in the field of business as a result of technological advancements, government regulations, and shifts in focus. These new career opportunities have arisen as a result: social media marketers, financial examiners, and project managers. In this article, the author discusses these new and emerging career opportunities in…

  11. Diagnosis and management of new and re-emerging diseases of highbush blueberries in Michigan

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Blueberries are an important commodity in Michigan and disease management is crucial for production of high-quality fruit. Over the past 6 years, a number of new and re-emerging diseases have been diagnosed in the state. In 2009, Blueberry scorch virus (BlScV) and Blueberry shock virus (BlShV) were ...

  12. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... under the WYO (Write Your Own) Program. 44 CFR part 62, appendix B. These data shall be validated/edited... Agency, Federal Insurance Administration, Financial Assistance/Subsidy Arrangement A Appendix A to Part... OF CLAIMS Pt. 62, App. A Appendix A to Part 62—Federal Emergency Management Agency, Federal...

  13. Sensitivities to source-term parameters of emergency planning zone boundaries for waste management facilities

    SciTech Connect

    Mueller, C.J.

    1995-07-01

    This paper reviews the key parameters comprising airborne radiological and chemical release source terms, discusses the ranges over which values of these parameters occur for plausible but severe waste management facility accidents, and relates the concomitant sensitivities of emergency planning zone boundaries predicted on calculated distances to early severe health effects.

  14. Assessing Roles of People, Technology and Structure in Emergency Management Systems: A Public Sector Perspective

    ERIC Educational Resources Information Center

    Kim, Minkyun; Sharman, Raj; Cook-Cottone, Catherine P.; Rao, H. Raghav; Upadhyaya, Shambhu J.

    2012-01-01

    Emergency management systems are a critical factor in successful mitigation of natural and man-made disasters, facilitating responder decision making in complex situations. Based on socio-technical systems, have which four components (people, technology, structure and task), this study develops a research framework of factors affecting effective…

  15. Managing the Transition to College: Family Functioning, Emotion Coping, and Adjustment in Emerging Adulthood

    ERIC Educational Resources Information Center

    Johnson, Vanessa Kahen; Gans, Susan E.; Kerr, Sandra; LaValle, William

    2010-01-01

    Using a self-reported assessment of 320 first-time college students, we tested the hypothesis that one's ability to manage emotion moderates the relationship between family environment and college adjustment. Results add to growing evidence that the way one views one's whole family environment during the emerging adulthood years is linked to one's…

  16. 75 FR 11191 - Privacy Act of 1974; Retirement of Department of Homeland Security Federal Emergency Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-10

    ... Federal Emergency Management Agency U.S. Fire Administration--001 9/11 Heroes Stamp Act of 2001 System of.... Fire Administration (USFA) is giving notice that it proposes to retire DHS/FEMA/USFA--001 9/11 Heroes Stamp Act of 2001 System of Records (70 FR 43218, July 26, 2005). ] This system was...

  17. Seeking Accountability through State-Appointed Emergency District Management. Working Paper #28

    ERIC Educational Resources Information Center

    Arsen, David; Mason, Mary L.

    2012-01-01

    Michigan's Local Government and School District Accountability Act of 2011 empowers the governor to appoint emergency managers (EMs) in financially-troubled school districts. EMs assume all powers of the superintendent and school board. They can reshape academic programs, nullify labor contracts, and open and close schools. This paper analyzes the…

  18. Bibliography for nuclear criticality accident experience, alarm systems, and emergency management

    SciTech Connect

    Putman, V.L.

    1995-09-01

    The characteristics, detection, and emergency management of nuclear criticality accidents outside reactors has been an important component of criticality safety for as long as the need for this specialized safety discipline has been recognized. The general interest and importance of such topics receives special emphasis because of the potentially lethal, albeit highly localized, effects of criticality accidents and because of heightened public and regulatory concerns for any undesirable event in nuclear and radiological fields. This bibliography lists references which are potentially applicable to or interesting for criticality alarm, detection, and warning systems; criticality accident emergency management; and their associated programs. The lists are annotated to assist bibliography users in identifying applicable: industry and regulatory guidance and requirements, with historical development information and comments; criticality accident characteristics, consequences, experiences, and responses; hazard-, risk-, or safety-analysis criteria; CAS design and qualification criteria; CAS calibration, maintenance, repair, and testing criteria; experiences of CAS designers and maintainers; criticality accident emergency management (planning, preparedness, response, and recovery) requirements and guidance; criticality accident emergency management experience, plans, and techniques; methods and tools for analysis; and additional bibliographies.

  19. 78 FR 62638 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management and Budget (OMB) Title: Low Income Home Energy Assistance Program (LIHEAP) Grantee Needs...

  20. Psychiatric and medical management of marijuana intoxication in the emergency department.

    PubMed

    Bui, Quan M; Simpson, Scott; Nordstrom, Kimberly

    2015-05-01

    We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient's psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. PMID:25987916

  1. Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

    PubMed Central

    Bui, Quan M.; Simpson, Scott; Nordstrom, Kimberly

    2015-01-01

    We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. PMID:25987916

  2. Massachusetts Emergency Departments’ Resources and Physicians’ Knowledge of Management of Traumatic Dental Injuries

    PubMed Central

    Needleman, Howard L.; Stucenski, Keri; Forbes, Peter; Chen, Qiaoli (Lily); Stack, Anne M.

    2012-01-01

    Background Hospital emergency departments (ED) are confronted with triaging and managing dental emergencies of both traumatic and non-traumatic origin. However, the literature suggests that there exists inadequate knowledge of the management of traumatic dental injuries (TDI) among medical professionals who must be knowledgeable and have the appropriate resources needed to triage or treat patients presenting with TDI. Aim The aims of this study were to; 1) evaluate the resources of Massachusetts emergency departments (MED) for TDI, 2) determine the knowledge of management of TDI among MED physicians, and 3) investigate potential factors that affect their knowledge. Material and Methods Surveys were mailed to MED directors and their physicians. The director survey contained questions regarding institutional information for each emergency department (ED). The physician survey contained questions about physician characteristics and tested their knowledge of managing dental trauma. Results A total of 72 surveys (16 MED directors and 56 physicians) were returned and included in the analysis. Only 50% of the MED had on-site dental coverage, 43.8% had 24-hour off-site dental coverage and none had a formal written dental trauma protocol. MED physician’s knowledge of the appropriate management of luxations and avulsions was generally good, but poor for dental fractures. The MED physician’s knowledge for the emergent nature of the various injuries was generally good with that of avulsions being the best. Physicians were more likely to have a better knowledge of managing dental trauma if they were specialists in pediatric emergency medicine (p=0.001) or their hospitals had an academic affiliation (p=0.05). Conclusions Based on the findings from this study educational campaigns must be undertaken to improve both the resources available to the ED, as well as to improve the knowledge of physicians regarding emergency management of TDI. In addition, efforts should be made by

  3. Preparing for veterinary emergencies: disaster management and the Incident Command System.

    PubMed

    Madigan, J; Dacre, I

    2009-08-01

    An important question that all veterinary schools should consider is whether veterinary students should be trained to deal with local or regional states of emergency or disasters, such as hurricanes, tornadoes, wildfires, hail and ice storms, wind storms, fires, earthquakes, tsunamis, floods and epidemics. When a large-scale emergency or disaster does strike, the consequences can be dire for the domestic and wild animals of the region and for the humans within the vicinity of seriously and painfully injured animals. The authors argue that emergency preparedness is essential for the veterinary profession to meet its obligations to both animals and humans. The four basic components of disaster management are: mitigation, preparedness, response/emergency relief and recovery. PMID:20128473

  4. Highlights from the 2014 International Symposium on HIV & Emerging Infectious Diseases (ISHEID): from cART management to the end of the HIV pandemic.

    PubMed

    Lafeuillade, Alain; Wainberg, Mark; Gougeon, Marie-Lise; Loes, Sabine Kinloch-de; Halfon, Philippe; Tissot-Dupont, Hervé

    2014-01-01

    The 2014 International Symposium on HIV and Emerging Infectious Diseases (ISHEID) provided a forum for investigators to hear the latest research developments in the clinical management of HIV and HCV infections as well as HIV cure research. Combined anti-retroviral therapy (c-ART) has had a profound impact on the disease prognosis and transformed this infection into a chronic disease. However, HIV is able to persist within the infected host and the pandemic is still growing. The main 2014 ISHEID theme was, hence "Together for a world without HIV and AIDS". In this report we not only give details on this main topic but also summarize what has been discussed in the areas of HCV coinfection and present a short summary on currently emerging viral diseases. PMID:25165483

  5. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations

    PubMed Central

    Dotson, G. Scott; Hudson, Naomi L.; Maier, Andrew

    2016-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management. PMID:26312660

  6. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations.

    PubMed

    Dotson, G Scott; Hudson, Naomi L; Maier, Andrew

    2015-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management. PMID:26312660

  7. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations.

    PubMed

    Dotson, G Scott; Hudson, Naomi L; Maier, Andrew

    2015-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management. PMID:26663307

  8. Current concepts in management of pain in children in the emergency department.

    PubMed

    Krauss, Baruch S; Calligaris, Lorenzo; Green, Steven M; Barbi, Egidio

    2016-01-01

    Pain is common in children presenting to emergency departments with episodic illnesses, acute injuries, and exacerbation of chronic disorders. We review recognition and assessment of pain in infants and children and discuss the manifestations of pain in children with chronic illness, recurrent pain syndromes, and cognitive impairment, including the difficulties of pain management in these patients. Non-pharmacological interventions, as adjuncts to pharmacological management for acute anxiety and pain, are described by age and development. We discuss the pharmacological management of acute pain and anxiety, reviewing invasive and non-invasive routes of administration, pharmacology, and adverse effects. PMID:26095580

  9. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (SGI IRIS VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  10. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (SGI IRIS VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  11. AIDS Training in the Workplace.

    ERIC Educational Resources Information Center

    Vest, Jusanne M.; And Others

    1991-01-01

    Management training regarding Acquired Immune Deficiency Syndrome (AIDS) begins with three needs assessment tools--instruments measuring fear of AIDS, knowledge of AIDS, and beliefs about the business consequences of the disease. (SK)

  12. The impact of nursing leadership and management on the control of HIV/AIDS: an ethnographic study.

    PubMed

    Nawafleh, Hani; Francis, Karen; Chapman, Ysanne

    2012-10-01

    This paper reports on an aspect of a larger ethnographic study that sought to investigate the impact of HIV/AIDS on the practice of primary care nurses in Jordan. Nursing leadership and the style of management adopted by senior nursing and medical administrators at the Ministry of Heath were identified as factors impacting on the practice of the nurses and their capacity to raise community awareness and contribute to the prevention and control of HIV/AIDS. The study was undertaken in three rural and three urban primary health care centres (PHCC). Data collection included participant observation, key informant interviews, and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of the nurse participants. PMID:23181375

  13. The Influential Factor Analysis of Classification Partition Management Mode on the Emergency Triage

    PubMed Central

    NA, Zhang; HUAIXIN, Cui

    2016-01-01

    Background: The aim of the study was to discuss on the influential factors of the mode of classification of partition management in the emergency triage. Method: Retrospectively analyzing the effects of emergency triage of 156 cases who adopted the classification partition management mode during Oct 2014 to Oct 2015 in Xuzhou Central Hospital (Xuzhou, Jiangsu Province, China). They were divided into triage success group of 108 cases and triage failure group of 48 cases. Comparing the single factor analysis and multi-factor analysis, and selecting possible influential factors. Result: According to the single factor analysis, for the patients who came to the doctor in the daytime and working days, the higher education degree and compliance they had, the faster the back-show time of emergency inspect and check came back, the more comprehensive the body examination and disease history taking were done, the simpler the disease condition was, the higher triage success rate they received. Compared to the emergency observation time between two groups, the difference was not statistically significant. According to the multi-factor analysis, the emergency check and examination back-show time, the comprehensive degree of body examination and disease history taking and the complexity degree of disease could be the independent risk factors for triage success. Conclusion: Simplify the examination procedure, improve the efficiency of back-show and acquire detail disease information are important methods for the improvement of triage success. PMID:27516994

  14. Management of disasters and complex emergencies in Africa: The challenges and constraints.

    PubMed

    Aliyu, Alhaji

    2015-01-01

    Natural and man-made catastrophes have caused significant destruction and loss of lives throughout human history. Disasters accompany a wide variety of events with multiple causes and consequences often leading to a cascade of related events. African continent has not been spared of these events. A new phenomenon in the continent is terrorism that is fuelled by globalization of arms trade and has contributed significantly to escalation of conflicts in sub-Saharan Africa (SSA) resulting in complex emergencies and destruction of socioeconomic structures. The aim of this paper is to review relevant papers on management of disasters and complex emergencies in Africa and the challenges and constraints against the background of a weakened health system. Systematic search of published literature was conducted between 1990 and 2013. Grey literature (technical reports, government documents), published peer review journals, abstracts, relevant books and internet articles were reviewed. The review revealed that the frequency of both natural and man-made disasters in Africa is escalating. Complex emergencies are also on the increase since the Rwandan crisis in 1994. The impact of these events has overstretched and overwhelmed the health care system that is least prepared to handle and cope with the surge capacity and also render normal services. In conclusion, there is an urgent need for national emergency agencies/departments across Africa to develop a robust emergency preparedness and response plan. Every hospital most have a disaster management committee with flexible disaster management plan to respond to these catastrophes. There is a need for curriculum review in tertiary institutions across SSA to introduce and or expand training in disaster management. PMID:26021392

  15. Federal Emergency Management Information Systems (FEMIS), System Administration Guide FEMIS: Phase 1, Version 1.1u

    SciTech Connect

    Cerna, P.A.; Conner, W.M.; Curtis, L.M.

    1995-06-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS software package.

  16. Managing biological networks by using text mining and computer-aided curation

    NASA Astrophysics Data System (ADS)

    Yu, Seok Jong; Cho, Yongseong; Lee, Min-Ho; Lim, Jongtae; Yoo, Jaesoo

    2015-11-01

    In order to understand a biological mechanism in a cell, a researcher should collect a huge number of protein interactions with experimental data from experiments and the literature. Text mining systems that extract biological interactions from papers have been used to construct biological networks for a few decades. Even though the text mining of literature is necessary to construct a biological network, few systems with a text mining tool are available for biologists who want to construct their own biological networks. We have developed a biological network construction system called BioKnowledge Viewer that can generate a biological interaction network by using a text mining tool and biological taggers. It also Boolean simulation software to provide a biological modeling system to simulate the model that is made with the text mining tool. A user can download PubMed articles and construct a biological network by using the Multi-level Knowledge Emergence Model (KMEM), MetaMap, and A Biomedical Named Entity Recognizer (ABNER) as a text mining tool. To evaluate the system, we constructed an aging-related biological network that consist 9,415 nodes (genes) by using manual curation. With network analysis, we found that several genes, including JNK, AP-1, and BCL-2, were highly related in aging biological network. We provide a semi-automatic curation environment so that users can obtain a graph database for managing text mining results that are generated in the server system and can navigate the network with BioKnowledge Viewer, which is freely available at http://bioknowledgeviewer.kisti.re.kr.

  17. WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting.

    PubMed

    Sartelli, Massimo; Catena, Fausto; Ansaloni, Luca; Coccolini, Federico; Griffiths, Ewen A; Abu-Zidan, Fikri M; Di Saverio, Salomone; Ulrych, Jan; Kluger, Yoram; Ben-Ishay, Ofir; Moore, Frederick A; Ivatury, Rao R; Coimbra, Raul; Peitzman, Andrew B; Leppaniemi, Ari; Fraga, Gustavo P; Maier, Ronald V; Chiara, Osvaldo; Kashuk, Jeffry; Sakakushev, Boris; Weber, Dieter G; Latifi, Rifat; Biffl, Walter; Bala, Miklosh; Karamarkovic, Aleksandar; Inaba, Kenji; Ordonez, Carlos A; Hecker, Andreas; Augustin, Goran; Demetrashvili, Zaza; Melo, Renato Bessa; Marwah, Sanjay; Zachariah, Sanoop K; Shelat, Vishal G; McFarlane, Michael; Rems, Miran; Gomes, Carlos Augusto; Faro, Mario Paulo; Júnior, Gerson Alves Pereira; Negoi, Ionut; Cui, Yunfeng; Sato, Norio; Vereczkei, Andras; Bellanova, Giovanni; Birindelli, Arianna; Di Carlo, Isidoro; Kok, Kenneth Y; Gachabayov, Mahir; Gkiokas, Georgios; Bouliaris, Konstantinos; Çolak, Elif; Isik, Arda; Rios-Cruz, Daniel; Soto, Rodolfo; Moore, Ernest E

    2016-01-01

    Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference. PMID:27478494

  18. Advanced Concepts and Controversies in Emergency Department Pain Management.

    PubMed

    Motov, Sergey M; Nelson, Lewis S

    2016-06-01

    Pain is the most common complaint for which patients come to the emergency department (ED). Emergency physicians are responsible for pain relief in a timely, efficient, and safe manner in the ED. The improvement in our understanding of the neurobiology of pain has balanced the utilization of nonopioid and opioid analgesia, and simultaneously has led to more rational and safer opioid prescribing practices. This article reviews advances in pain management in the ED for patients with acute and chronic pain as well as describes several newer strategies and controversies. PMID:27208710

  19. Knowledge of Emergency Management of Traumatized Teeth among Schoolteachers in Mashhad, Iran.

    PubMed

    Mehrabkhani, Maryam; Ajami, Behjatolmolok; Parisay, Iman; Bolboli, Ali; Akbarian, Golsa

    2015-01-01

    Background and aims. Dental trauma is an important oral health problem in children that requires immediate and appropriate management for long term success. The aim of this study was to evaluate the knowledge of elementary school teachers about emergency management of traumatic dental injuries in children. Materials and methods. A total of 163 teachers from 21 elementary schools from Mashhad, Iran participated in this study. Data were collected using a two-part questionnaire comprised of questions regarding demographic data and participants' knowledge about dental trauma. Results. The level of the teachers' knowledge was moderate (53.3%). Of the 163 participants, 104 (63.8%) were females and 59 (36.2%) were males. Among several predictors that were surveyed in this study, only the age of respondents signifi-cantly impacted the teachers' knowledge (P = 0.004). Conclusion. The results of this study showed the moderate level of knowledge of teachers regarding emergency manage-ment of traumatized teeth. Adding dental trauma management courses in the teacher training curriculum and requiring teachers to be updated in regards to this issue can improve their knowledge and thus led to better management of traumatic dental injuries in children. PMID:26236440

  20. Integrating emerging earth science technologies into disaster risk management: an enterprise architecture approach

    NASA Astrophysics Data System (ADS)

    Evans, J. D.; Hao, W.; Chettri, S. R.

    2014-12-01

    Disaster risk management has grown to rely on earth observations, multi-source data analysis, numerical modeling, and interagency information sharing. The practice and outcomes of disaster risk management will likely undergo further change as several emerging earth science technologies come of age: mobile devices; location-based services; ubiquitous sensors; drones; small satellites; satellite direct readout; Big Data analytics; cloud computing; Web services for predictive modeling, semantic reconciliation, and collaboration; and many others. Integrating these new technologies well requires developing and adapting them to meet current needs; but also rethinking current practice to draw on new capabilities to reach additional objectives. This requires a holistic view of the disaster risk management enterprise and of the analytical or operational capabilities afforded by these technologies. One helpful tool for this assessment, the GEOSS Architecture for the Use of Remote Sensing Products in Disaster Management and Risk Assessment (Evans & Moe, 2013), considers all phases of the disaster risk management lifecycle for a comprehensive set of natural hazard types, and outlines common clusters of activities and their use of information and computation resources. We are using these architectural views, together with insights from current practice, to highlight effective, interrelated roles for emerging earth science technologies in disaster risk management. These roles may be helpful in creating roadmaps for research and development investment at national and international levels.