Determining the appropriate strategies for emergency planning through AHP-SWOT.

PubMed

Kalatpour, Omid

2017-01-01

During an unexpected incident, companies should demonstrate appropriate behaviour based on predetermined and rehearsed emergency strategies. This paper describes how to select the proper strategies for emergency situations via means of the AHP-SWOT tool, where the initial SWOT analysis is conducted for the emergency management system, and the final strategies are selected via the analytic hierarchy process (AHP). Alternative response strategies comprise internal, shared and external responses. Most of the scenarios investigated for this study demanded a shared response. These findings highlight the importance of mutual aid agreements, cooperative exercises and the improvement of communication systems. Organisations can take advantage of integrated approaches to select the best strategies and tactics for normal situations in general and emergency situations in particular.

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

2016-07-08

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).

Applying New Diabetes Teaching Tools in Health-Related Extension Programming

ERIC Educational Resources Information Center

Grenci, Alexandra

2010-01-01

In response to the emerging global diabetes epidemic, health educators are searching for new and better education tools to help people make positive behavior changes to successfully prevent or manage diabetes. Conversation Maps[R] are new learner-driven education tools that have been developed to empower individuals to improve their health…

WHO-REMPAN for global health security and strengthening preparedness and response to radiation emergencies.

PubMed

Carr, Zhanat

2010-06-01

In response to the changing global environment and emerging new issues related to health security, the World Health Organization (WHO) is putting in place new tools for collective defense, such as the revised International Health Regulations (IHR) (2005). The new framework puts additional responsibilities on both Member States and WHO itself in order to effectively implement the IHR (2005) and react effectively in case of public health emergency events of any nature. Since its establishment in 1987, the Radiation Emergency Medical Preparedness and Assistance Network of WHO (WHO-REMPAN) has become an important asset for the organization's capacity to respond to radiation emergencies and to assist its Member States to strengthen their own response capacities. The paper describes in detail the framework for the WHO's role in preparedness and response to radiation emergencies, including Emergency Conventions and IHR (2005), and how the WHO-REMPAN, through its activities (i.e., technical guidelines development, training, education, research, and information sharing), provides a significant contribution to the organization's program of work towards achievement of the global health security goal.

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

DOE Office of Scientific and Technical Information (OSTI.GOV)

HCTT-CHE

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthenmore » existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.« less

Microbe-ID: An open source toolbox for microbial genotyping and species identification

USDA-ARS?s Scientific Manuscript database

Development of tools to identify species, genotypes, or novel strains of invasive organisms is critical for monitoring emergence and implementing rapid response measures. Molecular markers, although critical to identifying species or genotypes, require bioinformatic tools for analysis. However, user...

Special population planner, version 4.0.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuiper, J.; Tanzman, E.; Metz, W.

2007-03-26

Emergencies happen every day. Many are caused by storms or auto accidents and can be planned for, if not predicted. Emergencies resulting from natural hazards often affect a large number of people, and planning for them can be difficult, since knowledge of the needs of the people involved is generally unavailable. Emergencies resulting from accidents at industrial and military facilities can also be large scale in nature if people must be evacuated or sheltered in place. Federal planning for large scale emergencies is the responsibility of the Federal Emergency Management Agency (FEMA), which provides assistance to various emergency management agenciesmore » at the national, state and local level. More information about FEMA is available at http://www.fema.gov/. The purpose of the Special Population Planner (SPP) is to help emergency planners address the needs of persons with special needs. The exact definition of 'special population' is a policy decision. Policymakers have included a variety of groups in this term, such as persons with disabilities, those who do not have vehicles with which to evacuate, children who are unattended at times (latchkey children), and many others. The SPP was developed initially for the Alabama Emergency Management Agency as part of its Chemical Stockpile Emergency Preparedness Program (CSEPP), which aids emergency planning and preparedness in communities surrounding military installations across the United States where chemical weapons are stored pending their destruction under federal law. Like that specialized application, this open-source version contains a set of specialized Geographic Information System (GIS) tools to facilitate emergency planning on behalf of persons with special needs, regardless of how the term is defined. While the original SPP system was developed for emergency planning relating to chemical hazards, it can be applied to other threats as well. It is apparent from Hurricane Katrina and other natural and man-made disasters that many of the problems posed by emergency planning for a chemical weapons agent release are shared by other hazards as well. The notion that emergency planning shares common functions underlies the decision by FEMA to include the Chemical Stockpile Emergency Preparedness Program (CSEPP) in its 'all-hazards' planning approach. The CSEPP's official planning guidance operationalizes this approach by suggesting that state and local CSEPP emergency plans 'should be appended to the existing all-hazards emergency plan.' The SPP is programmed as a set of tools within an ESRI ArcMap 9.1 project. ArcMap is a component of both ESRI ArcGIS 9.1 and ESRI ArcView 9.1, and it provides a rich GIS user interface for viewing spatial and tabular data, analyzing it, and producing output reports and maps. This GIS interface has been augmented with the SPP tools for a user interface that provides custom functionality for emergency planning. The system as released also includes some hypothetical example records for special needs populations, facilities, resources, control points and sirens sufficient for showing how the system would work with real information. A GIS database is included with some publicly available example layers. The SPP is designed to support emergency planners as they address emergency management issues, and includes capabilities that support the collection and importing of data, the review of data in a spatial context, and GIS tools for emergency planning. The SPP system allows for the identification and categorization of response zones to allow for multiple levels of preparedness. An Immediate Response Zone (IRZ) might be designated as the area 0 to 10 miles from a facility where the response would be the most urgent. SPP can support more than one set of planning zones to accommodate different types of emergencies or the different jurisdictions of emergency response organizations. These areas can be delineated by any number of criteria that make sense for the area. An area like New Orleans might designate response zones based on the depth above/below sea level, or an urban area may categorize an IRZ as the 'central business district' with the PAZ encompassing the larger outlying area. Many of the sites involved in the CSEPP currently use an integrated emergency response information system to support their emergency management planning. The D2-Puff system (including or WebPuff 2.1) by Innovative Emergency Management, Inc. is the main software serving this purpose. More information on D2-Puff can be found at www.ieminc.com. SPP differs from D2-Puff in that it is designed for planning, not response to assist those with special needs, is programmed within a popular commercial GIS software system, and can be loaded with large amounts of data to support all hazards emergency planning.« less

WMD first response: requirements, emerging technologies, and policy implications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vergino, E S; Hoehn, W E

2000-06-19

In the US today, efforts are underway to defend against the possible terrorist use of weapons of mass destruction (WMD) against US cities. These efforts include the development and adaptation of technologies to support prevention and detection, to defend against a possible attack, and, if these fail, to provide both mitigation responses and attribution for a WMD incident. Technologies under development span a range of systems, from early detection and identification of an agent or explosive, to diagnostic and systems analysis tools; and to forensic analysis for law enforcement. Also, many techniques and tools that have been developed for othermore » applications are being examined to determine whether, with some modification, they could be of use by the emergency preparedness, public health, and law enforcement communities. However, anecdotal evidence suggests the existence of a serious disconnect between the technology development communities and these user communities. This disconnect arises because funding for technology development is derived primarily from sources (principally federal agencies) distant from the emergency response communities, which are predominantly state, county, or local entities. Moreover, the first responders with whom we have worked candidly admit that their jurisdictions have been given, or have purchased for them, a variety of technological devices, typically without consulting the emergency responders about their utility. In private discussions, emergency responders derisively refer to these as a closet full of useless toys. Technology developers have many new and relevant technologies currently in the development pipeline, but most have not been adequately vetted against the field needs or validated for field use. The Center for Global Security Research at the Lawrence Livermore National Laboratory and the Sam Nunn School of International Affairs at the Georgia Institute of Technology recently sponsored a two-day workshop to bring together some 50 representatives of the emergency response, technology development, and policy communities. Participating in this workshop were first responders (representing law enforcement, public health, and emergency response personnel from Los Angeles County, Salt Lake City, Atlanta, and London, England), technology developers from US government laboratories and universities, and policymakers from both the executive and legislative branches of the federal government. The workshop had several objectives. First, we wanted the emergency responders to define the utility of various technologies and tools currently available for first response to a WMD event. Second, we expected the workshop to provide input to the technologists directly from the field users, regarding their special requirements for, and constraints on the use of, new emergency response technologies. Third, we planned to expose the first responders to the types of new technologies under development and allow them the opportunity to ask questions and voice their needs. Finally, we planned to provide recommendations to policymakers for new directions for development and investment of technology.« less

Situational Awareness Geospatial Application (iSAGA)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sher, Benjamin

Situational Awareness Geospatial Application (iSAGA) is a geospatial situational awareness software tool that uses an algorithm to extract location data from nearly any internet-based, or custom data source and display it geospatially; allows user-friendly conduct of spatial analysis using custom-developed tools; searches complex Geographic Information System (GIS) databases and accesses high resolution imagery. iSAGA has application at the federal, state and local levels of emergency response, consequence management, law enforcement, emergency operations and other decision makers as a tool to provide complete, visual, situational awareness using data feeds and tools selected by the individual agency or organization. Feeds may bemore » layered and custom tools developed to uniquely suit each subscribing agency or organization. iSAGA may similarly be applied to international agencies and organizations.« less

76 FR 4708 - Agency Information Collection Activities: Submission for OMB Review; Comment Request, OMB No...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... assess disaster logistics planning and response capabilities and identify areas of relative strength and...; Logistics Capability Assessment Tool (LCAT) AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice...: Collection of Information Title: Logistics Capability Assessment Tool (LCAT). Type of Information Collection...

Unique Sensor Plane Maps Invisible Toxins for First Responders

ScienceCinema

Kroutil, Robert; Thomas, Mark; Aten, Keith

2018-05-30

A unique airborne emergency response tool, ASPECT is a Los Alamos/U.S. Environmental Protection Agency project that can put chemical and radiological mapping tools in the air over an accident scene. The name ASPECT is an acronym for Airborne Spectral Photometric Environmental Collection Technology.

Response to Paper III Economics in the Civics Curriculum. A Reaction to Andrew F. Brimmer.

ERIC Educational Resources Information Center

Schug, Mark C.

According to the document, Dr. Andrew Brimmer did an excellent job of identifying emerging economic concerns. Dr. Brimmer's characterization of economics as a tool kit can help young people examine important social questions using principles of economics as the tool for analysis. One way to build an economics tool kit is by placing more stress on…

Disaster Response and Preparedness Application: Emergency Environmental Response Tool (EERT)

NASA Technical Reports Server (NTRS)

Smoot, James; Carr, Hugh; Jester, Keith

2003-01-01

In 2000, the National Aeronautics and Space Administration (NASA) Environmental Office at the John C. Stennis Space Center (SSC) developed an Environmental Geographic Information Systems (EGIS) database. NASA had previously developed a GIS database at SSC to assist in the NASA Environmental Office's management of the Center. This GIS became the basis for the NASA-wide EGIS project, which was proposed after the applicability of the SSC database was demonstrated. Since its completion, the SSC EGIS has aided the Environmental Office with noise pollution modeling, land cover assessment, wetlands delineation, environmental hazards mapping, and critical habitat delineation for protected species. At SSC, facility management and safety officers are responsible for ensuring the physical security of the facilities, staff, and equipment as well as for responding to environmental emergencies, such as accidental releases of hazardous materials. All phases of emergency management (planning, mitigation, preparedness, and response) depend on data reliability and system interoperability from a variety of sources to determine the size and scope of the emergency operation. Because geospatial data are now available for all NASA facilities, it was suggested that this data could be incorporated into a computerized management information program to assist facility managers. The idea was that the information system could improve both the effectiveness and the efficiency of managing and controlling actions associated with disaster, homeland security, and other activities. It was decided to use SSC as a pilot site to demonstrate the efficacy of having a baseline, computerized management information system that ultimately was referred to as the Emergency Environmental Response Tool (EERT).

Nonfatal tool- or equipment-related injuries treated in US emergency departments among workers in the construction industry, 1998-2005.

PubMed

Lipscomb, Hester J; Schoenfisch, Ashley L; Shishlov, Kirill S; Myers, Douglas J

2010-06-01

Individuals in the construction industry are exposed to a variety of tools and pieces of equipment as they work. Data from the National Institute for Occupational Safety and Health (NIOSH) occupational supplement to the National Electronic Injury Surveillance System (NEISS-Work) were used to characterize tool- and equipment-related injuries among workers in the construction industry that were treated in US emergency departments between 1998 and 2005. Based on a national stratified probability sample of US hospitals with 24 hr emergency services, NEISS-Work allows calculation of national injury estimates. Over the 8-year period between 1998 and 2005, we estimated 786,900 (95% CI 546,600-1,027,200) ED-treated tool- or equipment-related injuries identified by the primary or secondary source of injury code. These injuries accounted for a quarter of all ED-treated construction industry injuries. Although over 100 different tools or pieces of equipment were responsible for these injuries, seven were responsible for over 65% of the injury burden: ladders, nail guns, power saws, hammers, knives, power drills, and welding tools in decreasing order. Current injury estimates and their severity, marked by the proportion of cases that were not released after ED treatment, indicate interventions are particularly needed to prevent injuries associated with use of ladders as well as nail guns and power saws. Attention should focus on design and guarding to more efficiently prevent these injuries rather than simply calling for the training of workers in how to safely use a dangerous tool or piece of equipment. 2010 Wiley-Liss, Inc.

Integrating Social Networks in Teaching in Higher Education

ERIC Educational Resources Information Center

Abousoliman, Onsy

2017-01-01

In response to the emerging and swiftly developing digital tools, this dissertation investigated integrating a specific category of these tools, social networks, in teaching in higher education. The study focused on exploring how social networks integration might impact the teaching/learning process and on investigating the challenges that could…

The Flash Environmental Assessment Tool: worldwide first aid for chemical accidents response, pro action, prevention and preparedness.

PubMed

Posthuma, Leo; Wahlstrom, Emilia; Nijenhuis, René; Dijkens, Chris; de Zwart, Dick; van de Meent, Dik; Hollander, Anne; Brand, Ellen; den Hollander, Henri A; van Middelaar, Johan; van Dijk, Sander; Hall, E F; Hoffer, Sally

2014-11-01

The United Nations response mechanism to environmental emergencies requested a tool to support disaster assessment and coordination actions by United Nations Disaster Assessment and Coordination (UNDAC) teams. The tool should support on-site decision making when substantial chemical emissions affect human health directly or via the environment and should be suitable for prioritizing impact reduction management options under challenging conditions worldwide. To answer this need, the Flash Environmental Assessment Tool (FEAT) was developed and the scientific and practical underpinning and application of this tool are described in this paper. FEAT consists of a printed decision framework and lookup tables, generated by combining the scientific data on chemicals, exposure pathways and vulnerabilities with the pragmatic needs of emergency field teams. Application of the tool yields information that can help prioritize impact reduction measures. The first years of use illustrated the usefulness of the tool as well as suggesting additional uses and improvements. An additional use is application of the back-office tool (Hazard Identification Tool, HIT), the results of which aid decision-making by the authorities of affected countries and the preparation of field teams for on-site deployment. Another extra use is in disaster pro action and prevention. In this case, the application of the tool supports safe land-use planning and improved technical design of chemical facilities. UNDAC teams are trained to use the tool after large-scale sudden onset natural disasters. Copyright © 2014 Elsevier Ltd. All rights reserved.

Emergency Home - PHE

Science.gov Websites

and reload this page. Skip over global navigation links U.S. Department of Health and Human Services Health Emergency - Leading a Nation Prepared Search Search Right Box1 Content 2017 Hurricane Response and Deaf or Hard of Hearing For Public Health Communicators and the Media Tools for the Media and Public

RTSTEP regional transportation simulation tool for emergency planning - final report.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ley, H.; Sokolov, V.; Hope, M.

2012-01-20

Large-scale evacuations from major cities during no-notice events - such as chemical or radiological attacks, hazardous material spills, or earthquakes - have an obvious impact on large regions rather than on just the directly affected area. The scope of impact includes the accommodation of emergency evacuation traffic throughout a very large area; the planning of resources to respond appropriately to the needs of the affected population; the placement of medical supplies and decontamination equipment; and the assessment and determination of primary escape routes, as well as routes for incoming emergency responders. Compared to events with advance notice, such as evacuationsmore » based on hurricanes approaching an affected area, the response to no-notice events relies exclusively on pre-planning and general regional emergency preparedness. Another unique issue is the lack of a full and immediate understanding of the underlying threats to the population, making it even more essential to gain extensive knowledge of the available resources, the chain of command, and established procedures. Given the size of the area affected, an advanced understanding of the regional transportation systems is essential to help with the planning for such events. The objectives of the work described here (carried out by Argonne National Laboratory) is the development of a multi-modal regional transportation model that allows for the analysis of different evacuation scenarios and emergency response strategies to build a wealth of knowledge that can be used to develop appropriate regional emergency response plans. The focus of this work is on the effects of no-notice evacuations on the regional transportation network, as well as the response of the transportation network to the sudden and unusual demand. The effects are dynamic in nature, with scenarios changing potentially from minute to minute. The response to a radiological or chemical hazard will be based on the time-delayed dispersion of such materials over a large area, with responders trying to mitigate the immediate danger to the population in a variety of ways that may change over time (e.g., in-place evacuation, staged evacuations, and declarations of growing evacuation zones over time). In addition, available resources will be marshaled in unusual ways, such as the repurposing of transit vehicles to support mass evacuations. Thus, any simulation strategy will need to be able to address highly dynamic effects and will need to be able to handle any mode of ground transportation. Depending on the urgency and timeline of the event, emergency responders may also direct evacuees to leave largely on foot, keeping roadways as clear as possible for emergency responders, logistics, mass transport, and law enforcement. This RTSTEP project developed a regional emergency evacuation modeling tool for the Chicago Metropolitan Area that emergency responders can use to pre-plan evacuation strategies and compare different response strategies on the basis of a rather realistic model of the underlying complex transportation system. This approach is a significant improvement over existing response strategies that are largely based on experience gained from small-scale events, anecdotal evidence, and extrapolation to the scale of the assumed emergency. The new tool will thus add to the toolbox available to emergency response planners to help them design appropriate generalized procedures and strategies that lead to an improved outcome when used during an actual event.« less

Big insights from small volumes: deciphering complex leukocyte behaviors using microfluidics

PubMed Central

Irimia, Daniel; Ellett, Felix

2016-01-01

Inflammation is an indispensable component of the immune response, and leukocytes provide the first line of defense against infection. Although the major stereotypic leukocyte behaviors in response to infection are well known, the complexities and idiosyncrasies of these phenotypes in conditions of disease are still emerging. Novel tools are indispensable for gaining insights into leukocyte behavior, and in the past decade, microfluidic technologies have emerged as an exciting development in the field. Microfluidic devices are readily customizable, provide tight control of experimental conditions, enable high precision of ex vivo measurements of individual as well as integrated leukocyte functions, and have facilitated the discovery of novel leukocyte phenotypes. Here, we review some of the most interesting insights resulting from the application of microfluidic approaches to the study of the inflammatory response. The aim is to encourage leukocyte biologists to integrate these new tools into increasingly more sophisticated experimental designs for probing complex leukocyte functions. PMID:27194799

Science preparedness and science response: perspectives on the dynamics of preparedness conference.

PubMed

Lant, Timothy; Lurie, Nicole

2013-01-01

The ability of the scientific modeling community to meaningfully contribute to postevent response activities during public health emergencies was the direct result of a discrete set of preparedness activities as well as advances in theory and technology. Scientists and decision-makers have recognized the value of developing scientific tools (e.g. models, data sets, communities of practice) to prepare them to be able to respond quickly--in a manner similar to preparedness activities by first-responders and emergency managers. Computational models have matured in their ability to better inform response plans by modeling human behaviors and complex systems. We advocate for further development of science preparedness activities as deliberate actions taken in advance of an unpredicted event (or an event with unknown consequences) to increase the scientific tools and evidence-base available to decision makers and the whole-of-community to limit adverse outcomes.

Aircraft Emergencies: Challenge and Response

NASA Technical Reports Server (NTRS)

Burian, Barbara K.

2010-01-01

Emergency and abnormal situations in aviation present flight crews with a number of challenges. Checklists are essential tools that have been developed to assist them to meet these challenges. However, in order for checklists to be most effective in these situations they must be designed with the operational and situational demands of emergencies and abnormal conditions in mind as well as human performance capabilities and limitations under high stress and workload.

Water Resilience

EPA Pesticide Factsheets

The Drinking Water and Wastewater Resiliency site provides tools and resources for drinking water and wastewater utilities in the full spectrum of emergency management which includes prevention, mitigation, preparedness, response and recovery.

Radiation-induced damage analysed by luminescence methods in retrospective dosimetry and emergency response.

PubMed

Woda, Clemens; Bassinet, Céline; Trompier, François; Bortolin, Emanuela; Della Monaca, Sara; Fattibene, Paola

2009-01-01

The increasing risk of a mass casualty scenario following a large scale radiological accident or attack necessitates the development of appropriate dosimetric tools for emergency response. Luminescence dosimetry has been reliably applied for dose reconstruction in contaminated settlements for several decades and recent research into new materials carried close to the human body opens the possibility of estimating individual doses for accident and emergency dosimetry using the same technique. This paper reviews the luminescence research into materials useful for accident dosimetry and applications in retrospective dosimetry. The properties of the materials are critically discussed with regard to the requirements for population triage. It is concluded that electronic components found within portable electronic devices, such as e.g. mobile phones, are at present the most promising material to function as a fortuitous dosimeter in an emergency response.

`G.A.T.E': Gap analysis for TTX evaluation

NASA Astrophysics Data System (ADS)

Cacciotti, Ilaria; Di Giovanni, Daniele; Pergolini, Alessandro; Malizia, Andrea; Carestia, Mariachiara; Palombi, Leonardo; Bellecci, Carlo; Gaudio, Pasquale

2016-06-01

A Table Top Exercise (TTX) gap analysis tool was developed with the aim to provide a complete, systematic and objective evaluation of TTXs organized in safety and security fields. A TTX consists in a discussion-based emergency management exercise, organized in a simulated emergency scenario, involving groups of players who are subjected to a set of solicitations (`injects'), in order to evaluate their emergency response abilities. This kind of exercise is devoted to identify strengths and shortfalls and to propose potential and promising changes in the approach to a particular situation. In order to manage the TTX derived data collection and analysis, a gap analysis tool would be very useful and functional at identifying the 'gap' between them and specific areas and actions for improvement, consisting the gap analysis in a comparison between actual performances and optimal/expected ones. In this context, a TTX gap analysis tool was designed, with the objective to provide an evaluation of Team players' competences and performances and TTX organization and structure. The influence of both the players' expertise and the reaction time (difference between expected time and time necessary to actually complete the injects) on the final evaluation of the inject responses was also taken into account.

Mental health and psychosocial support in humanitarian emergencies.

PubMed

van Ommeren, M; Hanna, F; Weissbecker, I; Ventevogel, P

2015-09-28

Armed conflicts and natural disasters impact negatively on the mental health and well-being of affected populations in the short- and long-term and affect the care of people with pre-existing mental health conditions. This paper outlines specific actions for mental health and psychosocial support by the health sector in the preparedness, response and recovery phases of emergencies. Broad recommendations for ministries of health are to: (1) embed mental health and psychosocial support in national health and emergency preparedness plans; (2) put in place national guidelines, standards and supporting tools for the provision of mental health and psychosocial support during emergencies; (3) strengthen the capacity of health professionals to identify and manage priority mental disorders during emergencies; and (4) utilize opportunities generated by the emergency response to contribute to development of sustainable mental health-care services.

The evolution of law in biopreparedness.

PubMed

Hodge, James G

2012-03-01

The decade following the terrorist attacks on September 11, 2001, and ensuing anthrax exposures that same fall has seen significant legal reforms designed to improve biopreparedness nationally. Over the past 10 years, a transformative series of legal changes have effectively (1) rebuilt components of federal, state, and local governments to improve response efforts; (2) created an entire new legal classification known as "public health emergencies"; and (3) overhauled existing legal norms defining the roles and responsibilities of public and private actors in emergency response efforts. The back story as to how law plays an essential role in facilitating biopreparedness, however, is pocked with controversies and conflicts between law- and policymakers, public health officials, emergency managers, civil libertarians, scholars, and others. Significant legal challenges for the next decade remain. Issues related to interjurisdictional coordination; duplicative legal declarations of emergency, disaster, and public health emergency; real-time legal decision making; and liability protections for emergency responders and entities remain unresolved. This article explores the evolving tale underlying the rise and prominence of law as a pivotal tool in national biopreparedness and response efforts in the interests of preventing excess morbidity and mortality during public health emergencies.

Radiological emergency response for community agencies with cognitive task analysis, risk analysis, and decision support framework.

PubMed

Meyer, Travis S; Muething, Joseph Z; Lima, Gustavo Amoras Souza; Torres, Breno Raemy Rangel; del Rosario, Trystyn Keia; Gomes, José Orlando; Lambert, James H

2012-01-01

Radiological nuclear emergency responders must be able to coordinate evacuation and relief efforts following the release of radioactive material into populated areas. In order to respond quickly and effectively to a nuclear emergency, high-level coordination is needed between a number of large, independent organizations, including police, military, hazmat, and transportation authorities. Given the complexity, scale, time-pressure, and potential negative consequences inherent in radiological emergency responses, tracking and communicating information that will assist decision makers during a crisis is crucial. The emergency response team at the Angra dos Reis nuclear power facility, located outside of Rio de Janeiro, Brazil, presently conducts emergency response simulations once every two years to prepare organizational leaders for real-life emergency situations. However, current exercises are conducted without the aid of electronic or software tools, resulting in possible cognitive overload and delays in decision-making. This paper describes the development of a decision support system employing systems methodologies, including cognitive task analysis and human-machine interface design. The decision support system can aid the coordination team by automating cognitive functions and improving information sharing. A prototype of the design will be evaluated by plant officials in Brazil and incorporated to a future trial run of a response simulation.

Evaluating the co-production of a near real time Earthquake Aftershock forecasting tool for humanitarian risk assessment and emergency planning

NASA Astrophysics Data System (ADS)

Quinn, Keira; Hope, Max; McCloskey, John; NicBhloscaidh, Mairead; Jimenez, Abigail; Dunlop, Paul

2015-04-01

Concern Worldwide and the University of Ulster Geophysics Research Group are engaged in a project to co-produce a suite of software and mapping tools to assess aftershock hazard in near real-time during the emergency response phase of earthquake disaster, and inform humanitarian emergency planning and response activities. This paper uses a social learning approach to evaluate this co-production process. Following Wenger (1999) we differentiate between the earthquake science and humanitarian communities of practice (CoP) along three dimensions: enterprise (the purpose of CoPs and the problems participants are working to address), repertoire (knowledge, skills, language), and identity (values and boundaries). We examine the effectiveness of learning between CoP, focusing on boundary work and objects, and various organisational structures and aspects of the wider political economy of learning that enable and hinder the co-production process. We conclude by identifying a number of ways to more effectively integrate earthquake science into humanitarian decision-making, policy development and programme design.

40 CFR Appendix III to Part 310 - Form: Application for Reimbursement to Local Governments for Emergency Response to Hazardous...

Code of Federal Regulations, 2011 CFR

2011-07-01

... RESPONSE TO HAZARDOUS SUBSTANCE RELEASES Pt. 310, App. III Appendix III to Part 310—Form: Application for... tools and supplies and similar materials purchased specifically for, and expended during, the response May include such items as chemical foam to suppress a fire; food purchased specifically for an...

Biomaterials and computation: a strategic alliance to investigate emergent responses of neural cells.

PubMed

Sergi, Pier Nicola; Cavalcanti-Adam, Elisabetta Ada

2017-03-28

Topographical and chemical cues drive migration, outgrowth and regeneration of neurons in different and crucial biological conditions. In the natural extracellular matrix, their influences are so closely coupled that they result in complex cellular responses. As a consequence, engineered biomaterials are widely used to simplify in vitro conditions, disentangling intricate in vivo behaviours, and narrowing the investigation on particular emergent responses. Nevertheless, how topographical and chemical cues affect the emergent response of neural cells is still unclear, thus in silico models are used as additional tools to reproduce and investigate the interactions between cells and engineered biomaterials. This work aims at presenting the synergistic use of biomaterials-based experiments and computation as a strategic way to promote the discovering of complex neural responses as well as to allow the interactions between cells and biomaterials to be quantitatively investigated, fostering a rational design of experiments.

Logic Modeling as a Tool to Prepare to Evaluate Disaster and Emergency Preparedness, Response, and Recovery in Schools

ERIC Educational Resources Information Center

Zantal-Wiener, Kathy; Horwood, Thomas J.

2010-01-01

The authors propose a comprehensive evaluation framework to prepare for evaluating school emergency management programs. This framework involves a logic model that incorporates Government Performance and Results Act (GPRA) measures as a foundation for comprehensive evaluation that complements performance monitoring used by the U.S. Department of…

The Global Emerging Infection Surveillance and Response System (GEIS), a U.S. government tool for improved global biosurveillance: a review of 2009

PubMed Central

2011-01-01

The Armed Forces Health Surveillance Center, Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) has the mission of performing surveillance for emerging infectious diseases that could affect the United States (U.S.) military. This mission is accomplished by orchestrating a global portfolio of surveillance projects, capacity-building efforts, outbreak investigations and training exercises. In 2009, this portfolio involved 39 funded partners, impacting 92 countries. This article discusses the current biosurveillance landscape, programmatic details of organization and implementation, and key contributions to force health protection and global public health in 2009. PMID:21388562

Essential Features of Responsible Governance of Agricultural Biotechnology

PubMed Central

Hartley, Sarah; Wickson, Fern

2016-01-01

Agricultural biotechnology continues to generate considerable controversy. We argue that to address this controversy, serious changes to governance are needed. The new wave of genomic tools and products (e.g., CRISPR, gene drives, RNAi, synthetic biology, and genetically modified [GM] insects and fish), provide a particularly useful opportunity to reflect on and revise agricultural biotechnology governance. In response, we present five essential features to advance more socially responsible forms of governance. In presenting these, we hope to stimulate further debate and action towards improved forms of governance, particularly as these new genomic tools and products continue to emerge. PMID:27144921

Essential Features of Responsible Governance of Agricultural Biotechnology.

PubMed

Hartley, Sarah; Gillund, Frøydis; van Hove, Lilian; Wickson, Fern

2016-05-01

Agricultural biotechnology continues to generate considerable controversy. We argue that to address this controversy, serious changes to governance are needed. The new wave of genomic tools and products (e.g., CRISPR, gene drives, RNAi, synthetic biology, and genetically modified [GM] insects and fish), provide a particularly useful opportunity to reflect on and revise agricultural biotechnology governance. In response, we present five essential features to advance more socially responsible forms of governance. In presenting these, we hope to stimulate further debate and action towards improved forms of governance, particularly as these new genomic tools and products continue to emerge.

Making vaccines "on demand": a potential solution for emerging pathogens and biodefense?

PubMed

De Groot, Anne S; Einck, Leo; Moise, Leonard; Chambers, Michael; Ballantyne, John; Malone, Robert W; Ardito, Matthew; Martin, William

2013-09-01

The integrated US Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) has made great strides in strategic preparedness and response capabilities. There have been numerous advances in planning, biothreat countermeasure development, licensure, manufacturing, stockpiling and deployment. Increased biodefense surveillance capability has dramatically improved, while new tools and increased awareness have fostered rapid identification of new potential public health pathogens. Unfortunately, structural delays in vaccine design, development, manufacture, clinical testing and licensure processes remain significant obstacles to an effective national biodefense rapid response capability. This is particularly true for the very real threat of "novel pathogens" such as the avian-origin influenzas H7N9 and H5N1, and new coronaviruses such as hCoV-EMC. Conventional approaches to vaccine development, production, clinical testing and licensure are incompatible with the prompt deployment needed for an effective public health response. An alternative approach, proposed here, is to apply computational vaccine design tools and rapid production technologies that now make it possible to engineer vaccines for novel emerging pathogen and WMD biowarfare agent countermeasures in record time. These new tools have the potential to significantly reduce the time needed to design string-of-epitope vaccines for previously unknown pathogens. The design process-from genome to gene sequence, ready to insert in a DNA plasmid-can now be accomplished in less than 24 h. While these vaccines are by no means "standard," the need for innovation in the vaccine design and production process is great. Should such vaccines be developed, their 60-d start-to-finish timeline would represent a 2-fold faster response than the current standard.

A Location Based Communication Proposal for Disaster Crisis Management

NASA Astrophysics Data System (ADS)

Gülnerman, A. G.; Goksel, C.; Tezer, A.

2014-12-01

The most vital applications within urban applications under the title of Geographical Information system applications are Disaster applications. Especially, In Turkey the most occured disaster type Earthquakes impacts are hard to retain in urban due to greatness of area, data and effected resident or victim. Currently, communications between victims and institutions congested and collapsed, after disaster that results emergency service delay and so secondary death and desperation. To avoid these types of life loss, the communication should be established between public and institutions. Geographical Information System Technology is seen capable of data management techniques and communication tool. In this study, Life Saving Kiosk Modal Proposal designed as a communication tool based on GIS, after disaster, takes locational emegency demands, meets emergency demands over notification maps which is created by those demands,increase public solidarity by visualizing close emergency demanded area surrounded another one and gathers emergency service demanded institutions notifications and aims to increasethe capability of management. This design prosals' leading role is public. Increase in capability depends on public major contribution to disaster management by required communication infrastructure establishment. The aim is to propound public power instead of public despiration. Apart from general view of disaster crisis management approaches, Life Saving Kiosk Modal Proposal indicates preparedness and response phases within the disaster cycle and solve crisis management with the organization of design in preparedness phase, use in response phase. This resolution modal flow diagram is builded between public, communication tool (kiosk) amd response force. The software is included in communication tools whose functions, interface designs and user algorithms are provided considering the public participation. In this study, disaster crisis management with public participation and power use with data flow modal based on location is came up for discussion by comparing with the other available applications in manner of time, detail of data, required staff and expertise degree, data reality and data archive.

Preparedness and Emergency Response Research Centers: Using a Public Health Systems Approach to Improve All-Hazards Preparedness and Response

PubMed Central

Leinhos, Mary; Williams-Johnson, Mildred

2014-01-01

In 2008, at the request of the Centers for Disease Control and Prevention (CDC), the Institute of Medicine (IOM) prepared a report identifying knowledge gaps in public health systems preparedness and emergency response and recommending near-term priority research areas. In accordance with the Pandemic and All-Hazards Preparedness Act mandating new public health systems research for preparedness and emergency response, CDC provided competitive awards establishing nine Preparedness and Emergency Response Research Centers (PERRCs) in accredited U.S. schools of public health. The PERRCs conducted research in four IOM-recommended priority areas: (1) enhancing the usefulness of public health preparedness and response (PHPR) training, (2) creating and maintaining sustainable preparedness and response systems, (3) improving PHPR communications, and (4) identifying evaluation criteria and metrics to improve PHPR for all hazards. The PERRCs worked closely with state and local public health, community partners, and advisory committees to produce practice-relevant research findings. PERRC research has generated more than 130 peer-reviewed publications and nearly 80 practice and policy tools and recommendations with the potential to significantly enhance our nation's PHPR to all hazards and that highlight the need for further improvements in public health systems. PMID:25355970

Flood-inundation maps for the St. Marys River at Decatur, Indiana

USGS Publications Warehouse

Strauch, Kellan R.

2015-08-24

The availability of these maps and associated Web mapping tools, along with the current river stage from USGS streamgages and forecasted flood stages from the NWS, provides emergency managers and residents with information that may be critical for flood-emergency planning and flood response activities such as evacuations and road closures, as well as for post-flood recovery efforts.

Decision support system for the response to infectious disease emergencies based on WebGIS and mobile services in China.

PubMed

Li, Ya-pin; Fang, Li-qun; Gao, Su-qing; Wang, Zhen; Gao, Hong-wei; Liu, Peng; Wang, Ze-Rui; Li, Yan-Li; Zhu, Xu-Guang; Li, Xin-Lou; Xu, Bo; Li, Yin-Jun; Yang, Hong; de Vlas, Sake J; Shi, Tao-Xing; Cao, Wu-Chun

2013-01-01

For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts.

ASPECT (Airborne Spectral Photometric Environmental Collection Technology) Fact Sheet

EPA Pesticide Factsheets

This multi-sensor screening tool provides infrared and photographic images with geospatial, chemical, and radiological data within minutes to support emergency responses, home-land security missions, environmental surveys, and climate monitoring missions.

The development of Operational Intervention Levels (OILs) for Soils - A decision support tool in nuclear and radiological emergency response

NASA Astrophysics Data System (ADS)

Lee Zhi Yi, Amelia; Dercon, Gerd; Blackburn, Carl; Kheng, Heng Lee

2017-04-01

In the event of a large-scale nuclear accident, the swift implementation of response actions is imperative. For food and agriculture, it is important to restrict contaminated food from being produced or gathered, and to put in place systems to prevent contaminated produce from entering the food chain. Emergency tools and response protocols exist to assist food control and health authorities but they tend to focus on radioactivity concentrations in food products as a means of restricting the distribution and sale of contaminated produce. Few, if any, emergency tools or protocols focus on the food production environment, for example radioactivity concentrations in soils. Here we present the Operational Intervention Levels for Soils (OIL for Soils) concept, an optimization tool developed at the IAEA to facilitate agricultural decision making and to improve nuclear emergency preparedness and response capabilities. Effective intervention relies on the prompt availability of radioactivity concentration data and the ability to implement countermeasures. Sampling in food and agriculture can be demanding because it may involve large areas and many sample types. In addition, there are finite resources available in terms of manpower and laboratory support. Consequently, there is a risk that timely decision making will be hindered and food safety compromised due to time taken to sample and analyse produce. However, the OILs for Soils concept developed based on experience in Japan can help in this situation and greatly assist authorities responsible for agricultural production. OILs for Soils - pre-determined reference levels of air dose rates linked to radionuclide concentrations in soils - can be used to trigger response actions particularly important for agricultural and food protection. Key considerations in the development of the OILs for Soils are: (1) establishing a pragmatic sampling approach to prioritize and optimize available resources and data requirements for decision making in agricultural sites: (2) creating a system that is adaptable to different countries, and; (3) developing a framework to calculate default values of OILs for Soils for application during an emergency. The OILs for Soils reference levels are calculated using a mathematical model. Empirical equations, paired with radionuclide data (e.g. Cs-134, Cs-137 and I-131) from the ICRU 53 report, are utilized to determine soil contamination from aerial monitoring air dose rate data. Modelling allows soil contamination values to be readily approximated and this is used to prioritize soil and food sampling sites. Reference levels are based on a model that considers radionuclide transfer factors for up-take into plants, soil density, and soil sampling depth. Decision actions for determined reference levels are suggested for processed foods, animal products, animal feed and crop products (including plants at the growing stage, mature stage, fallow farmland, and forestry products). With these steps, OILs for Soils provide practical guidance that will equip authorities to respond efficiently and help maintain the safety of the food supply during large-scale nuclear or radiological emergency situations.

Interactive Voice/Web Response System in clinical research

PubMed Central

Ruikar, Vrishabhsagar

2016-01-01

Emerging technologies in computer and telecommunication industry has eased the access to computer through telephone. An Interactive Voice/Web Response System (IxRS) is one of the user friendly systems for end users, with complex and tailored programs at its backend. The backend programs are specially tailored for easy understanding of users. Clinical research industry has experienced revolution in methodologies of data capture with time. Different systems have evolved toward emerging modern technologies and tools in couple of decades from past, for example, Electronic Data Capture, IxRS, electronic patient reported outcomes, etc. PMID:26952178

Interactive Voice/Web Response System in clinical research.

PubMed

Ruikar, Vrishabhsagar

2016-01-01

Emerging technologies in computer and telecommunication industry has eased the access to computer through telephone. An Interactive Voice/Web Response System (IxRS) is one of the user friendly systems for end users, with complex and tailored programs at its backend. The backend programs are specially tailored for easy understanding of users. Clinical research industry has experienced revolution in methodologies of data capture with time. Different systems have evolved toward emerging modern technologies and tools in couple of decades from past, for example, Electronic Data Capture, IxRS, electronic patient reported outcomes, etc.

Designer biomaterials for mechanobiology

NASA Astrophysics Data System (ADS)

Li, Linqing; Eyckmans, Jeroen; Chen, Christopher S.

2017-12-01

Biomaterials engineered with specific bioactive ligands, tunable mechanical properties and complex architecture have emerged as powerful tools to probe cell sensing and response to physical properties of their material surroundings, and ultimately provide designer approaches to control cell function.

Acceptability and Reliability of a Novel Palliative Care Screening Tool Among Emergency Department Providers.

PubMed

Bowman, Jason; George, Naomi; Barrett, Nina; Anderson, Kelsey; Dove-Maguire, Kalie; Baird, Janette

2016-06-01

The Palliative Care and Rapid Emergency Screening (P-CaRES) Project is an initiative intended to improve access to palliative care (PC) among emergency department (ED) patients with life-limiting illness by facilitating early referral for inpatient PC consultations. In the previous two phases of this project, we derived and validated a novel PC screening tool. This paper reports on the third and final preimplementation phase. Examine the acceptability of the P-CaRES tool among PC and ED providers as well as test its reliability on case vignettes. Compare variations in reliability and acceptability of the tool based on ED providers' roles (attendings, residents, and nurses) and lengths of experience. A two-part electronic survey was distributed to ED providers at multiple sites across the United States. We tested the reliability of the tool in the first part of the survey, through a series of case vignettes. A criterion standard of correct responses was first defined by consensus input from expert PC physicians' interpretations of the vignettes. The experts' input was validated using the Gwet's AC1 coefficient for inter-rater reliability. ED providers were then presented with the case vignettes and asked to use the P-CaRES tool to correctly identify which patients had unmet PC needs. ED provider responses were compared both against the criterion standard and against different subsets of respondents (divided both by role and by level of experience). The second part of the survey assessed acceptability of the P-CaRES tool among ED providers using responses to questions from a modified Ottawa Acceptability of Decision Rules Instrument, based on a 1-5 Likert rating scale. Descriptive statistics were used to report all outcomes. In total, 213 ED providers employed in three different regions across the country responded to the survey (39.4%) and 185 (86.9%) of those completed it. The majority of providers felt that the tool would be useful in their practice (80.5%), agreed that the tool was clear and unambiguous (87.1%), thought that use of the tool would likely benefit patients (87.5%), and thought that it would result in improved use of resources to help severely ill patients (83.6%). Over three-quarters of ED providers (78.5%) also self-reported that they refer patients with unmet PC needs less than 10% of the time, and only 10.8% of respondents believed that they are already utilizing an effective strategy to screen or refer patients to PC. Applying our P-CaRES tool to case vignettes, ED providers generated PC referrals in concordance with PC experts over 88.7% of the time (95% confidence interval = 86.4% to 90.6%), with an overall sensitivity of more than 90%. These results varied minimally regardless of the respondent's role in the ED or their level of experience. Screening by emergency medicine providers for unmet PC needs using a brief, novel, content-validated screening tool is acceptable and is also reliable when applied to case vignettes-regardless of provider role or experience. Clinical trial and further study are warranted and are currently under way. © 2016 by the Society for Academic Emergency Medicine.

Development of Medical Technology for Contingency Response to Marrow Toxic Agents

DTIC Science & Technology

2018-06-06

Health Physics e. Emergency Medicine f. Burn Care g. State Public Health h. Federal Public Health i. Emergency Management. 2. The group has...Preparedness 4 Project: Local Public Health Radiological Preparedness Gap Review and Tool Development Identification 1. The National Association...of County and City Health Officials (NACCHO) has held multiple conference calls with leaders within their organization to identify the areas of

Academic Emergency Medicine Physicians' Knowledge of Mechanical Ventilation.

PubMed

Wilcox, Susan R; Strout, Tania D; Schneider, Jeffrey I; Mitchell, Patricia M; Smith, Jessica; Lutfy-Clayton, Lucienne; Marcolini, Evie G; Aydin, Ani; Seigel, Todd A; Richards, Jeremy B

2016-05-01

Although emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) education or clinical practice. The objective of this study was to quantify EM attendings' education, experience, and knowledge regarding mechanical ventilation in the emergency department. We developed a survey of academic EM attendings' educational experiences with ventilators and a knowledge assessment tool with nine clinical questions. EM attendings at key teaching hospitals for seven EM residency training programs in the northeastern United States were invited to participate in this survey study. We performed correlation and regression analyses to evaluate the relationship between attendings' scores on the assessment instrument and their training, education, and comfort with ventilation. Of 394 EM attendings surveyed, 211 responded (53.6%). Of respondents, 74.5% reported receiving three or fewer hours of ventilation-related education from EM sources over the past year and 98 (46%) reported receiving between 0-1 hour of education. The overall correct response rate for the assessment tool was 73.4%, with a standard deviation of 19.9. The factors associated with a higher score were completion of an EM residency, prior emphasis on mechanical ventilation during one's own residency, working in a setting where an emergency physician bears primary responsibility for ventilator management, and level of comfort with managing ventilated patients. Physicians' comfort was associated with the frequency of ventilator changes and EM management of ventilation, as well as hours of education. EM attendings report caring for mechanically ventilated patients frequently, but most receive fewer than three educational hours a year on mechanical ventilation, and nearly half receive 0-1 hour. Physicians' performance on an assessment tool for mechanical ventilation is most strongly correlated with their self-reported comfort with mechanical ventilation.

I-WASTE: EPA's Suite of Homeland Security Decision Support ...

EPA Pesticide Factsheets

In the U.S., a single comprehensive approach to all-hazards domestic incident management has been established by the Department of Homeland Security through the National Response Framework. This helps prevent, prepare for, respond to, and recover from terrorist attacks, major disasters, and other emergencies. A significant component of responding to and recovering from wide-area or isolated events, whether natural, accidental, or intentional, is the management of waste resulting from the incident itself or from activities cleaning up after the incident. To facilitate the proper management of incident-derived waste, EPA developed the Incident Waste Assessment and Tonnage Estimator (I-WASTE). I-WASTE was developed by the U.S. EPA’s Homeland Security Research Program in partnership with EPA program and regional offices, other U.S. government agencies, industry, and state and local emergency response programs. Presenting the disaster waste tool at the ORD Tools Café held in EPA Region 7th on Dec 9th.

The Commander’s Emergency Response Program: A Model for Future Implementation

DTIC Science & Technology

2010-04-07

unintended Effects. The INVEST-E methodology serves as a tool for commanders and their designated practitioners to properly select projects, increasing...for commanders and their designated practitioners to properly select projects, increasing the effectiveness of CERP funds. 4 TABLE OF...and unintended Effects. The INVEST-E methodology serves as a tool for commanders and their designated practitioners to properly select projects

Puget Sound Operational Forecast System - A Real-time Predictive Tool for Marine Resource Management and Emergency Responses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Zhaoqing; Khangaonkar, Tarang; Chase, Jared M.

2009-12-01

To support marine ecological resource management and emergency response and to enhance scientific understanding of physical and biogeochemical processes in Puget Sound, a real-time Puget Sound Operational Forecast System (PS-OFS) was developed by the Coastal Ocean Dynamics & Ecosystem Modeling group (CODEM) of Pacific Northwest National Laboratory (PNNL). PS-OFS employs the state-of-the-art three-dimensional coastal ocean model and closely follows the standards and procedures established by National Oceanic and Atmospheric Administration (NOAA) National Ocean Service (NOS). PS-OFS consists of four key components supporting the Puget Sound Circulation and Transport Model (PS-CTM): data acquisition, model execution and product archive, model skill assessment,more » and model results dissemination. This paper provides an overview of PS-OFS and its ability to provide vital real-time oceanographic information to the Puget Sound community. PS-OFS supports pacific northwest region’s growing need for a predictive tool to assist water quality management, fish stock recovery efforts, maritime emergency response, nearshore land-use planning, and the challenge of climate change and sea level rise impacts. The structure of PS-OFS and examples of the system inputs and outputs, forecast results are presented in details.« less

Terminology tools: state of the art and practical lessons.

PubMed

Cimino, J J

2001-01-01

As controlled medical terminologies evolve from simple code-name-hierarchy arrangements, into rich, knowledge-based ontologies of medical concepts, increased demands are placed on both the developers and users of the terminologies. In response, researchers have begun developing tools to address their needs. The aims of this article are to review previous work done to develop these tools and then to describe work done at Columbia University and New York Presbyterian Hospital (NYPH). Researchers working with the Systematized Nomenclature of Medicine (SNOMED), the Unified Medical Language System (UMLS), and NYPH's Medical Entities Dictionary (MED) have created a wide variety of terminology browsers, editors and servers to facilitate creation, maintenance and use of these terminologies. Although much work has been done, no generally available tools have yet emerged. Consensus on requirement for tool functions, especially terminology servers is emerging. Tools at NYPH have been used successfully to support the integration of clinical applications and the merger of health care institutions. Significant advancement has occurred over the past fifteen years in the development of sophisticated controlled terminologies and the tools to support them. The tool set at NYPH provides a case study to demonstrate one feasible architecture.

E-DECIDER: Using Earth Science Data and Modeling Tools to Develop Decision Support for Earthquake Disaster Response

NASA Astrophysics Data System (ADS)

Glasscoe, Margaret T.; Wang, Jun; Pierce, Marlon E.; Yoder, Mark R.; Parker, Jay W.; Burl, Michael C.; Stough, Timothy M.; Granat, Robert A.; Donnellan, Andrea; Rundle, John B.; Ma, Yu; Bawden, Gerald W.; Yuen, Karen

2015-08-01

Earthquake Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response (E-DECIDER) is a NASA-funded project developing new capabilities for decision making utilizing remote sensing data and modeling software to provide decision support for earthquake disaster management and response. E-DECIDER incorporates the earthquake forecasting methodology and geophysical modeling tools developed through NASA's QuakeSim project. Remote sensing and geodetic data, in conjunction with modeling and forecasting tools allows us to provide both long-term planning information for disaster management decision makers as well as short-term information following earthquake events (i.e. identifying areas where the greatest deformation and damage has occurred and emergency services may need to be focused). This in turn is delivered through standards-compliant web services for desktop and hand-held devices.

The globalization of emergency medicine and its importance for public health.

PubMed Central

Anderson, Philip; Petrino, Roberta; Halpern, Pinchas; Tintinalli, Judith

2006-01-01

Emergency medicine (EM) is a global discipline that provides secondary disease prevention and is also a tool for primary prevention. It is a horizontally integrated system of emergency care consisting of access to EM care; provision of EM care in the community and during transportation of patients; and provision of care at the receiving facility or hospital emergency department. EM can offer many tools to improve public health. These tools include primary disease prevention; interventions for addressing substance abuse and interpersonal violence; education about safety practices; epidemiological surveillance; enrolment of patients in clinical research trials focusing on acute interventions; education and clinical training of health-care providers; and participation in local and regional responses to natural and man-made disasters. Public health advocates and health policy-makers can benefit from the opportunities of EM and can help overcome its challenges. Advocating the establishment and recognition of the specialty of EM worldwide can result in benefits for health-care education, help in incorporating the full scope of EM care into the system of public health, and expand the capabilities of EM for primary and secondary prevention for the benefit of the health of the public. PMID:17128364

Environmental Geographic Information Systems (EGIS) at Stennis Space Center (SSC)

NASA Technical Reports Server (NTRS)

Carr, Hugh; Smoot, James; Parikh, Joy

2004-01-01

This viewgraph presentation includes: 1) Background of SSC Environmental GIS (EGIS); 2) Principal Center Activities; 3) SSC's GIS Applications: a) Environmental Emergency Response Tool, b) CERCLA, c) Facilities Master Planning, d) Natural Resource Management and Site Assessment.

The use of UAS in disaster response operations

NASA Astrophysics Data System (ADS)

Gkotsis, I.; Eftychidis, G.; Kolios, P.

2017-09-01

The use of UAS by the emergency services has been received with great interest since UAS provide both informant and helper support in a flexible, effective and efficient manner. This is due to the fact that, UAS can strengthen the operational capabilities related to: prevention (e.g., patrolling of large and hard to reach areas), early detection (e.g., mapping of vulnerable elements), disaster preparedness (e.g., incident inspection), response (mapping damages, search and rescue, provide an ad hoc communication network, monitor evacuation, etc). Through PREDICATE, a project concerning civilian use of drones, the necessary methodologies to guide the selection and operational use of UAS in emergencies, are developed. To guide UAS selection, the project performed a detailed needs assessment in cooperation with civil protection and law enforcement agencies. As a result of this assessment, currently available technologies and market solutions were reviewed leading to the development of an online user-friendly tool to support selection of UAS based on operational requirements. To guide the use of UAS, PREDICATE developed an intelligent path planning toolkit to automate the operation of UAS and ease their use for the various civil protection operations. By employing the aforementioned tools, emergency services will be able to better understand how to select and make use of UAS for watch-keeping and patrolling of their own disaster-prone Regions of Interest. The research, innovation and applicability behind both these tools is detailed in this work.

Modeling a Civil Event Case Study for Consequence Management Using the IMPRINT Forces Module

NASA Technical Reports Server (NTRS)

Gacy, Marc; Gosakan, Mala; Eckdahl, Angela; Miller, Jeffrey R.

2012-01-01

A critical challenge in the Consequence Management (CM) domain is the appropriate allocation of necessary and skilled military and civilian personnel and materiel resources in unexpected emergencies. To aid this process we used the Forces module in the Improved Performance Research Integration Tool (IMPRINT). This module enables analysts to enter personnel and equipment capabilities, prioritized schedules and numbers available, along with unexpected emergency requirements in order to assess force response requirements. Using a suspected terrorist threat on a college campus, we developed a test case model which exercised the capabilities of the module, including the scope and scale of operations. The model incorporates data from multiple sources, including daily schedules and frequency of events such as fire calls. Our preliminary results indicate that the model can predict potential decreases in civilian emergency response coverage due to an involved unplanned incident requiring significant portions of police, fire and civil responses teams.

Optimal Combination of Non-Invasive Tools for the Early Detection of Potentially Life-Threatening Emergencies in Gynecology

PubMed Central

Varas, Catalina; Ravit, Marion; Mimoun, Camille; Panel, Pierre; Huchon, Cyrille; Fauconnier, Arnaud

2016-01-01

Objectives Potentially life-threatening gynecological emergencies (G-PLEs) are acute pelvic conditions that may spontaneously evolve into a life-threatening situation, or those for which there is a risk of sequelae or death in the absence of prompt diagnosis and treatment. The objective of this study was to identify the best combination of non-invasive diagnostic tools to ensure an accurate diagnosis and timely response when faced with G-PLEs for patients arriving with acute pelvic pain at the Gynecological Emergency Department (ED). Methods The data on non-invasive diagnostic tools were sourced from the records of patients presenting at the ED of two hospitals in the Parisian suburbs (France) with acute pelvic pain between September 2006 and April 2008. The medical history of the patients was obtained through a standardized questionnaire completed for a prospective observational study, and missing information was completed with data sourced from the medical forms. Diagnostic tool categories were predefined as a collection of signs or symptoms. We analyzed the association of each sign/symptom with G-PLEs using Pearson’s Chi-Square or Fischer’s exact tests. Symptoms and signs associated with G-PLEs (p-value < 0.20) were subjected to logistic regression to evaluate the diagnostic value of each of the predefined diagnostic tools and in various combinations. Results The data of 365 patients with acute pelvic pain were analyzed, of whom 103 were confirmed to have a PLE. We analyzed five diagnostic tools by logistic regression: Triage Process, History-Taking, Physical Examination, Ultrasonography, and Biological Exams. The combination of History-Taking and Ultrasonography had a C-index of 0.83, the highest for a model combining two tools. Conclusions The use of a standardized self-assessment questionnaire for history-taking and focal ultrasound examination were found to be the most successful tool combination for the diagnosis of gynecological emergencies in a Gynecological ED. Additional tools, such as physical examination, do not add substantial diagnostic value. PMID:27583697

Development of emergency response tools for accidental radiological contamination of French coastal areas.

PubMed

Duffa, Céline; Bailly du Bois, Pascal; Caillaud, Matthieu; Charmasson, Sabine; Couvez, Céline; Didier, Damien; Dumas, Franck; Fievet, Bruno; Morillon, Mehdi; Renaud, Philippe; Thébault, Hervé

2016-01-01

The Fukushima nuclear accident resulted in the largest ever accidental release of artificial radionuclides in coastal waters. This accident has shown the importance of marine assessment capabilities for emergency response and the need to develop tools for adequately predicting the evolution and potential impact of radioactive releases to the marine environment. The French Institute for Radiological Protection and Nuclear Safety (IRSN) equips its emergency response centre with operational tools to assist experts and decision makers in the event of accidental atmospheric releases and contamination of the terrestrial environment. The on-going project aims to develop tools for the management of marine contamination events in French coastal areas. This should allow us to evaluate and anticipate post-accident conditions, including potential contamination sites, contamination levels and potential consequences. In order to achieve this goal, two complementary tools are developed: site-specific marine data sheets and a dedicated simulation tool (STERNE, Simulation du Transport et du transfert d'Eléments Radioactifs dans l'environNEment marin). Marine data sheets are used to summarize the marine environment characteristics of the various sites considered, and to identify vulnerable areas requiring implementation of population protection measures, such as aquaculture areas, beaches or industrial water intakes, as well as areas of major ecological interest. Local climatological data (dominant sea currents as a function of meteorological or tidal conditions) serving as the basis for an initial environmental sampling strategy is provided whenever possible, along with a list of possible local contacts for operational management purposes. The STERNE simulation tool is designed to predict radionuclide dispersion and contamination in seawater and marine species by incorporating spatio-temporal data. 3D hydrodynamic forecasts are used as input data. Direct discharge points or atmospheric deposition source terms can be taken into account. STERNE calculates Eulerian radionuclide dispersion using advection and diffusion equations established offline from hydrodynamic calculations. A radioecological model based on dynamic transfer equations is implemented to evaluate activity concentrations in aquatic organisms. Essential radioecological parameters (concentration factors and single or multicomponent biological half-lives) have been compiled for main radionuclides and generic marine species (fish, molluscs, crustaceans and algae). Dispersion and transfer calculations are performed simultaneously on a 3D grid. Results can be plotted on maps, with possible tracking of spatio-temporal evolution. Post-processing and visualization can then be performed. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

Decision Support System for the Response to Infectious Disease Emergencies Based on WebGIS and Mobile Services in China

PubMed Central

Gao, Su-qing; Wang, Zhen; Gao, Hong-wei; Liu, Peng; Wang, Ze-rui; Li, Yan-li; Zhu, Xu-guang; Li, Xin-lou; Xu, Bo; Li, Yin-jun; Yang, Hong; de Vlas, Sake J.; Shi, Tao-xing; Cao, Wu-chun

2013-01-01

Background For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Methodology/Principal Findings Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. Conclusions/Significance The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts. PMID:23372780

Emerging and exotic zoonotic disease preparedness and response in the United States - coordination of the animal health component.

PubMed

Levings, Randall L

2012-09-01

For the response to a zoonotic disease outbreak to be effective, animal health authorities and disease specialists must be involved. Animal health measures are commonly directed at known diseases that threaten the health of animals and impact owners. The measures have long been applied to zoonotic diseases, including tuberculosis and brucellosis, and can be applied to emerging diseases. One Health (veterinary, public, wildlife and environmental health) and all-hazards preparedness work have done much to aid interdisciplinary understanding and planning for zoonotic diseases, although further improvements are needed. Actions along the prevention, preparedness, response and recovery continuum should be considered. Prevention of outbreaks consists largely of import controls on animals and animal products and biosecurity. Preparedness includes situational awareness, research, tool acquisition, modelling, training and exercises, animal movement traceability and policy development. Response would include detection systems and specialized personnel, institutions, authorities, strategies, methods and tools, including movement control, depopulation and vaccination if available and appropriate. The specialized elements would be applied within a general (nationally standardized) system of response. Recovery steps begin with continuity of business measures during the response and are intended to restore pre-event conditions. The surveillance for novel influenza A viruses in swine and humans and the preparedness for and response to the recent influenza pandemic illustrate the cooperation possible between the animal and public health communities. © 2012 Blackwell Verlag GmbH.

Systems biology: A tool for charting the antiviral landscape.

PubMed

Bowen, James R; Ferris, Martin T; Suthar, Mehul S

2016-06-15

The host antiviral programs that are initiated following viral infection form a dynamic and complex web of responses that we have collectively termed as "the antiviral landscape". Conventional approaches to studying antiviral responses have primarily used reductionist systems to assess the function of a single or a limited subset of molecules. Systems biology is a holistic approach that considers the entire system as a whole, rather than individual components or molecules. Systems biology based approaches facilitate an unbiased and comprehensive analysis of the antiviral landscape, while allowing for the discovery of emergent properties that are missed by conventional approaches. The antiviral landscape can be viewed as a hierarchy of complexity, beginning at the whole organism level and progressing downward to isolated tissues, populations of cells, and single cells. In this review, we will discuss how systems biology has been applied to better understand the antiviral landscape at each of these layers. At the organismal level, the Collaborative Cross is an invaluable genetic resource for assessing how genetic diversity influences the antiviral response. Whole tissue and isolated bulk cell transcriptomics serves as a critical tool for the comprehensive analysis of antiviral responses at both the tissue and cellular levels of complexity. Finally, new techniques in single cell analysis are emerging tools that will revolutionize our understanding of how individual cells within a bulk infected cell population contribute to the overall antiviral landscape. Copyright © 2016 Elsevier B.V. All rights reserved.

Integrating Emerging Data Sources into Operational Practice : State of the Practice Review

DOT National Transportation Integrated Search

2016-12-01

The purpose of this report is provide agencies responsible for Transportation Systems Management and Operations (TSM&O) with an introduction to successful Big Data tools and technologies that can be used to aggregate, store, and analyze new forms of ...

A Framework for Facilitating Ecosystem Services-based Decision-making and the Development of Decision-making Tools

EPA Science Inventory

There is an increasing understanding that top-down regulatory and technology driven responses are not sufficient to address current and emerging environmental challenges such as climate change, sustainable communities, and environmental justice. The vast majority of environmenta...

Ground and Helicopter Emergency Medical Services Time Tradeoffs Assessed with Geographic Information.

PubMed

Widener, Michael J; Ginsberg, Zac; Schleith, Daniel; Floccare, Douglas J; Hirshon, Jon Mark; Galvagno, Samuel

2015-07-01

We describe how geographic information systems (GIS) can be used to assess and compare estimated transport time for helicopter and ground emergency medical services. Recent research shows that while the odds of a trauma patient's survival increase with helicopter emergency medical services (HEMS), they may not increase to the extent necessary to make HEMS cost effective. This study offers an analytic tool to objectively quantify the patient travel time advantage that HEMS offers compared to ground emergency medical services (GEMS). Using helicopter dispatch data from the Maryland State Police from 2000-2011, we computed transport time estimates for HEMS and GEMS, compare these results to a reference transport time of 60 min, and use geospatial interpolation to extrapolate the total response times for each mode across the study region. Mapping the region's trauma incidents and modeling response times, our findings indicate the GIS framework for calculating transportation time tradeoffs is useful in identifying which areas can be better served by HEMS or GEMS. The use of GIS and the analytical methodology described in this study present a method to compare transportation by air and ground in the prehospital setting that accounts for how mode, distance, and road infrastructure impact total transport time. Whether used to generate regional maps in advance or applied real-time, the presented framework provides a tool to identify earlier incident locations that favor HEMS over GEMS transport modes.

Operational guidance for radiation emergency response organisations in Europe for using biodosimetric tools developed in EU MULTIBIODOSE project.

PubMed

Jaworska, Alicja; Ainsbury, Elizabeth A; Fattibene, Paola; Lindholm, Carita; Oestreicher, Ursula; Rothkamm, Kai; Romm, Horst; Thierens, Hubert; Trompier, Francois; Voisin, Philippe; Vral, Anne; Woda, Clemens; Wojcik, Andrzej

2015-04-01

In the event of a large-scale radiological emergency, the triage of individuals according to their degree of exposure forms an important initial step of the accident management. Although clinical signs and symptoms of a serious exposure may be used for radiological triage, they are not necessarily radiation specific and can lead to a false diagnosis. Biodosimetry is a method based on the analysis of radiation-induced changes in cells of the human body or in portable electronic devices and enables the unequivocal identification of exposed people who should receive medical treatment. The MULTIBIODOSE (MBD) consortium developed and validated several biodosimetric assays and adapted and tested them as tools for biological dose assessment in a mass-casualty event. Different biodosimetric assays were validated against the 'gold standard' of biological dosimetry-the dicentric assay. The assays were harmonised in such a way that, in an emergency situation, they can be run in parallel in a network of European laboratories. The aim of this guidance is to give a concise overview of the developed biodosimetric tools as well as how and when they can be used in an emergency situation. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Emergency Physician Utilization of Alcohol/Substance Screening, Brief Advice and Discharge: A 10-Year Comparison.

PubMed

Broderick, Kerryann B; Kaplan, Bonnie; Martini, Dyllon; Caruso, Emily

2015-10-01

In 2007, of the 130 million emergency department (ED) visits, ∼ 38 million were due to injury, and of those, 1.9 million involved alcohol. The emergency department is a pivotal place to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) due to the high number of patients presenting with alcohol/substance abuse risk factors or related injuries. This study compares two surveys, approximately 11 years apart, of emergency physicians nationwide which assesses the use of validated screening tools, the availability of community resources for alcohol/substance abuse treatment, and the prevailing attitudes of emergency physicians regarding Screening and Brief Intervention for alcohol/substance abuse. We performed cross-sectional anonymous surveys of 1500 emergency physicians drawn from American College of Emergency Physicians members. The survey results were compared for time interval change. The two surveys had comparable response rates. The median percentage of patients screened for alcohol/substance abuse in 1999 was 15%, vs. 20% in 2010. In 2010, 26% of emergency physicians had a formal screening tool, and the majority used Cut-down, Annoyed, Guilty, Eye-opener (85%). In 2010, a statistically significant increase in the number of emergency physicians said they would "always" or "almost always" use discharge instructions that were specific for alcohol/substance abuse, if available, vs. 1999. Few emergency physicians screen for alcohol/substance abuse despite evidence that screening and brief intervention is effective. Emergency physicians are receptive to the use of discharge material. Copyright © 2015 Elsevier Inc. All rights reserved.

Development of an Online Toolkit for Measuring Performance in Health Emergency Response Exercises.

PubMed

Agboola, Foluso; Bernard, Dorothy; Savoia, Elena; Biddinger, Paul D

2015-10-01

Exercises that simulate emergency scenarios are accepted widely as an essential component of a robust Emergency Preparedness program. Unfortunately, the variability in the quality of the exercises conducted, and the lack of standardized processes to measure performance, has limited the value of exercises in measuring preparedness. In order to help health organizations improve the quality and standardization of the performance data they collect during simulated emergencies, a model online exercise evaluation toolkit was developed using performance measures tested in over 60 Emergency Preparedness exercises. The exercise evaluation toolkit contains three major components: (1) a database of measures that can be used to assess performance during an emergency response exercise; (2) a standardized data collection tool (form); and (3) a program that populates the data collection tool with the measures that have been selected by the user from the database. The evaluation toolkit was pilot tested from January through September 2014 in collaboration with 14 partnering organizations representing 10 public health agencies and four health care agencies from eight states across the US. Exercise planners from the partnering organizations were asked to use the toolkit for their exercise evaluation process and were interviewed to provide feedback on the use of the toolkit, the generated evaluation tool, and the usefulness of the data being gathered for the development of the exercise after-action report. Ninety-three percent (93%) of exercise planners reported that they found the online database of performance measures appropriate for the creation of exercise evaluation forms, and they stated that they would use it again for future exercises. Seventy-two percent (72%) liked the exercise evaluation form that was generated from the toolkit, and 93% reported that the data collected by the use of the evaluation form were useful in gauging their organization's performance during the exercise. Seventy-nine percent (79%) of exercise planners preferred the evaluation form generated by the toolkit to other forms of evaluations. Results of this project show that users found the newly developed toolkit to be user friendly and more relevant to measurement of specific public health and health care capabilities than other tools currently available. The developed toolkit may contribute to the further advancement of developing a valid approach to exercise performance measurement.

Federal Radiological Monitoring and Assessment Center Health and Safety Manual

DOE Office of Scientific and Technical Information (OSTI.GOV)

FRMAC Health and Safety Working Group

2012-03-20

This manual is a tool to provide information to all responders and emergency planners and is suggested as a starting point for all organizations that provide personnel/assets for radiological emergency response. It defines the safety requirements for the protection of all emergency responders. The intent is to comply with appropriate regulations or provide an equal level of protection when the situation makes it necessary to deviate. In the event a situation arises which is not addressed in the manual, an appropriate management-level expert will define alternate requirements based on the specifics of the emergency situation. This manual is not intendedmore » to pertain to the general public.« less

Deployment of Small Unmanned Aerial Systems (sUAS) in Emergency and Disaster Response Scenarios to Support Local Emergency Management Agencies

NASA Astrophysics Data System (ADS)

Calamaio, C. L.; Walker, J.; Beck, J. M.; Graves, S. J.; Johnson, C.

2017-12-01

Researchers at the Information Technology and Systems Center at the University of Alabama in Huntsville are working closely with the Madison County Emergency Management Agency (EMA), GeoHuntsville's UAS Working Group, and the NOAA UAS Program Office, to conduct a series of practical demonstrations testing the use of small unmanned aerial systems (sUAS) for emergency response activities in Madison County, Alabama. These exercises demonstrate the use of UAS to detect and visualize hazards in affected areas via the delivery of aerial imagery and associated data products to law enforcement first responders in a variety of different scenarios, for example, search and rescue, tornado track mapping, damage assessment, and situational awareness/containment during active shooter incidents. In addition to showcasing the use of UAS as a tool for emergency services, these pilot exercises provide the opportunity to engage the appropriate stakeholders from several communities including first responders, geospatial intelligence, active members of the unmanned systems industry, and academia. This presentation will showcase the challenges associated with delivering quality data products for emergency services in a timely manner as well as the related challenges in integrating the technology into local emergency management.

78 FR 59924 - Centralized Capacity Markets in Regional Transmission Organizations and Independent System...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-30

... does the changing resource mix (i.e., increased reliance on natural gas-fired generation, increasing... resource planning policies, emerging technologies and fuels such as shale gas, price responsive demand and... design tools could prospectively augment, supplement or substitute for typical centralized capacity...

Training in the Community-Collaborative Context: A Case Study

ERIC Educational Resources Information Center

Yamada, Racquel-María

2014-01-01

Emerging community-based methodologies call for collaboration with speech community members. Although motivated, community members may lack the tools or training to contribute actively. In response, many linguists deliver training workshops in documentation or preservation, while others train community members to record data. Although workshops…

Body Motion and Graphing.

ERIC Educational Resources Information Center

Nemirovsky, Ricardo; Tierney, Cornelia; Wright, Tracy

1998-01-01

Analyzed two children's use of a computer-based motion detector to make sense of symbolic expressions (Cartesian graphs). Found three themes: (1) tool perspectives, efforts to understand graphical responses to body motion; (2) fusion, emergent ways of talking and behaving that merge symbols and referents; and (3) graphical spaces, when changing…

Multispectral, hyperspectral, and LiDAR remote sensing and geographic information fusion for improved earthquake response

NASA Astrophysics Data System (ADS)

Kruse, F. A.; Kim, A. M.; Runyon, S. C.; Carlisle, Sarah C.; Clasen, C. C.; Esterline, C. H.; Jalobeanu, A.; Metcalf, J. P.; Basgall, P. L.; Trask, D. M.; Olsen, R. C.

2014-06-01

The Naval Postgraduate School (NPS) Remote Sensing Center (RSC) and research partners have completed a remote sensing pilot project in support of California post-earthquake-event emergency response. The project goals were to dovetail emergency management requirements with remote sensing capabilities to develop prototype map products for improved earthquake response. NPS coordinated with emergency management services and first responders to compile information about essential elements of information (EEI) requirements. A wide variety of remote sensing datasets including multispectral imagery (MSI), hyperspectral imagery (HSI), and LiDAR were assembled by NPS for the purpose of building imagery baseline data; and to demonstrate the use of remote sensing to derive ground surface information for use in planning, conducting, and monitoring post-earthquake emergency response. Worldview-2 data were converted to reflectance, orthorectified, and mosaicked for most of Monterey County; CA. Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data acquired at two spatial resolutions were atmospherically corrected and analyzed in conjunction with the MSI data. LiDAR data at point densities from 1.4 pts/m2 to over 40 points/ m2 were analyzed to determine digital surface models. The multimodal data were then used to develop change detection approaches and products and other supporting information. Analysis results from these data along with other geographic information were used to identify and generate multi-tiered products tied to the level of post-event communications infrastructure (internet access + cell, cell only, no internet/cell). Technology transfer of these capabilities to local and state emergency response organizations gives emergency responders new tools in support of post-disaster operational scenarios.

Modeling operators' emergency response time for chemical processing operations.

PubMed

Murray, Susan L; Harputlu, Emrah; Mentzer, Ray A; Mannan, M Sam

2014-01-01

Operators have a crucial role during emergencies at a variety of facilities such as chemical processing plants. When an abnormality occurs in the production process, the operator often has limited time to either take corrective actions or evacuate before the situation becomes deadly. It is crucial that system designers and safety professionals can estimate the time required for a response before procedures and facilities are designed and operations are initiated. There are existing industrial engineering techniques to establish time standards for tasks performed at a normal working pace. However, it is reasonable to expect the time required to take action in emergency situations will be different than working at a normal production pace. It is possible that in an emergency, operators will act faster compared to a normal pace. It would be useful for system designers to be able to establish a time range for operators' response times for emergency situations. This article develops a modeling approach to estimate the time standard range for operators taking corrective actions or following evacuation procedures in emergency situations. This will aid engineers and managers in establishing time requirements for operators in emergency situations. The methodology used for this study combines a well-established industrial engineering technique for determining time requirements (predetermined time standard system) and adjustment coefficients for emergency situations developed by the authors. Numerous videos of workers performing well-established tasks at a maximum pace were studied. As an example, one of the tasks analyzed was pit crew workers changing tires as quickly as they could during a race. The operations in these videos were decomposed into basic, fundamental motions (such as walking, reaching for a tool, and bending over) by studying the videos frame by frame. A comparison analysis was then performed between the emergency pace and the normal working pace operations to determine performance coefficients. These coefficients represent the decrease in time required for various basic motions in emergency situations and were used to model an emergency response. This approach will make hazardous operations requiring operator response, alarm management, and evacuation processes easier to design and predict. An application of this methodology is included in the article. The time required for an emergency response was roughly a one-third faster than for a normal response time.

Summary of the Infectious Diseases and Disaster Response Conference in Abu Dhabi

DTIC Science & Technology

2012-01-01

current global surveillance efforts. The AFHSC-GEIS laboratory surveillance network has been an important player in global biosurveillance of...use in disaster response and is applicable to natural disasters as well as armed confl ict. During the small- group discussion, Dr Hajjar presented a...et al. The 6. global emerging infection surveillance and re- sponse system (GEIS), a U.S. government tool for improved global biosurveillance : a

Emergencies planning and response: Coupling an exposure model with different atmospheric dispersion models

NASA Astrophysics Data System (ADS)

Sanchez, E. Y.; Colman Lerner, J. E.; Porta, A.; Jacovkis, P. M.

2013-11-01

Information on spatial and time dependent concentration patterns of hazardous substances, as well as on the potential effects on population, is necessary to assist in chemical emergency planning and response. To that end, some models predict transport and dispersion of hazardous substances, and others estimate potential effects upon exposed population. Taken together, both groups constitute a powerful tool to estimate vulnerable regions and to evaluate environmental impact upon affected populations. The development of methodologies and models with direct application to the context in which we live allows us to draft a more clear representation of the risk scenario and, hence, to obtain the adequate tools for an optimal response. By means of the recently developed DDC (Damage Differential Coupling) exposure model, it was possible to optimize, from both the qualitative and the quantitative points of view, the estimation of the population affected by a toxic cloud, because the DDC model has a very good capacity to couple with different atmospheric dispersion models able to provide data over time. In this way, DDC analyzes the different concentration profiles (output from the transport model) associating them with some reference concentration to identify risk zones. In this work we present a disaster scenario in Chicago (USA), by coupling DDC with two transport models of different complexity, showing the close relationship between a representative result and the run time of the models. In the same way, it becomes evident that knowing the time evolution of the toxic cloud and of the affected regions significantly improves the probability of taking the correct decisions on planning and response facing the emergency.

An organizational metamodel for hospital emergency departments.

PubMed

Kaptan, Kubilay

2014-10-01

I introduce an organizational model describing the response of the hospital emergency department. The hybrid simulation/analytical model (called a "metamodel") can estimate a hospital's capacity and dynamic response in real time and incorporate the influence of damage to structural and nonstructural components on the organizational ones. The waiting time is the main parameter of response and is used to evaluate the disaster resilience of health care facilities. Waiting time behavior is described by using a double exponential function and its parameters are calibrated based on simulated data. The metamodel covers a large range of hospital configurations and takes into account hospital resources in terms of staff and infrastructures, operational efficiency, and the possible existence of an emergency plan; maximum capacity; and behavior both in saturated and overcapacitated conditions. The sensitivity of the model to different arrival rates, hospital configurations, and capacities and the technical and organizational policies applied during and before a disaster were investigated. This model becomes an important tool in the decision process either for the engineering profession or for policy makers.

Operational atmospheric modeling system CARIS for effective emergency response associated with hazardous chemical releases in Korea.

PubMed

Kim, Cheol-Hee; Park, Jin-Ho; Park, Cheol-Jin; Na, Jin-Gyun

2004-03-01

The Chemical Accidents Response Information System (CARIS) was developed at the Center for Chemical Safety Management in South Korea in order to track and predict the dispersion of hazardous chemicals in the case of an accident or terrorist attack involving chemical companies. The main objective of CARIS is to facilitate an efficient emergency response to hazardous chemical accidents by rapidly providing key information in the decision-making process. In particular, the atmospheric modeling system implemented in CARIS, which is composed of a real-time numerical weather forecasting model and an air pollution dispersion model, can be used as a tool to forecast concentrations and to provide a wide range of assessments associated with various hazardous chemicals in real time. This article introduces the components of CARIS and describes its operational modeling system. Some examples of the operational modeling system and its use for emergency preparedness are presented and discussed. Finally, this article evaluates the current numerical weather prediction model for Korea.

Australasian respiratory and emergency physicians do not use the pneumonia severity index in community-acquired pneumonia.

PubMed

Serisier, David J; Williams, Sophie; Bowler, Simon D

2013-02-01

The value of community-acquired pneumonia (CAP) severity scoring tools is almost exclusively reliant upon regular and accurate application in clinical practice. Until recently, the Australasian Therapeutic Guidelines has recommended the use of the Pneumonia Severity Index (PSI) in spite of poor user-friendliness. Electronic and postal survey of respiratory and emergency medicine physician and specialist registrar members of the Royal Australasian College was undertaken to assess the use of the PSI and the accuracy of its application to hypothetical clinical CAP scenarios. The confusion, urea, respiratory rate, blood pressure, age 65 or older (CURB-65) score was also assessed as a simpler alternative. Five hundred thirty-six (228 respiratory, 308 emergency) responses were received. Only 12% of respiratory and 35% of emergency physicians reported using the PSI always or frequently. The majority were unable to accurately approximate PSI scores, with significantly fewer respiratory than emergency physicians recording accurate severity classes (11.8% vs 21%, OR 0.50, 95% CI: 0.37-0.68, P < 0.0001). In contrast, significantly more respiratory physicians were able to accurately calculate the CURB-65 score (20.4% vs 15%, OR 1.45, 95% CI: 1.10-1.91, P = 0.006). Australasian specialist physicians primarily responsible for the acute management of CAP report infrequent use of the PSI and are unable to accurately apply its use to hypothetical scenarios. Furthermore, respiratory and emergency physicians contrasted distinctly in their use and application of the two commonest severity scoring systems--the recent recommendation of two further alternative scoring tools by Australian guidelines may add to this confusion. A simple, coordinated approach to pneumonia severity assessment across specialties in Australasia is needed. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

Humanisation and soft qualities in emergency rooms.

PubMed

Buffoli, Maddalena; Bellini, Eva; Dell'Ovo, Marta; Gola, Marco; Nachiero, Dario; Rebecchi, Andrea; Capolongo, Stefano

2016-01-01

Scenario. Currently, there are few evaluation methods that analyse social aspects in healthcare issues, especially humanisation and well-being, as perceived by users in emergency departments which are places in which patients' psycho-physical well-being is decisive. For this reason, research was conducted to create a tool to improve the quality of these areas. In order to conduct the research, the work was structured in three phases: the first, based on the analysis of State-of-the-Art and the current studies on the interactions established between the physical and emotional conditions of the structure and the users; the second, through the definition of a questionnaire which explores humanisation and comfort aspects; the third, through the application of the instrument. The paper presents and analyses data collected from the application on a case study in Milan, analysing the responses and proposing design suggestions for increasing the quality of emergency environments. In anticipation of future works, the application of such a tool can provide the opportunity to improve and enhance quality and staff efficiency in emergency department spaces.

Making vaccines “on demand”

PubMed Central

De Groot, Anne S; Einck, Leo; Moise, Leonard; Chambers, Michael; Ballantyne, John; Malone, Robert W; Ardito, Matthew; Martin, William

2013-01-01

The integrated US Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) has made great strides in strategic preparedness and response capabilities. There have been numerous advances in planning, biothreat countermeasure development, licensure, manufacturing, stockpiling and deployment. Increased biodefense surveillance capability has dramatically improved, while new tools and increased awareness have fostered rapid identification of new potential public health pathogens. Unfortunately, structural delays in vaccine design, development, manufacture, clinical testing and licensure processes remain significant obstacles to an effective national biodefense rapid response capability. This is particularly true for the very real threat of “novel pathogens” such as the avian-origin influenzas H7N9 and H5N1, and new coronaviruses such as hCoV-EMC. Conventional approaches to vaccine development, production, clinical testing and licensure are incompatible with the prompt deployment needed for an effective public health response. An alternative approach, proposed here, is to apply computational vaccine design tools and rapid production technologies that now make it possible to engineer vaccines for novel emerging pathogen and WMD biowarfare agent countermeasures in record time. These new tools have the potential to significantly reduce the time needed to design string-of-epitope vaccines for previously unknown pathogens. The design process—from genome to gene sequence, ready to insert in a DNA plasmid—can now be accomplished in less than 24 h. While these vaccines are by no means “standard,” the need for innovation in the vaccine design and production process is great. Should such vaccines be developed, their 60-d start-to-finish timeline would represent a 2-fold faster response than the current standard. PMID:23877094

Promoting Reflection in Teacher Preparation Programs: A Multilevel Model

ERIC Educational Resources Information Center

Etscheidt, Susan; Curran, Christina M.; Sawyer, Candace M.

2012-01-01

Teacher reflection has been promoted as a necessary tool for educators to sustain responsive instructional practices. A variety of approaches for integrating inquiry into teaching and reflection in practice emerged from extensive and intensive efforts to reform teacher preparation programs. Based on those conceptualizations, a three-level model of…

Predictive Endocrine Testing in the 21st Century Using In Vitro Assays of Estrogen Receptor Signaling Responses

EPA Science Inventory

Thousands of environmental chemicals are subject to regulatory review for their potential to be endocrine disruptors (ED). In vitro high-throughput screening (HTS) assays have emerged as a potential tool for prioritizing chemicals for ED-related whole-animal tests. In this study,...

Emergency radiobioassay preparedness exercises through the NIST radiochemistry intercomparison program.

PubMed

Nour, Svetlana; LaRosa, Jerry; Inn, Kenneth G W

2011-08-01

The present challenge for the international emergency radiobioassay community is to analyze contaminated samples rapidly while maintaining high quality results. The National Institute of Standards and Technology (NIST) runs a radiobioassay measurement traceability testing program to evaluate the radioanalytical capabilities of participating laboratories. The NIST Radiochemistry Intercomparison Program (NRIP) started more than 10 years ago, and emergency performance testing was added to the program seven years ago. Radiobioassay turnaround times under the NRIP program for routine production and under emergency response scenarios are 60 d and 8 h, respectively. Because measurement accuracy and sample turnaround time are very critical in a radiological emergency, response laboratories' analytical systems are best evaluated and improved through traceable Performance Testing (PT) programs. The NRIP provides participant laboratories with metrology tools to evaluate their performance and to improve it. The program motivates the laboratories to optimize their methodologies and minimize the turnaround time of their results. Likewise, NIST has to make adjustments and periodical changes in the bioassay test samples in order to challenge the participating laboratories continually. With practice, radioanalytical measurements turnaround time can be reduced to 3-4 h.

BP Spill Sampling and Monitoring Data April-September 2010 - Data Download Tool

EPA Pesticide Factsheets

This dataset analyzes waste from the the British Petroleum Deepwater Horizon Rig Explosion Emergency Response, providing opportunity to query data sets by metadata criteria and find resulting raw datasets in CSV format.The data query tool allows users to download air, water and sediment sampling and monitoring data that has been collected in response to the BP oil spill. All sampling and monitoring data that has been collected to date is available for download as raw structured data.The query tools enables CSV file creation to be refined based on the following search criteria: date range (between April 28, 2010 and 9/29/2010); location by zip, city, or county; media (solid waste, weathered oil, air, surface water, liquid waste, tar, sediment, water); substance categories (based on media selection) and substances (based on substance category selection).

Managing Sustainability with the Support of Business Intelligence Methods and Tools

NASA Astrophysics Data System (ADS)

Petrini, Maira; Pozzebon, Marlei

In this paper we explore the role of business intelligence (BI) in helping to support the management of sustainability in contemporary firms. The concepts of sustainability and corporate social responsibility (CSR) are among the most important themes to have emerged in the last decade at the global level. We suggest that BI methods and tools have an important but not yet well studied role to play in helping organizations implement and monitor sustainable and socially responsible business practices. Using grounded theory, the main contribution of our study is to propose a conceptual model that seeks to support the process of definition and monitoring of socio-environmental indicators and the relationship between their management and business strategy.

Current and emerging techniques for antibiotic susceptibility tests.

PubMed

Syal, Karan; Mo, Manni; Yu, Hui; Iriya, Rafael; Jing, Wenwen; Guodong, Sui; Wang, Shaopeng; Grys, Thomas E; Haydel, Shelley E; Tao, Nongjian

2017-01-01

Infectious diseases caused by bacterial pathogens are a worldwide burden. Serious bacterial infection-related complications, such as sepsis, affect over a million people every year with mortality rates ranging from 30% to 50%. Crucial clinical microbiology laboratory responsibilities associated with patient management and treatment include isolating and identifying the causative bacterium and performing antibiotic susceptibility tests (ASTs), which are labor-intensive, complex, imprecise, and slow (taking days, depending on the growth rate of the pathogen). Considering the life-threatening condition of a septic patient and the increasing prevalence of antibiotic-resistant bacteria in hospitals, rapid and automated diagnostic tools are needed. This review summarizes the existing commercial AST methods and discusses some of the promising emerging AST tools that will empower humans to win the evolutionary war between microbial genes and human wits.

Current and emerging techniques for antibiotic susceptibility tests

PubMed Central

Syal, Karan; Mo, Manni; Yu, Hui; Iriya, Rafael; Jing, Wenwen; Guodong, Sui; Wang, Shaopeng; Grys, Thomas E.; Haydel, Shelley E.; Tao, Nongjian

2017-01-01

Infectious diseases caused by bacterial pathogens are a worldwide burden. Serious bacterial infection-related complications, such as sepsis, affect over a million people every year with mortality rates ranging from 30% to 50%. Crucial clinical microbiology laboratory responsibilities associated with patient management and treatment include isolating and identifying the causative bacterium and performing antibiotic susceptibility tests (ASTs), which are labor-intensive, complex, imprecise, and slow (taking days, depending on the growth rate of the pathogen). Considering the life-threatening condition of a septic patient and the increasing prevalence of antibiotic-resistant bacteria in hospitals, rapid and automated diagnostic tools are needed. This review summarizes the existing commercial AST methods and discusses some of the promising emerging AST tools that will empower humans to win the evolutionary war between microbial genes and human wits. PMID:28638468

Overview of Hazard Assessment and Emergency Planning Software of Use to RN First Responders

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waller, E; Millage, K; Blakely, W F

2008-08-26

There are numerous software tools available for field deployment, reach-back, training and planning use in the event of a radiological or nuclear (RN) terrorist event. Specialized software tools used by CBRNe responders can increase information available and the speed and accuracy of the response, thereby ensuring that radiation doses to responders, receivers, and the general public are kept as low as reasonably achievable. Software designed to provide health care providers with assistance in selecting appropriate countermeasures or therapeutic interventions in a timely fashion can improve the potential for positive patient outcome. This paper reviews various software applications of relevance tomore » radiological and nuclear (RN) events that are currently in use by first responders, emergency planners, medical receivers, and criminal investigators.« less

Automated geo/ortho registered aerial imagery product generation using the mapping system interface card (MSIC)

NASA Astrophysics Data System (ADS)

Bratcher, Tim; Kroutil, Robert; Lanouette, André; Lewis, Paul E.; Miller, David; Shen, Sylvia; Thomas, Mark

2013-05-01

The development concept paper for the MSIC system was first introduced in August 2012 by these authors. This paper describes the final assembly, testing, and commercial availability of the Mapping System Interface Card (MSIC). The 2.3kg MSIC is a self-contained, compact variable configuration, low cost real-time precision metadata annotator with embedded INS/GPS designed specifically for use in small aircraft. The MSIC was specifically designed to convert commercial-off-the-shelf (COTS) digital cameras and imaging/non-imaging spectrometers with Camera Link standard data streams into mapping systems for airborne emergency response and scientific remote sensing applications. COTS digital cameras and imaging/non-imaging spectrometers covering the ultraviolet through long-wave infrared wavelengths are important tools now readily available and affordable for use by emergency responders and scientists. The MSIC will significantly enhance the capability of emergency responders and scientists by providing a direct transformation of these important COTS sensor tools into low-cost real-time aerial mapping systems.

National Alliance for Radiation Readiness: Leveraging Partnerships to Increase Preparedness.

PubMed

Blumenstock, James S; Allen, Meredith

2016-02-01

The National Alliance for Radiation Readiness (NARR) is an alliance of 16 national member organizations that have banded together to serve as the collective "voice of health" in radiological preparedness through: • participation in national dialogues on radiological emergency issues; • provision of thoughtful feedback on documents, policies, and guidelines; and • convening of partners to raise awareness of and resolve radiological emergency issues. NARR benefits from the intersection and interaction of public health, radiation control, healthcare, and emergency management professionals--all with an interest in bolstering the nation's preparedness for a radiological or nuclear incident. NARR is able to provide a unique perspective on radiological and nuclear preparedness by creating multi-disciplinary workgroups to develop guidance, recommendations, and provide subject matter feedback. NARR aims to build response and recovery capacity and capabilities by supporting the sharing of resources and tools, including technical methods and information through the development of an online clearinghouse. NARR also aims to identify and disseminate best practices, as well as define and educate on the roles and responsibilities of local, state, and federal government and the numerous agencies involved with the response to a radiological emergency.

The perspective of USDA APHIS Veterinary Services Emergency Management and Diagnostics in preparing and responding to Foreign Animal Diseases - plans, strategies, and countermeasures.

PubMed

Díez, J R; Styles, D K

2013-01-01

The United States Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) Veterinary Services (VS) is charged with monitoring, controlling, and responding to select reportable diseases and all foreign animal diseases. Emergency Management and Diagnostics (EM&D) oversees Foreign Animal Disease (FAD) preparedness and response. In order to effectively prepare for and respond to FADs, such as highly pathogenic avian influenza and foot-and-mouth disease, VS develops plans, strategies, and policies to effectively combat an intrusion. USDA APHIS VS has made significant gains in preparedness and response planning. However, much remains to be done especially in surveillance, diagnostic tools, and vaccines. There are significant needs for novel medical technologies to improve diagnostic capabilities and offer additional approaches for FAD response.

Developing a Mass Casualty Surge Capacity Protocol for Emergency Medical Services to Use for Patient Distribution.

PubMed

Shartar, Samuel E; Moore, Brooks L; Wood, Lori M

2017-12-01

Metropolitan areas must be prepared to manage large numbers of casualties related to a major incident. Most US cities do not have adequate trauma center capacity to manage large-scale mass casualty incidents (MCIs). Creating surge capacity requires the distribution of casualties to hospitals that are not designated as trauma centers. Our objectives were to extrapolate MCI response research into operational objectives for MCI distribution plan development; formulate a patient distribution model based on research, hospital capacities, and resource availability; and design and disseminate a casualty distribution tool for use by emergency medical services (EMS) personnel to distribute patients to the appropriate level of care. Working with hospitals within the region, we refined emergency department surge capacity for MCIs and developed a prepopulated tool for EMS providers to use to distribute higher-acuity casualties to trauma centers and lower-acuity casualties to nontrauma hospitals. A mechanism to remove a hospital from the list of available resources, if it is overwhelmed with patients who self-transport to the location, also was put into place. The number of critically injured survivors from an MCI has proven to be consistent, averaging 7% to 10%. Moving critically injured patients to level 1 trauma centers can result in a 25% reduction in mortality, when compared with care at nontrauma hospitals. US cities face major gaps in the surge capacity needed to manage an MCI. Sixty percent of "walking wounded" casualties self-transport to the closest hospital(s) to the incident. Directing critically ill patients to designated trauma centers has the potential to reduce mortality associated with the event. When applied to MCI responses, damage-control principles reduce resource utilization and optimize surge capacity. A universal system for mass casualty triage was identified and incorporated into the region's EMS. Flagship regional coordinating hospitals were designated to coordinate the logistics of the disaster response of both trauma-designated and undesignated hospitals. Finally, a distribution tool was created to direct the flow of critically injured patients to trauma centers and redirect patients with lesser injuries to centers without trauma designation. The tool was distributed to local EMS personnel and validated in a series of tabletop and functional drills. These efforts demonstrate that a regional response to MCIs can be implemented in metropolitan areas under-resourced for trauma care.

An attempt to implement tools to support examination of community-based activities for disaster mitigation: A case study in Toyokawa city, Japan

NASA Astrophysics Data System (ADS)

Karashima, Kazuki; Ohgai, Akira

2017-10-01

Japan is a country with a high risk for earthquake disasters. The measures used to promote structures' seismic safety, such as reconstruction, widening narrow roads, and the response capacities to deal with huge earthquakes are important. Techniques to support the examination of countermeasures to huge earthquakes are required. To improve this capability, the authors developed tools to: (1) evaluate fire-spread risk, (2) evaluate the difficulty of emergency response and evacuation, and (3) evaluate capacities of neighborhood communities for disaster mitigation. The usefulness of the tools was clarified by the demonstration experiments of previous studies. The next step was implementation of the tools in community-based activities for disaster mitigation. This study aimed to clarify the usability and problems of implementing the tools in community-based activities. The tools were used at several workshops in actual community-based activities for disaster mitigation for one year. After the last workshop, interviews and a questionnaire were conducted on municipal staff and consultant staff. The results found that the tools visually showed the fire-spread risk, the difficulty of evacuation under current conditions and after improvements, and the effects of each disaster mitigation activity. The users could easily explore the draft plans to promote seismic safety of urban structures and response capabilities. The tools were positively incorporated into some community-based activities for disaster mitigation. Thus, the tools have the possibility of successful use at continuing community-based activities and the possibility of implementing the tools will be promoted.

Load index model: An advanced tool to support decision making during mass-casualty incidents.

PubMed

Adini, Bruria; Aharonson-Daniel, Limor; Israeli, Avi

2015-03-01

In mass-casualty events, accessing information concerning hospital congestion levels is crucial to improving patient distribution and optimizing care. The study aimed to develop a decision support tool for distributing casualties to hospitals in an emergency scenario involving multiple casualties. A comprehensive literature review and structured interviews with 20 content experts produced a shortlist of relevant criteria for inclusion in the model. A "load index model" was prepared, incorporating results of a modified Delphi survey of 100 emergency response experts. The model was tested in three simulation exercises in which an emergency scenario was presented to six groups of senior emergency managers. Information was provided regarding capacities of 11 simulated admitting hospitals in the region, and evacuation destinations were requested for 600 simulated casualties. Of the three simulation rounds, two were performed without the model and one after its presentation. Following simulation experiments and implementation during a real-life security threat, the efficacy of the model was assessed. Variability between experts concerning casualties' evacuation destinations decreased significantly following the model's introduction. Most responders (92%) supported the need for standardized data, and 85% found that the model improved policy setting regarding casualty evacuation in an emergency situation. These findings were reaffirmed in a real-life emergency scenario. The proposed model improved capacity to ensure evacuation of patients to less congested medical facilities in emergency situations, thereby enhancing lifesaving medical services. The model supported decision-making processes in both simulation exercises and an actual emergency situation.

Ditchin' the Master's Gardening Tools for Our Own: Growing a Womanist Methodology from the Grassroots

ERIC Educational Resources Information Center

Marr, Vanessa L.

2014-01-01

This essay explores the autoethnographic possibilities of critical service-learning research and the emerging realities of a community-centered womanist methodological response. Drawing from Alice Walker's definition of "womanist" as a commitment to "survival and wholeness of entire people, male 'and' female," the author argues…

The "Uncanny" Character of Race: An Exploration of UK Preparedness through Youth Performance

ERIC Educational Resources Information Center

Chakrabarty, Namita

2011-01-01

Performance is a key tool in emergency preparedness and the rehearsal of professional response, simultaneously raising questions about the practice of cultural assumptions in this context. Usually the actors in preparedness exercises are civil servants who perform the work of the nihilistic imagination in often-apocalyptic fictional scenarios,…

EVALUATING HYDROLOGICAL RESPONSE TO FORECASTED LAND-USE CHANGE: SCENARIO TESTING WITH THE AUTOMATED GEOSPATIAL WATERSHED ASSESSMENT (AGWA) TOOL

EPA Science Inventory

Envisioning and evaluating future scenarios has emerged as a critical component of both science and social decision-making. The ability to assess, report, map, and forecast the life support functions of ecosystems is absolutely critical to our capacity to make informed decisions...

Wound Signaling: Monkeywrenching Macrophage Migration with Microscopes, Movies, and Math.

PubMed

Galko, Michael J

2016-08-08

Drosophila hemocytes (blood cells) have emerged as a powerful system to image wound-induced inflammatory responses in vivo. New work reveals that layering mathematical modeling on top of imaging may be the most powerful tool yet for determining the properties of wound-induced signals. Copyright © 2016 Elsevier Ltd. All rights reserved.

School Evaluation: A Lever for Meaningful Change.

ERIC Educational Resources Information Center

Evans, Max W.

The principal who genuinely wants to change things in his school has a potentially powerful tool in the North Central Association plan for school evaluation. A major roadblock to reform has been conservatism both in the profession and among the public. The emerging role of the principal saddles him with the responsibility for bringing about change…

Positron emission tomography/computerized tomography in lung cancer

PubMed Central

Vural, Gulin Ucmak

2014-01-01

Positron emission tomography (PET) using 2-(18F)-flouro-2-deoxy-D-glucose (FDG) has emerged as a useful tool in the clinical work-up of lung cancer. This review article provides an overview of applications of PET in diagnosis, staging, treatment response evaluation, radiotherapy planning, recurrence assessment and prognostication of lung cancer. PMID:24914421

Responsibility-Centred Budgeting: An Emerging Trend in Higher Education Budget Reform

ERIC Educational Resources Information Center

Zierdt, Ginger LuAnne

2009-01-01

Higher education institutions in the United States are entering a new era in budgeting. Therefore, institutions are actively engaging in dialogues about the budgeting tools that will most effectively assist them in achieving institutional goals and objectives within their strategic plans and being accountable for the use of scarce resources, as…

Disaster planning for vulnerable populations: leveraging Community Human Service Organizations direct service delivery personnel.

PubMed

Levin, Karen L; Berliner, Maegan; Merdjanoff, Alexis

2014-01-01

Given the variability, complexities, and available resources for local vulnerable populations, it is clear that preparing effectively for catastrophic events cannot be accomplished with a single, simple template. Inclusion of Community Human Service Organizations' (CHSO's) direct service delivery personnel ensures that emergency disaster planning efforts for vulnerable populations are effective and responsive to unique needs and constraints. By leveraging existing local resources, it extends the preparedness system's reach to the whole community. CHSO personnel already perform community-based services and directly engage with vulnerable and special needs populations; typically they are on the front lines during an emergency event. Generally, however, the CHSOs, staff, and clients are neither adequately prepared for disasters nor well integrated into emergency systems. To address preparedness gaps identified during Hurricane Sandy, regional CHSO and local health department partners requested that the Columbia Regional Learning Center provide preparedness trainings for their agencies and staff responsible for vulnerable clients. Evaluation of this initiative was begun with a mixed-methods approach consisting of collaborative learning activities, a function-based assessment tool, and a 5 Steps to Preparedness module. Results from a survey were inclusive because of a low response rate but suggested satisfaction with the training format and content; increases in awareness of a client preparedness role; and steps toward improved personal, agency, and client preparedness. Direct service delivery personnel can leverage routine client interactions for preparedness planning and thus can contribute significantly to vulnerable population and community disaster readiness. Trainings that provide preparedness tools can help support this role. CHSO personnel are knowledgeable and have the expertise to assist clients in personal preparedness planning; yet, there are challenges around their ability and willingness to take on additional responsibilities.

Developing AN Emergency Response Model for Offshore Oil Spill Disaster Management Using Spatial Decision Support System (sdss)

NASA Astrophysics Data System (ADS)

Balogun, Abdul-Lateef; Matori, Abdul-Nasir; Wong Toh Kiak, Kelvin

2018-04-01

Environmental resources face severe risks during offshore oil spill disasters and Geographic Information System (GIS) Environmental Sensitivity Index (ESI) maps are increasingly being used as response tools to minimize the huge impacts of these spills. However, ESI maps are generally unable to independently harmonize the diverse preferences of the multiple stakeholders' involved in the response process, causing rancour and delay in response time. This paper's Spatial Decision Support System (SDSS) utilizes the Analytic Hierarchy Process (AHP) model to perform tradeoffs in determining the most significant resources to be secured considering the limited resources and time available to perform the response operation. The AHP approach is used to aggregate the diverse preferences of the stakeholders and reach a consensus. These preferences, represented as priority weights, are incorporated in a GIS platform to generate Environmental sensitivity risk (ESR) maps. The ESR maps provide a common operational platform and consistent situational awareness for the multiple parties involved in the emergency response operation thereby minimizing discord among the response teams and saving the most valuable resources.

Design and evaluation of a disaster preparedness logistics tool.

PubMed

Neches, Robert; Ryutov, Tatyana; Kichkaylo, Tatiana; Burke, Rita V; Claudius, Ilene A; Upperman, Jeffrey S

2009-01-01

The purpose of this article is to describe the development and testing of the Pediatric Emergency Decision Support System (PEDSS), a dynamic tool for pediatric victim disaster planning. This is a descriptive article outlining an innovative automated approach to pediatric decision support and disaster planning. Disaster Resource Centers and umbrella hospitals in Los Angeles County. The authors use a model set of hypothetical patients for our pediatric disaster planning approach. The authors developed the PEDSS software to accomplish two goals: (a) core that supports user interaction and data management requirements (e.g., accessing demographic information about a healthcare facility's catchment area) and (b) set of modules each addressing a critical disaster preparation issue. The authors believe the PEDSS tool will help hospital disaster response personnel produce and maintain disaster response plans that apply best practice pediatric recommendations to their particular local conditions and requirements.

Design and Implementation of Real-Time Off-Grid Detection Tool Based on FNET/GridEye

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guo, Jiahui; Zhang, Ye; Liu, Yilu

2014-01-01

Real-time situational awareness tools are of critical importance to power system operators, especially during emergencies. The availability of electric power has become a linchpin of most post disaster response efforts as it is the primary dependency for public and private sector services, as well as individuals. Knowledge of the scope and extent of facilities impacted, as well as the duration of their dependence on backup power, enables emergency response officials to plan for contingencies and provide better overall response. Based on real-time data acquired by Frequency Disturbance Recorders (FDRs) deployed in the North American power grid, a real-time detection methodmore » is proposed. This method monitors critical electrical loads and detects the transition of these loads from an on-grid state, where the loads are fed by the power grid to an off-grid state, where the loads are fed by an Uninterrupted Power Supply (UPS) or a backup generation system. The details of the proposed detection algorithm are presented, and some case studies and off-grid detection scenarios are also provided to verify the effectiveness and robustness. Meanwhile, the algorithm has already been implemented based on the Grid Solutions Framework (GSF) and has effectively detected several off-grid situations.« less

Designing Real-time Decision Support for Trauma Resuscitations

PubMed Central

Yadav, Kabir; Chamberlain, James M.; Lewis, Vicki R.; Abts, Natalie; Chawla, Shawn; Hernandez, Angie; Johnson, Justin; Tuveson, Genevieve; Burd, Randall S.

2016-01-01

Background Use of electronic clinical decision support (eCDS) has been recommended to improve implementation of clinical decision rules. Many eCDS tools, however, are designed and implemented without taking into account the context in which clinical work is performed. Implementation of the pediatric traumatic brain injury (TBI) clinical decision rule at one Level I pediatric emergency department includes an electronic questionnaire triggered when ordering a head computed tomography using computerized physician order entry (CPOE). Providers use this CPOE tool in less than 20% of trauma resuscitation cases. A human factors engineering approach could identify the implementation barriers that are limiting the use of this tool. Objectives The objective was to design a pediatric TBI eCDS tool for trauma resuscitation using a human factors approach. The hypothesis was that clinical experts will rate a usability-enhanced eCDS tool better than the existing CPOE tool for user interface design and suitability for clinical use. Methods This mixed-methods study followed usability evaluation principles. Pediatric emergency physicians were surveyed to identify barriers to using the existing eCDS tool. Using standard trauma resuscitation protocols, a hierarchical task analysis of pediatric TBI evaluation was developed. Five clinical experts, all board-certified pediatric emergency medicine faculty members, then iteratively modified the hierarchical task analysis until reaching consensus. The software team developed a prototype eCDS display using the hierarchical task analysis. Three human factors engineers provided feedback on the prototype through a heuristic evaluation, and the software team refined the eCDS tool using a rapid prototyping process. The eCDS tool then underwent iterative usability evaluations by the five clinical experts using video review of 50 trauma resuscitation cases. A final eCDS tool was created based on their feedback, with content analysis of the evaluations performed to ensure all concerns were identified and addressed. Results Among 26 EPs (76% response rate), the main barriers to using the existing tool were that the information displayed is redundant and does not fit clinical workflow. After the prototype eCDS tool was developed based on the trauma resuscitation hierarchical task analysis, the human factors engineers rated it to be better than the CPOE tool for nine of 10 standard user interface design heuristics on a three-point scale. The eCDS tool was also rated better for clinical use on the same scale, in 84% of 50 expert–video pairs, and was rated equivalent in the remainder. Clinical experts also rated barriers to use of the eCDS tool as being low. Conclusions An eCDS tool for diagnostic imaging designed using human factors engineering methods has improved perceived usability among pediatric emergency physicians. PMID:26300010

Eusocial insects as emerging models for behavioural epigenetics.

PubMed

Yan, Hua; Simola, Daniel F; Bonasio, Roberto; Liebig, Jürgen; Berger, Shelley L; Reinberg, Danny

2014-10-01

Understanding the molecular basis of how behavioural states are established, maintained and altered by environmental cues is an area of considerable and growing interest. Epigenetic processes, including methylation of DNA and post-translational modification of histones, dynamically modulate activity-dependent gene expression in neurons and can therefore have important regulatory roles in shaping behavioural responses to environmental cues. Several eusocial insect species - with their unique displays of behavioural plasticity due to age, morphology and social context - have emerged as models to investigate the genetic and epigenetic underpinnings of animal social behaviour. This Review summarizes recent studies in the epigenetics of social behaviour and offers perspectives on emerging trends and prospects for establishing genetic tools in eusocial insects.

Preparing Emerging Doctoral Scholars for Transdisciplinary Research: A Developmental Approach

PubMed Central

Kemp, Susan P.; Nurius, Paula S.

2015-01-01

Research models that bridge disciplinary, theoretical, and methodological boundaries are increasingly common as funders and the public push for timely, effective, collaborative responses to pressing social and environmental problems. Although social work is inherently an integrative discipline, there is growing recognition of the need to better prepare emerging scholars for sophisticated transdisciplinary and translational research environments. This paper outlines a developmental, competency-oriented approach to enhancing the readiness of doctoral students and emerging scholars in social work and allied disciplines for transdisciplinary research, describes an array of pedagogical tools applicable in doctoral course work and other program elements, and urges coordinated attention to enhancing the field’s transdisciplinary training capacity. PMID:26005286

Crosstalk between the Unfolded Protein Response and NF-κB-Mediated Inflammation in the Progression of Chronic Kidney Disease

PubMed Central

Cruz, Gaile L.; Dickhout, Jeffrey G.

2015-01-01

The chronic inflammatory response is emerging as an important therapeutic target in progressive chronic kidney disease. A key transcription factor in the induction of chronic inflammation is NF-κB. Recent studies have demonstrated that sustained activation of the unfolded protein response (UPR) can initiate this NF-κB signaling phenomenon and thereby induce chronic kidney disease progression. A key factor influencing chronic kidney disease progression is proteinuria and this condition has now been demonstrated to induce sustained UPR activation. This review details the crosstalk between the UPR and NF-κB pathways as pertinent to chronic kidney disease. We present potential tools to study this phenomenon as well as potential therapeutics that are emerging to regulate the UPR. These therapeutics may prevent inflammation specifically induced in the kidney due to proteinuria-induced sustained UPR activation. PMID:25977931

Market Competition, Public Good and Institutional Governance: Analyses of Portugal's Experience

ERIC Educational Resources Information Center

Amaral, Alberto; Magalhaes, Antonio

2007-01-01

The emergence of the market as a regulatory tool for the public sector and the promotion of competition among institutions are based upon the idea that they promote institutions' responsiveness to society and a more efficient use of public funds. However, autonomous institutions forced to compete under market-like conditions may follow strategies…

Using remote sensing to monitor post-fire watershed recovery as a tool for management

Treesearch

Jess Clark; Marc Stamer; Kevin Cooper; Carolyn Napper; Terri Hogue; Alicia Kinoshita

2013-01-01

Post-fire watershed recovery is influenced by numerous variables but one of the most important factors is the rate of re-establishment of vegetative cover. Burned Area Emergency Response (BAER) teams, along with other agencies (Natural Resource Conservation Service, state, counties, cities, etc.), prescribe temporary post-fire mitigation treatments based on expected...

Developing an analytical tool for evaluating EMS system design changes and their impact on cardiac arrest outcomes: combining geographic information systems with register data on survival rates

PubMed Central

2013-01-01

Background Out-of-hospital cardiac arrest (OHCA) is a frequent and acute medical condition that requires immediate care. We estimate survival rates from OHCA in the area of Stockholm, through developing an analytical tool for evaluating Emergency Medical Services (EMS) system design changes. The study also is an attempt to validate the proposed model used to generate the outcome measures for the study. Methods and results This was done by combining a geographic information systems (GIS) simulation of driving times with register data on survival rates. The emergency resources comprised ambulance alone and ambulance plus fire services. The simulation model predicted a baseline survival rate of 3.9 per cent, and reducing the ambulance response time by one minute increased survival to 4.6 per cent. Adding the fire services as first responders (dual dispatch) increased survival to 6.2 per cent from the baseline level. The model predictions were validated using empirical data. Conclusion We have presented an analytical tool that easily can be generalized to other regions or countries. The model can be used to predict outcomes of cardiac arrest prior to investment in EMS design changes that affect the alarm process, e.g. (1) static changes such as trimming the emergency call handling time or (2) dynamic changes such as location of emergency resources or which resources should carry a defibrillator. PMID:23415045

Lessons from the Ebola Outbreak: Action Items for Emerging Infectious Disease Preparedness and Response.

PubMed

Jacobsen, Kathryn H; Aguirre, A Alonso; Bailey, Charles L; Baranova, Ancha V; Crooks, Andrew T; Croitoru, Arie; Delamater, Paul L; Gupta, Jhumka; Kehn-Hall, Kylene; Narayanan, Aarthi; Pierobon, Mariaelena; Rowan, Katherine E; Schwebach, J Reid; Seshaiyer, Padmanabhan; Sklarew, Dann M; Stefanidis, Anthony; Agouris, Peggy

2016-03-01

As the Ebola outbreak in West Africa wanes, it is time for the international scientific community to reflect on how to improve the detection of and coordinated response to future epidemics. Our interdisciplinary team identified key lessons learned from the Ebola outbreak that can be clustered into three areas: environmental conditions related to early warning systems, host characteristics related to public health, and agent issues that can be addressed through the laboratory sciences. In particular, we need to increase zoonotic surveillance activities, implement more effective ecological health interventions, expand prediction modeling, support medical and public health systems in order to improve local and international responses to epidemics, improve risk communication, better understand the role of social media in outbreak awareness and response, produce better diagnostic tools, create better therapeutic medications, and design better vaccines. This list highlights research priorities and policy actions the global community can take now to be better prepared for future emerging infectious disease outbreaks that threaten global public health and security.

The development of the PARENTS: a tool for parents to assess residents' non-technical skills in pediatric emergency departments.

PubMed

Moreau, Katherine A; Eady, Kaylee; Tang, Kenneth; Jabbour, Mona; Frank, Jason R; Campbell, Meaghan; Hamstra, Stanley J

2017-11-14

Parents can assess residents' non-technical skills (NTS) in pediatric emergency departments (EDs). There are no assessment tools, with validity evidence, for parental use in pediatric EDs. The purpose of this study was to develop the Parents' Assessment of Residents Enacting Non-Technical Skills (PARENTS) educational assessment tool and collect three sources of validity evidence (i.e., content, response process, internal structure) for it. We established content evidence for the PARENTS through interviews with physician-educators and residents, focus groups with parents, a literature review, and a modified nominal group technique with experts. We collected response process evidence through cognitive interviews with parents. To examine the internal structure evidence, we administered the PARENTS and performed exploratory factor analysis. Initially, a 20-item PARENTS was developed. Cognitive interviews led to the removal of one closed-ended item, the addition of resident photographs, and wording/formatting changes. Thirty-seven residents and 434 parents participated in the administration of the resulting 19-item PARENTS. Following factor analysis, a one-factor model prevailed. The study presents initial validity evidence for the PARENTS. It also highlights strategies for potentially: (a) involving parents in the assessment of residents, (b) improving the assessment of NTS in pediatric EDs, and (c) capturing parents' perspectives to improve the preparation of future physicians.

Modeling and Visualizing Flow of Chemical Agents Across Complex Terrain

NASA Technical Reports Server (NTRS)

Kao, David; Kramer, Marc; Chaderjian, Neal

2005-01-01

Release of chemical agents across complex terrain presents a real threat to homeland security. Modeling and visualization tools are being developed that capture flow fluid terrain interaction as well as point dispersal downstream flow paths. These analytic tools when coupled with UAV atmospheric observations provide predictive capabilities to allow for rapid emergency response as well as developing a comprehensive preemptive counter-threat evacuation plan. The visualization tools involve high-end computing and massive parallel processing combined with texture mapping. We demonstrate our approach across a mountainous portion of North California under two contrasting meteorological conditions. Animations depicting flow over this geographical location provide immediate assistance in decision support and crisis management.

Tool-use: An open window into body representation and its plasticity

PubMed Central

Martel, Marie; Cardinali, Lucilla; Roy, Alice C.; Farnè, Alessandro

2016-01-01

ABSTRACT Over the last decades, scientists have questioned the origin of the exquisite human mastery of tools. Seminal studies in monkeys, healthy participants and brain-damaged patients have primarily focused on the plastic changes that tool-use induces on spatial representations. More recently, we focused on the modifications tool-use must exert on the sensorimotor system and highlighted plastic changes at the level of the body representation used by the brain to control our movements, i.e., the Body Schema. Evidence is emerging for tool-use to affect also more visually and conceptually based representations of the body, such as the Body Image. Here we offer a critical review of the way different tool-use paradigms have been, and should be, used to try disentangling the critical features that are responsible for tool incorporation into different body representations. We will conclude that tool-use may offer a very valuable means to investigate high-order body representations and their plasticity. PMID:27315277

Tool-use: An open window into body representation and its plasticity.

PubMed

Martel, Marie; Cardinali, Lucilla; Roy, Alice C; Farnè, Alessandro

2016-01-01

Over the last decades, scientists have questioned the origin of the exquisite human mastery of tools. Seminal studies in monkeys, healthy participants and brain-damaged patients have primarily focused on the plastic changes that tool-use induces on spatial representations. More recently, we focused on the modifications tool-use must exert on the sensorimotor system and highlighted plastic changes at the level of the body representation used by the brain to control our movements, i.e., the Body Schema. Evidence is emerging for tool-use to affect also more visually and conceptually based representations of the body, such as the Body Image. Here we offer a critical review of the way different tool-use paradigms have been, and should be, used to try disentangling the critical features that are responsible for tool incorporation into different body representations. We will conclude that tool-use may offer a very valuable means to investigate high-order body representations and their plasticity.

A Computable Definition of Sepsis Facilitates Screening and Performance Improvement Tracking.

PubMed

Alessi, Lauren J; Warmus, Holly R; Schaffner, Erin K; Kantawala, Sajel; Carcillo, Joseph; Rosen, Johanna; Horvat, Christopher M

2018-03-01

Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children's hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods are organized in a plan-do-study-act cycle. During the "plan" phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control. The performance of a screening tool was evaluated in the emergency department. During the "do" phase, a novel inpatient workflow is being piloted, which involves regular sepsis screening by nurses using the tool, and a regimented response to high risk patients. Screening tool use in the emergency department reduced time to antibiotics (Fig. 1). Of the 6,159 admissions, EHR definitions identified 1,433 (23.3%) between July and December 2016 with sepsis, of which 159 (11.1%) had septic shock. Hospital mortality for all sepsis patients was 2.2% and 15.7% for septic shock (Table 1). These findings approximate epidemiologic studies of sepsis and severe sepsis, which report a prevalence range of 0.45-8.2% and mortality range of 8.2-25% (Table 2). 1-5 . Implementation of a sepsis screening tool is associated with improved performance. The prevalence of sepsis conditions identified with electronic definitions approximates the epidemiologic landscape characterized by other point-prevalence and administrative studies, providing face validity to this approach, and proving useful for tracking performance improvement.

Southeastern Center for Emerging Biologic Threats Tabletop Exercise: Foodborne Toxoplasmosis Outbreak on College Campuses

PubMed Central

Morris, J. Glenn; Greenspan, Allison; Howell, Kelly; Mitchell, Joanne; Jones, Jeffrey L.; Potter, Morris; Isakov, Alexander; Woods, Christopher; Hughes, James M.

2012-01-01

The use of tabletop exercises as a tool in emergency preparedness and response has proven to be an effective means of assessing readiness for unexpected events. Whereas most exercise developers target a population in a defined space (eg, state, county, metropolitan area, hospital), the Southeastern Center for Emerging Biologic Threats (SECEBT) conducted an innovative tabletop exercise involving an unusual foodborne outbreak pathogen, targeting public health agencies and academic institutions in 7 southeastern states. The exercise tested the ability of participants to respond to a simulated foodborne disease outbreak affecting the region. The attendees represented 4 federal agencies, 9 state agencies, 6 universities, 1 nonprofit organization, and 1 private corporation. The goals were to promote collaborative relationships among the players, identify gaps in plans and policies, and identify the unique contributions of each organization—and notably academic institutions—to outbreak recognition, investigation, and control. Participants discussed issues and roles related to outbreak detection and management, risk communication, and coordination of policies and responsibilities before, during, and after an emergency, with emphasis on assets of universities that could be mobilized during an outbreak response. The exercise generated several lessons and recommendations identified by participants and evaluators. Key recommendations included a need to establish trigger points and protocols for information sharing and alerts among public health, academic, and law enforcement; to establish relationships with local, state, and federal stakeholders to facilitate communications during an emergency; and to catalogue and leverage strengths, assets, and priorities of academic institutions to add value to outbreak responses. PMID:22283568

Chernobyl and Fukushima nuclear accidents: what has changed in the use of atmospheric dispersion modeling?

PubMed

Benamrane, Y; Wybo, J-L; Armand, P

2013-12-01

The threat of a major accidental or deliberate event that would lead to hazardous materials emission in the atmosphere is a great cause of concern to societies. This is due to the potential large scale of casualties and damages that could result from the release of explosive, flammable or toxic gases from industrial plants or transport accidents, radioactive material from nuclear power plants (NPPs), and chemical, biological, radiological or nuclear (CBRN) terrorist attacks. In order to respond efficiently to such events, emergency services and authorities resort to appropriate planning and organizational patterns. This paper focuses on the use of atmospheric dispersion modeling (ADM) as a support tool for emergency planning and response, to assess the propagation of the hazardous cloud and thereby, take adequate counter measures. This paper intends to illustrate the noticeable evolution in the operational use of ADM tools over 25 y and especially in emergency situations. This study is based on data available in scientific publications and exemplified using the two most severe nuclear accidents: Chernobyl (1986) and Fukushima (2011). It appears that during the Chernobyl accident, ADM were used few days after the beginning of the accident mainly in a diagnosis approach trying to reconstruct what happened, whereas 25 y later, ADM was also used during the first days and weeks of the Fukushima accident to anticipate the potentially threatened areas. We argue that the recent developments in ADM tools play an increasing role in emergencies and crises management, by supporting stakeholders in anticipating, monitoring and assessing post-event damages. However, despite technological evolutions, its prognostic and diagnostic use in emergency situations still arise many issues. Copyright © 2013 Elsevier Ltd. All rights reserved.

Integrated Modeling, Mapping, and Simulation (IMMS) framework for planning exercises.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Friedman-Hill, Ernest J.; Plantenga, Todd D.

2010-06-01

The Integrated Modeling, Mapping, and Simulation (IMMS) program is designing and prototyping a simulation and collaboration environment for linking together existing and future modeling and simulation tools to enable analysts, emergency planners, and incident managers to more effectively, economically, and rapidly prepare, analyze, train, and respond to real or potential incidents. When complete, the IMMS program will demonstrate an integrated modeling and simulation capability that supports emergency managers and responders with (1) conducting 'what-if' analyses and exercises to address preparedness, analysis, training, operations, and lessons learned, and (2) effectively, economically, and rapidly verifying response tactics, plans and procedures.

Designing a data-driven decision support tool for nurse scheduling in the emergency department: a case study of a southern New Jersey emergency department.

PubMed

Otegbeye, Mojisola; Scriber, Roslyn; Ducoin, Donna; Glasofer, Amy

2015-01-01

A health system serving Burlington and Camden Counties, New Jersey, sought to improve labor productivity for its emergency departments, with emphasis on optimizing nursing staff schedules. Using historical emergency department visit data and operating constraints, a decision support tool was designed to recommend the number of emergency nurses needed in each hour for each day of the week. The pilot emergency department nurse managers used the decision support tool's recommendations to redeploy nurse hours from weekends into a float pool to support periods of demand spikes on weekdays. Productivity improved significantly, with no unfavorable impact on patient throughput, and patient and staff satisfaction. Today's emergency department manager can leverage the increasing ease of access to the emergency department information system's data repository to successfully design a simple but effective tool to support the alignment of its nursing schedule with demand patterns. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

BP Spill Sampling and Monitoring Data

EPA Pesticide Factsheets

This dataset analyzes waste from the the British Petroleum Deepwater Horizon Rig Explosion Emergency Response, providing opportunity to query data sets by metadata criteria and find resulting raw datasets in CSV format.The data query tool allows users to download EPA's air, water and sediment sampling and monitoring data that has been collected in response to the BP oil spill. All sampling and monitoring data that has been collected to date is available for download as raw structured data.The query tools enables CSV file creation to be refined based on the following search criteria: date range (between April 28, 2010 and 9/29/2010); location by zip, city, or county; media (solid waste, weathered oil, air, surface water, liquid waste, tar, sediment, water); substance categories (based on media selection) and substances (based on substance category selection).

Critical Incident Stress Management in Schools: Mental Health Component.

ERIC Educational Resources Information Center

Tortorici Luna, Joanne M.

This manual provides a brief framework of organization that serves as a response tool for a wide spectrum of crisis circumstances encountered by schools. It is meant to be a generic guide for school teams and should be customized by each school that uses it. Even with emergency procedures in place, each crisis at a school needs to be evaluated as…

SSRL Emergency Response Shore Tool

NASA Technical Reports Server (NTRS)

Mah, Robert W.; Papasin, Richard; McIntosh, Dawn M.; Denham, Douglas; Jorgensen, Charles; Betts, Bradley J.; Del Mundo, Rommel

2006-01-01

The SSRL Emergency Response Shore Tool (wherein SSRL signifies Smart Systems Research Laboratory ) is a computer program within a system of communication and mobile-computing software and hardware being developed to increase the situational awareness of first responders at building collapses. This program is intended for use mainly in planning and constructing shores to stabilize partially collapsed structures. The program consists of client and server components, runs in the Windows operating system on commercial off-the-shelf portable computers, and can utilize such additional hardware as digital cameras and Global Positioning System devices. A first responder can enter directly, into a portable computer running this program, the dimensions of a required shore. The shore dimensions, plus an optional digital photograph of the shore site, can then be uploaded via a wireless network to a server. Once on the server, the shore report is time-stamped and made available on similarly equipped portable computers carried by other first responders, including shore wood cutters and an incident commander. The staff in a command center can use the shore reports and photographs to monitor progress and to consult with structural engineers to assess whether a building is in imminent danger of further collapse.

Workload differences across command levels and emergency response organizations during a major joint training exercise.

PubMed

Prytz, Erik G; Rybing, Jonas; Jonson, Carl-Oscar

2016-01-01

This study reports on an initial test using a validated workload measurement method, the NASA Task Load Index (TLX), as an indicator of joint emergency exercise effectiveness. Prior research on emergency exercises indicates that exercises must be challenging, ie, result in high workload, to be effective. However, this is often problematic with some participants being underloaded and some overloaded. The NASA TLX was used to test for differences in workload between commanders and subordinates and among three different emergency response organizations during a joint emergency exercise. Questionnaire-based evaluation with professional emergency responders. The study was performed in conjunction with a large-scale interorganizational joint emergency exercise in Sweden. A total of 20 participants from the rescue services, 12 from the emergency medical services, and 12 from the police participated in the study (N=44). Ten participants had a command-level role during the exercise and the remaining 34 were subordinates. The main outcome measures were the workload subscales of the NASA TLX: mental demands, physical demands, temporal demands, performance, effort, and frustration. The results showed that the organizations experienced different levels of workload, that the commanders experienced a higher workload than the subordinates, and that two out of three organizations fell below the twenty-fifth percentile of average workload scores compiled from 237 prior studies. The results support the notion that the NASA TLX could be a useful complementary tool to evaluate exercise designs and outcomes. This should be further explored and verified in additional studies.

Discrepancy among acute guideline levels for emergency response.

PubMed

Oberg, Mattias; Palmen, Nicole; Johanson, Gunnar

2010-12-15

Acute guidance values are tools for public health risk assessment and management during planning, preparedness and response related to sudden airborne release of hazardous chemicals. The two most frequently used values, i.e. Acute Exposure Guidance Levels (AEGL) and Emergency Response Planning Guideline (ERPG), were compared in qualitative and quantitative terms. There was no significant difference between the general level of AEGL and ERPG values, suggesting the two systems are equally precautious. However, the guidance values diverged by a factor of 3 or more for almost 40% of the substances, including many of high production volume. These deviations could be explained by differences in selection of critical effect or critical study and in a few cases differences in interpretation of the same critical study. Diverging guidance values may hamper proper risk communication and risk management. Key factors for broad international acceptance of harmonized values include transparency of the decision process, agreement on definition of toxicological tiers, and a target population including sensitive groups of the general population. In addition, development of purely health based values is encouraged. Risk management issues, such as land use and emergency response planning should be treated separately, as these rely on national legislation and considerations. Copyright © 2010 Elsevier B.V. All rights reserved.

Chemical and Biological National Security Program (CBNP) Annual Report FY2002 Overview Local Integration of NARAC With Cities (LINC)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ermak, D L; Nasstrom, J S; Tull, J E

The objective of the Local Integration of NARAC With Cities (LINC) project is to demonstrate the capability for providing local government agencies with advanced, CBNP-developed operational atmospheric plume prediction capabilities that can be seamlessly integrated with appropriate federal agency support for homeland security. LINC's approach is to integrate Lawrence Livermore National Laboratory's (LLNL) National Atmospheric Release Advisory Center (NARAC) tools and services with local emergency management and response centers. In the event of an airborne chemical or biological agent release in an urban area, large portions of the city and even the surrounding suburbs may be affected by the airbornemore » plume, depending on the type of agent, size of release, dissemination mechanism and ambient meteorological conditions. The goal of LINC is to provide real-time predictions that would be used by emergency managers and responders (fire, police, hazmat, etc.) to map the extent and effects of hazardous airborne material. Prompt predictions are provided to guide first responders in determining protective actions to be taken (use of personal protective equipment, evacuation, sheltering in place, etc.), safe locations for incident command posts, and critical facilities that may be at risk (hospitals, schools, etc.). LINC also provides response teams from multiple jurisdictions (local, state, and federal) with tools to effectively share information regarding the areas and populations at risk. The ultimate goal of LINC is a seamless and coordinated nationwide system that integrates NARAC prediction and situation awareness resources with the appropriate local, state and federal agencies for homeland security applications ranging from planning to emergency response to consequence assessment and attribution.« less

Educating medical staff about responding to a radiological or nuclear emergency.

PubMed

McCurley, M Carol; Miller, Charles W; Tucker, Florie E; Guinn, Amy; Donnelly, Elizabeth; Ansari, Armin; Holcombe, Maire; Nemhauser, Jeffrey B; Whitcomb, Robert C

2009-05-01

A growing body of audience research reveals medical personnel in hospitals are unprepared for a large-scale radiological emergency such as a terrorist event involving radioactive or nuclear materials. Also, medical personnel in hospitals lack a basic understanding of radiation principles, as well as diagnostic and treatment guidelines for radiation exposure. Clinicians have indicated that they lack sufficient training on radiological emergency preparedness; they are potentially unwilling to treat patients if those patients are perceived to be radiologically contaminated; and they have major concerns about public panic and overloading of clinical systems. In response to these findings, the Centers for Disease Control and Prevention (CDC) has developed a tool kit for use by hospital medical personnel who may be called on to respond to unintentional or intentional mass-casualty radiological and nuclear events. This tool kit includes clinician fact sheets, a clinician pocket guide, a digital video disc (DVD) of just-in-time basic skills training, a CD-ROM training on mass-casualty management, and a satellite broadcast dealing with medical management of radiological events. CDC training information emphasizes the key role that medical health physicists can play in the education and support of emergency department activities following a radiological or nuclear mass-casualty event.

Social media and its dual use in biopreparedness: communication and visualization tools in an animal bioterrorism incident.

PubMed

Sjöberg, Elisabeth; Barker, Gary C; Landgren, Jonas; Griberg, Isaac; Skiby, Jeffrey E; Tubbin, Anna; von Stapelmohr, Anne; Härenstam, Malin; Jansson, Mikael; Knutsson, Rickard

2013-09-01

This article focuses on social media and interactive challenges for emergency organizations during a bioterrorism or agroterrorism incident, and it outlines the dual-use dilemma of social media. Attackers or terrorists can use social media as their modus operandi, and defenders, including emergency organizations in law enforcement and public and animal health, can use it for peaceful purposes. To get a better understanding of the uses of social media in these situations, a workshop was arranged in Stockholm, Sweden, to raise awareness about social media and animal bioterrorism threats. Fifty-six experts and crisis communicators from international and national organizations participated. As a result of the workshop, it was concluded that emergency organizations can collect valuable information and monitor social media before, during, and after an outbreak. In order to make use of interactive communication to obtain collective intelligence from the public, emergency organizations must adapt to social networking technologies, requiring multidisciplinary knowledge in the fields of information, communication, IT, and biopreparedness. Social network messaging during a disease outbreak can be visualized in stream graphs and networks showing clusters of Twitter and Facebook users. The visualization of social media can be an important preparedness tool in the response to bioterrorism and agroterrorism.

Spatiotemporal Detection of Unusual Human Population Behavior Using Mobile Phone Data

PubMed Central

Dobra, Adrian; Williams, Nathalie E.; Eagle, Nathan

2015-01-01

With the aim to contribute to humanitarian response to disasters and violent events, scientists have proposed the development of analytical tools that could identify emergency events in real-time, using mobile phone data. The assumption is that dramatic and discrete changes in behavior, measured with mobile phone data, will indicate extreme events. In this study, we propose an efficient system for spatiotemporal detection of behavioral anomalies from mobile phone data and compare sites with behavioral anomalies to an extensive database of emergency and non-emergency events in Rwanda. Our methodology successfully captures anomalous behavioral patterns associated with a broad range of events, from religious and official holidays to earthquakes, floods, violence against civilians and protests. Our results suggest that human behavioral responses to extreme events are complex and multi-dimensional, including extreme increases and decreases in both calling and movement behaviors. We also find significant temporal and spatial variance in responses to extreme events. Our behavioral anomaly detection system and extensive discussion of results are a significant contribution to the long-term project of creating an effective real-time event detection system with mobile phone data and we discuss the implications of our findings for future research to this end. PMID:25806954

ShakeCast: Automating and improving the use of shakemap for post-earthquake deeision-making and response

USGS Publications Warehouse

Wald, D.; Lin, K.-W.; Porter, K.; Turner, Loren

2008-01-01

When a potentially damaging earthquake occurs, utility and other lifeline managers, emergency responders, and other critical users have an urgent need for information about the impact on their particular facilities so they can make appropriate decisions and take quick actions to ensure safety and restore system functionality. ShakeMap, a tool used to portray the extent of potentially damaging shaking following an earthquake, on its own can be useful for emergency response, loss estimation, and public information. However, to take full advantage of the potential of ShakeMap, we introduce ShakeCast. ShakeCast facilitates the complicated assessment of potential damage to a user's widely distributed facilities by comparing the complex shaking distribution with the potentially highly variable damageability of their inventory to provide a simple, hierarchical list and maps of structures or facilities most likely impacted. ShakeCast is a freely available, post-earthquake situational awareness application that automatically retrieves earthquake shaking data from ShakeMap, compares intensity measures against users' facilities, sends notifications of potential damage to responsible parties, and generates facility damage maps and other Web-based products for both public and private emergency managers and responders. ?? 2008, Earthquake Engineering Research Institute.

Speech, stone tool-making and the evolution of language.

PubMed

Cataldo, Dana Michelle; Migliano, Andrea Bamberg; Vinicius, Lucio

2018-01-01

The 'technological hypothesis' proposes that gestural language evolved in early hominins to enable the cultural transmission of stone tool-making skills, with speech appearing later in response to the complex lithic industries of more recent hominins. However, no flintknapping study has assessed the efficiency of speech alone (unassisted by gesture) as a tool-making transmission aid. Here we show that subjects instructed by speech alone underperform in stone tool-making experiments in comparison to subjects instructed through either gesture alone or 'full language' (gesture plus speech), and also report lower satisfaction with their received instruction. The results provide evidence that gesture was likely to be selected over speech as a teaching aid in the earliest hominin tool-makers; that speech could not have replaced gesturing as a tool-making teaching aid in later hominins, possibly explaining the functional retention of gesturing in the full language of modern humans; and that speech may have evolved for reasons unrelated to tool-making. We conclude that speech is unlikely to have evolved as tool-making teaching aid superior to gesture, as claimed by the technological hypothesis, and therefore alternative views should be considered. For example, gestural language may have evolved to enable tool-making in earlier hominins, while speech may have later emerged as a response to increased trade and more complex inter- and intra-group interactions in Middle Pleistocene ancestors of Neanderthals and Homo sapiens; or gesture and speech may have evolved in parallel rather than in sequence.

CERTS: Consortium for Electric Reliability Technology Solutions - Research Highlights

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eto, Joseph

2003-07-30

Historically, the U.S. electric power industry was vertically integrated, and utilities were responsible for system planning, operations, and reliability management. As the nation moves to a competitive market structure, these functions have been disaggregated, and no single entity is responsible for reliability management. As a result, new tools, technologies, systems, and management processes are needed to manage the reliability of the electricity grid. However, a number of simultaneous trends prevent electricity market participants from pursuing development of these reliability tools: utilities are preoccupied with restructuring their businesses, research funding has declined, and the formation of Independent System Operators (ISOs) andmore » Regional Transmission Organizations (RTOs) to operate the grid means that control of transmission assets is separate from ownership of these assets; at the same time, business uncertainty, and changing regulatory policies have created a climate in which needed investment for transmission infrastructure and tools for reliability management has dried up. To address the resulting emerging gaps in reliability R&D, CERTS has undertaken much-needed public interest research on reliability technologies for the electricity grid. CERTS' vision is to: (1) Transform the electricity grid into an intelligent network that can sense and respond automatically to changing flows of power and emerging problems; (2) Enhance reliability management through market mechanisms, including transparency of real-time information on the status of the grid; (3) Empower customers to manage their energy use and reliability needs in response to real-time market price signals; and (4) Seamlessly integrate distributed technologies--including those for generation, storage, controls, and communications--to support the reliability needs of both the grid and individual customers.« less

Heterogeneity in cervical spine assessment in paediatric trauma: A survey of physicians' knowledge and application at a paediatric major trauma centre.

PubMed

Buckland, Aaron J; Bressan, Silvia; Jowett, Helen; Johnson, Michael B; Teague, Warwick J

2016-10-01

Evidence-based decision-making tools are widely used to guide cervical spine assessment in adult trauma patients. Similar tools validated for use in injured children are lacking. A paediatric-specific approach is appropriate given important differences in cervical spine anatomy, mechanism of spinal injury and concerns over ionising radiation in children. The present study aims to survey physicians' knowledge and application of cervical spine assessment in injured children. A cross-sectional survey of physicians actively engaged in trauma care within a paediatric trauma centre was undertaken. Participation was voluntary and responses de-idenitified. The survey comprised 20 questions regarding initial assessment, imaging, immobilisation and perioperative management. Physicians' responses were compared with available current evidence. Sixty-seven physicians (28% registrars, 17% fellows and 55.2% consultants) participated. Physicians rated altered mental state, intoxication and distracting injury as the most important contraindications to cervical spine clearance in children. Fifty-four per cent considered adequate plain imaging to be 3-view cervical spine radiographs (anterior-posterior, lateral and odontoid), whereas 30% considered CT the most sensitive modality for detecting unstable cervical spine injuries. Physicians' responses reflected marked heterogeneity regarding semi-rigid cervical collars and what constitutes cervical spine 'clearance'. Greater consensus existed for perioperative precautions in this setting. Physicians actively engaged in paediatric trauma care demonstrate marked heterogeneity in their knowledge and application of cervical spine assessment. This is compounded by a lack of paediatric-specific evidence and definitions, involvement of multiple specialties and staff turnover within busy departments. A validated decision-making tool for cervical spine assessment will represent an important advance in paediatric trauma. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Improving Global Building Exposure Data for Disaster Forecasting, Mitigation, and Response

NASA Astrophysics Data System (ADS)

Chen, R. S.; Huyck, C.; Lewis, G.; Becker, M.; Vinay, S.; Tralli, D.; Eguchi, R.

2013-12-01

This paper describes an exploratory study being performed under the NASA Applied Sciences Program where the goal is to integrate Earth science data and information for disaster forecasting, mitigation and response. Specifically, we are delivering EO-derived built environment data and information for use in catastrophe (CAT) models and loss estimation tools. CAT models and loss estimation tools typically use GIS exposure databases to characterize the real-world environment. These datasets are often a source of great uncertainty in the loss estimates, particularly in international events, because the data are incomplete, and sometimes inaccurate and disparate in quality from one region to another. Preliminary research by project team members as part of the Global Earthquake Model (GEM) consortium suggests that a strong relationship exists between the height and volume of built-up areas and NASA data products from the Suomi National Polar-Orbiting Partnership (NPP) Visible Infrared Imaging Radiometer Suite (VIIRS), the Moderate Resolution Imaging Spectroradiometer (MODIS), and the NASA Socioeconomic Data and Applications Center (SEDAC). Applying this knowledge within the framework of the GEM Global Exposure Database (GED) is significantly enhancing our ability to quantify building exposure, particularly in developing countries and emerging insurance markets. Global insurance products that have a more comprehensive basis for assessing risk and exposure - as from EO-derived data and information assimilated into CAT models and loss estimation tools - will help a) help to transform the way in which we measure, monitor and assess the vulnerability of our communities globally, and in turn, b) help encourage the investments needed - especially in the developing world - stimulating economic growth and actions that would lead to a more disaster-resilient world. Improved building exposure data will also be valuable for near-real time applications such as emergency response planning and post-disaster damage and needs assessment.

Assessing regional public health preparedness: a new tool for considering cross-border issues.

PubMed

Jones, Maggie; O'Carroll, Patrick; Thompson, Jack; D'Ambrosio, Luann

2008-01-01

To provide regional, state, and local public health officials a conceptual framework and checklist for assessing regional public health emergency preparedness, specifically in regard to cross-border public health preparedness needs. The project had four phases that are as follows: defining the scope, conducting a literature review, soliciting expert opinion, and creating the assessment framework and checklist. A conceptual framework was developed to define the scope of the project on the basis of the kinds of resources likely to be shared across borders in a public health response (eg, data, supplies, staff), in support of the public health functions likely to be important in a health emergency (eg, epidemiology, laboratory). A literature review was then conducted to identify key articles and tools addressing regional preparedness. Key informant interviews (n = 23) were conducted with public health and emergency management professionals in the Pacific Northwest to identify a set of systems, agreements, and protocols that should be systematically considered in assessing regional public health preparedness. Using the literature review and themes from interviews, a checklist was developed. A checklist was developed for use by public health leaders, which recommends 24 specific agreements, protocols, systems, and management structures that should be considered to foster cross-border public health preparedness. Regional public health preparedness represents not only the sum of state-level preparedness of the states in a region but also the capacity of those states to collaborate across state and international borders during a public health emergency. This checklist provides a tool to systematically consider cross-border preparedness issues.

Re-emerging Lassa fever outbreaks in Nigeria: Re-enforcing "One Health" community surveillance and emergency response practice.

PubMed

Tambo, Ernest; Adetunde, Oluwasegun T; Olalubi, Oluwasogo A

2018-04-28

We evaluated the impact of man-made conflict events and climate change impact in guiding evidence-based community "One Health" epidemiology and emergency response practice against re-/emerging epidemics. Increasing evidence of emerging and re-emerging zoonotic diseases including recent Lassa fever outbreaks in almost 20 states in Nigeria led to 101 deaths and 175 suspected and confirmed cases since August 2015. Of the 75 laboratory confirmed cases, 90 deaths occurred representing 120% laboratory-confirmed case fatality. The outbreak has been imported into neighbouring country such as Benin, where 23 deaths out of 68 cases has also been reported. This study assesses the current trends in re-emerging Lassa fever outbreak in understanding spatio-geographical reservoir(s), risk factors pattern and Lassa virus incidence mapping, inherent gaps and raising challenges in health systems. It is shown that Lassa fever peak endemicity incidence and prevalence overlap the dry season (within January to March) and reduced during the wet season (of May to November) annually in Sierra Leone, Senegal to Eastern Nigeria. We documented a scarcity of consistent data on rodent (reservoirs)-linked Lassa fever outbreak, weak culturally and socio-behavioural effective prevention and control measures integration, weak or limited community knowledge and awareness to inadequate preparedness capacity and access to affordable case management in affected countries. Hence, robust sub/regional leadership commitment and investment in Lassa fever is urgently needed in building integrated and effective community "One Health" surveillance and rapid response approach practice coupled with pest management and phytosanitation measures against Lassa fever epidemic. This offers new opportunities in understanding human-animal interactions in strengthening Lassa fever outbreak early detection and surveillance, warning alerts and rapid response implementation in vulnerable settings. Leveraging on Africa CDC centre, advances in cloud-sourcing and social media tools and solutions is core in developing and integrating evidence-based and timely risk communication, and reporting systems in improving contextual community-based immunization and control decision making policy to effectively defeat Lassa fever outbreak and other emerging pandemics public health emergencies in Africa and worldwide.

A GIS-based generic real-time risk assessment framework and decision tools for chemical spills in the river basin.

PubMed

Jiang, Jiping; Wang, Peng; Lung, Wu-seng; Guo, Liang; Li, Mei

2012-08-15

This paper presents a generic framework and decision tools of real-time risk assessment on Emergency Environmental Decision Support System for response to chemical spills in river basin. The generic "4-step-3-model" framework is able to delineate the warning area and the impact on vulnerable receptors considering four types of hazards referring to functional area, societal impact, and human health and ecology system. Decision tools including the stand-alone system and software components were implemented on GIS platform. A detailed case study on the Songhua River nitrobenzene spill illustrated the goodness of the framework and tool Spill first responders and decision makers of catchment management will benefit from the rich, visual and dynamic hazard information output from the software. Copyright © 2012 Elsevier B.V. All rights reserved.

Assessment of hospital emergency management in the Beijing area.

PubMed

Yantao, Xin

2011-06-01

In recent years, the number of public health emergencies has increased. Improving hospital emergency management is an important challenge. This is a pilot study intended to assess hospital emergency management in the Beijing area, make recommendations to government health authorities and hospital managers, and offer references for similar studies. This was an observational, cross-sectional survey. Forty-five hospitals in the Beijing area were selected randomly. A self-administered questionnaire was used as a data collection tool. It comprised of three sections: (1) Section A was the introduction; (2) Section B asked for the respondent's personal information; and (3) Section C comprised the major part of the questionnaire and was intended to gather information regarding the hospital's general emergency management situation. The survey response rate was 44%, accounting for 29% of total hospitals that the study targeted. No hospital had an established emergency management department or full-time staff for emergency management. A total of 15-45% of the hospitals had established a hospital emergency management committee, performed a vulnerability analysis, or evaluated emergency management regularly. Twenty-five percent of respondents thought that the local government health authority had established an integrated hospital incident command system. A total of 40%-55% of hospitals contracted with outside institutions for supplements, backup of key functional systems and professional support. After the occurrence of the 2003 severe acute respiratory syndrome (SARS) epidemic, Chinese hospital managers took many measures to improve hospital resilience. However, most of these efforts lacked the guidance of theories, concepts, principles, and methods. An integrated, standardized, operational hospital emergency management model has not been established. Although the survey response rate was relatively low, some clues for further study were discovered, and suggestions to the health authority for hospital emergency management improvement were revealed.

Promoting information sharing for multijurisdictional public health emergency preparedness.

PubMed

Grier, Nancy L; Homish, Gregory G; Rowe, Donald W; Barrick, Christopher

2011-01-01

The objective was to assess the planning needs of emergency management and public health professionals to provide a flexible and comprehensive planning tool. This study first assessed the needs of emergency management and public health professionals via an online survey. On the basis of results of the assessment, pertinent information was collected and organized into an online resource tool. The assessment was designed to address the needs of local, state, and federal government administrators working in emergency management and public health. The online tool was designed for use by any entity that functions to promote public health in the event of an emergency. Sixty-four participants completed the assessment survey. Seven states were represented. Most participants were senior-level administrators or management-level employees and were employed in public health, emergency, or bioterrorism preparedness, or in emergency medical services. Needs assessment for preparedness tools. The results of the survey identified a need for increased access to information (especially concerning liability issues and authority to enter into agreements) and high levels of interest in the availability of an online planning tool. The majority (80.7%) of respondents indicated an ability to locate and quantify resources within their own jurisdiction but only about half (42.9%) could do the same for resources outside of their jurisdiction. Finally, 71.9% reported having no assessment tool to measure emergency capacity and limitations. Planning for cross-border and multijurisdictional emergencies depends on access to pertinent information and the feasibility of attaining such information. The creation of a comprehensive guide to multijurisdictional collaborations, with its self-assessment checklists, can easily provide such information to emergency. In addition, information sharing and increased collaboration can lead to increased utilization of emergency preparedness best practices.

Evaluation of the Human IgG Antibody Response to Aedes albopictus Saliva as a New Specific Biomarker of Exposure to Vector Bites

PubMed Central

Doucoure, Souleymane; Mouchet, François; Cornelie, Sylvie; DeHecq, Jean Sébastien; Rutee, Abdul Hamid; Roca, Yelin; Walter, Annie; Hervé, Jean Pierre; Misse, Dorothée; Favier, François; Gasque, Philippe; Remoue, Franck

2012-01-01

Background The spread of Aedes albopictus, a vector for re-emergent arbovirus diseases like chikungunya and dengue, points up the need for better control strategies and new tools to evaluate transmission risk. Human antibody (Ab) responses to mosquito salivary proteins could represent a reliable biomarker for evaluating human-vector contact and the efficacy of control programs. Methodology/Principal Findings We used ELISA tests to evaluate specific immunoglobulin G (IgG) responses to salivary gland extracts (SGE) in adults exposed to Aedes albopictus in Reunion Island. The percentage of immune responders (88%) and levels of anti-SGE IgG Abs were high in exposed individuals. At an individual level, our results indicate heterogeneity of the exposure to Aedes albopictus bites. In addition, low-level immune cross-reactivity between Aedes albopictus and Aedes aegypti SGEs was observed, mainly in the highest responders. Conclusion/Significance Ab responses to saliva could be used as an immuno-epidemiological tool for evaluating exposure to Aedes albopictus bites. Combined with entomological and epidemiological methods, a “salivary” biomarker of exposure to Aedes albopictus could enhance surveillance of its spread and the risk of arbovirus transmission, and could be used as a direct tool for the evaluation of Aedes albopictus control strategies. PMID:22363823

Towards the development of a screening tool to enhance the detection of elder abuse and neglect by emergency medical technicians (EMTs): a qualitative study.

PubMed

Cannell, M Brad; Jetelina, Katelyn K; Zavadsky, Matt; Gonzalez, Jennifer M Reingle

2016-06-01

To develop a screening tool to enhance elder abuse and neglect detection and reporting rates among emergency medical technicians (EMTs). Our primary aim was to identify the most salient indicators of elder abuse and neglect for potential inclusion on a screening tool. We also sought to identify practical elements of the tool that would optimize EMT uptake and use in the field, such as format, length and number of items, and types of response options available. Qualitative data were collected from 23 EMTs and Adult Protective Services (APS) caseworkers that participated in one of five semi-structured focus groups. Focus group data were iteratively coded by two coders using inductive thematic identification and data reduction. Findings were subject to interpretation by the research team. EMTs and APS caseworks identified eight domains of items that might be included on a screening tool: (1) exterior home condition; (2) interior living conditions; (3) social support; (4) medical history; (5) caregiving quality; (6) physical condition of the older adult; (7) older adult's behavior; and, (8) EMTs instincts. The screening tool should be based on observable cues in the physical or social environment, be very brief, easily integrated into electronic charting systems, and provide a decision rule for reporting guidance to optimize utility for EMTs in the field. We described characteristics of a screening tool for EMTs to enhance detection and reporting of elder abuse and neglect to APS. Future research should narrow identified items and evaluate how these domains positively predict confirmed cases of elder abuse and neglect.

[Development and testing of a preparedness and response capacity questionnaire in public health emergency for Chinese provincial and municipal governments].

PubMed

Hu, Guo-Qing; Rao, Ke-Qin; Sun, Zhen-Qiu

2008-12-01

To develop a capacity questionnaire in public health emergency for Chinese local governments. Literature reviews, conceptual modelling, stake-holder analysis, focus group, interview, and Delphi technique were employed together to develop the questionnaire. Classical test theory and case study were used to assess the reliability and validity. (1) A 2-dimension conceptual model was built. A preparedness and response capacity questionnaire in public health emergency with 10 dimensions and 204 items, was developed. (2) Reliability and validity results. Internal consistency: except for dimension 3 and 8, the Cronbach's alpha coefficient of other dimensions was higher than 0.60. The alpha coefficients of dimension 3 and dimension 8 were 0.59 and 0.39 respectively; Content validity: the questionnaire was recognized by the investigatees; Construct validity: the Spearman correlation coefficients among the 10 dimensions fluctuated around 0.50, ranging from 0.26 to 0.75 (P<0.05); Discrimination validity: comparisons of 10 dimensions among 4 provinces did not show statistical significance using One-way analysis of variance (P>0.05). Criterion-related validity: case study showed significant difference among the 10 dimensions in Beijing between February 2003 (before SARS event) and November 2005 (after SARS event). The preparedness and response capacity questionnaire in public health emergency is a reliable and valid tool, which can be used in all provinces and municipalities in China.

Faculty Use of Established and Emerging Technologies in Higher Education: A Unified Theory of Acceptance and Use of Technology Perspective

ERIC Educational Resources Information Center

Lewis, Carmen C.; Fretwell, Cherie E.; Ryan, Jim; Parham, James B.

2013-01-01

Our effectiveness as instructors lies ultimately in how well our students can understand and apply the concepts we teach. In response to the growing importance of accountability in the educational process and the abundance of social networking technology and communication tools available for possible classroom use, this paper will use The Unified…

Travel simulation modeling: an emerging tool for visitor management in wilderness

Treesearch

David N. Cole

2004-01-01

Rhe amount, type, timing, and location of visitor use all have profound effects on the quality of the natural resources and visitor experiences in wilderness. Therefore, it is important to monitor the flow of visitation, in space and over time, and predict how distributions are likely to change in response to both management actions and factors that are not subject to...

Disentangling the Lexicons of Disaster Response in Twitter

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hodas, Nathan O.; Ver Steeg, Greg; Harrison, Joshua J.

Abstract: People around the world use social media platforms such as Twitter heavily to express their opinion about various as- pects of daily life. In the same way social media changes communication in daily life, it also is transforming the way individuals communicate during disasters and emergencies. Emergency officials have come to rely on social media to communicate alerts and updates. How do users communi- cate risk on social media? We used a novel information- theoretic unsupervised learning tool, CorEx, to extract and classify highly relevant words used by the public on Twit- ter during known emergencies, such as fires,more » explosions, and hurricanes. By utilizing the resulting classification strategy, authorities can use the derived language to craft more rel- evant risk communication to maximize the effectiveness of short-message broadcasts such as the Wireless Emergency Alerts (WEA) service.« less

Filovirus Research in Gabon and Equatorial Africa: The Experience of a Research Center in the Heart of Africa

PubMed Central

Leroy, Eric; Gonzalez, Jean Paul

2012-01-01

Health research programs targeting the population of Gabon and Equatorial Africa at the International Center for Medical Research in Franceville (CIRMF), Gabon, have evolved during the years since its inception in 1979 in accordance with emerging diseases. Since the reemergence of Ebola virus in Central Africa, the CIRMF “Emerging Viral Disease Unit” developed diagnostic tools and epidemiologic strategies and transfers of such technology to support the response of the National Public Health System and the World Health Organization to epidemics of Ebola virus disease. The Unit carries out a unique investigation program on the natural history of the filoviruses, emergence of epidemics, and Ebola virus pathogenesis. In addition, academic training is provided at all levels to regional and international students covering emerging conditions (host factors, molecular biology, genetics) that favor the spread of viral diseases. PMID:23170174

[Research on infrared safety protection system for machine tool].

PubMed

Zhang, Shuan-Ji; Zhang, Zhi-Ling; Yan, Hui-Ying; Wang, Song-De

2008-04-01

In order to ensure personal safety and prevent injury accident in machine tool operation, an infrared machine tool safety system was designed with infrared transmitting-receiving module, memory self-locked relay and voice recording-playing module. When the operator does not enter the danger area, the system has no response. Once the operator's whole or part of body enters the danger area and shades the infrared beam, the system will alarm and output an control signal to the machine tool executive element, and at the same time, the system makes the machine tool emergency stop to prevent equipment damaged and person injured. The system has a module framework, and has many advantages including safety, reliability, common use, circuit simplicity, maintenance convenience, low power consumption, low costs, working stability, easy debugging, vibration resistance and interference resistance. It is suitable for being installed and used in different machine tools such as punch machine, pour plastic machine, digital control machine, armor plate cutting machine, pipe bending machine, oil pressure machine etc.

A Computable Definition of Sepsis Facilitates Screening and Performance Improvement Tracking

PubMed Central

Warmus, Holly R.; Schaffner, Erin K.; Kantawala, Sajel; Carcillo, Joseph; Rosen, Johanna; Horvat, Christopher M.

2018-01-01

Background: Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. Objectives: We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children’s hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods: Methods are organized in a plan-do-study-act cycle. During the “plan” phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control. The performance of a screening tool was evaluated in the emergency department. During the “do” phase, a novel inpatient workflow is being piloted, which involves regular sepsis screening by nurses using the tool, and a regimented response to high risk patients. Results: Screening tool use in the emergency department reduced time to antibiotics (Fig. 1). Of the 6,159 admissions, EHR definitions identified 1,433 (23.3%) between July and December 2016 with sepsis, of which 159 (11.1%) had septic shock. Hospital mortality for all sepsis patients was 2.2% and 15.7% for septic shock (Table 1). These findings approximate epidemiologic studies of sepsis and severe sepsis, which report a prevalence range of 0.45–8.2% and mortality range of 8.2–25% (Table 2).1–5 Conclusions/Implications: Implementation of a sepsis screening tool is associated with improved performance. The prevalence of sepsis conditions identified with electronic definitions approximates the epidemiologic landscape characterized by other point-prevalence and administrative studies, providing face validity to this approach, and proving useful for tracking performance improvement. PMID:29732457

Systems Biology Approaches for Discovering Biomarkers for Traumatic Brain Injury

PubMed Central

Feala, Jacob D.; AbdulHameed, Mohamed Diwan M.; Yu, Chenggang; Dutta, Bhaskar; Yu, Xueping; Schmid, Kara; Dave, Jitendra; Tortella, Frank

2013-01-01

Abstract The rate of traumatic brain injury (TBI) in service members with wartime injuries has risen rapidly in recent years, and complex, variable links have emerged between TBI and long-term neurological disorders. The multifactorial nature of TBI secondary cellular response has confounded attempts to find cellular biomarkers for its diagnosis and prognosis or for guiding therapy for brain injury. One possibility is to apply emerging systems biology strategies to holistically probe and analyze the complex interweaving molecular pathways and networks that mediate the secondary cellular response through computational models that integrate these diverse data sets. Here, we review available systems biology strategies, databases, and tools. In addition, we describe opportunities for applying this methodology to existing TBI data sets to identify new biomarker candidates and gain insights about the underlying molecular mechanisms of TBI response. As an exemplar, we apply network and pathway analysis to a manually compiled list of 32 protein biomarker candidates from the literature, recover known TBI-related mechanisms, and generate hypothetical new biomarker candidates. PMID:23510232

An agent based simulation tool for scheduling emergency department physicians.

PubMed

Jones, Spencer S; Evans, R Scott

2008-11-06

Emergency department overcrowding is a problem that threatens the public health of communities and compromises the quality of care given to individual patients. The Institute of Medicine recommends that hospitals employ information technology and operations research methods to reduce overcrowding. This paper describes the development of an agent based simulation tool that has been designed to evaluate the impact of various physician staffing configurations on patient waiting times in the emergency department. We evaluate the feasibility of this tool at a single hospital emergency department.

Coping with terrorism

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kerr, D.M.

1985-01-01

Terrorism has emerged as a tool of low-intensity conflict used to undermine Western and moderate governments. There is evidence that the US faces a new threshold of terrorist threat both at home and abroad because the tools are available, media attention is global and often undisciplined, and the motives for terrorist attack span a wide spectrum. The US has no internal consensus of how to respond to acts of terrorism. The goal of the terrorists is to erode faith in the government and the democratic system. The author analyzes the threat and examines opportunities for an adequate response. Among hismore » recommendations are to make infrastructure networks more robust and less vulnerable, the use of new technologies that enhance security, clear guidelines for intelligence gathering and analysis, specially trained response forces, and political moderation and cooperation.« less

Research priorities for the development and implementation of serological tools for malaria surveillance.

PubMed

Elliott, Salenna R; Fowkes, Freya J I; Richards, Jack S; Reiling, Linda; Drew, Damien R; Beeson, James G

2014-01-01

Surveillance is a key component of control and elimination programs. Malaria surveillance has been typically reliant on case reporting by health services, entomological estimates and parasitemia (Plasmodium species) point prevalence. However, these techniques become less sensitive and relatively costly as transmission declines. There is great potential for the development and application of serological biomarkers of malaria exposure as sero-surveillance tools to strengthen malaria control and elimination. Antibodies to malaria antigens are sensitive biomarkers of population-level malaria exposure and can be used to identify hotspots of malaria transmission, estimate transmission levels, monitor changes over time or the impact of interventions on transmission, confirm malaria elimination, and monitor re-emergence of malaria. Sero-surveillance tools could be used in reference laboratories or developed as simple point-of-care tests for community-based surveillance, and different applications and target populations dictate the technical performance required from assays that are determined by properties of antigens and antibody responses. To advance the development of sero-surveillance tools for malaria elimination, major gaps in our knowledge need to be addressed through further research. These include greater knowledge of potential antigens, the sensitivity and specificity of antibody responses, and the longevity of these responses and defining antigens and antibodies that differentiate between exposure to Plasmodium falciparum and P. vivax. Additionally, a better understanding of the influence of host factors, such as age, genetics, and comorbidities on antibody responses in different populations is needed.

Research priorities for the development and implementation of serological tools for malaria surveillance

PubMed Central

Elliott, Salenna R.; Fowkes, Freya J.I.; Richards, Jack S.; Reiling, Linda; Drew, Damien R.

2014-01-01

Surveillance is a key component of control and elimination programs. Malaria surveillance has been typically reliant on case reporting by health services, entomological estimates and parasitemia (Plasmodium species) point prevalence. However, these techniques become less sensitive and relatively costly as transmission declines. There is great potential for the development and application of serological biomarkers of malaria exposure as sero-surveillance tools to strengthen malaria control and elimination. Antibodies to malaria antigens are sensitive biomarkers of population-level malaria exposure and can be used to identify hotspots of malaria transmission, estimate transmission levels, monitor changes over time or the impact of interventions on transmission, confirm malaria elimination, and monitor re-emergence of malaria. Sero-surveillance tools could be used in reference laboratories or developed as simple point-of-care tests for community-based surveillance, and different applications and target populations dictate the technical performance required from assays that are determined by properties of antigens and antibody responses. To advance the development of sero-surveillance tools for malaria elimination, major gaps in our knowledge need to be addressed through further research. These include greater knowledge of potential antigens, the sensitivity and specificity of antibody responses, and the longevity of these responses and defining antigens and antibodies that differentiate between exposure to Plasmodium falciparum and P. vivax. Additionally, a better understanding of the influence of host factors, such as age, genetics, and comorbidities on antibody responses in different populations is needed. PMID:25580254

Distributed virtual environment for emergency medical training

NASA Astrophysics Data System (ADS)

Stytz, Martin R.; Banks, Sheila B.; Garcia, Brian W.; Godsell-Stytz, Gayl M.

1997-07-01

In many professions where individuals must work in a team in a high stress environment to accomplish a time-critical task, individual and team performance can benefit from joint training using distributed virtual environments (DVEs). One professional field that lacks but needs a high-fidelity team training environment is the field of emergency medicine. Currently, emergency department (ED) medical personnel train by using words to create a metal picture of a situation for the physician and staff, who then cooperate to solve the problems portrayed by the word picture. The need in emergency medicine for realistic virtual team training is critical because ED staff typically encounter rarely occurring but life threatening situations only once in their careers and because ED teams currently have no realistic environment in which to practice their team skills. The resulting lack of experience and teamwork makes diagnosis and treatment more difficult. Virtual environment based training has the potential to redress these shortfalls. The objective of our research is to develop a state-of-the-art virtual environment for emergency medicine team training. The virtual emergency room (VER) allows ED physicians and medical staff to realistically prepare for emergency medical situations by performing triage, diagnosis, and treatment on virtual patients within an environment that provides them with the tools they require and the team environment they need to realistically perform these three tasks. There are several issues that must be addressed before this vision is realized. The key issues deal with distribution of computations; the doctor and staff interface to the virtual patient and ED equipment; the accurate simulation of individual patient organs' response to injury, medication, and treatment; and an accurate modeling of the symptoms and appearance of the patient while maintaining a real-time interaction capability. Our ongoing work addresses all of these issues. In this paper we report on our prototype VER system and its distributed system architecture for an emergency department distributed virtual environment for emergency medical staff training. The virtual environment enables emergency department physicians and staff to develop their diagnostic and treatment skills using the virtual tools they need to perform diagnostic and treatment tasks. Virtual human imagery, and real-time virtual human response are used to create the virtual patient and present a scenario. Patient vital signs are available to the emergency department team as they manage the virtual case. The work reported here consists of the system architectures we developed for the distributed components of the virtual emergency room. The architectures we describe consist of the network level architecture as well as the software architecture for each actor within the virtual emergency room. We describe the role of distributed interactive simulation and other enabling technologies within the virtual emergency room project.

Cloud computing for energy management in smart grid - an application survey

NASA Astrophysics Data System (ADS)

Naveen, P.; Kiing Ing, Wong; Kobina Danquah, Michael; Sidhu, Amandeep S.; Abu-Siada, Ahmed

2016-03-01

The smart grid is the emerging energy system wherein the application of information technology, tools and techniques that make the grid run more efficiently. It possesses demand response capacity to help balance electrical consumption with supply. The challenges and opportunities of emerging and future smart grids can be addressed by cloud computing. To focus on these requirements, we provide an in-depth survey on different cloud computing applications for energy management in the smart grid architecture. In this survey, we present an outline of the current state of research on smart grid development. We also propose a model of cloud based economic power dispatch for smart grid.

Defining disaster resilience: comparisons from key stakeholders involved in emergency management in Victoria, Australia.

PubMed

Goode, Natassia; Salmon, Paul M; Spencer, Caroline; McArdle, Dudley; Archer, Frank

2017-01-01

Three years after the introduction of the National Strategy for Disaster Resilience there remains no unanimously adopted definition of disaster resilience within Australia's emergency management sector. The aim of this study is to determine what the concept means to key stakeholders in the emergency management sector in the Australian State of Victoria, and how these conceptualisations overlap and diverge. Via an online survey, 113 people were asked how they define disaster resilience in their work in the emergency management sector. A data mining software tool, Leximancer, was employed to uncover the relationships between the definitions provided. The findings show that stakeholders see resilience as an 'ability' that encompasses emergency management activities and personal responsibility. However, the findings also highlight some possible points of conflict between stakeholders. In addition, the paper outlines and discusses a number of potential consequences for the implementation and the success of the resilience-based approach in Australia. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

From Civil Protection Plan to Disaster Management. PETer evolution from GIS tool to multi-area Emergency Management System

NASA Astrophysics Data System (ADS)

Frigerio, Simone; Sterlacchini, Simone; Malet, Jean-Philippe; Glade, Thomas

2010-05-01

PETer (Protection and Emergency of the Territory) has been developed since 2006 as a tool to manage all the information available to perform a wide range of Civil Protection activities. Based on MapObjects spatial support, it was relied on capacity to manage data from different sources and at different scale, offering practical GIS-tools for a technical and practical use during crisis state. At the first stages of the development, after different assessment, critical on-field analysis and a direct proof on test area, the approach came into sight like a valid database management for the entire dataset, but quite static, not full-blown for every emergency necessity, too complicate and not enough user-friendly, considering people in charge during emergency management, the quick change of state with many parameters involved and also uncertainty, hesitation, confusion or general panic among decision makers. As a second step of research, a more down-to-earth methodology targeted to cope with the aftermath of critical events is presented here. It takes advantage of Geographical Information Systems (GIS), Decision Support Systems (DSS), and Information and Communication Technology (ICT) to prepare, apply and coordinate Civil Protection plans. The main aim was to set up and manage contingency plans in advance; that is, to identify and prepare people in charge to take action to define the activities to be performed, to be aware of available resources and to optimize the communication system among the people involved, in order to efficiently face a prospective crisis phase. A disaster preparedness plan should anticipate the demands for a disaster relief operation and indicate the most effective way of joining those requirements. Through scientific and technical co-operation between public and private research groups, a new platform was planned and set up, in order to test the aims of the project. The application was based on a cooperative organizational structure by which information was managed at different levels, linking all people in decision-making roles: crews in the field, the mobile command post and the control room. The tool automatically performs organizational and operational activities within a Civil Protection plan, in line with enforceable regulations. It couples: data processing capabilities by GIS; workflow management modules by DSS and communication systems by the ICT. More specifically, the work presents the overall concept and the system architecture of a generic decision-support system in progress of development, displaying the aims of emergency management and then shows a DSS first of all for Civil Protection Plan within Disaster Preparedness and Response framework in a Consortium of Mountain Municipalities (Valtellina di Tirano, Central Alps, Northern Italy). A multi-area approach (involving the management of disaster scenarios at the La Valette landslide in the Barcelonnette Basin, South French Alps) has been introduced to calibrate the platform, to compare available dataset, information details, laws in force in different countries, stakeholders' responsibility and end-users' background. Work in progress involves multi-task tools useful in emergency situation, to enforce open-communication devices (SMS automatic platform, SKYPE interface, visual video), integrate existing monitoring system and web-service to tailor open-sharing information with emergency management demand.

Disaster Response Tools for Decision Support and Data Discovery - E-DECIDER and GeoGateway

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Donnellan, A.; Parker, J. W.; Granat, R. A.; Lyzenga, G. A.; Pierce, M. E.; Wang, J.; Grant Ludwig, L.; Eguchi, R. T.; Huyck, C. K.; Hu, Z.; Chen, Z.; Yoder, M. R.; Rundle, J. B.; Rosinski, A.

2015-12-01

Providing actionable data for situational awareness following an earthquake or other disaster is critical to decision makers in order to improve their ability to anticipate requirements and provide appropriate resources for response. E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) is a decision support system producing remote sensing and geophysical modeling products that are relevant to the emergency preparedness and response communities and serves as a gateway to enable the delivery of actionable information to these communities. GeoGateway is a data product search and analysis gateway for scientific discovery, field use, and disaster response focused on NASA UAVSAR and GPS data that integrates with fault data, seismicity and models. Key information on the nature, magnitude and scope of damage, or Essential Elements of Information (EEI), necessary to achieve situational awareness are often generated from a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. We have worked in partnership with the California Earthquake Clearinghouse to develop actionable data products for use in their response efforts, particularly in regularly scheduled, statewide exercises like the recent May 2015 Capstone/SoCal NLE/Ardent Sentry Exercises and in the August 2014 South Napa earthquake activation. We also provided a number of products, services, and consultation to the NASA agency-wide response to the April 2015 Gorkha, Nepal earthquake. We will present perspectives on developing tools for decision support and data discovery in partnership with the Clearinghouse and for the Nepal earthquake. Products delivered included map layers as part of the common operational data plan for the Clearinghouse, delivered through XchangeCore Web Service Data Orchestration, enabling users to create merged datasets from multiple providers. For the Nepal response effort, products included models, damage and loss estimates, and aftershock forecasts that were posted to a NASA information site and delivered directly to end-users such as USAID, OFDA, World Bank, and UNICEF.

Systems biology: a new tool for farm animal science.

PubMed

Hollung, Kristin; Timperio, Anna M; Olivan, Mamen; Kemp, Caroline; Coto-Montes, Ana; Sierra, Veronica; Zolla, Lello

2014-03-01

It is rapidly emerging that the tender meat phenotype is affected by an enormous amount of variables, not only tied to genetics (livestock breeding selection), but also to extrinsic factors, such as feeding conditions, physical activity, rearing environment, administration of hormonal growth promotants, pre-slaughter handling and stress. Proteomics has been widely accepted by meat scientists over the last years and is now commonly used to shed light on the postmortem processes involved in meat tenderization. This review discusses the latest findings with the use of proteomics and systems biology to study the different biochemical pathways postmortem aiming at understanding the concerted action of different molecular mechanisms responsible for meat quality. The conversion of muscle to meat postmortem can be described as a sequence of events involving molecular pathways controlled by a complex interplay of many factors. Among the different pathways emerging are the influence of apoptosis and lately also the role of autophagy in muscle postmortem development. This review thus, focus on how systems-wide integrated investigations (metabolomics, transcriptomics, interactomics, phosphoproteomics, mathematical modeling), which have emerged as complementary tools to proteomics, have helped establishing a few milestones in our understanding of the events leading from muscle to meat conversion.

Thermo-elasto-plastic simulations of femtosecond laser-induced multiple-cavity in fused silica

NASA Astrophysics Data System (ADS)

Beuton, R.; Chimier, B.; Breil, J.; Hébert, D.; Mishchik, K.; Lopez, J.; Maire, P. H.; Duchateau, G.

2018-04-01

The formation and the interaction of multiple cavities, induced by tightly focused femtosecond laser pulses, are studied using a developed numerical tool, including the thermo-elasto-plastic material response. Simulations are performed in fused silica in cases of one, two, and four spots of laser energy deposition. The relaxation of the heated matter, launching shock waves in the surrounding cold material, leads to cavity formation and emergence of areas where cracks may be induced. Results show that the laser-induced structure shape depends on the energy deposition configuration and demonstrate the potential of the used numerical tool to obtain the desired designed structure or technological process.

The Spacecraft Emergency Response System (SERS) for Autonomous Mission Operations

NASA Technical Reports Server (NTRS)

Breed, Julia; Chu, Kai-Dee; Baker, Paul; Starr, Cynthia; Fox, Jeffrey; Baitinger, Mick

1998-01-01

Today, most mission operations are geared toward lowering cost through unmanned operations. 7-day/24-hour operations are reduced to either 5-day/8-hour operations or become totally autonomous, especially for deep-space missions. Proper and effective notification during a spacecraft emergency could mean success or failure for an entire mission. The Spacecraft Emergency Response System (SERS) is a tool designed for autonomous mission operations. The SERS automatically contacts on-call personnel as needed when crises occur, either on-board the spacecraft or within the automated ground systems. Plus, the SERS provides a group-ware solution to facilitate the work of the person(s) contacted. The SERS is independent of the spacecraft's automated ground system. It receives and catalogues reports for various ground system components in near real-time. Then, based on easily configurable parameters, the SERS determines whom, if anyone, should be alerted. Alerts may be issued via Sky-Tel 2-way pager, Telehony, or e-mail. The alerted personnel can then review and respond to the spacecraft anomalies through the Netscape Internet Web Browser, or directly review and respond from the Sky-Tel 2-way pager.

Development of the HD-Teen Inventory

PubMed Central

Driessnack, Martha; Williams, Janet K.; Barnette, J. Jackson; Sparbel, Kathleen J.; Paulsen, Jane S.

2013-01-01

Adolescents, who have a parent with Huntington Disease (HD), not only are at genetic risk for HD but also are witness to its onset and devastating clinical progression as their parent declines. To date, no mechanism has been developed to direct health care providers to the atypical adolescent experiences of these teens. The purpose of this report is to describe the process of developing the HD-Teen Inventory clinical assessment tool. Forty-eight teens and young adults from 19 U.S. states participated in the evaluation of the HD-Teen Inventory tool. Following item analysis, the number of items was reduced and item frequency and reaction scales were combined, based on the strong correlation (r = .94). The resultant tool contains 15 inventory and 2 open-ended response items. The HD-Teen Inventory emerged as a more compact and efficient tool for identifying the most salient concerns of at-risk teens in HD families in research and/or clinical practice. PMID:21632913

Development of the HD-Teen Inventory.

PubMed

Driessnack, Martha; Williams, Janet K; Barnette, J Jackson; Sparbel, Kathleen J; Paulsen, Jane S

2012-05-01

Adolescents, who have a parent with Huntington Disease (HD), not only are at genetic risk for HD but also are witness to its onset and devastating clinical progression as their parent declines. To date, no mechanism has been developed to direct health care providers to the atypical adolescent experiences of these teens. The purpose of this report is to describe the process of developing the HD-Teen Inventory clinical assessment tool. Forty-eight teens and young adults from 19 U.S. states participated in the evaluation of the HD-Teen Inventory tool. Following item analysis, the number of items was reduced and item frequency and reaction scales were combined, based on the strong correlation (r = .94). The resultant tool contains 15 inventory and 2 open-ended response items. The HD-Teen Inventory emerged as a more compact and efficient tool for identifying the most salient concerns of at-risk teens in HD families in research and/or clinical practice.

Modeling Tool for Decision Support during Early Days of an Anthrax Event.

PubMed

Rainisch, Gabriel; Meltzer, Martin I; Shadomy, Sean; Bower, William A; Hupert, Nathaniel

2017-01-01

Health officials lack field-implementable tools for forecasting the effects that a large-scale release of Bacillus anthracis spores would have on public health and hospitals. We created a modeling tool (combining inhalational anthrax caseload projections based on initial case reports, effects of variable postexposure prophylaxis campaigns, and healthcare facility surge capacity requirements) to project hospitalizations and casualties from a newly detected inhalation anthrax event, and we examined the consequences of intervention choices. With only 3 days of case counts, the model can predict final attack sizes for simulated Sverdlovsk-like events (1979 USSR) with sufficient accuracy for decision making and confirms the value of early postexposure prophylaxis initiation. According to a baseline scenario, hospital treatment volume peaks 15 days after exposure, deaths peak earlier (day 5), and recovery peaks later (day 23). This tool gives public health, hospital, and emergency planners scenario-specific information for developing quantitative response plans for this threat.

Hot spots in a wired world: WHO surveillance of emerging and re-emerging infectious diseases.

PubMed

Heymann, D L; Rodier, G R

2001-12-01

The resurgence of the microbial threat, rooted in several recent trends, has increased the vulnerability of all nations to the risk of infectious diseases, whether newly emerging, well-established, or deliberately caused. Infectious disease intelligence, gleaned through sensitive surveillance, is the best defence. The epidemiological and laboratory techniques needed to detect, investigate, and contain a deliberate outbreak are the same as those used for natural outbreaks. In April 2000, WHO formalised an infrastructure (the Global Outbreak Alert and Response Network) for responding to the heightened need for early awareness of outbreaks and preparedness to respond. The Network, which unites 110 existing networks, is supported by several new mechanisms and a computer-driven tool for real time gathering of disease intelligence. The procedure for outbreak alert and response has four phases: systematic detection, outbreak verification, real time alerts, and rapid response. For response, the framework uses different strategies for combating known risks and unexpected events, and for improving both global and national preparedness. New forces at work in an electronically interconnected world are beginning to break down the traditional reluctance of countries to report outbreaks due to fear of the negative impact on trade and tourism. About 65% of the world's first news about infectious disease events now comes from informal sources, including press reports and the internet.

Ultra-Scale Computing for Emergency Evacuation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bhaduri, Budhendra L; Nutaro, James J; Liu, Cheng

2010-01-01

Emergency evacuations are carried out in anticipation of a disaster such as hurricane landfall or flooding, and in response to a disaster that strikes without a warning. Existing emergency evacuation modeling and simulation tools are primarily designed for evacuation planning and are of limited value in operational support for real time evacuation management. In order to align with desktop computing, these models reduce the data and computational complexities through simple approximations and representations of real network conditions and traffic behaviors, which rarely represent real-world scenarios. With the emergence of high resolution physiographic, demographic, and socioeconomic data and supercomputing platforms, itmore » is possible to develop micro-simulation based emergency evacuation models that can foster development of novel algorithms for human behavior and traffic assignments, and can simulate evacuation of millions of people over a large geographic area. However, such advances in evacuation modeling and simulations demand computational capacity beyond the desktop scales and can be supported by high performance computing platforms. This paper explores the motivation and feasibility of ultra-scale computing for increasing the speed of high resolution emergency evacuation simulations.« less

Quantitative proteomics to study carbapenem resistance in Acinetobacter baumannii

PubMed Central

Tiwari, Vishvanath; Tiwari, Monalisa

2014-01-01

Acinetobacter baumannii is an opportunistic pathogen causing pneumonia, respiratory infections and urinary tract infections. The prevalence of this lethal pathogen increases gradually in the clinical setup where it can grow on artificial surfaces, utilize ethanol as a carbon source. Moreover it resists desiccation. Carbapenems, a β-lactam, are the most commonly prescribed drugs against A. baumannii. Resistance against carbapenem has emerged in Acinetobacter baumannii which can create significant health problems and is responsible for high morbidity and mortality. With the development of quantitative proteomics, a considerable progress has been made in the study of carbapenem resistance of Acinetobacter baumannii. Recent updates showed that quantitative proteomics has now emerged as an important tool to understand the carbapenem resistance mechanism in Acinetobacter baumannii. Present review also highlights the complementary nature of different quantitative proteomic methods used to study carbapenem resistance and suggests to combine multiple proteomic methods for understanding the response to antibiotics by Acinetobacter baumannii. PMID:25309531

Development of Northeast Asia Nuclear Power Plant Accident Simulator.

PubMed

Kim, Juyub; Kim, Juyoul; Po, Li-Chi Cliff

2017-06-15

A conclusion from the lessons learned after the March 2011 Fukushima Daiichi accident was that Korea needs a tool to estimate consequences from a major accident that could occur at a nuclear power plant located in a neighboring country. This paper describes a suite of computer-based codes to be used by Korea's nuclear emergency response staff for training and potentially operational support in Korea's national emergency preparedness and response program. The systems of codes, Northeast Asia Nuclear Accident Simulator (NANAS), consist of three modules: source-term estimation, atmospheric dispersion prediction and dose assessment. To quickly assess potential doses to the public in Korea, NANAS includes specific reactor data from the nuclear power plants in China, Japan and Taiwan. The completed simulator is demonstrated using data for a hypothetical release. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Emerging infection and sepsis biomarkers: will they change current therapies?

PubMed Central

Jacobs, Lauren

2016-01-01

Introduction Sepsis is a heterogeneous syndrome characterized by both immune hyperactivity and relative immune suppression. Biomarkers have the potential to improve recognition and management of sepsis through three main applications: diagnosis, monitoring response to treatment, and stratifying patients based on prognosis or underlying biological response. Areas Covered This review focuses on specific examples of well-studied, evidence-supported biomarkers, and discusses their role in clinical practice with special attention to antibiotic stewardship and cost-effectiveness. Biomarkers were selected based on availability of robust prospective trials and meta-analyses which supported their role as emerging tools to improve the clinical management of sepsis. Expert Commentary Great strides have been made in candidate sepsis biomarker discovery and testing, with the biomarkers in this review showing promise. Yet sepsis remains a dynamic illness with a great degree of biological heterogeneity – heterogeneity which may be further resolved by recently discovered gene expression-based endotypes in septic shock. PMID:27533847

Modeling of natural risks in GIS, decision support in the Civil Protection and Emergency Planning

NASA Astrophysics Data System (ADS)

Santos, M.; Martins, L.; Moreira, S.; Costa, A.; Matos, F.; Teixeira, M.; Bateira, C.

2012-04-01

The assessment of natural hazards in Civil Protection is essential in the prevention and mitigation of emergency situations. This paper presents the results of the development of mapping susceptibility to landslides, floods, forest fires and soil erosion, using GIS (Geographic Information System) tools in two municipalities - Santo Tirso and Trofa - in the district of Oporto, in the northwest of Portugal. The mapping of natural hazards fits in the legislative plan of the Municipal Civil Protection (Law No. 65/2007 of 12 November) and it provides the key elements to planning and preparing an appropriate response in case some of the processes / phenomena occur, thus optimizing the procedures for protection and relief provided by the Municipal Civil Protection Service. Susceptibility mapping to landslides, floods, forest fires and soil erosion was performed with GIS tools resources. The methodology used to compile the mapping of landslides, forest fires and soil erosion was based on the modeling of different conditioning factors and validated with field work and event log. The mapping of susceptibility to floods and flooding was developed through mathematical parameters (statistical, hydrologic and hydraulic), supported by field work and the recognition of individual characteristics of each sector analysis and subsequently analyzed in a GIS environment The mapping proposal was made in 1:5000 scale which allows not only the identification of large sets affected by the spatial dynamics of the processes / phenomena, but also a more detailed analysis, especially when combined with geographic information systems (GIS) thus allowing to study more specific situations that require a quick response. The maps developed in this study are fundamental to the understanding, prediction and prevention of susceptibility and risks present in the municipalities, being a valuable tool in the process of Emergency Planning, since it identifies priority areas of intervention for farther detail analysis, promote and safeguard mechanisms to prevent injury and it anticipates the possibility of potential interventions that can minimize the risk.

The NASA John C. Stennis Environmental Geographic Information System

NASA Technical Reports Server (NTRS)

Cohan, Tyrus

2002-01-01

Contents include the following: 1. Introduction: Background information. Initial applications of the SSC EGIS. Ongoing projects. 2.Scope of SSC EGIS. 3. Data layers. 4. Onsite operations. 5. Landcover classifications. 6. Current activities. 7. GIS/Key. 8. Infrastructure base map - development. 9. Infrastructure base map - application. 10. Incorrected layer. 11. Corrected layer. 12. Emergency environmental response tool. 13. Future directions. 14. Bridging the gaps. 15. Environmental geographical information system.

Patient care transitions from the emergency department to the medicine ward: evaluation of a standardized electronic signout tool.

PubMed

Gonzalo, Jed D; Yang, Julius J; Stuckey, Heather L; Fischer, Christopher M; Sanchez, Leon D; Herzig, Shoshana J

2014-08-01

To evaluate the impact of a new electronic handoff tool for emergency department to medicine ward patient transfers over a 1-year period. Prospective mixed-methods analysis of data submitted by medicine residents following admitting shifts before and after eSignout implementation. University-based, tertiary-care hospital. Internal medicine resident physicians admitting patients from the emergency department. An electronic handoff tool (eSignout) utilizing automated paging communication and responsibility acceptance without mandatory verbal communication between emergency department and medicine ward providers. (i) Incidence of reported near misses/adverse events, (ii) communication of key clinical information and quality of verbal communication and (iii) characterization of near misses/adverse events. Seventy-eight of 80 surveys (98%) and 1058 of 1388 surveys (76%) were completed before and after eSignout implementation. Compared with pre-intervention, residents in the post-intervention period reported similar number of shifts with a near miss/adverse event (10.3 vs. 7.8%; P = 0.27), similar communication of key clinical information, and improved verbal signout quality, when it occurred. Compared with the former process requiring mandatory verbal communication, 93% believed the eSignout was more efficient and 61% preferred the eSignout. Patient safety issues related to perceived sufficiency/accuracy of diagnosis, treatment or disposition, and information quality. The eSignout was perceived as more efficient and preferred over the mandatory verbal signout process. Rates of reported adverse events were similar before and after the intervention. Our experience suggests electronic platforms with optional verbal communication can be used to standardize and improve the perceived efficiency of patient handoffs. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Surfing on the morning after: analysis of an emergency contraception website.

PubMed

Gainer, Erin; Sollet, Christian; Ulmann, Marion; Lévy, Delphine; Ulmann, André

2003-03-01

The introduction of widespread nonprescription delivery of hormonal emergency contraception (EC) calls for development of innovative tools to provide information to and gather feedback from EC users. Individuals seeking confidential information on sexual health and contraception are increasingly turning to the Internet as the resource of choice. This study employed analytical software and manual content analysis to examine the use of a website dedicated to an EC product (www.norlevo.com) over the course of 2 years. Frequency of visits to and pageviews of the site increased consistently over the 2-year time period, and the bulk of the visitors to the site were EC users seeking responses to frequently asked questions. The most common concern raised by users was the occurrence of spotting and menstrual bleeding following EC use. This analysis reveals that within the context of nonprescription access to hormonal EC, a website can constitute a potent educational tool for health professionals and EC users and provide a valuable source of post-marketing feedback on product use.

Leveraging Social Computing for Personalized Crisis Communication using Social Media.

PubMed

Leykin, Dmitry; Aharonson-Daniel, Limor; Lahad, Mooli

2016-03-24

The extensive use of social media in modern life redefines social interaction and communication. Communication plays an important role in mitigating, or exacerbating, the psychological and behavioral responses to critical incidents and disasters. As recent disasters demonstrated, people tend to converge to social media during and following emergencies. Authorities can then use this media and other computational methods to gain insights from the public, mainly to enhance situational awareness, but also to improve their communication with the public and public adherence to instructions. The current review presents a conceptual framework for studying psychological aspects of crisis and risk communication using the social media through social computing. Advanced analytical tools can be integrated in the processes and objectives of crisis communication. The availability of the computational techniques can improve communication with the public by a process of Hyper-Targeted Crisis Communication. The review suggests that using advanced computational tools for target-audience profiling and linguistic matching in social media, can facilitate more sensitive and personalized emergency communication.

Reliability of a structured interview for admission to an emergency medicine residency program.

PubMed

Blouin, Danielle

2010-10-01

Interviews are most important in resident selection. Structured interviews are more reliable than unstructured ones. We sought to measure the interrater reliability of a newly designed structured interview during the selection process to an Emergency Medicine residency program. The critical incident technique was used to extract the desired dimensions of performance. The interview tool consisted of 7 clinical scenarios and 1 global rating. Three trained interviewers marked each candidate on all scenarios without discussing candidates' responses. Interitem consistency and estimates of variance were computed. Twenty-eight candidates were interviewed. The generalizability coefficient was 0.67. Removing the central tendency ratings increased the coefficient to 0.74. Coefficients of interitem consistency ranged from 0.64 to 0.74. The structured interview tool provided good although suboptimal interrater reliability. Increasing the number of scenarios improves reliability as does applying differential weights to the rating scale anchors. The latter would also facilitate the identification of those candidates with extreme ratings.

Ecological and social correlates of chimpanzee tool use.

PubMed

Sanz, Crickette M; Morgan, David B

2013-11-19

The emergence of technology has been suggested to coincide with scarcity of staple resources that led to innovations in the form of tool-assisted strategies to diversify or augment typical diets. We examined seasonal patterns of several types of tool use exhibited by a chimpanzee (Pan troglodytes) population residing in central Africa, to determine whether their technical skills provided access to fallback resources when preferred food items were scarce. Chimpanzees in the Goualougo Triangle exhibit a diverse repertoire of tool behaviours, many of which are exhibited throughout the year. Further, they have developed specific tool sets to overcome the issues of accessibility to particular food items. Our conclusion is that these chimpanzees use a sophisticated tool technology to cope with seasonal changes in relative food abundance and gain access to high-quality foods. Subgroup sizes were smaller in tool using contexts than other foraging contexts, suggesting that the size of the social group may not be as important in promoting complex tool traditions as the frequency and type of social interactions. Further, reports from other populations and species showed that tool use may occur more often in response to ecological opportunities and relative profitability of foraging techniques than scarcity of resources.

Development of Tool Representations in the Dorsal and Ventral Visual Object Processing Pathways

PubMed Central

Kersey, Alyssa J.; Clark, Tyia S.; Lussier, Courtney A.; Mahon, Bradford Z.; Cantlon, Jessica F.

2016-01-01

Tools represent a special class of objects, because they are processed across both the dorsal and ventral visual object processing pathways. Three core regions are known to be involved in tool processing: the left posterior middle temporal gyrus, the medial fusiform gyrus (bilaterally), and the left inferior parietal lobule. A critical and relatively unexplored issue concerns whether, in development, tool preferences emerge at the same time and to a similar degree across all regions of the tool-processing network. To test this issue, we used functional magnetic resonance imaging to measure the neural amplitude, peak location, and the dispersion of tool-related neural responses in the youngest sample of children tested to date in this domain (ages 4–8 years). We show that children recruit overlapping regions of the adult tool-processing network and also exhibit similar patterns of co-activation across the network to adults. The amplitude and co-activation data show that the core components of the tool-processing network are established by age 4. Our findings on the distributions of peak location and dispersion of activation indicate that the tool network undergoes refinement between ages 4 and 8 years. PMID:26108614

Ecological and social correlates of chimpanzee tool use

PubMed Central

Sanz, Crickette M.; Morgan, David B.

2013-01-01

The emergence of technology has been suggested to coincide with scarcity of staple resources that led to innovations in the form of tool-assisted strategies to diversify or augment typical diets. We examined seasonal patterns of several types of tool use exhibited by a chimpanzee (Pan troglodytes) population residing in central Africa, to determine whether their technical skills provided access to fallback resources when preferred food items were scarce. Chimpanzees in the Goualougo Triangle exhibit a diverse repertoire of tool behaviours, many of which are exhibited throughout the year. Further, they have developed specific tool sets to overcome the issues of accessibility to particular food items. Our conclusion is that these chimpanzees use a sophisticated tool technology to cope with seasonal changes in relative food abundance and gain access to high-quality foods. Subgroup sizes were smaller in tool using contexts than other foraging contexts, suggesting that the size of the social group may not be as important in promoting complex tool traditions as the frequency and type of social interactions. Further, reports from other populations and species showed that tool use may occur more often in response to ecological opportunities and relative profitability of foraging techniques than scarcity of resources. PMID:24101626

Decision Support for Emergency Operations Centers

NASA Technical Reports Server (NTRS)

Harvey, Craig; Lawhead, Joel; Watts, Zack

2005-01-01

The Flood Disaster Mitigation Decision Support System (DSS) is a computerized information system that allows regional emergency-operations government officials to make decisions regarding the dispatch of resources in response to flooding. The DSS implements a real-time model of inundation utilizing recently acquired lidar elevation data as well as real-time data from flood gauges, and other instruments within and upstream of an area that is or could become flooded. The DSS information is updated as new data become available. The model generates realtime maps of flooded areas and predicts flood crests at specified locations. The inundation maps are overlaid with information on population densities, property values, hazardous materials, evacuation routes, official contact information, and other information needed for emergency response. The program maintains a database and a Web portal through which real-time data from instrumentation are gathered into the database. Also included in the database is a geographic information system, from which the program obtains the overlay data for areas of interest as needed. The portal makes some portions of the database accessible to the public. Access to other portions of the database is restricted to government officials according to various levels of authorization. The Flood Disaster Mitigation DSS has been integrated into a larger DSS named REACT (Real-time Emergency Action Coordination Tool), which also provides emergency operations managers with data for any type of impact area such as floods, fires, bomb

Stimulating a Great Lakes coastal wetland seed bank using portable cofferdams: implications for habitat rehabilitation

USGS Publications Warehouse

Kowalski, K.P.; Wilcox, D.A.; Wiley, M.J.

2009-01-01

Coastal wetland seed banks exposed by low lake levels or through management actions fuel the reestablishment of emergent plant assemblages (i.e., wetland habitat) critical to Great Lakes aquatic biota. This project explored the effectiveness of using portable, water-filled cofferdams as a management tool to promote the natural growth of emergent vegetation from the seed bank in a Lake Erie coastal wetland. A series of dams stretching approximately 450??m was installed temporarily to isolate hydrologically a 10-ha corner of the Crane Creek wetland complex from Lake Erie. The test area was dewatered in 2004 to mimic a low-water year, and vegetation sampling characterized the wetland seed bank response at low, middle, and high elevations in areas open to and protected from bird and mammal herbivory. The nearly two-month drawdown stimulated a rapid seed-bank-driven response by 45 plant taxa. Herbivory had little effect on plant species richness, regardless of the location along an elevation gradient. Inundation contributed to the replacement of immature emergent plant species with submersed aquatic species after the dams failed and were removed prematurely. This study revealed a number of important issues that must be considered for effective long-term implementation of portable cofferdam technology to stimulate wetland seed banks, including duration of dewatering, product size, source of clean water, replacement of damaged dams, and regular maintenance. This technology is a potentially important tool in the arsenal used by resource managers seeking to rehabilitate the functions and values of Great Lakes coastal wetland habitats.

Survey of Emergency and Essential Surgical, Obstetric and Anaesthetic Services Available in Bangladeshi Government Health Facilities.

PubMed

Loveday, Jonathan; Sachdev, Sonal P; Cherian, Meena N; Katayama, Francisco; Akhtaruzzaman, A K M; Thomas, Joe; Huda, N; Faragher, E Brian; Johnson, Walter D

2017-07-01

Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services. Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies. For this survey, the Bangladeshi Ministry of Health sent the SAT to sub-district, district/general and teaching hospitals throughout the country in April 2013. Responses were received from 240 healthcare facilities (49.5% response rate): 218 sub-district and 22 district/general hospitals. At the sub-district level, caesarean section was offered by 55% of facilities, laparotomy by 7% and open fracture repair by 8%. At the district/general hospital level, 95% offered caesarean section, 86% offered laparotomy and 77% offered open fracture treatment. Availability of anaesthesia services, general equipment and supplies reflected this trend, where district/general hospitals were better equipped than sub-district hospitals, though equipment and infrastructure shortages persist. There has been overall impressive progress by the Bangladeshi Government in providing essential surgical services. Areas for improvement remain across all key areas, including infrastructure, human resources, surgical interventions offered and available equipment. Investment in surgical services offers a cost-effective opportunity to continue to improve the health of the Bangladeshi population and move the country towards universal healthcare coverage.

Vaccine Design: Emerging Concepts and Renewed Optimism

PubMed Central

Grimm, Sebastian K.; Ackerman, Margaret E.

2013-01-01

Arguably, vaccination represents the single most effective medical intervention ever developed. Yet, vaccines have failed to provide any or adequate protection against some of the most significant global diseases. The pathogens responsible for these vaccine-recalcitrant diseases have properties that allow them to evade immune surveillance and misdirect or eliminate the immune response. However, genomic and systems biology tools, novel adjuvants and delivery systems, and refined molecular insight into protective immunity have started to redefine the landscape, and results from recent efficacy trials of HIV and malaria vaccines have instilled hope that another golden age of vaccines may be on the horizon. PMID:23474232

Professional Regulation: A Potentially Valuable Tool in Responding to “Stem Cell Tourism”

PubMed Central

Zarzeczny, Amy; Caulfield, Timothy; Ogbogu, Ubaka; Bell, Peter; Crooks, Valorie A.; Kamenova, Kalina; Master, Zubin; Rachul, Christen; Snyder, Jeremy; Toews, Maeghan; Zoeller, Sonja

2014-01-01

The growing international market for unproven stem cell-based interventions advertised on a direct-to-consumer basis over the internet (“stem cell tourism”) is a source of concern because of the risks it presents to patients as well as their supporters, domestic health care systems, and the stem cell research field. Emerging responses such as public and health provider-focused education and national regulatory efforts are encouraging, but the market continues to grow. Physicians play a number of roles in the stem cell tourism market and, in many jurisdictions, are members of a regulated profession. In this article, we consider the use of professional regulation to address physician involvement in stem cell tourism. Although it is not without its limitations, professional regulation is a potentially valuable tool that can be employed in response to problematic types of physician involvement in the stem cell tourism market. PMID:25241736

A combined paging alert and web-based instrument alters clinician behavior and shortens hospital length of stay in acute pancreatitis.

PubMed

Dimagno, Matthew J; Wamsteker, Erik-Jan; Rizk, Rafat S; Spaete, Joshua P; Gupta, Suraj; Sahay, Tanya; Costanzo, Jeffrey; Inadomi, John M; Napolitano, Lena M; Hyzy, Robert C; Desmond, Jeff S

2014-03-01

There are many published clinical guidelines for acute pancreatitis (AP). Implementation of these recommendations is variable. We hypothesized that a clinical decision support (CDS) tool would change clinician behavior and shorten hospital length of stay (LOS). Observational study, entitled, The AP Early Response (TAPER) Project. Tertiary center emergency department (ED) and hospital. Two consecutive samplings of patients having ICD-9 code (577.0) for AP were generated from the emergency department (ED) or hospital admissions. Diagnosis of AP was based on conventional Atlanta criteria. The Pre-TAPER-CDS-Tool group (5/30/06-6/22/07) had 110 patients presenting to the ED with AP per 976 ICD-9 (577.0) codes and the Post-TAPER-CDS-Tool group (5/30/06-6/22/07) had 113 per 907 ICD-9 codes (7/14/10-5/5/11). The TAPER-CDS-Tool, developed 12/2008-7/14/2010, is a combined early, automated paging-alert system, which text pages ED clinicians about a patient with AP and an intuitive web-based point-of-care instrument, consisting of seven early management recommendations. The pre- vs. post-TAPER-CDS-Tool groups had similar baseline characteristics. The post-TAPER-CDS-Tool group met two management goals more frequently than the pre-TAPER-CDS-Tool group: risk stratification (P<0.0001) and intravenous fluids >6L/1st 0-24 h (P=0.0003). Mean (s.d.) hospital LOS was significantly shorter in the post-TAPER-CDS-Tool group (4.6 (3.1) vs. 6.7 (7.0) days, P=0.0126). Multivariate analysis identified four independent variables for hospital LOS: the TAPER-CDS-Tool associated with shorter LOS (P=0.0049) and three variables associated with longer LOS: Japanese severity score (P=0.0361), persistent organ failure (P=0.0088), and local pancreatic complications (<0.0001). The TAPER-CDS-Tool is associated with changed clinician behavior and shortened hospital LOS, which has significant financial implications.

Unique Sensor Plane Maps Invisible Toxins for First Responders

ScienceCinema

Kroutil, Robert; Thomas, Mark; Aten, Keith

2017-12-09

A unique airborne emergency response tool, ASPECT is a Los Alamos/U.S. Environmental Protection Agency project that can put chemical and radiological mapping tools in the air over an accident scene. The name ASPECT is an acronym for Airborne Spectral Photometric Environmental Collection Technology. Update, Sept. 19, 2008: Flying over storm-damaged refineries and chemical factories, a twin-engine plane carrying the ASPECT (Airborne Spectral Photometric Environmental Collection Technology) system has been on duty throughout the recent hurricanes that have swept the Florida and Gulf Coast areas. ASPECT is a project of the U.S. U.S. Environmental Protection Agencys National Decontamination Team. Los Alamos National Laboratory leads a science and technology program supporting the EPA and the ASPECT aircraft. Casting about with a combination of airborne photography and infrared spectroscopy, the highly instrumented plane provides emergency responders on the ground with a clear concept of where danger lies, and the nature of the sometimes-invisible plumes that could otherwise kill them. ASPECT is the nations only 24/7 emergency response aircraft with chemical plume mapping capability. Bob Kroutil of Bioscience Division is the project leader, and while he said the team has put in long hours, both on the ground and in the air, its a worthwhile effort. The plane flew over 320 targeted sites in four days, he noted. Prior to the deployment to the Gulf Coast, the plane had been monitoring the Democratic National Convention in Denver, Colorado. Los Alamos National Laboratory Divisions that are supporting ASPECT include, in addition to B-Division, CTN-5: Networking Engineering and IRM-CAS: Communication, Arts, and Services. Leslie Mansell, CTN-5, and Marilyn Pruitt, IRM-CAS, were recognized the the U.S. EPA for their outstanding support to the hurricane response of Gustav in Louisiana and Ike in Texas. The information from the data collected in the most recent event, Hurricane Ike, was sent to the EPA Region 6 Rapid Needs Assessment and the State of Texas Joint Field Office in Austin, Texas. It appears that though there is considerable damage in Galveston and Texas City, there are fewer chemical leaks than during either hurricanes Katrina or Rita. Specific information gathered from the data was reported out to the U.S. Environmental Protection Agency Headquarters, the Federal Emergency Management Agency, the Department of Homeland Security, and the State of Texas Emergency Management Agency.

A GIS-based model to estimate flood consequences and the degree of accessibility and operability of strategic emergency response structures in urban areas

NASA Astrophysics Data System (ADS)

Albano, R.; Sole, A.; Adamowski, J.; Mancusi, L.

2014-11-01

Efficient decision-making regarding flood risk reduction has become a priority for authorities and stakeholders in many European countries. Risk analysis methods and techniques are a useful tool for evaluating costs and benefits of possible interventions. Within this context, a methodology to estimate flood consequences was developed in this paper that is based on GIS, and integrated with a model that estimates the degree of accessibility and operability of strategic emergency response structures in an urban area. The majority of the currently available approaches do not properly analyse road network connections and dependencies within systems, and as such a loss of roads could cause significant damages and problems to emergency services in cases of flooding. The proposed model is unique in that it provides a maximum-impact estimation of flood consequences on the basis of the operability of the strategic emergency structures in an urban area, their accessibility, and connection within the urban system of a city (i.e. connection between aid centres and buildings at risk), in the emergency phase. The results of a case study in the Puglia region in southern Italy are described to illustrate the practical applications of this newly proposed approach. The main advantage of the proposed approach is that it allows for defining a hierarchy between different infrastructure in the urban area through the identification of particular components whose operation and efficiency are critical for emergency management. This information can be used by decision-makers to prioritize risk reduction interventions in flood emergencies in urban areas, given limited financial resources.

Emergency Airway Response Team Simulation Training: A Nursing Perspective.

PubMed

Crimlisk, Janet T; Krisciunas, Gintas P; Grillone, Gregory A; Gonzalez, R Mauricio; Winter, Michael R; Griever, Susan C; Fernandes, Eduarda; Medzon, Ron; Blansfield, Joseph S; Blumenthal, Adam

Simulation-based education is an important tool in the training of professionals in the medical field, especially for low-frequency, high-risk events. An interprofessional simulation-based training program was developed to enhance Emergency Airway Response Team (EART) knowledge, team dynamics, and personnel confidence. This quality improvement study evaluated the EART simulation training results of nurse participants. Twenty-four simulation-based classes of 4-hour sessions were conducted during a 12-week period. Sixty-three nurses from the emergency department (ED) and the intensive care units (ICUs) completed the simulation. Participants were evaluated before and after the simulation program with a knowledge-based test and a team dynamics and confidence questionnaire. Additional comparisons were made between ED and ICU nurses and between nurses with previous EART experience and those without previous EART experience. Comparison of presimulation (presim) and postsimulation (postsim) results indicated a statistically significant gain in both team dynamics and confidence and Knowledge Test scores (P < .01). There were no differences in scores between ED and ICU groups in presim or postsim scores; nurses with previous EART experience demonstrated significantly higher presim scores than nurses without EART experience, but there were no differences between these nurse groups at postsim. This project supports the use of simulation training to increase nurses' knowledge, confidence, and team dynamics in an EART response. Importantly, nurses with no previous experience achieved outcome scores similar to nurses who had experience, suggesting that emergency airway simulation is an effective way to train both new and experienced nurses.

Evaluating the success of an emergency response medical information system.

PubMed

Petter, Stacie; Fruhling, Ann

2011-07-01

STATPack™ is an information system used to aid in the diagnosis of pathogens in hospitals and state public health laboratories. STATPack™ is used as a communication and telemedicine diagnosis tool during emergencies. This paper explores the success of this emergency response medical information system (ERMIS) using a well-known framework of information systems success developed by DeLone and McLean. Using an online survey, the entire population of STATPack™ users evaluated the success of the information system by considering system quality, information quality, system use, intention to use, user satisfaction, individual impact, and organizational impact. The results indicate that the overall quality of this ERMIS (i.e., system quality, information quality, and service quality) has a positive impact on both user satisfaction and intention to use the system. However, given the nature of ERMIS, overall quality does not necessarily predict use of the system. Moreover, the user's satisfaction with the information system positively affected the intention to use the system. User satisfaction, intention to use, and system use had a positive influence on the system's impact on the individual. Finally, the organizational impacts of the system were positively influenced by use of the system and the system's individual impact on the user. The results of the study demonstrate how to evaluate the success of an ERMIS as well as introduce potential changes in how one applies the DeLone and McLean success model in an emergency response medical information system context. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Early warning and response system (EWARS) for dengue outbreaks: Recent advancements towards widespread applications in critical settings

PubMed Central

Kroeger, Axel; Olliaro, Piero; Rocklöv, Joacim; Sewe, Maquins Odhiambo; Tejeda, Gustavo; Benitez, David; Gill, Balvinder; Hakim, S. Lokman; Gomes Carvalho, Roberta; Bowman, Leigh; Petzold, Max

2018-01-01

Background Dengue outbreaks are increasing in frequency over space and time, affecting people’s health and burdening resource-constrained health systems. The ability to detect early emerging outbreaks is key to mounting an effective response. The early warning and response system (EWARS) is a toolkit that provides countries with early-warning systems for efficient and cost-effective local responses. EWARS uses outbreak and alarm indicators to derive prediction models that can be used prospectively to predict a forthcoming dengue outbreak at district level. Methods We report on the development of the EWARS tool, based on users’ recommendations into a convenient, user-friendly and reliable software aided by a user’s workbook and its field testing in 30 health districts in Brazil, Malaysia and Mexico. Findings 34 Health officers from the 30 study districts who had used the original EWARS for 7 to 10 months responded to a questionnaire with mainly open-ended questions. Qualitative content analysis showed that participants were generally satisfied with the tool but preferred open-access vs. commercial software. EWARS users also stated that the geographical unit should be the district, while access to meteorological information should be improved. These recommendations were incorporated into the second-generation EWARS-R, using the free R software, combined with recent surveillance data and resulted in higher sensitivities and positive predictive values of alarm signals compared to the first-generation EWARS. Currently the use of satellite data for meteorological information is being tested and a dashboard is being developed to increase user-friendliness of the tool. The inclusion of other Aedes borne viral diseases is under discussion. Conclusion EWARS is a pragmatic and useful tool for detecting imminent dengue outbreaks to trigger early response activities. PMID:29727447

Early warning and response system (EWARS) for dengue outbreaks: Recent advancements towards widespread applications in critical settings.

PubMed

Hussain-Alkhateeb, Laith; Kroeger, Axel; Olliaro, Piero; Rocklöv, Joacim; Sewe, Maquins Odhiambo; Tejeda, Gustavo; Benitez, David; Gill, Balvinder; Hakim, S Lokman; Gomes Carvalho, Roberta; Bowman, Leigh; Petzold, Max

2018-01-01

Dengue outbreaks are increasing in frequency over space and time, affecting people's health and burdening resource-constrained health systems. The ability to detect early emerging outbreaks is key to mounting an effective response. The early warning and response system (EWARS) is a toolkit that provides countries with early-warning systems for efficient and cost-effective local responses. EWARS uses outbreak and alarm indicators to derive prediction models that can be used prospectively to predict a forthcoming dengue outbreak at district level. We report on the development of the EWARS tool, based on users' recommendations into a convenient, user-friendly and reliable software aided by a user's workbook and its field testing in 30 health districts in Brazil, Malaysia and Mexico. 34 Health officers from the 30 study districts who had used the original EWARS for 7 to 10 months responded to a questionnaire with mainly open-ended questions. Qualitative content analysis showed that participants were generally satisfied with the tool but preferred open-access vs. commercial software. EWARS users also stated that the geographical unit should be the district, while access to meteorological information should be improved. These recommendations were incorporated into the second-generation EWARS-R, using the free R software, combined with recent surveillance data and resulted in higher sensitivities and positive predictive values of alarm signals compared to the first-generation EWARS. Currently the use of satellite data for meteorological information is being tested and a dashboard is being developed to increase user-friendliness of the tool. The inclusion of other Aedes borne viral diseases is under discussion. EWARS is a pragmatic and useful tool for detecting imminent dengue outbreaks to trigger early response activities.

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

DOE Office of Scientific and Technical Information (OSTI.GOV)

ORAU's Oak Ridge Institute for Science Education

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do justmore » that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.« less

Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

PubMed Central

Shah, Gulzar H.; Newell, Bobbie; Whitworth, Ruth E.

2016-01-01

Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved emergency preparedness. Methods: We used the 2013 National Profile of LHDs study to perform Poisson regression of emergency preparedness activities. Results: Only 38.3% of LHDs participated in full-scale exercises or drills for an emergency in the 12 months period prior to the survey, but a much larger proportion provided emergency preparedness training to staff (84.3%), and/or participated in tabletop exercises (76.4%). Our multivariable analysis showed that after adjusting for several resource-related LHD characteristics, LHDs with more of the 6 information systems still tend to have slightly more preparedness activities. In addition, having a designated emergency preparedness coordinator, and having one or more emergency preparedness staff were among the most significant factors associated with LHDs performing more emergency preparedness activities. Conclusion: LHDs might want to utilize better health information systems and information technology tools to improve their activity level in emergency preparedness, through improved information dissemination, and evidence collection. PMID:27694648

The public health dashboard: a surveillance model for bioterrorism preparedness.

PubMed

Foldy, Seth L; Biedrzycki, Paul A; Baker, Bevan K; Swain, Geoffrey R; Howe, Donna S; Gieryn, Douglas; Barthell, Edward N; Pemble, Kim R

2004-01-01

The City of Milwaukee Health Department piloted a short-term, near real-time syndromic surveillance and communication tool by using an existing secure regional Internet infrastructure. Voluntary, active syndromic case reporting by hospital Emergency Departments was combined with other data streams, including clinical laboratory reports of communicable disease, hospital emergency room diversions, ambulance runs, medical examiner reports of unusual or suspicious deaths, poison control and nursing hotline call volumes, and pharmacy over-the-counter sales. These data were aggregated into a "Surveillance Dashboard" format that was used to communicate community syndromic health trends to hospitals, Emergency Departments, and other providers using a secure Internet technology. Emergency Departments at 8 area hospitals reported a total of 314 cases meeting syndromic criteria from 26,888 patient encounters. Participants were satisfied with data entry and communications. All participating Emergency Departments received e-mail and text pager alerts sent by the Milwaukee Health Department. No unexplained findings or suggestions of an early outbreak were reported through syndrome surveillance for the 4-week duration of the project. Similar surveillance and communications systems could provide multiple benefits to Emergency Department workflow and management, as well as to public health and emergency response.

Successful strategies for recruitment of emergency medical volunteers.

PubMed

Hasselmann, Anne Rinchiuso

2013-06-01

A robust medical volunteer program is critical to ensuring a successful response to public health and medical emergencies. The New York City (NYC) Department of Health and Mental Hygiene created the NYC Medical Reserve Corps in 2003 to build a multidisciplinary team of health professionals who wish to assist NYC with response during large-scale health emergencies. This article reports on the search to determine which recruitment activities have been most successful to date, with the goal of modeling future activities upon those that worked best. A retrospective review of effectiveness of recruitment strategies to identify and register new NYC Medical Reserve Corps volunteers was undertaken. A broad range of recruitment activities have been implemented since the program's inception, with varying degrees of success. Various recruitment modalities were tried, including direct invitations to licensed professionals by the NYC Health Commissioner and announcements through professional organization partners. The direct invitation by the NYC Health Commissioner to health professionals licensed in 1 of the 5 boroughs of NYC has proved to be the most successful recruitment tool to date. The local health commissioner or other trusted community figure is an excellent messenger for recruiting emergency volunteers. It is also critical that recruitment messages reach as many potential volunteers as possible to ensure that the requisite number of volunteers and mix of professional disciplines are identified.

Zika Virus in Ontario: Evaluating a Rapid Risk Assessment Tool for Emerging Infectious Disease Threats.

PubMed

Van Meer, Ryan; Hohenadel, Karin; Fitzgerald-Husek, Alanna; Warshawsky, Bryna; Sider, Doug; Schwartz, Brian; Nelder, Mark P

To determine the Ontario-specific risk of local and travel-related Zika virus transmission in the context of a public health emergency of international concern, Public Health Ontario (PHO) completed a rapid risk assessment (RRA) on January 29, 2016, using a newly developed RRA guidance tool. The RRA concluded that risk of local mosquito-borne transmission was low, with a high risk of imported cases through travel. The RRA was updated 3 times based on predetermined triggers. An independent evaluation assessed both the application of the RRA guidance tool (process evaluation) and the usefulness of the RRA (outcome evaluation). We conducted face-to-face, semi-structured interviews with 7 individuals who participated in the creation or review of the Zika virus RRA and 4 end-users at PHO and the Ministry of Health and Long-Term Care. An inductive thematic analysis of responses was undertaken, whereby themes were directly informed by the data. The process evaluation determined that most steps outlined in the RRA guidance tool were adhered to, including forming a cross-functional writing team, clarifying the scope and describing context, completing the RRA summary report, and updating the RRA based on predefined triggers. The outcome evaluation found that end-users judged the Zika virus RRA as evidence-informed, useful, consistent, and timely. The evaluation established that the locally tailored guidance tool, adapted from national and international approaches to RRAs, facilitated a systematic, evidence-informed, and timely formal RRA process at PHO for the Zika virus RRA, which met the needs of end-users. Based on the evaluation, PHO will modify future RRAs by incorporating some flexibility into the literature review process to support timeliness of the RRA, explicitly describing the limitations of studies used to inform the RRA, and refining risk algorithms to better suit emerging infectious disease threats. It is anticipated that these refinements will improve upon the timely assessment of novel or reemerging infectious diseases.

ONCHIT security in distributed environments: a proposed model for implantable devices.

PubMed

Lorence, Daniel; Lee, James; Richards, Michael

2010-08-01

Recent ONCHIT mandates call for increased individual health data collection efforts as well as heightened security measures. To date most healthcare organizations have been reluctant to exchange information, citing confidentiality concerns and unshared costs incurred by specific organizations. Implantable monitoring and treatment devices are rapidly emerging as data collection interface tools in response to such mandates. Proposed here is a translational, device-independent consumer-based solution, which focuses on information controlled by specific patients, and functions within a distributed (organization neutral) environment. While the conceptual applications employed in this technology set are provided by way of illustration, they may also serve as a transformative model for emerging EMR/EHR requirements.

Perfluorocarbon Nanoparticles:. A Theranostic Platform Technology

NASA Astrophysics Data System (ADS)

Lanza, Gregory M.; Winter, Patrick M.; Caruthers, Shelton D.; Hughes, Michael S.; Hu, Grace; Pan, Dipanjan; Schmieder, Anne H.; Pham, Christine; Wickline, Samuel A.

2013-09-01

Nanomedicine clearly offers unique tools to address intractable medical problems in cancer and cardiovascular disease from entirely new perspectives. Among the theranostic options emerging in this new wave of biotechnology development, the perfluorocarbon nanoparticles have shown robust potential in vivo for diagnosing, characterizing, treating and following proliferating cancers, progressive atherosclerosis, rheumatoid arthritis and much more. These molecular imaging agents have been demonstrated for use with ultrasound, MRI, CT, and SPECT/CT. Moreover, the synergism of imaging for confirmation of therapeutic delivery, for dosimetry, and for noninvasively following early treatment responses is discussed. Image-guided drug delivery based on nanotechnology is emerging as a powerful clinical opportunity, and PFC nanoparticles are among the leading technologies reaching clinical testing today with this potential.

The Pandemic Influenza Policy Model: A Planning Tool for Military Public Health Officials

DTIC Science & Technology

2009-06-01

Containment . Geneva , WHO , 2006. 7. Luke CJ , Subbarao K : Vaccines for pandemic infl uenza . Emerg Infect Dis 2006 ; 12 (1) : 66 – 72...Report (SAR) 18. NUMBER OF PAGES 9 19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b . ABSTRACT unclassified c. THIS PAGE unclassified...simulations . Simulation 2005 ; 81 (10) : 671 – 99 . 19. Pourbohloul B , Meyers LA , Skowronski DM , Krajden M , Patrick DM , Brunham RC

USGS Integration of New Science and Technology, Appendix A

USGS Publications Warehouse

Brey, Marybeth; Knights, Brent C.; Cupp, Aaron R.; Amberg, Jon J.; Chapman, Duane C.; Calfee, Robin D.; Duncker, James J.

2017-01-01

This product summarizes the USGS plans for integration of new science and technology into Asian Carp control efforts for 2017. This includes the 1) implementation and evaluation of new tactics and behavioral information for monitoring, surveillance, control and containment; 2) understanding behavior and reproduction of Asian carp in established and emerging populations to inform deterrent deployment, rapid response, and removal efforts; and 3) development and evaluation of databases, decision support tools and performance measures.

Updated preparedness and response framework for influenza pandemics.

PubMed

Holloway, Rachel; Rasmussen, Sonja A; Zaza, Stephanie; Cox, Nancy J; Jernigan, Daniel B

2014-09-26

The complexities of planning for and responding to the emergence of novel influenza viruses emphasize the need for systematic frameworks to describe the progression of the event; weigh the risk of emergence and potential public health impact; evaluate transmissibility, antiviral resistance, and severity; and make decisions about interventions. On the basis of experience from recent influenza responses, CDC has updated its framework to describe influenza pandemic progression using six intervals (two prepandemic and four pandemic intervals) and eight domains. This updated framework can be used for influenza pandemic planning and serves as recommendations for risk assessment, decision-making, and action in the United States. The updated framework replaces the U.S. federal government stages from the 2006 implementation plan for the National Strategy for Pandemic Influenza (US Homeland Security Council. National strategy for pandemic influenza: implementation plan. Washington, DC: US Homeland Security Council; 2006. Available at http://www.flu.gov/planning-preparedness/federal/pandemic-influenza-implementation.pdf). The six intervals of the updated framework are as follows: 1) investigation of cases of novel influenza, 2) recognition of increased potential for ongoing transmission, 3) initiation of a pandemic wave, 4) acceleration of a pandemic wave, 5) deceleration of a pandemic wave, and 6) preparation for future pandemic waves. The following eight domains are used to organize response efforts within each interval: incident management, surveillance and epidemiology, laboratory, community mitigation, medical care and countermeasures, vaccine, risk communications, and state/local coordination. Compared with the previous U.S. government stages, this updated framework provides greater detail and clarity regarding the potential timing of key decisions and actions aimed at slowing the spread and mitigating the impact of an emerging pandemic. Use of this updated framework is anticipated to improve pandemic preparedness and response in the United States. Activities and decisions during a response are event-specific. These intervals serve as a reference for public health decision-making by federal, state, and local health authorities in the United States during an influenza pandemic and are not meant to be prescriptive or comprehensive. This framework incorporates information from newly developed tools for pandemic planning and response, including the Influenza Risk Assessment Tool and the Pandemic Severity Assessment Framework, and has been aligned with the pandemic phases restructured in 2013 by the World Health Organization.

Using exercises to improve public health preparedness in Asia, the Middle East and Africa

PubMed Central

2014-01-01

Background Exercises are increasingly common tools used by the health sector and other sectors to evaluate their preparedness to respond to public health threats. Exercises provide an opportunity for multiple sectors to practice, test and evaluate their response to all types of public health emergencies. The information from these exercises can be used to refine and improve preparedness plans. There is a growing body of literature about the use of exercises among local, state and federal public health agencies in the United States. There is much less information about the use of exercises among public health agencies in other countries and the use of exercises that involve multiple countries. Results We developed and conducted 12 exercises (four sub-national, five national, three sub-regional) from August 2006 through December 2008. These 12 exercises included 558 participants (average 47) and 137 observers (average 11) from 14 countries. Participants consistently rated the overall quality of the exercises as very good or excellent. They rated the exercises lowest on their ability to identifying key gaps in performance. The vast majority of participants noted that they would use the information they gained at the exercise to improve their organization’s preparedness to respond to an influenza pandemic. Participants felt the exercises were particularly good at raising awareness and understanding about public health threats, assisting in evaluating plans and identifying priorities for improvement, and building relationships that strengthen preparedness and response across sectors and across countries. Participants left the exercises with specific ideas about the most important actions that they should engage in after the exercise such as improved planning coordination across sectors and countries and better training of health workers and response personnel. Conclusions These experiences suggest that exercises can be a valuable, low-burden tool to improve emergency preparedness and response in countries around the world. They also demonstrate that countries can work together to develop and conduct successful exercises designed to improve regional preparedness to public health threats. The development of standardized evaluation methods for exercises may be an additional tool to help focus the actions to be taken as a result of the exercise and to improve future exercises. Exercises show great promise as tools to improve public health preparedness across sectors and countries. PMID:25063987

Development of the Parent Responses to School Functioning Questionnaire.

PubMed

Barber Garcia, Brittany N; Gray, Laura S; Simons, Laura E; Logan, Deirdre E

2017-10-01

Parents play an important role in supporting school functioning in youth with chronic pain, but no validated tools exists to assess parental responses to child and adolescent pain behaviors in the school context. Such a tool would be useful in identifying targets of change to reduce pain-related school impairment. The goal of this study was to develop and preliminarily validate the Parent Responses to School Functioning Questionnaire (PRSF), a parent self-report measure of this construct. After initial expert review and pilot testing, the measure was administered to 418 parents of children (ages 6-17 years) seen for initial multidisciplinary chronic pain clinic evaluation. The final 16-item PRSF showed evidence of good internal consistency (α = .82) and 2-week test-retest reliability (intraclass correlation coefficient = .87). Criterion validity was demonstrated by significant correlations with school absence rates and overall school functioning, and construct validity was demonstrated by correlations with general parental responses to pain. Three subscales emerged capturing parents' personal distress, parents' level of distrust of the school, and parents' expectations and behaviors related to their child's management of challenging school situations. These results provide preliminary support for the PRSF as a psychometrically sound tool to assess parents' responses to child pain in the school setting. The 16-item PRSF measures parental responses to their child's chronic pain in the school context. The clinically useful measure can inform interventions aimed reducing functional disability in children with chronic pain by enhancing parents' ability to respond adaptively to child pain behaviors. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

The emergence of the visual word form: Longitudinal evolution of category-specific ventral visual areas during reading acquisition

PubMed Central

Monzalvo, Karla; Dehaene, Stanislas

2018-01-01

How does education affect cortical organization? All literate adults possess a region specialized for letter strings, the visual word form area (VWFA), within the mosaic of ventral regions involved in processing other visual categories such as objects, places, faces, or body parts. Therefore, the acquisition of literacy may induce a reorientation of cortical maps towards letters at the expense of other categories such as faces. To test this cortical recycling hypothesis, we studied how the visual cortex of individual children changes during the first months of reading acquisition. Ten 6-year-old children were scanned longitudinally 6 or 7 times with functional magnetic resonance imaging (fMRI) before and throughout the first year of school. Subjects were exposed to a variety of pictures (words, numbers, tools, houses, faces, and bodies) while performing an unrelated target-detection task. Behavioral assessment indicated a sharp rise in grapheme–phoneme knowledge and reading speed in the first trimester of school. Concurrently, voxels specific to written words and digits emerged at the VWFA location. The responses to other categories remained largely stable, although right-hemispheric face-related activity increased in proportion to reading scores. Retrospective examination of the VWFA voxels prior to reading acquisition showed that reading encroaches on voxels that are initially weakly specialized for tools and close to but distinct from those responsive to faces. Remarkably, those voxels appear to keep their initial category selectivity while acquiring an additional and stronger responsivity to words. We propose a revised model of the neuronal recycling process in which new visual categories invade weakly specified cortex while leaving previously stabilized cortical responses unchanged. PMID:29509766

Strengths and weaknesses in team communication processes in a UK emergency department setting: findings using the Communication Assessment Tool-Team.

PubMed

Graham, Blair; Smith, Jason E; Enki, Doyo

2017-12-01

Identifying weaknesses in emergency department (ED) communication may highlight areas where quality improvement may be beneficial. This study explores whether the Communication Assessment Tool-Team (CAT-T) survey can identify communication strengths and weaknesses in a UK setting. This study aimed to determine the frequency of patient responses for each item on the CAT-T survey and to compare the proportion of responses according to patient and operational characteristics. Adults presenting to the minors area of a semi-urban ED between April and May 2015 were included. Those lacking capacity or in custody were excluded. Multivariate analysis identified associations between responses and demographic/operational characteristics. A total of 407/526 eligible patients responded (77.3%). Respondents were mostly White British (93.9%), with a median age of 45 years. Most responses were obtained during daytime hours (84.2% between 08 : 00 and 18 : 00). The median reported times to triage, assessment and disposition were 15, 35 and 90 min, respectively. Items most frequently rated as 'very good'/'excellent' (strengths) were 'ambulance staff treated me with respect' (86.7%), ED staff 'let me talk without interruptions' (85%) and 'paid attention to me' (83.7%). Items most frequently rated as 'poor'/'fair' (weaknesses) were 'encouraged me to ask questions', 'reception treated me with respect' (10.4%) and 'staff showed an interest in my health' (6.8%). Arrival time, analgesia at triage and time to assessment were associated with significantly increased odds of positive perception of team communication for a range of items. The CAT-T survey may be used within a UK setting to identify discrete strengths and weaknesses in ED team communication.

The emergence of the visual word form: Longitudinal evolution of category-specific ventral visual areas during reading acquisition.

PubMed

Dehaene-Lambertz, Ghislaine; Monzalvo, Karla; Dehaene, Stanislas

2018-03-01

How does education affect cortical organization? All literate adults possess a region specialized for letter strings, the visual word form area (VWFA), within the mosaic of ventral regions involved in processing other visual categories such as objects, places, faces, or body parts. Therefore, the acquisition of literacy may induce a reorientation of cortical maps towards letters at the expense of other categories such as faces. To test this cortical recycling hypothesis, we studied how the visual cortex of individual children changes during the first months of reading acquisition. Ten 6-year-old children were scanned longitudinally 6 or 7 times with functional magnetic resonance imaging (fMRI) before and throughout the first year of school. Subjects were exposed to a variety of pictures (words, numbers, tools, houses, faces, and bodies) while performing an unrelated target-detection task. Behavioral assessment indicated a sharp rise in grapheme-phoneme knowledge and reading speed in the first trimester of school. Concurrently, voxels specific to written words and digits emerged at the VWFA location. The responses to other categories remained largely stable, although right-hemispheric face-related activity increased in proportion to reading scores. Retrospective examination of the VWFA voxels prior to reading acquisition showed that reading encroaches on voxels that are initially weakly specialized for tools and close to but distinct from those responsive to faces. Remarkably, those voxels appear to keep their initial category selectivity while acquiring an additional and stronger responsivity to words. We propose a revised model of the neuronal recycling process in which new visual categories invade weakly specified cortex while leaving previously stabilized cortical responses unchanged.

Disaster Response and Decision Support in Partnership with the California Earthquake Clearinghouse

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Rosinski, A.; Vaughan, D.; Morentz, J.

2014-12-01

Getting the right information to the right people at the right time is critical during a natural disaster. E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) is a NASA decision support system designed to produce remote sensing and geophysical modeling data products that are relevant to the emergency preparedness and response communities and serve as a gateway to enable the delivery of NASA decision support products to these communities. The E-DECIDER decision support system has several tools, services, and products that have been used to support end-user exercises in partnership with the California Earthquake Clearinghouse since 2012, including near real-time deformation modeling results and on-demand maps of critical infrastructure that may have been potentially exposed to damage by a disaster. E-DECIDER's underlying service architecture allows the system to facilitate delivery of NASA decision support products to the Clearinghouse through XchangeCore Web Service Data Orchestration that allows trusted information exchange among partner agencies. This in turn allows Clearinghouse partners to visualize data products produced by E-DECIDER and other NASA projects through incident command software such as SpotOnResponse or ArcGIS Online.

How a disaster preparedness rotation helps teach the seven NAVMEC professional competencies: the Texas A&M University Experience.

PubMed

Bissett, Wesley T; Zoran, Debra L; Clendenin, Angela; Espitia, Noberto F; Moyer, William; Rogers, Kenita S

2013-01-01

Changing societal expectations provide new challenges and opportunities for the veterinary medical profession. These changing expectations and approaches to the education of veterinary students in the future are reflected in the North American Veterinary Medical Education Consortium's report "Roadmap for Veterinary Medical Education in the 21st Century: Responsive, Collaborative, Flexible." They are also reflected in the expectations of the populace, who no longer find it acceptable that animals are not included in both planning for and responding to natural or manmade disasters. In response to the changing needs of society and the veterinary profession, Texas A&M University College of Veterinary Medicine has developed a required rotation in the fourth-year curriculum on emergency planning and response. The unique requirements of emergency preparedness and response and the design of the rotation provide an ideal platform for providing this valued public service while simultaneously addressing the seven professional competencies outlined in the NAVMEC roadmap. This article describes an overview of the rotation and its content and identifies opportunities for students to practice these important professional competencies using the tools introduced in this new rotation.

Quantitative evaluation of "Can It Happen in Kansas: Response to Terrorism and Emerging Infections".

PubMed

Ablah, Elizabeth; Molgaard, Craig A; Fredrickson, Doren D; Wetta-Hall, Ruth; Cook, David J

2005-11-01

This study describes the evaluation of a 2-year plan to train 10 percent of Kansas' multidisciplinary health professionals for response to terrorism and emerging infections. This project was part of a national effort covering 19 states funded by the Health Resources and Services Administration in 2003. The initial training occurred in six 2-day workshops. A terrorism preparedness questionnaire was developed to assess Health Resources and Services Administration terrorism response competencies/learning objectives. These were measured before, after, and 3 months after training in a hybrid cross-sectional and cohort follow-up design. Health professionals' mean scores significantly improved on all four Health Resources and Services Administration terrorism self-reported competencies from pretest to posttest. Three months posttraining, health professionals' mean scores decreased slightly but remained significantly higher than their pretest scores. This project prepared healthcare professionals to respond to the medical consequences of terrorism. The integration of core competencies into the evaluation plan allowed for trainees to evaluate their confidence and abilities. The evaluation plan and curriculum may serve as useful tools for preparation of healthcare workers nationwide, with the potential to rebuild the public health infrastructure to assume preparedness responsibilities.

Three-Stage Decision-Making Model under Restricted Conditions for Emergency Response to Ships Not under Control.

PubMed

Wu, Bing; Yan, Xinping; Wang, Yang; Zhang, Di; Guedes Soares, C

2017-12-01

A ship that is not under control (NUC) is a typical incident that poses serious problems when in confined waters close to shore. The emergency response to NUC ships is to select the best risk control options, which is a challenge in restricted conditions (e.g., time limitation, resource constraint, and information asymmetry), particularly in inland waterway transportation. To enable a quick and effective response, this article develops a three-stage decision-making framework for NUC ship handling. The core of this method is (1) to propose feasible options for each involved entity (e.g., maritime safety administration, NUC ship, and ships passing by) under resource constraint in the first stage, (2) to select the most feasible options by comparing the similarity of the new case and existing cases in the second stage, and (3) to make decisions considering the cooperation between the involved organizations by using a developed Bayesian network in the third stage. Consequently, this work provides a useful tool to achieve well-organized management of NUC ships. © 2017 Society for Risk Analysis.

NASA SensorWeb and OGC Standards for Disaster Management

NASA Technical Reports Server (NTRS)

Mandl, Dan

2010-01-01

I. Goal: Enable user to cost-effectively find and create customized data products to help manage disasters; a) On-demand; b) Low cost and non-specialized tools such as Google Earth and browsers; c) Access via open network but with sufficient security. II. Use standards to interface various sensors and resultant data: a) Wrap sensors in Open Geospatial Consortium (OGC) standards; b) Wrap data processing algorithms and servers with OGC standards c) Use standardized workflows to orchestrate and script the creation of these data; products. III. Target Web 2.0 mass market: a) Make it simple and easy to use; b) Leverage new capabilities and tools that are emerging; c) Improve speed and responsiveness.

Correlating yeast cell stress physiology to changes in the cell surface morphology: atomic force microscopic studies.

PubMed

Canetta, Elisabetta; Walker, Graeme M; Adya, Ashok K

2006-07-06

Atomic Force Microscopy (AFM) has emerged as a powerful biophysical tool in biotechnology and medicine to investigate the morphological, physical, and mechanical properties of yeasts and other biological systems. However, properties such as, yeasts' response to environmental stresses, metabolic activities of pathogenic yeasts, cell-cell/cell-substrate adhesion, and cell-flocculation have rarely been investigated so far by using biophysical tools. Our recent results obtained by AFM on one strain each of Saccharomyces cerevisiae and Schizosaccharomyces pombe show a clear correlation between the physiology of environmentally stressed yeasts and the changes in their surface morphology. The future directions of the AFM related techniques in relation to yeasts are also discussed.

Emergent FDA biodefense issues for microarray technology: process analytical technology.

PubMed

Weinberg, Sandy

2004-11-01

A successful biodefense strategy relies upon any combination of four approaches. A nation can protect its troops and citizenry first by advanced mass vaccination, second, by responsive ring vaccination, and third, by post-exposure therapeutic treatment (including vaccine therapies). Finally, protection can be achieved by rapid detection followed by exposure limitation (suites and air filters) or immediate treatment (e.g., antibiotics, rapid vaccines and iodine pills). All of these strategies rely upon or are enhanced by microarray technologies. Microarrays can be used to screen, engineer and test vaccines. They are also used to construct early detection tools. While effective biodefense utilizes a variety of tactical tools, microarray technology is a valuable arrow in that quiver.

Using blogs and wikis in a graduate public health course.

PubMed

Cobus, Laura

2009-01-01

Blogs and wikis are examples of Web 2.0 technology that facilitate collaboration in the online world. In the health sciences, the emergence of these social tools potentially increases the risk of generating harmful or biased information. Therefore, it is the health professional's responsibility to have the skills to critically appraise Web content that has not undergone traditional peer review. This was the focus in a three-credit graduate Urban Public Health course taught by a librarian and was addressed with assignments using blog and wiki technology within the course management tool Blackboard. The assignments fostered comprehension of the issues surrounding blogs and wikis as they relate to public health.

Evidence-based support for the all-hazards approach to emergency preparedness

PubMed Central

2012-01-01

Background During the last decade there has been a need to respond and recover from various types of emergencies including mass casualty events (MCEs), mass toxicological/chemical events (MTEs), and biological events (pandemics and bio-terror agents). Effective emergency preparedness is more likely to be achieved if an all-hazards response plan is adopted. Objectives To investigate if there is a relationship among hospitals' preparedness for various emergency scenarios, and whether components of one emergency scenario correlate with preparedness for other emergency scenarios. Methods Emergency preparedness levels of all acute-care hospitals for MCEs, MTEs, and biological events were evaluated, utilizing a structured evaluation tool based on measurable parameters. Evaluations were made by professional experts in two phases: evaluation of standard operating procedures (SOPs) followed by a site visit. Relationships among total preparedness and different components' scores for various types of emergencies were analyzed. Results Significant relationships were found among preparedness for different emergencies. Standard Operating Procedures (SOPs) for biological events correlated with preparedness for all investigated emergency scenarios. Strong correlations were found between training and drills with preparedness for all investigated emergency scenarios. Conclusions Fundamental critical building blocks such as SOPs, training, and drill programs improve preparedness for different emergencies including MCEs, MTEs, and biological events, more than other building blocks, such as equipment or knowledge of personnel. SOPs are especially important in unfamiliar emergency scenarios. The findings support the adoption of an all-hazards approach to emergency preparedness. PMID:23098065

Cambio : a file format translation and analysis application for the nuclear response emergency community.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lasche, George P.

2009-10-01

Cambio is an application intended to automatically read and display any spectrum file of any format in the world that the nuclear emergency response community might encounter. Cambio also provides an analysis capability suitable for HPGe spectra when detector response and scattering environment are not well known. Why is Cambio needed: (1) Cambio solves the following problem - With over 50 types of formats from instruments used in the field and new format variations appearing frequently, it is impractical for every responder to have current versions of the manufacturer's software from every instrument used in the field; (2) Cambio convertsmore » field spectra to any one of several common formats that are used for analysis, saving valuable time in an emergency situation; (3) Cambio provides basic tools for comparing spectra, calibrating spectra, and isotope identification with analysis suited especially for HPGe spectra; and (4) Cambio has a batch processing capability to automatically translate a large number of archival spectral files of any format to one of several common formats, such as the IAEA SPE or the DHS N42. Currently over 540 analysts and members of the nuclear emergency response community worldwide are on the distribution list for updates to Cambio. Cambio users come from all levels of government, university, and commercial partners around the world that support efforts to counter terrorist nuclear activities. Cambio is Unclassified Unlimited Release (UUR) and distributed by internet downloads with email notifications whenever a new build of Cambio provides for new formats, bug fixes, or new or improved capabilities. Cambio is also provided as a DLL to the Karlsruhe Institute for Transuranium Elements so that Cambio's automatic file-reading capability can be included at the Nucleonica web site.« less

Developing an operational capabilities index of the emergency services sector.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Collins, M.J.; Eaton, L.K.; Shoemaker, Z.M.

2012-02-20

In order to enhance the resilience of the Nation and its ability to protect itself in the face of natural and human-caused hazards, the ability of the critical infrastructure (CI) system to withstand specific threats and return to normal operations after degradation must be determined. To fully analyze the resilience of a region and the CI that resides within it, both the actual resilience of the individual CI and the capability of the Emergency Services Sector (ESS) to protect against and respond to potential hazards need to be considered. Thus, a regional resilience approach requires the comprehensive consideration of allmore » parts of the CI system as well as the characterization of emergency services. This characterization must generate reproducible results that can support decision making with regard to risk management, disaster response, business continuity, and community planning and management. To address these issues, Argonne National Laboratory, in collaboration with the U.S. Department of Homeland Security (DHS) Sector Specific Agency - Executive Management Office, developed a comprehensive methodology to create an Emergency Services Sector Capabilities Index (ESSCI). The ESSCI is a performance metric that ranges from 0 (low level of capabilities) to 100 (high). Because an emergency services program has a high ESSCI, however, does not mean that a specific event would not be able to affect a region or cause severe consequences. And because a program has a low ESSCI does not mean that a disruptive event would automatically lead to serious consequences in a region. Moreover, a score of 100 on the ESSCI is not the level of capability expected of emergency services programs; rather, it represents an optimal program that would rarely be observed. The ESSCI characterizes the state of preparedness of a jurisdiction in terms of emergency and risk management. Perhaps the index's primary benefit is that it can systematically capture, at a given point in time, the capabilities of a jurisdiction to protect itself from, mitigate, respond to, and recover from a potential incident. On the basis of this metric, an interactive tool - the ESSCI Dashboard - can identify scenarios for enhancement that can be implemented, and it can identify the repercussions of these scenarios on the jurisdiction. It can assess the capabilities of law enforcement, fire fighting, search and rescue, emergency medical services, hazardous materials response, dispatch/911, and emergency management services in a given jurisdiction and it can help guide those who need to prioritize what limited resources should be used to improve these capabilities. Furthermore, this tool can be used to compare the level of capabilities of various jurisdictions that have similar socioeconomic characteristics. It can thus help DHS define how it can support risk reduction and community preparedness at a national level. This tool aligns directly with Presidential Policy Directive 8 by giving a jurisdiction a metric of its ESS's capabilities and by promoting an interactive approach for defining options to improve preparedness and to effectively respond to a disruptive event. It can be used in combination with other CI performance metrics developed at Argonne National Laboratory, such as the vulnerability index and the resilience index for assessing regional resilience.« less

Investment in preventing and preparing for biological emergencies and disasters: social and economic costs of disasters versus costs of surveillance and response preparedness.

PubMed

Rushton, J; Upton, M

2006-04-01

Biological emergencies such as the appearance of an exotic transboundary or emerging disease can become disasters. The question that faces Veterinary Services in developing countries is how to balance resources dedicated to active insurance measures, such as border control, surveillance, working with the governments of developing countries, and investing in improving veterinary knowledge and tools, with passive measures, such as contingency funds and vaccine banks. There is strong evidence that the animal health situation in developed countries has improved and is relatively stable. In addition, through trade with other countries, developing countries are becoming part of the international animal health system, the status of which is improving, though with occasional setbacks. However, despite these improvements, the risk of a possible biological disaster still remains, and has increased in recent times because of the threat of bioterrorism. This paper suggests that a model that combines decision tree analysis with epidemiology is required to identify critical points in food chains that should be strengthened to reduce the risk of emergencies and prevent emergencies from becoming disasters.

Demonstration of a software design and statistical analysis methodology with application to patient outcomes data sets

PubMed Central

Mayo, Charles; Conners, Steve; Warren, Christopher; Miller, Robert; Court, Laurence; Popple, Richard

2013-01-01

Purpose: With emergence of clinical outcomes databases as tools utilized routinely within institutions, comes need for software tools to support automated statistical analysis of these large data sets and intrainstitutional exchange from independent federated databases to support data pooling. In this paper, the authors present a design approach and analysis methodology that addresses both issues. Methods: A software application was constructed to automate analysis of patient outcomes data using a wide range of statistical metrics, by combining use of C#.Net and R code. The accuracy and speed of the code was evaluated using benchmark data sets. Results: The approach provides data needed to evaluate combinations of statistical measurements for ability to identify patterns of interest in the data. Through application of the tools to a benchmark data set for dose-response threshold and to SBRT lung data sets, an algorithm was developed that uses receiver operator characteristic curves to identify a threshold value and combines use of contingency tables, Fisher exact tests, Welch t-tests, and Kolmogorov-Smirnov tests to filter the large data set to identify values demonstrating dose-response. Kullback-Leibler divergences were used to provide additional confirmation. Conclusions: The work demonstrates the viability of the design approach and the software tool for analysis of large data sets. PMID:24320426

Demonstration of a software design and statistical analysis methodology with application to patient outcomes data sets.

PubMed

Mayo, Charles; Conners, Steve; Warren, Christopher; Miller, Robert; Court, Laurence; Popple, Richard

2013-11-01

With emergence of clinical outcomes databases as tools utilized routinely within institutions, comes need for software tools to support automated statistical analysis of these large data sets and intrainstitutional exchange from independent federated databases to support data pooling. In this paper, the authors present a design approach and analysis methodology that addresses both issues. A software application was constructed to automate analysis of patient outcomes data using a wide range of statistical metrics, by combining use of C#.Net and R code. The accuracy and speed of the code was evaluated using benchmark data sets. The approach provides data needed to evaluate combinations of statistical measurements for ability to identify patterns of interest in the data. Through application of the tools to a benchmark data set for dose-response threshold and to SBRT lung data sets, an algorithm was developed that uses receiver operator characteristic curves to identify a threshold value and combines use of contingency tables, Fisher exact tests, Welch t-tests, and Kolmogorov-Smirnov tests to filter the large data set to identify values demonstrating dose-response. Kullback-Leibler divergences were used to provide additional confirmation. The work demonstrates the viability of the design approach and the software tool for analysis of large data sets.

Preparing for Euro 2012: developing a hazard risk assessment.

PubMed

Wong, Evan G; Razek, Tarek; Luhovy, Artem; Mogilevkina, Irina; Prudnikov, Yuriy; Klimovitskiy, Fedor; Yutovets, Yuriy; Khwaja, Kosar A; Deckelbaum, Dan L

2015-04-01

Risk assessment is a vital step in the disaster-preparedness continuum as it is the foundation of subsequent phases, including mitigation, response, and recovery. To develop a risk assessment tool geared specifically towards the Union of European Football Associations (UEFA) Euro 2012. In partnership with the Donetsk National Medical University, Donetsk Research and Development Institute of Traumatology and Orthopedics, Donetsk Regional Public Health Administration, and the Ministry of Emergency of Ukraine, a table-based tool was created, which, based on historical evidence, identifies relevant potential threats, evaluates their impacts and likelihoods on graded scales based on previous available data, identifies potential mitigating shortcomings, and recommends further mitigation measures. This risk assessment tool has been applied in the vulnerability-assessment-phase of the UEFA Euro 2012. Twenty-three sub-types of potential hazards were identified and analyzed. Ten specific hazards were recognized as likely to very likely to occur, including natural disasters, bombing and blast events, road traffic collisions, and disorderly conduct. Preventative measures, such as increased stadium security and zero tolerance for impaired driving, were recommended. Mitigating factors were suggested, including clear, incident-specific preparedness plans and enhanced inter-agency communication. This hazard risk assessment tool is a simple aid in vulnerability assessment, essential for disaster preparedness and response, and may be applied broadly to future international events.

Virus-Like-Vaccines against HIV

PubMed Central

Andersson, Anne-Marie C.; Schwerdtfeger, Melanie; Holst, Peter J.

2018-01-01

Protection against chronic infections has necessitated the development of ever-more potent vaccination tools. HIV seems to be the most challenging foe, with a remarkable, poorly immunogenic and fragile surface glycoprotein and the ability to overpower the cell immune system. Virus-like-particle (VLP) vaccines have emerged as potent inducers of antibody and helper T cell responses, while replication-deficient viral vectors have yielded potent cytotoxic T cell responses. Here, we review the emerging concept of merging these two technologies into virus-like-vaccines (VLVs) for the targeting of HIV. Such vaccines are immunologically perceived as viruses, as they infect cells and produce VLPs in situ, but they only resemble viruses, as the replication defective vectors and VLPs cannot propagate an infection. The inherent safety of such a platform, despite robust particle production, is a distinct advantage over live-attenuated vaccines that must balance safety and immunogenicity. Previous studies have delivered VLVs encoded in modified Vaccinia Ankara vectors and we have developed the concept into a single-reading adenovirus-based technology capable of eliciting robust CD8+ and CD4+ T cells responses and trimer binding antibody responses. Such vaccines offer the potential to display the naturally produced immunogen directly and induce an integrated humoral and cellular immune response. PMID:29439476

Virus-Like-Vaccines against HIV.

PubMed

Andersson, Anne-Marie C; Schwerdtfeger, Melanie; Holst, Peter J

2018-02-11

Protection against chronic infections has necessitated the development of ever-more potent vaccination tools. HIV seems to be the most challenging foe, with a remarkable, poorly immunogenic and fragile surface glycoprotein and the ability to overpower the cell immune system. Virus-like-particle (VLP) vaccines have emerged as potent inducers of antibody and helper T cell responses, while replication-deficient viral vectors have yielded potent cytotoxic T cell responses. Here, we review the emerging concept of merging these two technologies into virus-like-vaccines (VLVs) for the targeting of HIV. Such vaccines are immunologically perceived as viruses, as they infect cells and produce VLPs in situ, but they only resemble viruses, as the replication defective vectors and VLPs cannot propagate an infection. The inherent safety of such a platform, despite robust particle production, is a distinct advantage over live-attenuated vaccines that must balance safety and immunogenicity. Previous studies have delivered VLVs encoded in modified Vaccinia Ankara vectors and we have developed the concept into a single-reading adenovirus-based technology capable of eliciting robust CD8⁺ and CD4⁺ T cells responses and trimer binding antibody responses. Such vaccines offer the potential to display the naturally produced immunogen directly and induce an integrated humoral and cellular immune response.

Emergency nurses' evaluation of observational pain assessment tools for older people with cognitive impairment.

PubMed

Fry, Margaret; Arendts, Glenn; Chenoweth, Lynn

2017-05-01

To explore emergency nurses' perceptions of the feasibility and utility of Pain Assessment in Advanced Dementia tool in people over 65 with cognitive impairment. The Pain Assessment in Advanced Dementia tool was then compared with The Abbey Pain Scale, Doloplus-2 and PACSLAC. The objective was to determine which observational pain assessment tool was the most appropriate for the emergency department context and the cognitively impaired older person. The number of older people with cognitive impairment conditions, such as dementia, presenting to the emergency department is increasing. Approximately 28% of people over 65 years who present will have cognitive impairment. Older people with cognitive impairment often receive suboptimal pain management in the ED. There is limited evidence of the use and/or appropriateness of dementia-specific pain observation assessment tools in the ED. This was a multicentre exploratory qualitative study, which was conducted within a constructivist paradigm. Focus group interviews were conducted with nurses across three hospital emergency departments. Data were subject to thematic analysis. Six focus groups were conducted with 36 nurses over a 12-week period. Four themes emerged from the analysis: 1) cognitive impairment is a barrier to pain management; 2) PAINAD gives structure to pain assessment; 3) PAINAD assists to convey pain intensity; and 4) selection of an appropriate observational pain assessment tool. This study identified that emergency nurses find it challenging to detect, assess and manage pain in cognitively impaired people. While the use of the PAINAD helped to address these challenges compared to other tools, nurses also identified the important role that family and carers can play in pain assessment and management for older people with cognitive impairment. This study has generated new knowledge that has broad application across clinical settings, which can assist to transform pain management practice and reduce human suffering. The use of an observational pain assessment tool can provide for greater practice consistency for patients with communication difficulties. Pain management for older people with cognitive impairment is best achieved by the use an appropriate observational pain assessment tool and with a multidisciplinary approach that includes the person and their family/carer. © 2016 John Wiley & Sons Ltd.

National Library of Medicine

MedlinePlus

... Disasters and Public Health Emergencies The NLM Disaster Information Management Research Center has tools, guides, and databases to ... Disasters and Public Health Emergencies The NLM Disaster Information Management Research Center has tools, guides, and databases to ...

Rural Emergency Medical Services (EMS) and Trauma

MedlinePlus

... Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning Tools Testing New Approaches Rural Health IT ... to the 2015 WWAMI Rural Health Research Center report, Prehospital Emergency Medical Services Personnel in Rural Areas: ...

Operational Research during the Ebola Emergency.

PubMed

Fitzpatrick, Gabriel; Decroo, Tom; Draguez, Bertrand; Crestani, Rosa; Ronsse, Axelle; Van den Bergh, Rafael; Van Herp, Michel

2017-07-01

Operational research aims to identify interventions, strategies, or tools that can enhance the quality, effectiveness, or coverage of programs where the research is taking place. Médecins Sans Frontières admitted ≈5,200 patients with confirmed Ebola virus disease during the Ebola outbreak in West Africa and from the beginning nested operational research within its emergency response. This research covered critical areas, such as understanding how the virus spreads, clinical trials, community perceptions, challenges within Ebola treatment centers, and negative effects on non-Ebola healthcare. Importantly, operational research questions were decided to a large extent by returning volunteers who had first-hand knowledge of the immediate issues facing teams in the field. Such a method is appropriate for an emergency medical organization. Many challenges were also identified while carrying out operational research across 3 different countries, including the basic need for collecting data in standardized format to enable comparison of findings among treatment centers.

Exploiting virus-like particles as innovative vaccines against emerging viral infections.

PubMed

Jeong, Hotcherl; Seong, Baik Lin

2017-03-01

Emerging viruses pose a major threat to humans and livestock with global public health and economic burdens. Vaccination remains an effective tool to reduce this threat, and yet, the conventional cell culture often fails to produce sufficient vaccine dose. As an alternative to cell-culture based vaccine, virus-like particles (VLPs) are considered as a highpriority vaccine strategy against emerging viruses. VLPs represent highly ordered repetitive structures via macromolecular assemblies of viral proteins. The particulate nature allows efficient uptake into antigen presenting cells stimulating both innate and adaptive immune responses towards enhanced vaccine efficacy. Increasing research activity and translation opportunity necessitate the advances in the design of VLPs and new bioprocessing modalities for efficient and cost-effective production. Herein, we describe major achievements and challenges in this endeavor, with respect to designing strategies to harnessing the immunogenic potential, production platforms, downstream processes, and some exemplary cases in developing VLP-based vaccines.

Spike-train spectra and network response functions for non-linear integrate-and-fire neurons.

PubMed

Richardson, Magnus J E

2008-11-01

Reduced models have long been used as a tool for the analysis of the complex activity taking place in neurons and their coupled networks. Recent advances in experimental and theoretical techniques have further demonstrated the usefulness of this approach. Despite the often gross simplification of the underlying biophysical properties, reduced models can still present significant difficulties in their analysis, with the majority of exact and perturbative results available only for the leaky integrate-and-fire model. Here an elementary numerical scheme is demonstrated which can be used to calculate a number of biologically important properties of the general class of non-linear integrate-and-fire models. Exact results for the first-passage-time density and spike-train spectrum are derived, as well as the linear response properties and emergent states of recurrent networks. Given that the exponential integrate-fire model has recently been shown to agree closely with the experimentally measured response of pyramidal cells, the methodology presented here promises to provide a convenient tool to facilitate the analysis of cortical-network dynamics.

Disaster Vulnerability of Hospitals: A Nationwide Surveillance in Japan.

PubMed

Ochi, Sae; Kato, Shigeaki; Kobayashi, Kenichi; Kanatani, Yasuhiro

2015-12-01

Hospital preparedness against disasters is key to achieving disaster mitigation for health. To gain a holistic view of hospitals in Japan, one of the most disaster-prone countries, a nationwide surveillance of hospital preparedness was conducted. A cross-sectional, paper-based interview was conducted that targeted all of the 8701 registered hospitals in Japan. Preparedness was assessed with regard to local hazards, compliance to building code, and preparation of resources such as electricity, water, communication tools, and transportation tools. Answers were obtained from 6122 hospitals (response rate: 70.3%), among which 20.5% were public (national or city-run) hospitals and others were private. Eight percent were the hospitals assigned as disaster-base hospitals and the others were non-disaster-base hospitals. Overall compliance to building code, power generators, water tanks, emergency communication tools, and helicopter platforms was 90%, 84%, 95%, 43%, and 22%, respectively. Major vulnerabilities in logistics in mega-cities and stockpiles required for chronic care emerged from the results of this nationwide surveillance of hospitals in Japan. To conduct further intensive surveillance to meet community health needs, appropriate sampling methods should be established on the basis of this preliminary study. Holistic vulnerability analysis of community hospitals will lead to more robust disaster mitigation at the local level.

Scheduling unplanned surgery: a tool for improving dialogue about queue position on emergency theatre lists.

PubMed

Fitzgerald, Janna; Lum, Martin; Dadich, Ann

2006-05-01

Theatre use is heavily influenced by the presentation and scheduling of emergency cases for unplanned surgery. This research guided the development of a triage standard for scheduling emergency surgery in New South Wales public hospitals and aimed to contribute to a better understanding of decision-making practices. An emergency-surgery survey asked questions about urgency of a set of clinical conditions and appropriate time frames for patients to receive surgical treatment for these conditions. Surveys were distributed via 71 NSW public hospitals. A total of 198 decision makers responded: surgeons (42.8%), anaesthetists (24.7%), and nurses (32.5%). Principal component analysis was applied to reduce the data to three urgency classifications, and analysis of variance was used to assess variance of opinions between professional groups. The data suggested that the parameters that distinguish the codes (1, very urgent; 2, semi-urgent; 3, least urgent) were not unequivocally apparent. Although there was a consistent approach to the "urgency 1" and "urgency 3" categories, there were significant differences between responses when determining "urgency 2". The data indicated that when making decisions, anaesthetists act as intermediaries between surgeons and nurses. There was significant disparity between individuals when respondents were asked to state an ideal time for the commencement of surgery and the maximum length of time that the surgery could wait. This presented a need for a risk assessment tool to be incorporated when developing a dynamic prototype triage instrument.

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.

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

Being Social: Integrating Social Media into Public Information Support to Emergency Response #smem

DTIC Science & Technology

2013-03-01

used extensively to help connect citizens with pets and to help locate missing hospital records.55 This information can be helpful to the homeland...principles offer reliable tools for successful use of social media. The mention to be careful with “tiny URLs” is an unusual inclusion and seems...20–26. 55 that social media can meet. Self-regulation and careful administration are elements that serve to ensure that the sites that are

Bridging the Gap: Developing a Tool to Support Local Civilian and Military Disaster Preparedness

DTIC Science & Technology

2010-01-01

HSC, 2005), the National Strategy for Physical Protection of Critical Infrastructures and Key Assets (DHS, 2003b), the National Strategy for Mari- time...10-2501 (p. 46), The installation CEMP 10-2 provides comprehensive guidance for emergency response to physical threats resulting from major accidents...installations must develop a CEMP 10-2 using the AF [Air Force] template to address the physical threats to their base. . . . The CEMP 10-2 should be

Modeling, Simulation, and Analysis for State and Local Emergency Planning and Response: Concept of Operations

DTIC Science & Technology

2009-01-01

must be considered for each threat. The Department of Homeland Security (DHS) has defined 15 National Planning Scenarios ( NPSs ), along with a...considered how to incorporate the 15 NPSs and the Target Capabilities List developed by DHS. Finally, we considered the work being done by Dr. Charles...suite of models and other tools hampers effective planning and re- sponse for all hazards, including the NPSs . The ES community has many meth- ods

Adaptive Leadership in Times of Crisis

DTIC Science & Technology

2011-12-01

HAyASHI AnD AMEy Soo Chiemi Hayashi is Research Director of the Risk Response Network at the World Economic Forum . Amey Soo is a Researcher at the...and the resulting complexities of this world. after each crisis it must be the goal of author- ities to learn from the lessons that emerged and...digital media, which offers essential tools that anyone aspiring to lead in the 21st century must master. Learning from its past mistakes, the

Translational PK/PD of Anti-Infective Therapeutics

PubMed Central

Rathi, Chetan; Lee, Richard E.; Meibohm, Bernd

2016-01-01

Translational PK/PD modeling has emerged as a critical technique for quantitative analysis of the relationship between dose, exposure and response of antibiotics. By combining model components for pharmacokinetics, bacterial growth kinetics and concentration-dependent drug effects, these models are able to quantitatively capture and simulate the complex interplay between antibiotic, bacterium and host organism. Fine-tuning of these basic model structures allows to further account for complicating factors such as resistance development, combination therapy, or host responses. With this tool set at hand, mechanism-based PK/PD modeling and simulation allows to develop optimal dosing regimens for novel and established antibiotics for maximum efficacy and minimal resistance development. PMID:27978987

Non-coding RNAs and Their Roles in Stress Response in Plants.

PubMed

Wang, Jingjing; Meng, Xianwen; Dobrovolskaya, Oxana B; Orlov, Yuriy L; Chen, Ming

2017-10-01

Eukaryotic genomes encode thousands of non-coding RNAs (ncRNAs), which play crucial roles in transcriptional and post-transcriptional regulation of gene expression. Accumulating evidence indicates that ncRNAs, especially microRNAs (miRNAs) and long ncRNAs (lncRNAs), have emerged as key regulatory molecules in plant stress responses. In this review, we have summarized the current progress on the understanding of plant miRNA and lncRNA identification, characteristics, bioinformatics tools, and resources, and provided examples of mechanisms of miRNA- and lncRNA-mediated plant stress tolerance. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Occurrence and overlap of natural disasters, complex emergencies and epidemics during the past decade (1995–2004)

PubMed Central

Spiegel, Paul B; Le, Phuoc; Ververs, Mija-Tesse; Salama, Peter

2007-01-01

Background The fields of expertise of natural disasters and complex emergencies (CEs) are quite distinct, with different tools for mitigation and response as well as different types of competent organizations and qualified professionals who respond. However, natural disasters and CEs can occur concurrently in the same geographic location, and epidemics can occur during or following either event. The occurrence and overlap of these three types of events have not been well studied. Methods All natural disasters, CEs and epidemics occurring within the past decade (1995–2004) that met the inclusion criteria were included. The largest 30 events in each category were based on the total number of deaths recorded. The main databases used were the Emergency Events Database for natural disasters, the Uppsala Conflict Database Program for CEs and the World Health Organization outbreaks archive for epidemics. Analysis During the past decade, 63% of the largest CEs had ≥1 epidemic compared with 23% of the largest natural disasters. Twenty-seven percent of the largest natural disasters occurred in areas with ≥1 ongoing CE while 87% of the largest CEs had ≥1 natural disaster. Conclusion Epidemics commonly occur during CEs. The data presented in this article do not support the often-repeated assertion that epidemics, especially large-scale epidemics, commonly occur following large-scale natural disasters. This observation has important policy and programmatic implications when preparing and responding to epidemics. There is an important and previously unrecognized overlap between natural disasters and CEs. Training and tools are needed to help bridge the gap between the different type of organizations and professionals who respond to natural disasters and CEs to ensure an integrated and coordinated response. PMID:17411460

Development of Tool Representations in the Dorsal and Ventral Visual Object Processing Pathways.

PubMed

Kersey, Alyssa J; Clark, Tyia S; Lussier, Courtney A; Mahon, Bradford Z; Cantlon, Jessica F

2016-07-01

Tools represent a special class of objects, because they are processed across both the dorsal and ventral visual object processing pathways. Three core regions are known to be involved in tool processing: the left posterior middle temporal gyrus, the medial fusiform gyrus (bilaterally), and the left inferior parietal lobule. A critical and relatively unexplored issue concerns whether, in development, tool preferences emerge at the same time and to a similar degree across all regions of the tool-processing network. To test this issue, we used functional magnetic resonance imaging to measure the neural amplitude, peak location, and the dispersion of tool-related neural responses in the youngest sample of children tested to date in this domain (ages 4-8 years). We show that children recruit overlapping regions of the adult tool-processing network and also exhibit similar patterns of co-activation across the network to adults. The amplitude and co-activation data show that the core components of the tool-processing network are established by age 4. Our findings on the distributions of peak location and dispersion of activation indicate that the tool network undergoes refinement between ages 4 and 8 years. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Enhancing Leadership Quality. TQ Source Tips & Tools: Emerging Strategies to Enhance Educator Quality

ERIC Educational Resources Information Center

National Comprehensive Center for Teacher Quality, 2008

2008-01-01

Teaching Quality (TQ) Source Tips & Tools: Emerging Strategies to Enhance Educator Quality is an online resource developed by the TQ Center. It is designed to help education practitioners tap into strategies and resources they can use to enhance educator quality. This publication is based on the TQ Source Tips & Tools topic area "Enhancing…

Prediction and perception of hazards in professional drivers: Does hazard perception skill differ between safe and less-safe fire-appliance drivers?

PubMed

Crundall, David; Kroll, Victoria

2018-05-18

Can hazard perception testing be useful for the emergency services? Previous research has found emergency response drivers' (ERDs) to perform better than controls, however these studies used clips of normal driving. In contrast, the current study filmed footage from a fire-appliance on blue-light training runs through Nottinghamshire, and endeavoured to discriminate between different groups of EDRs based on experience and collision risk. Thirty clips were selected to create two variants of the hazard perception test: a traditional push-button test requiring speeded-responses to hazards, and a prediction test that occludes at hazard onset and provides four possible outcomes for participants to choose between. Three groups of fire-appliance drivers (novices, low-risk experienced and high-risk experienced), and age-matched controls undertook both tests. The hazard perception test only discriminated between controls and all FA drivers, whereas the hazard prediction test was more sensitive, discriminating between high and low-risk experienced fire appliance drivers. Eye movement analyses suggest that the low-risk drivers were better at prioritising the hazardous precursors, leading to better predictive accuracy. These results pave the way for future assessment and training tools to supplement emergency response driver training, while supporting the growing literature that identifies hazard prediction as a more robust measure of driver safety than traditional hazard perception tests. Copyright © 2018 Elsevier Ltd. All rights reserved.

Portable Neutron Sensors for Emergency Response Operations

DOE Office of Scientific and Technical Information (OSTI.GOV)

,

2012-06-24

This article presents the experimental work performed in the area of neutron detector development at the Remote Sensing Laboratory–Andrews Operations (RSL-AO) sponsored by the U.S. Department of Energy, National Nuclear Security Administration (NNSA) in the last four years. During the 1950s neutron detectors were developed mostly to characterize nuclear reactors where the neutron flux is high. Due to the indirect nature of neutron detection via interaction with other particles, neutron counting and neutron energy measurements have never been as precise as gamma-ray counting measurements and gamma-ray spectroscopy. This indirect nature is intrinsic to all neutron measurement endeavors (except perhaps formore » neutron spin-related experiments, viz. neutron spin-echo measurements where one obtains μeV energy resolution). In emergency response situations generally the count rates are low, and neutrons may be scattered around in inhomogeneous intervening materials. It is also true that neutron sensors are most efficient for the lowest energy neutrons, so it is not as easy to detect and count energetic neutrons. Most of the emergency response neutron detectors are offshoots of nuclear device diagnostics tools and special nuclear materials characterization equipment, because that is what is available commercially. These instruments mostly are laboratory equipment, and not field-deployable gear suited for mobile teams. Our goal is to design and prototype field-deployable, ruggedized, lightweight, efficient neutron detectors.« less

A Novel Tool for Assessment of Emergency Medicine Resident Skill in Determining Diagnosis and Management for Emergent Electrocardiograms: A Multicenter Study.

PubMed

Hartman, Nicholas D; Wheaton, Natasha B; Williamson, Kelly; Quattromani, Erin N; Branzetti, Jeremy B; Aldeen, Amer Z

2016-12-01

Reading emergent electrocardiograms (ECGs) is one of the emergency physician's most crucial tasks, yet no well-validated tool exists to measure resident competence in this skill. To assess validity of a novel tool measuring emergency medicine resident competency for interpreting, and responding to, critical ECGs. In addition, we aim to observe trends in this skill for resident physicians at different levels of training. This is a multi-center, prospective study of postgraduate year (PGY) 1-4 residents at five emergency medicine (EM) residency programs in the United States. An assessment tool was created that asks the physician to identify either the ECG diagnosis or the best immediate management. One hundred thirteen EM residents from five EM residency programs submitted completed assessment surveys, including 43 PGY-1s, 33 PGY-2s, and 37 PGY-3/4s. PGY-3/4s averaged 74.6% correct (95% confidence interval [CI] 70.9-78.4) and performed significantly better than PGY-1s, who averaged 63.2% correct (95% CI 58.0-68.3). PGY-2s averaged 69.0% (95% CI 62.2-73.7). Year-to-year differences were more pronounced in management than in diagnosis. Residency training in EM seems to be associated with improved ability to interpret "critical" ECGs as measured by our assessment tool. This lends validity evidence for the tool by correlating with a previously observed association between residency training and improved ECG interpretation. Resident skill in ECG interpretation remains less than ideal. Creation of this sort of tool may allow programs to assess resident performance as well as evaluate interventions designed to improve competency. Copyright © 2016 Elsevier Inc. All rights reserved.

Nanotechnology: emerging tool for diagnostics and therapeutics.

PubMed

Chakraborty, Mainak; Jain, Surangna; Rani, Vibha

2011-11-01

Nanotechnology is an emerging technology which is an amalgamation of different aspects of science and technology that includes disciplines such as electrical engineering, mechanical engineering, biology, physics, chemistry, and material science. It has potential in the fields of information and communication technology, biotechnology, and medicinal technology. It involves manipulating the dimensions of nanoparticles at an atomic scale to make use of its physical and chemical properties. All these properties are responsible for the wide application of nanoparticles in the field of human health care. Promising new technologies based on nanotechnology are being utilized to improve diverse aspects of medical treatments like diagnostics, imaging, and gene and drug delivery. This review summarizes the most promising nanomaterials and their application in human health.

Metabolic pathways for the whole community.

PubMed

Hanson, Niels W; Konwar, Kishori M; Hawley, Alyse K; Altman, Tomer; Karp, Peter D; Hallam, Steven J

2014-07-22

A convergence of high-throughput sequencing and computational power is transforming biology into information science. Despite these technological advances, converting bits and bytes of sequence information into meaningful insights remains a challenging enterprise. Biological systems operate on multiple hierarchical levels from genomes to biomes. Holistic understanding of biological systems requires agile software tools that permit comparative analyses across multiple information levels (DNA, RNA, protein, and metabolites) to identify emergent properties, diagnose system states, or predict responses to environmental change. Here we adopt the MetaPathways annotation and analysis pipeline and Pathway Tools to construct environmental pathway/genome databases (ePGDBs) that describe microbial community metabolism using MetaCyc, a highly curated database of metabolic pathways and components covering all domains of life. We evaluate Pathway Tools' performance on three datasets with different complexity and coding potential, including simulated metagenomes, a symbiotic system, and the Hawaii Ocean Time-series. We define accuracy and sensitivity relationships between read length, coverage and pathway recovery and evaluate the impact of taxonomic pruning on ePGDB construction and interpretation. Resulting ePGDBs provide interactive metabolic maps, predict emergent metabolic pathways associated with biosynthesis and energy production and differentiate between genomic potential and phenotypic expression across defined environmental gradients. This multi-tiered analysis provides the user community with specific operating guidelines, performance metrics and prediction hazards for more reliable ePGDB construction and interpretation. Moreover, it demonstrates the power of Pathway Tools in predicting metabolic interactions in natural and engineered ecosystems.

Artificial Muscles Based on Electroactive Polymers as an Enabling Tool in Biomimetics

NASA Technical Reports Server (NTRS)

Bar-Cohen, Y.

2007-01-01

Evolution has resolved many of nature's challenges leading to working and lasting solutions that employ principles of physics, chemistry, mechanical engineering, materials science, and many other fields of science and engineering. Nature's inventions have always inspired human achievements leading to effective materials, structures, tools, mechanisms, processes, algorithms, methods, systems, and many other benefits. Some of the technologies that have emerged include artificial intelligence, artificial vision, and artificial muscles, where the latter is the moniker for electroactive polymers (EAPs). To take advantage of these materials and make them practical actuators, efforts are made worldwide to develop capabilities that are critical to the field infrastructure. Researchers are developing analytical model and comprehensive understanding of EAP materials response mechanism as well as effective processing and characterization techniques. The field is still in its emerging state and robust materials are still not readily available; however, in recent years, significant progress has been made and commercial products have already started to appear. In the current paper, the state-of-the-art and challenges to artificial muscles as well as their potential application to biomimetic mechanisms and devices are described and discussed.

Leveraging Social Computing for Personalized Crisis Communication using Social Media

PubMed Central

Leykin, Dmitry; Aharonson-Daniel, Limor; Lahad, Mooli

2016-01-01

Introduction: The extensive use of social media in modern life redefines social interaction and communication. Communication plays an important role in mitigating, or exacerbating, the psychological and behavioral responses to critical incidents and disasters. As recent disasters demonstrated, people tend to converge to social media during and following emergencies. Authorities can then use this media and other computational methods to gain insights from the public, mainly to enhance situational awareness, but also to improve their communication with the public and public adherence to instructions. Methods: The current review presents a conceptual framework for studying psychological aspects of crisis and risk communication using the social media through social computing. Results: Advanced analytical tools can be integrated in the processes and objectives of crisis communication. The availability of the computational techniques can improve communication with the public by a process of Hyper-Targeted Crisis Communication. Discussion: The review suggests that using advanced computational tools for target-audience profiling and linguistic matching in social media, can facilitate more sensitive and personalized emergency communication. PMID:27092290

Advanced Planning for Tsunamis in California

NASA Astrophysics Data System (ADS)

Miller, K.; Wilson, R. I.; Larkin, D.; Reade, S.; Carnathan, D.; Davis, M.; Nicolini, T.; Johnson, L.; Boldt, E.; Tardy, A.

2013-12-01

The California Tsunami Program is comprised of the California Governor's Office of Emergency Services (CalOES) and the California Geological Survey (CGS) and funded through the National Tsunami Hazard Mitigation Program (NTHMP) and the Federal Emergency Management Agency (FEMA). The program works closely with the 20 coastal counties in California, as well as academic, and industry experts to improve tsunami preparedness and mitigation in shoreline communities. Inundation maps depicting 'worst case' inundation modeled from plausible sources around the Pacific were released in 2009 and have provided a foundation for public evacuation and emergency response planning in California. Experience during recent tsunamis impacting the state (Japan 2011, Chile 2010, Samoa 2009) has brought to light the desire by emergency managers and decision makers for even more detailed information ahead of future tsunamis. A solution to provide enhanced information has been development of 'playbooks' to plan for a variety of expected tsunami scenarios. Elevation 'playbook' lines can be useful for partial tsunami evacuations when enough information about forecast amplitude and arrival times is available to coastal communities and there is sufficient time to make more educated decisions about who to evacuate for a given scenario or actual event. NOAA-issued Tsunami Alert Bulletins received in advance of a distant event will contain an expected wave height (a number) for each given section of coast. Provision of four elevation lines for possible inundation enables planning for different evacuation scenarios based on the above number potentially alleviating the need for an 'all or nothing' decision with regard to evacuation. Additionally an analytical tool called FASTER is being developed to integrate storm, tides, modeling errors, and local tsunami run-up potential with the forecasted tsunami amplitudes in real-time when a tsunami Alert is sent out. Both of these products will help communities better implement evacuations and response activities for minor to moderate (less than maximum) tsunami events. A working group comprised of federal, state, and local governmental scientists, emergency managers, first responders, and community planners has explored details and delivery of the above tools for incorporation into emergency management protocols. The eventual outcome will be inclusion in plans, testing of protocols and methods via drills and exercises and application, as appropriate, during an impending tsunami event.

Damage extraction of buildings in the 2015 Gorkha, Nepal earthquake from high-resolution SAR data

NASA Astrophysics Data System (ADS)

Yamazaki, Fumio; Bahri, Rendy; Liu, Wen; Sasagawa, Tadashi

2016-05-01

Satellite remote sensing is recognized as one of the effective tools for detecting and monitoring affected areas due to natural disasters. Since SAR sensors can capture images not only at daytime but also at nighttime and under cloud-cover conditions, they are especially useful at an emergency response period. In this study, multi-temporal high-resolution TerraSAR-X images were used for damage inspection of the Kathmandu area, which was severely affected by the April 25, 2015 Gorkha Earthquake. The SAR images obtained before and after the earthquake were utilized for calculating the difference and correlation coefficient of backscatter. The affected areas were identified by high values of the absolute difference and low values of the correlation coefficient. The post-event high-resolution optical satellite images were employed as ground truth data to verify our results. Although it was difficult to estimate the damage levels for individual buildings, the high resolution SAR images could illustrate their capability in detecting collapsed buildings at emergency response times.

Public health, GIS, and the internet.

PubMed

Croner, Charles M

2003-01-01

Internet access and use of georeferenced public health information for GIS application will be an important and exciting development for the nation's Department of Health and Human Services and other health agencies in this new millennium. Technological progress toward public health geospatial data integration, analysis, and visualization of space-time events using the Web portends eventual robust use of GIS by public health and other sectors of the economy. Increasing Web resources from distributed spatial data portals and global geospatial libraries, and a growing suite of Web integration tools, will provide new opportunities to advance disease surveillance, control, and prevention, and insure public access and community empowerment in public health decision making. Emerging supercomputing, data mining, compression, and transmission technologies will play increasingly critical roles in national emergency, catastrophic planning and response, and risk management. Web-enabled public health GIS will be guided by Federal Geographic Data Committee spatial metadata, OpenGIS Web interoperability, and GML/XML geospatial Web content standards. Public health will become a responsive and integral part of the National Spatial Data Infrastructure.

Federal Emergency Management Information System (FEMIS) System Administration Guide for FEMIS Version 1.4.6

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arp, J.A.; Bower, J.C.; Burnett, R.A.

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 areamore » 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.« less

Federal Emergency Management Information System (FEMIS), Installation Guide for FEMIS 1.4.6

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arp, J.A.; Burnett, R.A.; Carter, R.J.

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 areamore » 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.« less

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Angel, L.K.; Bower, J.C.; Burnett, R.A.

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 areamore » 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.« less

Evolution and population genetics of exotic and reemerging pathogens: traditional and novel tools and approaches

Treesearch

N.J. Grünwald; E.M. Goss

2011-01-01

Given human population growth and accelerated global trade, the rate of emergence of exotic plant pathogens is bound to increase. Understanding the processes that lead to the emergence of new pathogens can help manage emerging epidemics. Novel tools for analyzing population genetic variation can be used to infer the evolutionary history of populations or species,...

aLicante sUrgical Community Emergencies New Tool for the enUmeration of Morbidities: a simplified auditing tool for community-acquired gastrointestinal surgical emergencies.

PubMed

Villodre, Celia; Rebasa, Pere; Estrada, José Luís; Zaragoza, Carmen; Zapater, Pedro; Mena, Luís; Lluís, Félix

2016-11-01

In a previous study, we found that Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) overpredicts morbidity risk in emergency gastrointestinal surgery. Our aim was to find a POSSUM equation adjustment. A prospective observational study was performed on 2,361 patients presenting with a community-acquired gastrointestinal surgical emergency. The first 1,000 surgeries constituted the development cohort, the second 1,000 events were the first validation intramural cohort, and the remaining 361 cases belonged to a second validation extramural cohort. (1) A modified POSSUM equation was obtained. (2) Logistic regression was used to yield a statistically significant equation that included age, hemoglobin, white cell count, sodium and operative severity. (3) A chi-square automatic interaction detector decision tree analysis yielded a statistically significant equation with 4 variables, namely cardiac failure, sodium, operative severity, and peritoneal soiling. A modified POSSUM equation and a simplified scoring system (aLicante sUrgical Community Emergencies New Tool for the enUmeration of Morbidities [LUCENTUM]) are described. Both tools significantly improve prediction of surgical morbidity in community-acquired gastrointestinal surgical emergencies. Copyright © 2016 Elsevier Inc. All rights reserved.

Outcome Measures in Myasthenia Gravis: Incorporation Into Clinical Practice.

PubMed

Muppidi, Srikanth

2017-03-01

The development of validated assessment tools for evaluating disease status and response to interventions in patients with myasthenia gravis (MG) has been driven by clinical studies of emerging MG therapies. However, only a small proportion of MG-focused neurology practices have adopted these assessment tools for routine clinical use. This article reviews the suitability of 5 assessment instruments for incorporation into clinical practice, which should be driven by their ability to contribute to improved patient outcomes, and to be implemented within practice personnel and resource constraints. It is recommended that assessments based on both physician-evaluated and patient-reported outcomes be selected, to adequately evaluate both point-in-time symptom load and functional impact of MG symptoms over time. Provider resource allocation and reimbursement issues may be the most significant roadblocks to successful ongoing use of these tools; to that end, the addition of regular assessments to MG standards of care is recommended.

Implementing Liberia's poverty reduction strategy: An assessment of emergency and essential surgical care.

PubMed

Sherman, Lawrence; Clement, Peter T; Cherian, Meena N; Ndayimirije, Nestor; Noel, Luc; Dahn, Bernice; Gwenigale, Walter T; Kushner, Adam L

2011-01-01

To document infrastructure, personnel, procedures performed, and supplies and equipment available at all county hospitals in Liberia using the World Health Organization Tool for Situational Analysis of Emergency and Essential Surgical Care. Survey of county hospitals using the World Health Organization Tool for Situational Analysis of Emergency and Essential Surgical Care. Sixteen county hospitals in Liberia. Infrastructure, personnel, procedures performed, and supplies and equipment available. Uniformly, gross deficiencies in infrastructure, personnel, and supplies and equipment were identified. The World Health Organization Tool for Situational Analysis of Emergency and Essential Surgical Care was useful in identifying baseline emergency and surgical conditions for evidenced-based planning. To achieve the Poverty Reduction Strategy and delivery of the Basic Package of Health and Social Welfare Services, additional resources and manpower are needed to improve surgical and anesthetic care.

Hazard Analysis of Critical Control Points Assessment as a Tool to Respond to Emerging Infectious Disease Outbreaks

PubMed Central

Edmunds, Kelly L.; Hunter, Paul R.; Few, Roger; Bell, Diana J.

2013-01-01

Highly pathogenic avian influenza virus (HPAI) strain H5N1 has had direct and indirect economic impacts arising from direct mortality and control programmes in over 50 countries reporting poultry outbreaks. HPAI H5N1 is now reported as the most widespread and expensive zoonotic disease recorded and continues to pose a global health threat. The aim of this research was to assess the potential of utilising Hazard Analysis of Critical Control Points (HACCP) assessments in providing a framework for a rapid response to emerging infectious disease outbreaks. This novel approach applies a scientific process, widely used in food production systems, to assess risks related to a specific emerging health threat within a known zoonotic disease hotspot. We conducted a HACCP assessment for HPAI viruses within Vietnam’s domestic poultry trade and relate our findings to the existing literature. Our HACCP assessment identified poultry flock isolation, transportation, slaughter, preparation and consumption as critical control points for Vietnam’s domestic poultry trade. Introduction of the preventative measures highlighted through this HACCP evaluation would reduce the risks posed by HPAI viruses and pressure on the national economy. We conclude that this HACCP assessment provides compelling evidence for the future potential that HACCP analyses could play in initiating a rapid response to emerging infectious diseases. PMID:23967294

Data collection tools for maternal and child health in humanitarian emergencies: a systematic review

PubMed Central

Dickinson, Fiona; Kerr, Robbie; Boschi-Pinto, Cynthia; Mathai, Matthews; van den Broek, Nynke

2015-01-01

Abstract Objective To describe tools used for the assessment of maternal and child health issues in humanitarian emergency settings. Methods We systematically searched MEDLINE, Web of Knowledge and POPLINE databases for studies published between January 2000 and June 2014. We also searched the websites of organizations active in humanitarian emergencies. We included studies reporting the development or use of data collection tools concerning the health of women and children in humanitarian emergencies. We used narrative synthesis to summarize the studies. Findings We identified 100 studies: 80 reported on conflict situations and 20 followed natural disasters. Most studies (76/100) focused on the health status of the affected population while 24 focused on the availability and coverage of health services. Of 17 different data collection tools identified, 14 focused on sexual and reproductive health, nine concerned maternal, newborn and child health and four were used to collect information on sexual or gender-based violence. Sixty-nine studies were done for monitoring and evaluation purposes, 18 for advocacy, seven for operational research and six for needs assessment. Conclusion Practical and effective means of data collection are needed to inform life-saving actions in humanitarian emergencies. There are a wide variety of tools available, not all of which have been used in the field. A simplified, standardized tool should be developed for assessment of health issues in the early stages of humanitarian emergencies. A cluster approach is recommended, in partnership with operational researchers and humanitarian agencies, coordinated by the World Health Organization. PMID:26478629

DyNAVacS: an integrative tool for optimized DNA vaccine design.

PubMed

Harish, Nagarajan; Gupta, Rekha; Agarwal, Parul; Scaria, Vinod; Pillai, Beena

2006-07-01

DNA vaccines have slowly emerged as keystones in preventive immunology due to their versatility in inducing both cell-mediated as well as humoral immune responses. The design of an efficient DNA vaccine, involves choice of a suitable expression vector, ensuring optimal expression by codon optimization, engineering CpG motifs for enhancing immune responses and providing additional sequence signals for efficient translation. DyNAVacS is a web-based tool created for rapid and easy design of DNA vaccines. It follows a step-wise design flow, which guides the user through the various sequential steps in the design of the vaccine. Further, it allows restriction enzyme mapping, design of primers spanning user specified sequences and provides information regarding the vectors currently used for generation of DNA vaccines. The web version uses Apache HTTP server. The interface was written in HTML and utilizes the Common Gateway Interface scripts written in PERL for functionality. DyNAVacS is an integrated tool consisting of user-friendly programs, which require minimal information from the user. The software is available free of cost, as a web based application at URL: http://miracle.igib.res.in/dynavac/.

How linear response shaped models of neural circuits and the quest for alternatives.

PubMed

Herfurth, Tim; Tchumatchenko, Tatjana

2017-10-01

In the past decades, many mathematical approaches to solve complex nonlinear systems in physics have been successfully applied to neuroscience. One of these tools is the concept of linear response functions. However, phenomena observed in the brain emerge from fundamentally nonlinear interactions and feedback loops rather than from a composition of linear filters. Here, we review the successes achieved by applying the linear response formalism to topics, such as rhythm generation and synchrony and by incorporating it into models that combine linear and nonlinear transformations. We also discuss the challenges encountered in the linear response applications and argue that new theoretical concepts are needed to tackle feedback loops and non-equilibrium dynamics which are experimentally observed in neural networks but are outside of the validity regime of the linear response formalism. Copyright © 2017 Elsevier Ltd. All rights reserved.

Use of standardized multidimensional evaluation tools and the emergence of the case manager's professional identity in France.

PubMed

Nugue, Mathilde; De Stampa, Matthieu; Couturier, Yves; Somme, Dominique

2012-01-01

In France, the national public health plan proposes a group of innovations including the initiation of case management for older adults in complex situations, particularly those with cognitive disorders. In this context, public authorities asked case managers to use a standardized multidimensional evaluation tool. The results of a qualitative study on the pertinence of such a tool relative to the emergence of this new professional field are described. Early use of an evaluation tool seems to be linked to the emergence of a new professional identity for recently recruited case managers. Factors determining the strength of this link are training tool standardization, computerization, and local structure's involvement. Our results contribute to identifying one of the ways by which professional identity can be changed to become a case manager.

The use of social media and mobile device applications to disseminate natural hazard information by Natural Resources Canada

NASA Astrophysics Data System (ADS)

Bird, A. L.; Ulmi, M.; Majewski, C.; Hayek, K.; Edwards, W.; McCormack, D. A.; Cole, R. T.; de Paor, D. R.

2011-12-01

Public expectation of near-instant and reliable information is constantly rising. Such expectation puts increasing demands on organizations charged with providing the public with information on hazard events in near-real-time, while ensuring quality and accuracy of content. Natural Resources Canada (NRCan) has responded by augmenting existing methods for earthquake information distribution with new and varied methods for relaying natural hazards information. We profile tools now employed operationally by NRCan to distribute earthquake information to emergency measures organizations, news media and the public. Also presented will be an example of a smart-'phone application which includes several tools for natural hazard preparedness and response, supplemented with automated real-time alerts.

Contextual analysis of immunological response through whole-organ fluorescent imaging.

PubMed

Woodruff, Matthew C; Herndon, Caroline N; Heesters, B A; Carroll, Michael C

2013-09-01

As fluorescent microscopy has developed, significant insights have been gained into the establishment of immune response within secondary lymphoid organs, particularly in draining lymph nodes. While established techniques such as confocal imaging and intravital multi-photon microscopy have proven invaluable, they provide limited insight into the architectural and structural context in which these responses occur. To interrogate the role of the lymph node environment in immune response effectively, a new set of imaging tools taking into account broader architectural context must be implemented into emerging immunological questions. Using two different methods of whole-organ imaging, optical clearing and three-dimensional reconstruction of serially sectioned lymph nodes, fluorescent representations of whole lymph nodes can be acquired at cellular resolution. Using freely available post-processing tools, images of unlimited size and depth can be assembled into cohesive, contextual snapshots of immunological response. Through the implementation of robust iterative analysis techniques, these highly complex three-dimensional images can be objectified into sortable object data sets. These data can then be used to interrogate complex questions at the cellular level within the broader context of lymph node biology. By combining existing imaging technology with complex methods of sample preparation and capture, we have developed efficient systems for contextualizing immunological phenomena within lymphatic architecture. In combination with robust approaches to image analysis, these advances provide a path to integrating scientific understanding of basic lymphatic biology into the complex nature of immunological response.

Professional regulation: a potentially valuable tool in responding to "stem cell tourism".

PubMed

Zarzeczny, Amy; Caulfield, Timothy; Ogbogu, Ubaka; Bell, Peter; Crooks, Valorie A; Kamenova, Kalina; Master, Zubin; Rachul, Christen; Snyder, Jeremy; Toews, Maeghan; Zoeller, Sonja

2014-09-09

The growing international market for unproven stem cell-based interventions advertised on a direct-to-consumer basis over the internet ("stem cell tourism") is a source of concern because of the risks it presents to patients as well as their supporters, domestic health care systems, and the stem cell research field. Emerging responses such as public and health provider-focused education and national regulatory efforts are encouraging, but the market continues to grow. Physicians play a number of roles in the stem cell tourism market and, in many jurisdictions, are members of a regulated profession. In this article, we consider the use of professional regulation to address physician involvement in stem cell tourism. Although it is not without its limitations, professional regulation is a potentially valuable tool that can be employed in response to problematic types of physician involvement in the stem cell tourism market. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Journal of Special Operations Medicine. Volume 10, Edition 3, Summer 2010

DTIC Science & Technology

2010-01-01

team from Bagram to help. This spe- cial team of healthcare providers was utilized by him and the SF medics in other parts of Afghanistan, as well...Give the local doc a set of basic dental tools, not an $8,000 state-of-the-art chair that is not sustainable.” LTC Harrington said he utilized a unique...produced. Furthermore, the SF teams utilize DoD CERP (Commander’s Emergency Response Program) funding for the local purchases, but this tends to take

A Penny for Your Thoughts, a Nickel for Your Heart: The Influence of the Commander’s Emergency Response Program on Insurgency

DTIC Science & Technology

2009-12-01

131 x THIS PAGE INTENTIONALLY LEFT BLANK xi LIST OF FIGURES Figure 2.1. Maslow’s Hierarchy of Needs ...popular needs and a population’s perception of the value they place on various needs based on Maslow’s hierarchy . The deserve component is determined...government that the international actor is trying to legitimize. Maslow’s hierarchy of needs is a useful tool for the analysis of this relationship

The Role of Focused Echocardiography in Pediatric Intensive Care: A Critical Appraisal

PubMed Central

Gaspar, Heloisa Amaral; Morhy, Samira Saady

2015-01-01

Echocardiography is a key tool for hemodynamic assessment in Intensive Care Units (ICU). Focused echocardiography performed by nonspecialist physicians has a limited scope, and the most relevant parameters assessed by focused echocardiography in Pediatric ICU are left ventricular systolic function, fluid responsiveness, cardiac tamponade and pulmonary hypertension. Proper ability building of pediatric emergency care physicians and intensivists to perform focused echocardiography is feasible and provides improved care of severely ill children and thus should be encouraged. PMID:26605333

Innovations in healthcare finance lessons from the 401(k) model.

PubMed

Myers, Chris; Lineen, Jason

2008-10-01

*Escalating health benefit expenses are leading employers to shift more of the costs to their employees. *Global financial services companies and startup entrepreneurs are competing to develop private-sector solutions to capitalize on the ailing and mis-aligned healthcare financing system. *Emerging innovations are targeting insured individuals who are facing increasing responsibility for first-dollar coverage. *Healthcare providers should view patients as individual "price-sensitive payers" as new tools enable them to shop around for services based on cost and quality.

Stennis acquires new ladder truck

NASA Image and Video Library

2009-10-20

The Stennis Space Center Fire Department added to its fire-fighting capabilities with acquisition of a new emergency response vehicle, Ladder-1, for use on-site. The E-One HP78 Aerial Truck is a combination aerial ladder and fire suppression unit and is designed with the latest safety technology. Featuring a 78-foot ladder and a pumping capability of 1,500 gallons per minute, the new truck provides firefighters with a tremendous rescue and fire suppression tool, Stennis Fire Chief Clark Smith said.

Unique Sensor Plane Maps Invisible Toxins for First Responders

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kroutil, Robert; Thomas, Mark; Aten, Keith

A unique airborne emergency response tool, ASPECT is a Los Alamos/U.S. Environmental Protection Agency project that can put chemical and radiological mapping tools in the air over an accident scene. The name ASPECT is an acronym for Airborne Spectral Photometric Environmental Collection Technology. Update, Sept. 19, 2008: Flying over storm-damaged refineries and chemical factories, a twin-engine plane carrying the ASPECT (Airborne Spectral Photometric Environmental Collection Technology) system has been on duty throughout the recent hurricanes that have swept the Florida and Gulf Coast areas. ASPECT is a project of the U.S. U.S. Environmental Protection Agencys National Decontamination Team. Los Alamosmore » National Laboratory leads a science and technology program supporting the EPA and the ASPECT aircraft. Casting about with a combination of airborne photography and infrared spectroscopy, the highly instrumented plane provides emergency responders on the ground with a clear concept of where danger lies, and the nature of the sometimes-invisible plumes that could otherwise kill them. ASPECT is the nations only 24/7 emergency response aircraft with chemical plume mapping capability. Bob Kroutil of Bioscience Division is the project leader, and while he said the team has put in long hours, both on the ground and in the air, its a worthwhile effort. The plane flew over 320 targeted sites in four days, he noted. Prior to the deployment to the Gulf Coast, the plane had been monitoring the Democratic National Convention in Denver, Colorado. Los Alamos National Laboratory Divisions that are supporting ASPECT include, in addition to B-Division, CTN-5: Networking Engineering and IRM-CAS: Communication, Arts, and Services. Leslie Mansell, CTN-5, and Marilyn Pruitt, IRM-CAS, were recognized the the U.S. EPA for their outstanding support to the hurricane response of Gustav in Louisiana and Ike in Texas. The information from the data collected in the most recent event, Hurricane Ike, was sent to the EPA Region 6 Rapid Needs Assessment and the State of Texas Joint Field Office in Austin, Texas. It appears that though there is considerable damage in Galveston and Texas City, there are fewer chemical leaks than during either hurricanes Katrina or Rita. Specific information gathered from the data was reported out to the U.S. Environmental Protection Agency Headquarters, the Federal Emergency Management Agency, the Department of Homeland Security, and the State of Texas Emergency Management Agency.« less

The medical decision model and decision maker tools for management of radiological and nuclear incidents.

PubMed

Koerner, John F; Coleman, C Norman; Murrain-Hill, Paula; FitzGerald, Denis J; Sullivan, Julie M

2014-06-01

Effective decision making during a rapidly evolving emergency such as a radiological or nuclear incident requires timely interim decisions and communications from onsite decision makers while further data processing, consultation, and review are ongoing by reachback experts. The authors have recently proposed a medical decision model for use during a radiological or nuclear disaster, which is similar in concept to that used in medical care, especially when delay in action can have disastrous effects. For decision makers to function most effectively during a complex response, they require access to onsite subject matter experts who can provide information, recommendations, and participate in public communication efforts. However, in the time before this expertise is available or during the planning phase, just-in-time tools are essential that provide critical overview of the subject matter written specifically for the decision makers. Recognizing the complexity of the science, risk assessment, and multitude of potential response assets that will be required after a nuclear incident, the Office of the Assistant Secretary for Preparedness and Response, in collaboration with other government and non-government experts, has prepared a practical guide for decision makers. This paper illustrates how the medical decision model process could facilitate onsite decision making that includes using the deliberative reachback process from science and policy experts and describes the tools now available to facilitate timely and effective incident management.

44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

The National Clinical Assessment Tool for Medical Students in the Emergency Department (NCAT-EM)

PubMed Central

Jung, Julianna; Franzen, Douglas; Lawson, Luan; Manthey, David; Tews, Matthew; Dubosh, Nicole; Fisher, Jonathan; Haughey, Marianne; House, Joseph B.; Trainor, Arleigh; Wald, David A.; Hiller, Katherine

2018-01-01

Introduction Clinical assessment of medical students in emergency medicine (EM) clerkships is a highly variable process that presents unique challenges and opportunities. Currently, clerkship directors use institution-specific tools with unproven validity and reliability that may or may not address competencies valued most highly in the EM setting. Standardization of assessment practices and development of a common, valid, specialty-specific tool would benefit EM educators and students. Methods A two-day national consensus conference was held in March 2016 in the Clerkship Directors in Emergency Medicine (CDEM) track at the Council of Residency Directors in Emergency Medicine (CORD) Academic Assembly in Nashville, TN. The goal of this conference was to standardize assessment practices and to create a national clinical assessment tool for use in EM clerkships across the country. Conference leaders synthesized the literature, articulated major themes and questions pertinent to clinical assessment of students in EM, clarified the issues, and outlined the consensus-building process prior to consensus-building activities. Results The first day of the conference was dedicated to developing consensus on these key themes in clinical assessment. The second day of the conference was dedicated to discussing and voting on proposed domains to be included in the national clinical assessment tool. A modified Delphi process was initiated after the conference to reconcile questions and items that did not reach an a priori level of consensus. Conclusion The final tool, the National Clinical Assessment Tool for Medical Students in Emergency Medicine (NCAT-EM) is presented here. PMID:29383058

Use of Digital Pens for Rapid Epidemiologic Data Collection During a Foodborne Outbreak Investigation.

PubMed

Mathewson, Abigail A; Daly, Elizabeth R; Cavallo, Steffany J; Alic, Adnela

2015-08-01

Public health investigations require rapid assessment, response, and initiation of control measures. In 2012, the New Hampshire Department of Health and Human Services used digital pens to rapidly acquire epidemiologic data during a gastrointestinal illness outbreak. Menus were obtained and a standard questionnaire was administered to exposed persons using digital pens. Questionnaire data were downloaded into an electronic file for analysis. Sixty-nine (74%) of 93 exposed persons completed a questionnaire. Of 6389 data entries made on digital paper, 218 (3%) required correction; of these, 201 (92%) involved a free-form variable and 17 (8%) involved a check-box variable. Digital pens saved an estimated 5 to 6 hours of data-entry time. This outbreak provided an opportunity to assess the value of digital pens for decreasing data-entry burden and allowing more timely data analysis in an emergent setting. Depending on the size of the outbreak and complexity of the survey, there is likely a threshold when use of digital pens would provide a clear benefit to outbreak response. As new technology becomes available for use in emergency preparedness settings, public health agencies must continuously review and update response plans and evaluate investigation tools to ensure timely disease control and response activities.

User's Guide for MetView: A Meteorological Display and Assessment Tool

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glantz, Clifford S.; Pelton, Mitchell A.; Allwine, K Jerry

2000-09-27

MetView Version 2.0 is an easy-to-use model for accessing, viewing, and analyzing meteorological data. MetView provides both graphical and numerical displays of data. It can accommodate data from an extensive meteorological monitoring network that includes near-surface monitoring locations, instrumented towers, sodars, and meteorologist observations. MetView is used operationally for both routine, emergency response, and research applications at the U.S. Department of Energy's Hanford Site. At the Site's Emergency Operations Center, MetView aids in the access, visualization, and interpretation of real-time meteorological data. Historical data can also be accessed and displayed. Emergency response personnel at the Emergency Operations Center use MetViewmore » products in the formulation of protective action recommendations and other decisions. In the initial stage of an emergency, MetView can be operated using a very simple, five-step procedure. This first-responder procedure allows non-technical staff to rapidly generate meteorological products and disseminate key information. After first-responder information products are produced, the Emergency Operations Center's technical staff can conduct more sophisticated analyses using the model. This may include examining the vertical variation in winds, assessing recent changes in atmospheric conditions, evaluating atmospheric mixing rates, and forecasting changes in meteorological conditions. This user's guide provides easy-to-follow instructions for both first-responder and routine operation of the model. Examples, with explanations, are provided for each type of MetView output display. Information is provided on the naming convention, format, and contents of each type of meteorological data file used by the model area. This user's guide serves as a ready reference for experienced MetView users and a training manual for new users.« less

How can systems engineering inform the methods of programme evaluation in health professions education?

PubMed

Rojas, David; Grierson, Lawrence; Mylopoulos, Maria; Trbovich, Patricia; Bagli, Darius; Brydges, Ryan

2018-04-01

We evaluate programmes in health professions education (HPE) to determine their effectiveness and value. Programme evaluation has evolved from use of reductionist frameworks to those addressing the complex interactions between programme factors. Researchers in HPE have recently suggested a 'holistic programme evaluation' aiming to better describe and understand the implications of 'emergent processes and outcomes'. We propose a programme evaluation framework informed by principles and tools from systems engineering. Systems engineers conceptualise complexity and emergent elements in unique ways that may complement and extend contemporary programme evaluations in HPE. We demonstrate how the abstract decomposition space (ADS), an engineering knowledge elicitation tool, provides the foundation for a systems engineering informed programme evaluation designed to capture both planned and emergent programme elements. We translate the ADS tool to use education-oriented language, and describe how evaluators can use it to create a programme-specific ADS through iterative refinement. We provide a conceptualisation of emergent elements and an equation that evaluators can use to identify the emergent elements in their programme. Using our framework, evaluators can analyse programmes not as isolated units with planned processes and planned outcomes, but as unfolding, complex interactive systems that will exhibit emergent processes and emergent outcomes. Subsequent analysis of these emergent elements will inform the evaluator as they seek to optimise and improve the programme. Our proposed systems engineering informed programme evaluation framework provides principles and tools for analysing the implications of planned and emergent elements, as well as their potential interactions. We acknowledge that our framework is preliminary and will require application and constant refinement. We suggest that our framework will also advance our understanding of the construct of 'emergence' in HPE research. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

The challenge of measuring emergency preparedness: integrating component metrics to build system-level measures for strategic national stockpile operations.

PubMed

Jackson, Brian A; Faith, Kay Sullivan

2013-02-01

Although significant progress has been made in measuring public health emergency preparedness, system-level performance measures are lacking. This report examines a potential approach to such measures for Strategic National Stockpile (SNS) operations. We adapted an engineering analytic technique used to assess the reliability of technological systems-failure mode and effects analysis-to assess preparedness. That technique, which includes systematic mapping of the response system and identification of possible breakdowns that affect performance, provides a path to use data from existing SNS assessment tools to estimate likely future performance of the system overall. Systems models of SNS operations were constructed and failure mode analyses were performed for each component. Linking data from existing assessments, including the technical assistance review and functional drills, to reliability assessment was demonstrated using publicly available information. The use of failure mode and effects estimates to assess overall response system reliability was demonstrated with a simple simulation example. Reliability analysis appears an attractive way to integrate information from the substantial investment in detailed assessments for stockpile delivery and dispensing to provide a view of likely future response performance.

Linking the morphological and metabolomic response of Lactuca sativa L exposed to emerging contaminants using GC × GC-MS and chemometric tools.

PubMed

Hurtado, Carlos; Parastar, Hadi; Matamoros, Víctor; Piña, Benjamín; Tauler, Romà; Bayona, Josep M

2017-07-26

The occurrence of contaminants of emerging concern (CECs) in irrigation waters (up to low μg L -1 ) and irrigated crops (ng g -1 in dry weight) has been reported, but the linkage between plant morphological changes and plant metabolomic response has not yet been addressed. In this study, a non-targeted metabolomic analysis was performed on lettuce (Lactuca sativa L) exposed to 11 CECs (pharmaceuticals, personal care products, anticorrosive agents and surfactants) by irrigation. The plants were watered with different CEC concentrations (0-50 µg L -1 ) for 34 days under controlled conditions and then harvested, extracted, derivatised and analysed by comprehensive two-dimensional gas chromatography coupled to a time-of-flight mass spectrometer (GC × GC-TOFMS). The resulting raw data were analysed using multivariate curve resolution (MCR) and partial least squares (PLS) methods. The metabolic response indicates that exposure to CECs at environmentally relevant concentrations (0.05 µg L -1 ) can cause significant metabolic alterations in plants (carbohydrate metabolism, the citric acid cycle, pentose phosphate pathway and glutathione pathway) linked to changes in morphological parameters (leaf height, stem width) and chlorophyll content.

Putting the t in tools: a roadmap for implementation of new global and regional transgender guidance.

PubMed

Wolf, R Cameron; Adams, Darrin; Dayton, Robyn; Verster, Annette; Wong, Joe; Romero, Marcela; Mazin, Rafael; Settle, Edmund; Sladden, Tim; Keatley, JoAnne

2016-01-01

Transgender (trans) activists and global health partners have collaborated to develop new tools and guidance for assessing and addressing HIV and other health needs within trans populations. Trans women experience a heavy burden of HIV and other sexually transmitted infections (STIs), high incidence of violence and difficulties accessing gender-affirming services. At the same time, little has been published on trans men's health, HIV issues, needs and experiences. Young trans people are especially marginalized and vulnerable, with few programmes and services specifically tailored to their needs. Trans-specific data and guidance are needed to adapt the global response to HIV to meet the needs of the trans population. While the needs of this group have only recently received attention, global, regional and other technical guidance documents are being developed to address these gaps. Regional blueprints for comprehensive care for trans people in Latin America, the Caribbean, and Asia and the Pacific are now available. These tools - supported by the Pan American Health Organization, World Health Organization, US President's Emergency Plan for AIDS Relief and the United Nations Development Programme, in collaboration with regional trans groups - provide a contextual map, indicating opportunities for interventions in health, HIV, violence, stigma and discrimination, social protection and human rights. Global guidance includes the World Health Organization's Policy Brief: Transgender People and HIV, and the interagency publication, Implementing Comprehensive HIV and STI Programmes with Transgender People. Community empowerment and capacity building are the focus of the new tools for global and regional transgender guidance. The goal is to strengthen and ensure community-led responses to the HIV challenge in trans populations. This article describes the new tools and guidance and considers the steps needed to use them to appropriately support and engage transgender populations within national AIDS, STI, and sexual and reproductive health responses and programmes. The time to use these tools and guidance for advocacy, strategic planning, capacity building, programme design and training is now.

Cationic liposomes as vaccine adjuvants.

PubMed

Christensen, Dennis; Korsholm, Karen S; Rosenkrands, Ida; Lindenstrøm, Thomas; Andersen, Peter; Agger, Else Marie

2007-10-01

Cationic liposomes are lipid-bilayer vesicles with a positive surface charge that have re-emerged as a promising new adjuvant technology. Although there is some evidence that cationic liposomes themselves can improve the immune response against coadministered vaccine antigens, their main functions are to protect the antigens from clearance in the body and deliver the antigens to professional antigen-presenting cells. In addition, cationic liposomes can be used to introduce immunomodulators to enhance and modulate the immune response in a desirable direction and, thereby, represent an efficient tool when designing tailor-made adjuvants for specific disease targets. In this article we review the recent progress on cationic liposomes as vehicles, enhancing the effect of immunomodulators and the presentation of vaccine antigens.

Who regulates ethics in the virtual world?

PubMed

Sharma, Seemu; Lomash, Hitashi; Bawa, Seema

2015-02-01

This paper attempts to give an insight into emerging ethical issues due to the increased usage of the Internet in our lives. We discuss three main theoretical approaches relating to the ethics involved in the information technology (IT) era: first, the use of IT as a tool; second, the use of social constructivist methods; and third, the approach of phenomenologists. Certain aspects of ethics and IT have been discussed based on a phenomenological approach and moral development. Further, ethical issues related to social networking sites are discussed. A plausible way to make the virtual world ethically responsive is collective responsibility which proposes that society has the power to influence but not control behavior in the virtual world.

Establishing Recommendations for Stroke Systems in the Thrombectomy Era: The Upstate New York Stakeholder Proceedings.

PubMed

Magdon-Ismail, Zainab; Benesch, Curtis; Cushman, Jeremy T; Brissette, Ian; Southerland, Andrew M; Brandler, Ethan S; Sozener, Cemal B; Flor, Sue; Hemmitt, Roseanne; Wales, Kathleen; Parrigan, Krystal; Levine, Steven R

2017-07-01

The American Heart Association/American Stroke Association and Department of Health Stroke Coverdell Program convened a stakeholder meeting in upstate NY to develop recommendations to enhance stroke systems for acute large vessel occlusion. Prehospital, hospital, and Department of Health leadership were invited (n=157). Participants provided goals/concerns and developed recommendations for prehospital triage and interfacility transport, rating each using a 3-level impact (A [high], B, and C [low]) and implementation feasibility (1 [high], 2, and 3 [low]) scale. Six weeks later, participants finalized recommendations. Seventy-one stakeholders (45% of invitees) attended. Six themes around goals/concerns emerged: (1) emergency medical services capacity, (2) validated prehospital screening tools, (3) facility capability, (4) triage/transport guidelines, (5) data capture/feedback tools, and (6) facility competition. In response, high-impact (level A) prehospital recommendations, stratified by implementation feasibility, were (1) use of online medical control for triage (6%); (2) regional transportation strategy (31%), standardized emergency medical services checklists (18%), quality metrics (14%), standardized prehospital screening tools (13%), and feedback for performance improvement (7%); and (3) smartphone application algorithm for screening/decision-making (6%) and ambulance-based telemedicine (6%). Level A interfacility transfer recommendations were (1) standardized transfer process (32%)/timing goals (16%)/regionalized systems (11%), performance metrics (11%), image sharing capabilities (7%); (2) provider education (9%) and stroke toolbox (5%); and (3) interfacility telemedicine (7%) and feedback (2%). The methods used and recommendations generated provide models for stroke system enhancement. Implementation may vary based on geographic need/capacity and be contingent on establishing standard care practices. Further research is needed to establish optimal implementation strategies. © 2017 American Heart Association, Inc.

Is the learning value of workplace-based assessment being realised? A qualitative study of trainer and trainee perceptions and experiences.

PubMed

Barrett, Aileen; Galvin, Rose; Scherpbier, Albert J J A; Teunissen, Pim W; O'Shaughnessy, Ann; Horgan, Mary

2017-03-01

Workplace-based assessments (WBAs) were originally intended to inform learning and development by structuring effective observation-based feedback. The success of this innovation has not yet been established due in part to the widely varied tools, implementation strategies and research approaches. Using a conceptual framework of experience, trajectories and reifications in workplace learning, we aimed to explore trainer and trainee experiences and perceptions of the learning value of WBAs. Trainers and trainees who had used at least one WBA in the previous year were invited to participate in semistructured interviews for this phenomenological study. We used a template analysis method to explore and compare the experiences of the two groups, using the emergent themes to develop an understanding of the impact of these experiences on perceptions of learning value. Nine trainers and eight trainees participated in the study. Common themes emerged among the two groups around issues of responsibility and engagement along with (mis)understandings of the purpose of the individual tools. Trainer-specific themes emerged related to the concurrent implementation of a new e-portfolio and perceptions of increased workload. Trainees associated WBA with a training structure support value but could not translate experiences into learning values. WBAs provide trainees with a justified reason to approach trainers for feedback. WBAs, however, are not being reified as the formative assessments originally intended. A culture change may be required to change the focus of WBA research and reconceptualise this set of tools and methods as a workplace learning practice . Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Teamwork Assessment Tools in Obstetric Emergencies: A Systematic Review.

PubMed

Onwochei, Desire N; Halpern, Stephen; Balki, Mrinalini

2017-06-01

Team-based training and simulation can improve patient safety, by improving communication, decision making, and performance of team members. Currently, there is no general consensus on whether or not a specific assessment tool is better adapted to evaluate teamwork in obstetric emergencies. The purpose of this qualitative systematic review was to find the tools available to assess team effectiveness in obstetric emergencies. We searched Embase, Medline, PubMed, Web of Science, PsycINFO, CINAHL, and Google Scholar for prospective studies that evaluated nontechnical skills in multidisciplinary teams involving obstetric emergencies. The search included studies from 1944 until January 11, 2016. Data on reliability and validity measures were collected and used for interpretation. A descriptive analysis was performed on the data. Thirteen studies were included in the final qualitative synthesis. All the studies assessed teams in the context of obstetric simulation scenarios, but only six included anesthetists in the simulations. One study evaluated their teamwork tool using just validity measures, five using just reliability measures, and one used both. The most reliable tools identified were the Clinical Teamwork Scale, the Global Assessment of Obstetric Team Performance, and the Global Rating Scale of performance. However, they were still lacking in terms of quality and validity. More work needs to be conducted to establish the validity of teamwork tools for nontechnical skills, and the development of an ideal tool is warranted. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these tools.

A survey of tools and resources for the next generation analyst

NASA Astrophysics Data System (ADS)

Hall, David L.; Graham, Jake; Catherman, Emily

2015-05-01

We have previously argued that a combination of trends in information technology (IT) and changing habits of people using IT provide opportunities for the emergence of a new generation of analysts that can perform effective intelligence, surveillance and reconnaissance (ISR) on a "do it yourself" (DIY) or "armchair" approach (see D.L. Hall and J. Llinas (2014)). Key technology advances include: i) new sensing capabilities including the use of micro-scale sensors and ad hoc deployment platforms such as commercial drones, ii) advanced computing capabilities in mobile devices that allow advanced signal and image processing and modeling, iii) intelligent interconnections due to advances in "web N" capabilities, and iv) global interconnectivity and increasing bandwidth. In addition, the changing habits of the digital natives reflect new ways of collecting and reporting information, sharing information, and collaborating in dynamic teams. This paper provides a survey and assessment of tools and resources to support this emerging analysis approach. The tools range from large-scale commercial tools such as IBM i2 Analyst Notebook, Palantir, and GeoSuite to emerging open source tools such as GeoViz and DECIDE from university research centers. The tools include geospatial visualization tools, social network analysis tools and decision aids. A summary of tools is provided along with links to web sites for tool access.

A hermeneutic phenomenological study of the experiences of female African American undergraduate engineering students at a predominantly White and an historically Black institution

NASA Astrophysics Data System (ADS)

Frillman, Sharron Ann

2011-12-01

This phenomenological study examined the experiences of twelve female African Americans enrolled as fulltime undergraduate engineering students at North Carolina Agricultural and Technical State University, an historically Black university, and seven female African Americans enrolled as undergraduate engineering students at Purdue University in West Lafayette, Indiana, a traditionally White institution. Interviews provided insights into the "lived" experiences of these young women and the factors they believe have contributed to their success in their respective engineering programs. Data analysis involved coding each participant's responses to interview questions using Atlas.ti, a powerful qualitative data analysis tool. This generated 181 codes that were further categorized into nine emergent themes, indicating the potential for extensive associations among the variables. The emergent themes are as follows: (1) Demographic information/special circumstances, (2) Personal attributes and characteristics, (3) Personal insights, (4) Sense of mission, (5) Sources of negative stress, (6) Success strategies, (7) Various forms of support, (8) Would/would not have made it to where she is now, and (9) Being African American and female in engineering. Analysis of these themes and their relationships led to the development of the Frillman Model of Emergent Themes in Female African American Engineering Students. Success. In addressing similarities and differences, three overriding theme categories emerged. These were: (1) Four personhood themes and dual social identity theme; (2) Environmental input and response theme; and (3) Outcome emergent theme of Would/Would not have made it to where she is now. Recommendations were made for future research to expand upon this exploratory study.

Region Three Aerial Measurement System Flight Planning Tool - 12006

DOE Office of Scientific and Technical Information (OSTI.GOV)

Messick, Chuck; Pham, Minh; Smith, Ron

The Region 3 Aerial Measurement System Flight Planning Tool is used by the National Nuclear Security Agency (NNSA), United States Department of Energy, Radiological Assistance Program, Region 3, to respond to emergency radiological situations. The tool automates the flight planning package process while decreasing Aerial Measuring System response times and decreases the potential for human error. Deployment of the Region Three Aerial Measurement System Flight Planning Tool has resulted in an immediate improvement to the flight planning process in that time required for mission planning has been reduced from 1.5 hours to 15 minutes. Anecdotally, the RAP team reports thatmore » the rate of usable data acquired during surveys has improved from 40-60 percent to over 90 percent since they began using the tool. Though the primary product of the flight planning tool is a pdf format document for use by the aircraft flight crew, the RAP team has begun carrying their laptop computer on the aircraft during missions. By connecting a Global Positioning System (GPS) device to the laptop and using ESRI ArcMap's GPS tool bar to overlay the aircraft position directly on the flight plan in real time, the RAP team can evaluate and correct the aircraft position as the mission is executed. (authors)« less

The Prescription Opioid Epidemic: Social Media Responses to the Residents' Perspective Article.

PubMed

Choo, Esther K; Mazer-Amirshahi, Maryann; Juurlink, David; Kobner, Scott; Scott, Kevin; Lin, Michelle

2016-01-01

In June 2014, Annals of Emergency Medicine collaborated with the Academic Life in Emergency Medicine (ALiEM) blog-based Web site to host an online discussion session featuring the Annals Residents' Perspective article "The Opioid Prescription Epidemic and the Role of Emergency Medicine" by Poon and Greenwood-Ericksen. This dialogue included a live videocast with the authors and other experts, a detailed discussion on the ALiEM Web site's comment section, and real-time conversations on Twitter. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,262 unique page views from 433 cities in 41 countries on the ALiEM Web site, 408,498 Twitter impressions, and 168 views of the video interview with the authors. Four major themes about prescription opioids identified included the following: physician knowledge, inconsistent medical education, balance between overprescribing and effective pain management, and approaches to solutions. Free social media technologies provide a unique opportunity to engage with a diverse community of emergency medicine and non-emergency medicine clinicians, nurses, learners, and even patients. Such technologies may allow more rapid hypothesis generation for future research and more accelerated knowledge translation. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

A Simple Graphical Method for Quantification of Disaster Management Surge Capacity Using Computer Simulation and Process-control Tools.

PubMed

Franc, Jeffrey Michael; Ingrassia, Pier Luigi; Verde, Manuela; Colombo, Davide; Della Corte, Francesco

2015-02-01

Surge capacity, or the ability to manage an extraordinary volume of patients, is fundamental for hospital management of mass-casualty incidents. However, quantification of surge capacity is difficult and no universal standard for its measurement has emerged, nor has a standardized statistical method been advocated. As mass-casualty incidents are rare, simulation may represent a viable alternative to measure surge capacity. Hypothesis/Problem The objective of the current study was to develop a statistical method for the quantification of surge capacity using a combination of computer simulation and simple process-control statistical tools. Length-of-stay (LOS) and patient volume (PV) were used as metrics. The use of this method was then demonstrated on a subsequent computer simulation of an emergency department (ED) response to a mass-casualty incident. In the derivation phase, 357 participants in five countries performed 62 computer simulations of an ED response to a mass-casualty incident. Benchmarks for ED response were derived from these simulations, including LOS and PV metrics for triage, bed assignment, physician assessment, and disposition. In the application phase, 13 students of the European Master in Disaster Medicine (EMDM) program completed the same simulation scenario, and the results were compared to the standards obtained in the derivation phase. Patient-volume metrics included number of patients to be triaged, assigned to rooms, assessed by a physician, and disposed. Length-of-stay metrics included median time to triage, room assignment, physician assessment, and disposition. Simple graphical methods were used to compare the application phase group to the derived benchmarks using process-control statistical tools. The group in the application phase failed to meet the indicated standard for LOS from admission to disposition decision. This study demonstrates how simulation software can be used to derive values for objective benchmarks of ED surge capacity using PV and LOS metrics. These objective metrics can then be applied to other simulation groups using simple graphical process-control tools to provide a numeric measure of surge capacity. Repeated use in simulations of actual EDs may represent a potential means of objectively quantifying disaster management surge capacity. It is hoped that the described statistical method, which is simple and reusable, will be useful for investigators in this field to apply to their own research.

REACT Real-Time Emergency Action Coordination Tool

NASA Technical Reports Server (NTRS)

2004-01-01

Recently the Emergency Management Operations Center (EMOC) of St. Tammany Parish turned to the Technology Development and Transfer Office (TDTO) of NASA's Stennis Space Center (SSC) for help in combating the problems associated with water inundation. Working through a Dual-Use Development Agreement the Technology Development and Transfer Office, EMOC and a small geospatial applications company named Nvision provided the parish with a new front-line defense. REACT, Real-time Emergency Action coordination Tool is a decision support system that integrates disparate information to enable more efficient decision making by emergency management personnel.

Using quantitative disease dynamics as a tool for guiding response to avian influenza in poultry in the United States of America☆

PubMed Central

Pepin, K.M.; Spackman, E.; Brown, J.D.; Pabilonia, K.L.; Garber, L.P.; Weaver, J.T.; Kennedy, D.A.; Patyk, K.A.; Huyvaert, K.P.; Miller, R.S.; Franklin, A.B.; Pedersen, K.; Bogich, T.L.; Rohani, P.; Shriner, S.A.; Webb, C.T.; Riley, S.

2014-01-01

Wild birds are the primary source of genetic diversity for influenza A viruses that eventually emerge in poultry and humans. Much progress has been made in the descriptive ecology of avian influenza viruses (AIVs), but contributions are less evident from quantitative studies (e.g., those including disease dynamic models). Transmission between host species, individuals and flocks has not been measured with sufficient accuracy to allow robust quantitative evaluation of alternate control protocols. We focused on the United States of America (USA) as a case study for determining the state of our quantitative knowledge of potential AIV emergence processes from wild hosts to poultry. We identified priorities for quantitative research that would build on existing tools for responding to AIV in poultry and concluded that the following knowledge gaps can be addressed with current empirical data: (1) quantification of the spatio-temporal relationships between AIV prevalence in wild hosts and poultry populations, (2) understanding how the structure of different poultry sectors impacts within-flock transmission, (3) determining mechanisms and rates of between-farm spread, and (4) validating current policy-decision tools with data. The modeling studies we recommend will improve our mechanistic understanding of potential AIV transmission patterns in USA poultry, leading to improved measures of accuracy and reduced uncertainty when evaluating alternative control strategies. PMID:24462191

Pros and cons of conjoint analysis of discrete choice experiments to define classification and response criteria in rheumatology.

PubMed

Taylor, William J

2016-03-01

Conjoint analysis of choice or preference data has been used in marketing for over 40 years but has appeared in healthcare settings much more recently. It may be a useful technique for applications within the rheumatology field. Conjoint analysis in rheumatology contexts has mainly used the approaches implemented in 1000Minds Ltd, Dunedin, New Zealand, Sawtooth Software, Orem UT, USA. Examples include classification criteria, composite response criteria, service prioritization tools and utilities assessment. Limitations imposed by very many attributes can be managed using new techniques. Conjoint analysis studies of classification and response criteria suggest that the assumption of equal weighting of attributes cannot be met, which challenges traditional approaches to composite criteria construction. Weights elicited through choice experiments with experts can derive more accurate classification criteria, than unweighted criteria. Studies that find significant variation in attribute weights for composite response criteria for gout make construction of such criteria problematic. Better understanding of various multiattribute phenomena is likely to increase with increased use of conjoint analysis, especially when the attributes concern individual perceptions or opinions. In addition to classification criteria, some applications for conjoint analysis that are emerging in rheumatology include prioritization tools, remission criteria, and utilities for life areas.

Doctorate of Nursing Practice Students' Impressions of Uses for Visual Thinking Strategies.

PubMed

Hensel, Desiree; Moorman, Margaret

2017-08-01

Visual Thinking Strategies (VTS) is a structured art-viewing technique designed to teach critical thinking and aesthetic appreciation. Literature on how VTS might be used in nursing is just emerging. This qualitative descriptive study examined written responses to how 14 doctorate of nursing practice students thought they might use VTS in their practice after engaging in a classroom session. Three themes emerged for how nurses might use VTS: Facilitating Interpersonal Relationships, Changing Thinking in Practice, and As a Teaching Tool. This study contributes to the growing body of literature that suggests that art and VTS and can be used in nursing with practitioners of all levels to promote conversations that involve listening intently and considering other possibilities. J Contin Educ Nurs. 2017;48(8):365-368. Copyright 2017, SLACK Incorporated.

Subspecialisation in Emergency Radiology: Proposal for a harmonised European curriculum.

PubMed

Wagner, M G; Fischer, M R; Scaglione, M; Linsenmaier, U; Schueller, G; Berger, F H; Dick, E; Basilico, R; Stajgis, M; Calli, C; Vaidya, S; Wirth, Stefan

2017-01-01

Introduction: Radiology plays a crucial role in the emergency care setting by delivering early and precise diagnoses under pressure of time, right at the beginning of patient treatment. Although there is a need for postgraduate education in emergency radiology, most of the national bodies responsible do not offer it in a uniform fashion and a general proof of qualification is missing in Europe. Therefore, the European Society of Radiology (ESR) has founded the (Sub-)Society of Emergency Radiology (ESER), prompting them to develop a European curriculum. This trend, which is currently also encouraged in many other non-radiological specialties which demand the highest professional qualifications, often lacks expertise in medical education. Goals: The goal of this article is the general description of the curricular planning process for a European postgraduate subspecialisation programme, using the example of Emergency Radiology (European Diploma in Emergency Radiology, EDER), including the utilisation of TOOLS and recommendations derived from comparable projects. Project description: The project was divided into partial steps: the timeline displayed in a GANTT chart, and tasks and responsibilities assigned in a RASCI matrix. The curriculum was iteratively developed using the KERN approach and steps were prioritised using the PARETO principle. Furthermore, the following TOOLS were used: limitations and needs assessment, SWOT analysis, formulating learning objectives and categorising them after MILLER and SCLO, and using BLOOM's taxonomy for cognitive learning objectives and operationalising them according to MAGER. Psychomotoric and affective learning objectives were assigned to CANMEDS roles, grouped by topic using CLUSTERING, and then mapped by MATRIX analysis to appropriate learning and evaluation methods. Striving for continuous improvement, the curriculum was finally embedded in curricular quality management. Results: The standardisation of the EDER access, considering the different national conditions, the minimisation of European learners' attendance phases, restricting expenses by best possible use of existing structures, respecting the requirements and retaining the support of the European umbrella society ESR, finishing the project by a specific deadline and the demands of continuous improvement were particular challenges. A curriculum with the eligibility of five years' speciality training in general radiology has evolved on schedule. The subspeciality training lasts at least one year and is divided into webinars, workshops during congresses (e.g. the annual ESR and ESER congresses) and one year practical training at the individual learner's corresponding local hospitals, which adhere to a catalogue of requirements, comparable to national educational policies. The curriculum is completed by passing a written and oral exam (diploma) and re-accreditation every five years. Conclusions: Despite complex requirements, the TOOLS utilised allowed an almost seamless, resource-minimised, professional, location-independent distributed development of a European subspeciality curriculum within one year. The definitive implementation is still due. If any deviations from the draft presented should become necessary in the future, the embedment in the curricular quality management will lead to a redirection in the right way and, furthermore, secure a continuous improvement in the best way possible.

Subspecialisation in Emergency Radiology: Proposal for a harmonised European curriculum

PubMed Central

Wagner, M. G.; Fischer, M. R.; Scaglione, M.; Linsenmaier, U.; Schueller, G.; Berger, F. H.; Dick, E.; Basilico, R.; Stajgis, M.; Calli, C.; Vaidya, S.; Wirth, Stefan

2017-01-01

Introduction: Radiology plays a crucial role in the emergency care setting by delivering early and precise diagnoses under pressure of time, right at the beginning of patient treatment. Although there is a need for postgraduate education in emergency radiology, most of the national bodies responsible do not offer it in a uniform fashion and a general proof of qualification is missing in Europe. Therefore, the European Society of Radiology (ESR) has founded the (Sub-)Society of Emergency Radiology (ESER), prompting them to develop a European curriculum. This trend, which is currently also encouraged in many other non-radiological specialties which demand the highest professional qualifications, often lacks expertise in medical education. Goals: The goal of this article is the general description of the curricular planning process for a European postgraduate subspecialisation programme, using the example of Emergency Radiology (European Diploma in Emergency Radiology, EDER), including the utilisation of TOOLS and recommendations derived from comparable projects. Project description: The project was divided into partial steps: the timeline displayed in a GANTT chart, and tasks and responsibilities assigned in a RASCI matrix. The curriculum was iteratively developed using the KERN approach and steps were prioritised using the PARETO principle. Furthermore, the following TOOLS were used: limitations and needs assessment, SWOT analysis, formulating learning objectives and categorising them after MILLER and SCLO, and using BLOOM’s taxonomy for cognitive learning objectives and operationalising them according to MAGER. Psychomotoric and affective learning objectives were assigned to CANMEDS roles, grouped by topic using CLUSTERING, and then mapped by MATRIX analysis to appropriate learning and evaluation methods. Striving for continuous improvement, the curriculum was finally embedded in curricular quality management. Results: The standardisation of the EDER access, considering the different national conditions, the minimisation of European learners’ attendance phases, restricting expenses by best possible use of existing structures, respecting the requirements and retaining the support of the European umbrella society ESR, finishing the project by a specific deadline and the demands of continuous improvement were particular challenges. A curriculum with the eligibility of five years’ speciality training in general radiology has evolved on schedule. The subspeciality training lasts at least one year and is divided into webinars, workshops during congresses (e.g. the annual ESR and ESER congresses) and one year practical training at the individual learner’s corresponding local hospitals, which adhere to a catalogue of requirements, comparable to national educational policies. The curriculum is completed by passing a written and oral exam (diploma) and re-accreditation every five years. Conclusions: Despite complex requirements, the TOOLS utilised allowed an almost seamless, resource-minimised, professional, location-independent distributed development of a European subspeciality curriculum within one year. The definitive implementation is still due. If any deviations from the draft presented should become necessary in the future, the embedment in the curricular quality management will lead to a redirection in the right way and, furthermore, secure a continuous improvement in the best way possible. PMID:29226229

Geographic Information System Technology Leveraged for Crisis Planning, Emergency, Response, and Disaster Management

NASA Astrophysics Data System (ADS)

Ross, A.; Little, M. M.

2013-12-01

NASA's Atmospheric Science Data Center (ASDC) is piloting the use of Geographic Information System (GIS) technology that can be leveraged for crisis planning, emergency response, and disaster management/awareness. Many different organizations currently use GIS tools and geospatial data during a disaster event. ASDC datasets have not been fully utilized by this community in the past due to incompatible data formats that ASDC holdings are archived in. Through the successful implementation of this pilot effort and continued collaboration with the larger Homeland Defense and Department of Defense emergency management community through the Homeland Infrastructure Foundation-Level Data Working Group (HIFLD WG), our data will be easily accessible to those using GIS and increase the ability to plan, respond, manage, and provide awareness during disasters. The HIFLD WG Partnership has expanded to include more than 5,900 mission partners representing the 14 executive departments, 98 agencies, 50 states (and 3 territories), and more than 700 private sector organizations to directly enhance the federal, state, and local government's ability to support domestic infrastructure data gathering, sharing and protection, visualization, and spatial knowledge management.The HIFLD WG Executive Membership is lead by representatives from the Department of Defense (DoD) Office of the Assistant Secretary of Defense for Homeland Defense and Americas' Security Affairs - OASD (HD&ASA); the Department of Homeland Security (DHS), National Protection and Programs Directorate's Office of Infrastructure Protection (NPPD IP); the National Geospatial-Intelligence Agency (NGA) Integrated Working Group - Readiness, Response and Recovery (IWG-R3); the Department of Interior (DOI) United States Geological Survey (USGS) National Geospatial Program (NGP), and DHS Federal Emergency Management Agency (FEMA).

Risk communication as a core public health competence in infectious disease management: Development of the ECDC training curriculum and programme.

PubMed

Dickmann, Petra; Abraham, Thomas; Sarkar, Satyajit; Wysocki, Piotr; Cecconi, Sabrina; Apfel, Franklin; Nurm, Ülla-Karin

2016-01-01

Risk communication has been identified as a core competence for guiding public health responses to infectious disease threats. The International Health Regulations (2005) call for all countries to build capacity and a comprehensive understanding of health risks before a public health emergency to allow systematic and coherent communication, response and management. Research studies indicate that while outbreak and crisis communication concepts and tools have long been on the agenda of public health officials, there is still a need to clarify and integrate risk communication concepts into more standardised practices and improve risk communication and health, particularly among disadvantaged populations. To address these challenges, the European Centre for Disease Prevention and Control (ECDC) convened a group of risk communication experts to review and integrate existing approaches and emerging concepts in the development of a training curriculum. This curriculum articulates a new approach in risk communication moving beyond information conveyance to knowledge- and relationship-building. In a pilot training this approach was reflected both in the topics addressed and in the methods applied. This article introduces the new conceptual approach to risk communication capacity building that emerged from this process, presents the pilot training approach developed, and shares the results of the course evaluation.

Prefrontal Reactivity to Social Signals of Threat as a Predictor of Treatment Response in Anxious Youth

PubMed Central

Kujawa, Autumn; Swain, James E; Hanna, Gregory L; Koschmann, Elizabeth; Simpson, David; Connolly, Sucheta; Fitzgerald, Kate D; Monk, Christopher S; Phan, K Luan

2016-01-01

Neuroimaging has shown promise as a tool to predict likelihood of treatment response in adult anxiety disorders, with potential implications for clinical decision-making. Despite the relatively high prevalence and emergence of anxiety disorders in youth, very little work has evaluated neural predictors of response to treatment. The goal of the current study was to examine brain function during emotional face processing as a predictor of response to treatment in children and adolescents (age 7–19 years; N=41) with generalized, social, and/or separation anxiety disorder. Prior to beginning treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline or cognitive behavior therapy (CBT), participants completed an emotional faces matching task during functional magnetic resonance imaging (fMRI). Whole brain responses to threatening (ie, angry and fearful) and happy faces were examined as predictors of change in anxiety severity following treatment. Greater activation in inferior and superior frontal gyri, including dorsolateral prefrontal cortex and ventrolateral prefrontal cortex, as well as precentral/postcentral gyri during processing of threatening faces predicted greater response to CBT and SSRI treatment. For processing of happy faces, activation in postcentral gyrus was a significant predictor of treatment response. Post-hoc analyses indicated that effects were not significantly moderated by type of treatment. Findings suggest that greater activation in prefrontal regions involved in appraising and regulating responses to social signals of threat predict better response to SSRI and CBT treatment in anxious youth and that neuroimaging may be a useful tool for predicting how youth will respond to treatment. PMID:26708107

76 FR 63936 - Agency Information Collection Activities: Proposed Collection; Comment Request; PrepCAST

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

...CAST AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY: The Federal Emergency...CAST) (formerly known as the National Incident Management System Compliance Assistance Support Tool (NIMSCAST)). PrepCAST is a self-assessment tool for State, territorial, Tribal, and local governments to...

Workplace Violence in the Emergency Department: Giving Staff the Tools and Support to Report

PubMed Central

Stene, Julie; Larson, Erin; Levy, Maria; Dohlman, Michon

2015-01-01

Workplace violence is increasing across the nation’s Emergency Departments (EDs) and nurses often perceive it as part of their job. Through a quality-improvement project, reporting processes were found to be inconsistent and nurses often did not know what acts constitute violence. As a result, nurses were under-reporting violence in the ED, and as a direct result resources were not recognized or provided. A staff nurse-led workgroup developed an initial survey to assess the perception and occurrence of violence within the ED in nurses and patient care assistants. This workgroup evaluated the survey responses and identified a need for the development of a brief, concise reporting tool and an educational program. A reporting tool was created and education was provided in multiple venues and modalities. A follow-up process and support were given from nursing leadership. A posteducation survey was completed by nurses and patient care assistants to assess their comprehension of acts of workplace violence, and found their perception that workplace violence was part of their job was reduced by half, along with increased knowledge about acts constituting workplace violence, and what is reportable to law enforcement. As a result of the education, the reporting of the violent acts has increased, and staff perceive the ED to be a safer environment. With the appropriate education, reporting tool, and leadership support, ED nurses can create a culture with a zero-tolerance policy for violence within the department, creating a safer environment for staff and patients. PMID:25902352

Antecedents and precipitants of patient-related violence in the emergency department: Results from the Australian VENT Study (Violence in Emergency Nursing and Triage).

PubMed

Pich, Jacqueline V; Kable, Ashley; Hazelton, Mike

2017-08-01

Workplace violence is one of the most significant and hazardous issues faced by nurses globally. It is a potentially life-threatening and life-affecting workplace hazard often downplayed as just "part of the job" for nurses. A cross-sectional design was used and data were collected using a purpose developed survey tool. Surveys were distributed to all members of the College of Emergency Nurses' Australasia (CENA) in 2010 and 537 eligible responses were received (RR=51%). Patient-related violence was reported by 87% of nurses in the last six months. Precipitants and antecedents for episodes of violence were reported in three categories: nurse-related; patient-related and emergency-department specific factors. Triaging was identified as the highest risk nursing activity, and the triage area identified as the highest risk location in the department. Patients who presented with alcohol intoxication, substance misuse or mental health issues were identified as the groups at greatest risk for potential violence. Patient-related violence was reported by the majority of emergency nurses surveyed. A number of precipitants and antecedents perceived to be risk factors by participants were found to be significant and are unavoidable in the working lives of emergency department nurses. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Fluorescent Sensors Based on Aggregation-Induced Emission: Recent Advances and Perspectives.

PubMed

Gao, Meng; Tang, Ben Zhong

2017-10-27

Fluorescent sensors with advantages of excellent sensitivity, rapid response, and easy operation are emerging as powerful tools in environmental monitoring, biological research, and disease diagnosis. However, conventional fluorophores featured with π-planar structures usually suffer from serious self-quenching in the aggregated state, poor photostability, and small Stokes' shift. In contrast to conventional aggregation-caused quenching (ACQ) fluorophores, the newly emerged aggregation-induced emission fluorogens (AIEgens) are featured with high emission efficiency in the aggregated state, which provide unique opportunities for various sensing applications with advantages of high signal-to-noise ratio, strong photostability, and large Stokes' shift. In this review, we will first briefly give an introduction of the AIE concept and the turn-on sensing principles. Then, we will discuss the recent examples of AIE sensors according to types of analytes. Finally, we will give a perspective on the future developments of AIE sensors. We hope this review will inspire more endeavors to devote to this emerging world.

Building emotional intelligence: a strategy for emerging nurse leaders to reduce workplace bullying.

PubMed

Bennett, Karen; Sawatzky, Jo-Ann V

2013-01-01

Bullying is one of the most concerning forms of aggression in health care organizations. Conceptualized as an emotion-based response, bullying is often triggered by today's workplace challenges. Unfortunately, workplace bullying is an escalating problem in nursing. Bullying contributes to unhealthy and toxic environments, which in turn contribute to ineffective patient care, increased stress, and decreased job satisfaction among health care providers. These equate to a poor workforce environment, which in turn increases hospital costs when nurses choose to leave. Nurse managers are in positions of power to recognize and address negative workplace behaviors, such as bullying. However, emerging leaders in particular may not be equipped with the tools to deal with bullying and consequently may choose to overlook it. Substantive evidence from other disciplines supports the contention that individuals with greater emotional intelligence are better equipped to recognize early signs of negative behavior, such as bullying. Therefore, fostering emotional intelligence in emerging nurse leaders may lead to less bullying and more positive workplace environments for nurses in the future.

Circulating Cell Free Tumor DNA Detection as a Routine Tool for Lung Cancer Patient Management

PubMed Central

Vendrell, Julie A.; Mau-Them, Frédéric Tran; Béganton, Benoît; Godreuil, Sylvain; Coopman, Peter; Solassol, Jérôme

2017-01-01

Circulating tumoral DNA (ctDNA), commonly named “liquid biopsy”, has emerged as a new promising noninvasive tool to detect biomarker in several cancers including lung cancer. Applications involving molecular analysis of ctDNA in lung cancer have increased and encompass diagnosis, response to treatment, acquired resistance and prognosis prediction, while bypassing the problem of tumor heterogeneity. ctDNA may then help perform dynamic genetic surveillance in the era of precision medicine through indirect tumoral genomic information determination. The aims of this review were to examine the recent technical developments that allowed the detection of genetic alterations of ctDNA in lung cancer. Furthermore, we explored clinical applications in patients with lung cancer including treatment efficiency monitoring, acquired therapy resistance mechanisms and prognosis value. PMID:28146051

From Forecasters to the General Public: A Communication Tool to Understand Decision-making Challenges in Weather-related Early Warning Systems

NASA Astrophysics Data System (ADS)

Terti, G.; Ruin, I.; Kalas, M.; Lorini, V.; Sabbatini, T.; i Alonso, A. C.

2017-12-01

New technologies are currently adopted worldwide to improve weather forecasts and communication of the corresponding warnings to the end-users. "EnhANcing emergency management and response to extreme WeatHER and climate Events" (ANYWHERE) project is an innovating action that aims at developing and implementing a European decision-support platform for weather-related risks integrating cutting-edge forecasting technology. The initiative is built in a collaborative manner where researchers, developers, potential users and other stakeholders meet frequently to define needs, capabilities and challenges. In this study, we propose a role-playing game to test the added value of the ANYWHERE platform on i) the decision-making process and the choice of warning levels under uncertainty, ii) the management of the official emergency response and iii) the crisis communication and triggering of protective actions at different levels of the warning system (from hazard detection to citizen response). The designed game serves as an interactive communication tool. Here, flood and flash flood focused simulations seek to enhance participant's understanding of the complexities and challenges embedded in various levels of the decision-making process under the threat of weather disasters (e.g., forecasting/warnings, official emergency actions, self-protection). Also, we facilitate collaboration and coordination between the participants who belong to different national or local agencies/authorities across Europe. The game is first applied and tested in ANYWHERE's workshop in Helsinki (September, 2017) where about 30-50 people, including researchers, forecasters, civil protection and representatives of related companies, are anticipated to play the simulation. The main idea is to provide to the players a virtual case study that well represents realistic uncertainties and dilemmas embedded in the real-time forecasting-warning processes. At the final debriefing step the participants are encouraged to exchange knowledge, thoughts and insights on their capability or difficulty to decide and communicate their action based on the available information and given constrains. Such feedback will be analyzed and presented and future potentialities for the application of the game will be discussed.

Introducing ShakeMap to potential users in Puerto Rico using scenarios of damaging historical and probable earthquakes

NASA Astrophysics Data System (ADS)

Huerfano, V. A.; Cua, G.; von Hillebrandt, C.; Saffar, A.

2007-12-01

The island of Puerto Rico has a long history of damaging earthquakes. Major earthquakes from off-shore sources have affected Puerto Rico in 1520, 1615, 1670, 1751, 1787, 1867, and 1918 (Mueller et al, 2003; PRSN Catalogue). Recent trenching has also yielded evidence of possible M7.0 events inland (Prentice, 2000). The high seismic hazard, large population, high tsunami potential and relatively poor construction practice can result in a potentially devastating combination. Efficient emergency response in event of a large earthquake will be crucial to minimizing the loss of life and disruption of lifeline systems in Puerto Rico. The ShakeMap system (Wald et al, 2004) developed by the USGS to rapidly display and disseminate information about the geographical distribution of ground shaking (and hence potential damage) following a large earthquake has proven to be a vital tool for post earthquake emergency response efforts, and is being adopted/emulated in various seismically active regions worldwide. Implementing a robust ShakeMap system is among the top priorities of the Puerto Rico Seismic Network. However, the ultimate effectiveness of ShakeMap in post- earthquake response depends not only on its rapid availability, but also on the effective use of the information it provides. We developed ShakeMap scenarios of a suite of damaging historical and probable earthquakes that severely impact San Juan, Ponce, and Mayagüez, the 3 largest cities in Puerto Rico. Earthquake source parameters were obtained from McCann and Mercado (1998); and Huérfano (2004). For historical earthquakes that generated tsunamis, tsunami inundation maps were generated using the TIME method (Shuto, 1991). The ShakeMap ground shaking maps were presented to local and regional governmental and emergency response agencies at the 2007 Annual conference of the Puerto Rico Emergency Management and Disaster Administration in San Juan, PR, and at numerous other emergency management talks and training sessions. Economic losses are estimated using the ShakeMap scenario ground motions (Saffar, 2007). The calibration tasks necessary in generating these scenarios (developing Vs30 maps, attenuation relationships) complement the on-going efforts of the Puerto Rico Seismic Network to generate ShakeMaps in real-time.

Serpentinomics-an emerging new field of study

Treesearch

Jessica Wright; Eric von Wettberg

2009-01-01

"Serpentinomics" is an emerging field of study which has the potential to greatly advance our understanding of serpentine ecology. Several newly developing –omic fields, often using high-throughput tools developed for molecular biology, will advance the field of serpentine ecology, or, "serpentinomics." Using tools from the...

Emerging tools and technologies in watershed management

Treesearch

D. Phillip Guertin; Scott N. Miller; David C. Goodrich

2000-01-01

The field of watershed management is highly dependent on spatially distributed data. Over the past decade, significant advances have been made toward the capture, storage, and use of spatial data. Emerging tools and technologies hold great promise for improving the scientific understanding of watershed processes and are already revolutionizing watershed research....

Usability Testing of a Complex Clinical Decision Support Tool in the Emergency Department: Lessons Learned.

PubMed

Press, Anne; McCullagh, Lauren; Khan, Sundas; Schachter, Andy; Pardo, Salvatore; McGinn, Thomas

2015-09-10

As the electronic health record (EHR) becomes the preferred documentation tool across medical practices, health care organizations are pushing for clinical decision support systems (CDSS) to help bring clinical decision support (CDS) tools to the forefront of patient-physician interactions. A CDSS is integrated into the EHR and allows physicians to easily utilize CDS tools. However, often CDSS are integrated into the EHR without an initial phase of usability testing, resulting in poor adoption rates. Usability testing is important because it evaluates a CDSS by testing it on actual users. This paper outlines the usability phase of a study, which will test the impact of integration of the Wells CDSS for pulmonary embolism (PE) diagnosis into a large urban emergency department, where workflow is often chaotic and high stakes decisions are frequently made. We hypothesize that conducting usability testing prior to integration of the Wells score into an emergency room EHR will result in increased adoption rates by physicians. The objective of the study was to conduct usability testing for the integration of the Wells clinical prediction rule into a tertiary care center's emergency department EHR. We conducted usability testing of a CDS tool in the emergency department EHR. The CDS tool consisted of the Wells rule for PE in the form of a calculator and was triggered off computed tomography (CT) orders or patients' chief complaint. The study was conducted at a tertiary hospital in Queens, New York. There were seven residents that were recruited and participated in two phases of usability testing. The usability testing employed a "think aloud" method and "near-live" clinical simulation, where care providers interacted with standardized patients enacting a clinical scenario. Both phases were audiotaped, video-taped, and had screen-capture software activated for onscreen recordings. Phase I: Data from the "think-aloud" phase of the study showed an overall positive outlook on the Wells tool in assessing a patient for a PE diagnosis. Subjects described the tool as "well-organized" and "better than clinical judgment". Changes were made to improve tool placement into the EHR to make it optimal for decision-making, auto-populating boxes, and minimizing click fatigue. Phase II: After incorporating the changes noted in Phase 1, the participants noted tool improvements. There was less toggling between screens, they had all the clinical information required to complete the tool, and were able to complete the patient visit efficiently. However, an optimal location for triggering the tool remained controversial. This study successfully combined "think-aloud" protocol analysis with "near-live" clinical simulations in a usability evaluation of a CDS tool that will be implemented into the emergency room environment. Both methods proved useful in the assessment of the CDS tool and allowed us to refine tool usability and workflow.

Multi-criteria decision analysis tools for prioritising emerging or re-emerging infectious diseases associated with climate change in Canada.

PubMed

Cox, Ruth; Sanchez, Javier; Revie, Crawford W

2013-01-01

Global climate change is known to result in the emergence or re-emergence of some infectious diseases. Reliable methods to identify the infectious diseases of humans and animals and that are most likely to be influenced by climate are therefore required. Since different priorities will affect the decision to address a particular pathogen threat, decision makers need a standardised method of prioritisation. Ranking methods and Multi-Criteria Decision approaches provide such a standardised method and were employed here to design two different pathogen prioritisation tools. The opinion of 64 experts was elicited to assess the importance of 40 criteria that could be used to prioritise emerging infectious diseases of humans and animals in Canada. A weight was calculated for each criterion according to the expert opinion. Attributes were defined for each criterion as a transparent and repeatable method of measurement. Two different Multi-Criteria Decision Analysis tools were tested, both of which used an additive aggregation approach. These were an Excel spreadsheet tool and a tool developed in software 'M-MACBETH'. The tools were trialed on nine 'test' pathogens. Two different methods of criteria weighting were compared, one using fixed weighting values, the other using probability distributions to account for uncertainty and variation in expert opinion. The ranking of the nine pathogens varied according to the weighting method that was used. In both tools, using both weighting methods, the diseases that tended to rank the highest were West Nile virus, Giardiasis and Chagas, while Coccidioidomycosis tended to rank the lowest. Both tools are a simple and user friendly approach to prioritising pathogens according to climate change by including explicit scoring of 40 criteria and incorporating weighting methods based on expert opinion. They provide a dynamic interactive method that can help to identify pathogens for which a full risk assessment should be pursued.

Multi-Criteria Decision Analysis Tools for Prioritising Emerging or Re-Emerging Infectious Diseases Associated with Climate Change in Canada

PubMed Central

Cox, Ruth; Sanchez, Javier; Revie, Crawford W.

2013-01-01

Global climate change is known to result in the emergence or re-emergence of some infectious diseases. Reliable methods to identify the infectious diseases of humans and animals and that are most likely to be influenced by climate are therefore required. Since different priorities will affect the decision to address a particular pathogen threat, decision makers need a standardised method of prioritisation. Ranking methods and Multi-Criteria Decision approaches provide such a standardised method and were employed here to design two different pathogen prioritisation tools. The opinion of 64 experts was elicited to assess the importance of 40 criteria that could be used to prioritise emerging infectious diseases of humans and animals in Canada. A weight was calculated for each criterion according to the expert opinion. Attributes were defined for each criterion as a transparent and repeatable method of measurement. Two different Multi-Criteria Decision Analysis tools were tested, both of which used an additive aggregation approach. These were an Excel spreadsheet tool and a tool developed in software ‘M-MACBETH’. The tools were trialed on nine ‘test’ pathogens. Two different methods of criteria weighting were compared, one using fixed weighting values, the other using probability distributions to account for uncertainty and variation in expert opinion. The ranking of the nine pathogens varied according to the weighting method that was used. In both tools, using both weighting methods, the diseases that tended to rank the highest were West Nile virus, Giardiasis and Chagas, while Coccidioidomycosis tended to rank the lowest. Both tools are a simple and user friendly approach to prioritising pathogens according to climate change by including explicit scoring of 40 criteria and incorporating weighting methods based on expert opinion. They provide a dynamic interactive method that can help to identify pathogens for which a full risk assessment should be pursued. PMID:23950868

Successful removal of strangulating metal penile ring using a dental handpiece.

PubMed

Etetafia, Mabel Okiemute; Nwajei, Charles Onochie

2014-07-11

Under emergency conditions, the dental handpiece can be a useful tool for removing a strangulating penile ring. To report the successful use of a dental handpiece (dental drill) to remove a strangulating penile ring in an emergency. A case report of a strangulating metal penile ring in a psychiatric patient who presented at the accident and emergency unit of Delta State University Teaching Hospital. The metal ring was removed using a diamond bur in a dental handpiece. In case of emergency, the dental handpiece is a useful tool for removing a strangulating penile ring. 2014 BMJ Publishing Group Ltd.

Web GIS in practice III: creating a simple interactive map of England's Strategic Health Authorities using Google Maps API, Google Earth KML, and MSN Virtual Earth Map Control

PubMed Central

Boulos, Maged N Kamel

2005-01-01

This eye-opener article aims at introducing the health GIS community to the emerging online consumer geoinformatics services from Google and Microsoft (MSN), and their potential utility in creating custom online interactive health maps. Using the programmable interfaces provided by Google and MSN, we created three interactive demonstrator maps of England's Strategic Health Authorities. These can be browsed online at – Google Maps API (Application Programming Interface) version, – Google Earth KML (Keyhole Markup Language) version, and – MSN Virtual Earth Map Control version. Google and MSN's worldwide distribution of "free" geospatial tools, imagery, and maps is to be commended as a significant step towards the ultimate "wikification" of maps and GIS. A discussion is provided of these emerging online mapping trends, their expected future implications and development directions, and associated individual privacy, national security and copyrights issues. Although ESRI have announced their planned response to Google (and MSN), it remains to be seen how their envisaged plans will materialize and compare to the offerings from Google and MSN, and also how Google and MSN mapping tools will further evolve in the near future. PMID:16176577

t4 Workshop Report*

PubMed Central

Bouhifd, Mounir; Beger, Richard; Flynn, Thomas; Guo, Lining; Harris, Georgina; Hogberg, Helena; Kaddurah-Daouk, Rima; Kamp, Hennicke; Kleensang, Andre; Maertens, Alexandra; Odwin-DaCosta, Shelly; Pamies, David; Robertson, Donald; Smirnova, Lena; Sun, Jinchun; Zhao, Liang; Hartung, Thomas

2017-01-01

Summary Metabolomics promises a holistic phenotypic characterization of biological responses to toxicants. This technology is based on advanced chemical analytical tools with reasonable throughput, including mass-spectroscopy and NMR. Quality assurance, however – from experimental design, sample preparation, metabolite identification, to bioinformatics data-mining – is urgently needed to assure both quality of metabolomics data and reproducibility of biological models. In contrast to microarray-based transcriptomics, where consensus on quality assurance and reporting standards has been fostered over the last two decades, quality assurance of metabolomics is only now emerging. Regulatory use in safety sciences, and even proper scientific use of these technologies, demand quality assurance. In an effort to promote this discussion, an expert workshop discussed the quality assurance needs of metabolomics. The goals for this workshop were 1) to consider the challenges associated with metabolomics as an emerging science, with an emphasis on its application in toxicology and 2) to identify the key issues to be addressed in order to establish and implement quality assurance procedures in metabolomics-based toxicology. Consensus has still to be achieved regarding best practices to make sure sound, useful, and relevant information is derived from these new tools. PMID:26536290

Demography and Public Health Emergency Preparedness: Making the Connection

PubMed Central

Katz, Rebecca

2009-01-01

The tools and techniques of population sciences are extremely relevant to the discipline of public health emergency preparedness: protecting and securing the population’s health requires information about that population. While related fields such as security studies have successfully integrated demographic tools into their research and literature, the theoretical and practical connection between the methods of demography and the practice of public health emergency preparedness is weak. This article suggests the need to further the interdisciplinary use of demography by examining the need for a systematic use of population science techniques in public health emergency preparedness. Ultimately, we demonstrate how public health emergency preparedness can incorporate demography to develop more effective preparedness plans. Important policy implications emerge: demographers and preparedness experts need to collaborate more formally in order to facilitate community resilience and mitigate the consequences of public health emergencies. PMID:20694030

Petri Nets as Modeling Tool for Emergent Agents

NASA Technical Reports Server (NTRS)

Bergman, Marto

2004-01-01

Emergent agents, those agents whose local interactions can cause unexpected global results, require a method of modeling that is both dynamic and structured Petri Nets, a modeling tool developed for dynamic discrete event system of mainly functional agents, provide this, and have the benefit of being an established tool. We present here the details of the modeling method here and discuss how to implement its use for modeling agent-based systems. Petri Nets have been used extensively in the modeling of functional agents, those agents who have defined purposes and whose actions should result in a know outcome. However, emergent agents, those agents who have a defined structure but whose interaction causes outcomes that are unpredictable, have not yet found a modeling style that suits them. A problem with formally modeling emergent agents that any formal modeling style usually expects to show the results of a problem and the results of problems studied using emergent agents are not apparent from the initial construction. However, the study of emergent agents still requires a method to analyze the agents themselves, and have sensible conversation about the differences and similarities between types of emergent agents. We attempt to correct this problem by applying Petri Nets to the characterization of emergent agents. In doing so, the emergent properties of these agents can be highlighted, and conversation about the nature and compatibility of the differing methods of agent creation can begin.

Report on the emergency response to the event on May 14, 1997, at the plutonuim reclamation facility, Hanford Site, Richland,Washington

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shoop, D.S.

1997-08-20

On the evening of May 14,1997, a chemical explosion Occurred at the Plutonium Reclamation Facility (PRF) in the 200 West Area(200-W) of the Hanford Site. The event warranted the declaration of an Alert emergency, activation of the Hanford Emergency Response Organization (BRO), and notification of offsite agencies. As a result of the emergency declaration, a subsequent evaluation was conducted to assess: 9 the performance of the emergency response organization o the occupational health response related to emergency activities o event notifications to offsite and environmental agencies. Additionally, the evaluation was designed to: 9 document the chronology of emergency and occupationalmore » health responses and environmental notifications connected with the explosion at the facility 0 assess the adequacy of the Hanford Site emergency preparedness activities; response readiness; and emergency management actions, occupational health, and environmental actions 0 provide an analysis of the causes of the deficiencies and weaknesses in the preparedness and response system that have been identified in the evaluation of the response a assign organizational responsibility to correct deficiencies and weaknesses a improve future performance 0 adjust elements of emergency implementing procedures and emergency preparedness activities.« less

Logistics modelling: improving resource management and public information strategies in Florida.

PubMed

Walsh, Daniel M; Van Groningen, Chuck; Craig, Brian

2011-10-01

One of the most time-sensitive and logistically-challenging emergency response operations today is to provide mass prophylaxis to every man, woman and child in a community within 48 hours of a bioterrorism attack. To meet this challenge, federal, state and local public health departments in the USA have joined forces to develop, test and execute large-scale bioterrorism response plans. This preparedness and response effort is funded through the US Centers for Disease Control and Prevention's Cities Readiness Initiative, a programme dedicated to providing oral antibiotics to an entire population within 48 hours of a weaponised inhalation anthrax attack. This paper will demonstrate how the State of Florida used a logistics modelling tool to improve its CRI mass prophylaxis plans. Special focus will be on how logistics modelling strengthened Florida's resource management policies and validated its public information strategies.

Behavioural responses of the snail Lymnaea acuminata to carbohydrates in snail-attractant pellets

NASA Astrophysics Data System (ADS)

Tiwari, Farindra; Singh, D. K.

Snail control is one of the most important tools in the campaign to reduce the incidence of fascioliasis. In order to attain this objective, the method of bait formulation in order to contain an attractant and a molluscicide is an expedient approach to lure the target snail population to the molluscicide. This study identifies certain carbohydrates, namely sucrose, maltose, glucose, fructose and starch, for preparing such baits. These were tested on Lymnaea acuminata, an intermediate host of the digenean trematodes Fasciola hepatica and Fasciola gigantica. The behavioural responses of snails to these carbohydrates were examined. Significant variations in behavioural responses were observed in the snail even when the five carbohydrates were used in low concentrations in snail-attractant pellets. Starch emerged as the strongest attractant for Lymnaea acuminata, followed by maltose.

Modular telerobot control system for accident response

NASA Astrophysics Data System (ADS)

Anderson, Richard J. M.; Shirey, David L.

1999-08-01

The Accident Response Mobile Manipulator System (ARMMS) is a teleoperated emergency response vehicle that deploys two hydraulic manipulators, five cameras, and an array of sensors to the scene of an incident. It is operated from a remote base station that can be situated up to four kilometers away from the site. Recently, a modular telerobot control architecture called SMART was applied to ARMMS to improve the precision, safety, and operability of the manipulators on board. Using SMART, a prototype manipulator control system was developed in a couple of days, and an integrated working system was demonstrated within a couple of months. New capabilities such as camera-frame teleoperation, autonomous tool changeout and dual manipulator control have been incorporated. The final system incorporates twenty-two separate modules and implements seven different behavior modes. This paper describes the integration of SMART into the ARMMS system.

An assessment of Chemical, Biological, Radiologic, Nuclear, and Explosive preparedness among emergency department healthcare providers in an inner city emergency department.

PubMed

Kotora, Joseph G

2015-01-01

Emergency healthcare providers are required to care for victims of Chemical, Biological, Radiologic, Nuclear, and Explosive (CBRNE) agents. However, US emergency departments are often ill prepared to manage CBRNE casualties. Most providers lack adequate knowledge or experience in the areas of patient decontamination, hospital-specific disaster protocols, interagency familiarization, and available supply of necessary medical equipment and medications. This study evaluated the CBRNE preparedness of physicians, nurses, and midlevel providers in an urban tertiary care emergency department. This retrospective observational survey study used a previously constructed questionnaire instrument. A total of 205 e-mail invitations were sent to 191 eligible providers through an online survey distribution tool (Survey Monkey®). Respondents were enrolled from February 1, 2014 to March 15, 2014. Simple frequencies of correct answers were used to determine the level of preparedness of each group. Cronbach's coefficient α was used to validate the precision of the study instrument. Finally, validity coefficients and analysis of variance ANOVA were used to determine the strength of correlation between demographic variables, as well as the variation between individual responses. Fifty-nine providers responded to the questionnaire (31.14 percent response rate). The overall frequency of correct answers was 66.26 percent, indicating a relatively poor level of CBRNE preparedness. The study instrument lacked precision and reliability (coefficient α 0.4050). Significant correlations were found between the frequency of correct answers and the respondents' gender, practice experience, and previous experience with a CBRNE incident. Significant variance exists between how providers believe casualties should be decontaminated, which drugs should be administered, and the interpretation of facility-specific protocols. Emergency care providers are inadequately prepared to manage CBRNE incidents. Furthermore, a valid and precise instrument capable of measuring preparedness needs to be developed. Standardized educational curriculums that consider healthcare providers' genders, occupations, and experience levels may assist in closing the knowledge gaps between providers and reinforce emergency departments' CBRNE preparedness.

Technology Assessment and Roadmap for the Emergency Radiation Dose Assessment Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Turteltaub, K W; Hartman-Siantar, C; Easterly, C

2005-10-03

A Joint Interagency Working Group (JIWG) under the auspices of the Department of Homeland Security Office of Research and Development conducted a technology assessment of emergency radiological dose assessment capabilities as part of the overall need for rapid emergency medical response in the event of a radiological terrorist event in the United States. The goal of the evaluation is to identify gaps and recommend general research and development needs to better prepare the Country for mitigating the effects of such an event. Given the capabilities and roles for responding to a radiological event extend across many agencies, a consensus ofmore » gaps and suggested development plans was a major goal of this evaluation and road-mapping effort. The working group consisted of experts representing the Departments of Homeland Security, Health and Human Services (Centers for Disease Control and the National Institutes of Health), Food and Drug Administration, Department of Defense and the Department of Energy's National Laboratories (see appendix A for participants). The specific goals of this Technology Assessment and Roadmap were to: (1) Describe the general context for deployment of emergency radiation dose assessment tools following terrorist use of a radiological or nuclear device; (2) Assess current and emerging dose assessment technologies; and (3) Put forward a consensus high-level technology roadmap for interagency research and development in this area. This report provides a summary of the consensus of needs, gaps and recommendations for a research program in the area of radiation dosimetry for early response, followed by a summary of the technologies available and on the near-term horizon. We then present a roadmap for a research program to bring present and emerging near-term technologies to bear on the gaps in radiation dose assessment and triage. Finally we present detailed supporting discussion on the nature of the threats we considered, the status of technology today, promising emerging technologies and references for further reading.« less

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2014 CFR

2014-10-01

... response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Federal Participation § 352.27 Federal role in the emergency response. In addition to the Federal component of the licensee offsite emergency response plan described in subpart B (§ 352.26), and after...

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2011 CFR

2011-10-01

... response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Federal Participation § 352.27 Federal role in the emergency response. In addition to the Federal component of the licensee offsite emergency response plan described in subpart B (§ 352.26), and after...

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2013 CFR

2013-10-01

... response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Federal Participation § 352.27 Federal role in the emergency response. In addition to the Federal component of the licensee offsite emergency response plan described in subpart B (§ 352.26), and after...

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2012 CFR

2012-10-01

... response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Federal Participation § 352.27 Federal role in the emergency response. In addition to the Federal component of the licensee offsite emergency response plan described in subpart B (§ 352.26), and after...

A dynamical systems perspective for a real-time response to a marine oil spill.

PubMed

García-Garrido, V J; Ramos, A; Mancho, A M; Coca, J; Wiggins, S

2016-11-15

This paper discusses the combined use of tools from dynamical systems theory and remote sensing techniques and shows how they are effective instruments which may greatly contribute to the decision making protocols of the emergency services for the real-time management of oil spills. This work presents the successful interplay of these techniques for a recent situation, the sinking of the Oleg Naydenov fishing ship that took place in Spain, close to the Canary Islands, in April 2015. Copyright © 2016. Published by Elsevier Ltd.

Implications of organizational ethics to healthcare.

PubMed

Ells, Carolyn; MacDonald, Chris

2002-01-01

Organizational ethics is an emerging field concerned with the study and practice of the ethical behaviour of organizations. For effective application to healthcare settings, we argue that organizational ethics requires attention to organizations' special characteristics combined with tools borrowed from the fields of business ethics and bioethics. We identify and discuss several implications of this burgeoning field to healthcare organizations, showing how organizational ethics can facilitate policy making, accountability, self-evaluation, and patient and business perspectives. In our conclusion, we suggest an action plan for healthcare organizations to help them respond appropriately to their ethical responsibilities.

Decision making technical support study for the US Army's Chemical Stockpile Disposal Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Feldman, D.L.; Dobson, J.E.

1990-08-01

This report examines the adequacy of current command and control systems designed to make timely decisions that would enable sufficient warning and protective response to an accident at the Edgewood area of Aberdeen Proving Ground (APG), Maryland, and at Pine Bluff Arsenal (PBA), Arkansas. Institutional procedures designed to facilitate rapid accident assessment, characterization, warning, notification, and response after the onset of an emergency and computer-assisted decision-making aids designed to provide salient information to on- and-off-post emergency responders are examined. The character of emergency decision making at APG and PBA, as well as potential needs for improvements to decision-making practices, procedures,more » and automated decision-support systems (ADSSs), are described and recommendations are offered to guide equipment acquisition and improve on- and off-post command and control relationships. We recommend that (1) a continued effort be made to integrate on- and off-post command control, and decision-making procedures to permit rapid decision making; (2) the pathways for alert and notification among on- and off-post officials be improved and that responsibilities and chain of command among off-post agencies be clarified; (3) greater attention be given to organizational and social context factors that affect the adequacy of response and the likelihood that decision-making systems will work as intended; and (4) faster improvements be made to on-post ADSSs being developed at APG and PBA, which hold considerable promise for depicting vast amounts of information. Phased development and procurement of computer-assisted decision-making tools should be undertaken to balance immediate needs against available resources and to ensure flexibility, equity among sites, and compatibility among on- and off-post systems. 112 refs., 6 tabs.« less

Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies

PubMed Central

Gillespie, Amaya M; Obregon, Rafael; El Asawi, Rania; Richey, Catherine; Manoncourt, Erma; Joshi, Kshiitij; Naqvi, Savita; Pouye, Ade; Safi, Naqibullah; Chitnis, Ketan; Quereshi, Sabeeha

2016-01-01

ABSTRACT Following the World Health Organization (WHO) declaration of a Public Health Emergency of International Concern regarding the Ebola outbreak in West Africa in July 2014, UNICEF was asked to co-lead, in coordination with WHO and the ministries of health of affected countries, the communication and social mobilization component—which UNICEF refers to as communication for development (C4D)—of the Ebola response. For the first time in an emergency setting, C4D was formally incorporated into each country's national response, alongside more typical components such as supplies and logistics, surveillance, and clinical care. This article describes the lessons learned about social mobilization and community engagement in the emergency response to the Ebola outbreak, with a particular focus on UNICEF's C4D work in Guinea, Liberia, and Sierra Leone. The lessons emerged through an assessment conducted by UNICEF using 4 methods: a literature review of key documents, meeting reports, and other articles; structured discussions conducted in June 2015 and October 2015 with UNICEF and civil society experts; an electronic survey, launched in October and November 2015, with staff from government, the UN, or any partner organization who worked on Ebola (N = 53); and key informant interviews (N = 5). After triangulating the findings from all data sources, we distilled lessons under 7 major domains: (1) strategy and decentralization: develop a comprehensive C4D strategy with communities at the center and decentralized programming to facilitate flexibility and adaptation to the local context; (2) coordination: establish C4D leadership with the necessary authority to coordinate between partners and enforce use of standard operating procedures as a central coordination and quality assurance tool; (3) entering and engaging communities: invest in key communication channels (such as radio) and trusted local community members; (4) messaging: adapt messages and strategies continually as patterns of the epidemic change over time; (5) partnerships: invest in strategic partnerships with community, religious leaders, journalists, radio stations, and partner organizations; (6) capacity building: support a network of local and international professionals with capacity for C4D who can be deployed rapidly; (7) data and performance monitoring: establish clear C4D process and impact indicators and strive for real-time data analysis and rapid feedback to communities and authorities to inform decision making. Ultimately, communication, community engagement, and social mobilization need to be formally placed within the global humanitarian response architecture with proper funding to effectively support future public health emergencies, which are as much a social as a health phenomenon. PMID:28031301

Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies.

PubMed

Gillespie, Amaya M; Obregon, Rafael; El Asawi, Rania; Richey, Catherine; Manoncourt, Erma; Joshi, Kshiitij; Naqvi, Savita; Pouye, Ade; Safi, Naqibullah; Chitnis, Ketan; Quereshi, Sabeeha

2016-12-23

Following the World Health Organization (WHO) declaration of a Public Health Emergency of International Concern regarding the Ebola outbreak in West Africa in July 2014, UNICEF was asked to co-lead, in coordination with WHO and the ministries of health of affected countries, the communication and social mobilization component-which UNICEF refers to as communication for development (C4D)-of the Ebola response. For the first time in an emergency setting, C4D was formally incorporated into each country's national response, alongside more typical components such as supplies and logistics, surveillance, and clinical care. This article describes the lessons learned about social mobilization and community engagement in the emergency response to the Ebola outbreak, with a particular focus on UNICEF's C4D work in Guinea, Liberia, and Sierra Leone. The lessons emerged through an assessment conducted by UNICEF using 4 methods: a literature review of key documents, meeting reports, and other articles; structured discussions conducted in June 2015 and October 2015 with UNICEF and civil society experts; an electronic survey, launched in October and November 2015, with staff from government, the UN, or any partner organization who worked on Ebola (N = 53); and key informant interviews (N = 5). After triangulating the findings from all data sources, we distilled lessons under 7 major domains: (1) strategy and decentralization: develop a comprehensive C4D strategy with communities at the center and decentralized programming to facilitate flexibility and adaptation to the local context; (2) coordination: establish C4D leadership with the necessary authority to coordinate between partners and enforce use of standard operating procedures as a central coordination and quality assurance tool; (3) entering and engaging communities: invest in key communication channels (such as radio) and trusted local community members; (4) messaging: adapt messages and strategies continually as patterns of the epidemic change over time; (5) partnerships: invest in strategic partnerships with community, religious leaders, journalists, radio stations, and partner organizations; (6) capacity building: support a network of local and international professionals with capacity for C4D who can be deployed rapidly; (7) data and performance monitoring: establish clear C4D process and impact indicators and strive for real-time data analysis and rapid feedback to communities and authorities to inform decision making. Ultimately, communication, community engagement, and social mobilization need to be formally placed within the global humanitarian response architecture with proper funding to effectively support future public health emergencies, which are as much a social as a health phenomenon. © Gillespie et al.

Coordinating Post-Tsunami Field Surveys in the us

NASA Astrophysics Data System (ADS)

Kong, L. S.; Chiesa, C.; Dunbar, P. K.; Huart, J.; Richards, K.; Shulters, M.; Stein, A.; Tamura, G.; Wilson, R. I.; Young, E.

2011-12-01

Post-tsunami scientific field surveys are critical for improving the understanding of tsunamis and developing tools and programs to mitigate their effects. After a destructive tsunami, international, national, and local tsunami scientists need to gather information, much of which is perishable or degrades significantly with time. An influx of researchers can put stress on countries already overwhelmed by humanitarian response to the disaster and by the demands of emergency management and other support agencies. In the United States, in addition to university research scientists, government agencies such as the National Oceanic and Atmospheric Administration (NOAA), the U.S. Geologic Survey (USGS), and state/territorial emergency management agencies and geological surveys endeavor to collect physical and social science data to better understand the physics of tsunamis and the impact they have on coastal communities and ecosystems. After a Presidential Major Disaster Declaration, the Federal Emergency Management Agency (FEMA) Joint Field Office works with state/territory emergency management agencies to coordinate response to disasters. In the short-term, the collection and immediate sharing of data enable decision-making that better organizes and deploys often-limited resources to the areas most critically in need of response; and in the long-term, improves recovery planning that will mitigate the losses from the next tsunami. Recent tsunamis have emphasized the need for improved coordination of data collection among scientists and federal, state, and local emergency managers. Improved coordination will ensure data collection efforts are carried out in a safe, secure, efficient, and timely manner. To improve coordination of activities that will better integrate the scientific investigations with government response, the US National Tsunami Hazard Mitigation Program and Pacific Risk Management 'Ohana (PRiMO) are working together to develop a consistent framework for a tsunami technical clearinghouse (TTC). The goals of the TTC, which would include at a minimum an electronic information server but could also include a physical location, are to: 1) assist in the response to, damage assessment of, and early recovery from the natural disaster; 2) facilitate researcher access to the affected areas; and 3) contribute to the capture of valuable and perishable data. The Working Group, composed of representatives from NOAA, USGS, FEMA, and state and local emergency managers and geoscientists, will engage with other stakeholders and the science community to review existing national standard operating procedures for post-tsunami scientific field surveys and data collection, as well as make recommendations for domestic application. The outcomes are intended to propose a national structure that can be consistently implemented within each state and territory.

Implementation and evaluation of health passport communication tools in emergency departments.

PubMed

Heifetz, Marina; Lunsky, Yona

2018-01-01

People with IDD (intellectual or developmental disabilities) and their families consistently report dissatisfaction with their emergency department experience. Clear care plans and communication tools may not only improve the quality of patient care, but also can prevent unnecessary visits and reduce the likelihood of return visits. To evaluate communication tools to be used by people with IDD in psychiatric and general emergency departments in three different regions of Ontario. Health passport communication tools were locally tailored and implemented in each of the three regions. A total of 28 questionnaires and 18 interviews with stakeholders (e.g., hospital staff, community agency representatives, families) were completed across the regions to obtain feedback on the implementation of health passports with people with IDD. Participants felt that the health passport tools provided helpful information, improved communication between patients with IDD and hospital staff, and were user friendly. Continued efforts are needed to work with communities on maintenance of this tool, ensuring all hospital staff are utilizing the information. These findings emphasize the merits of health passport tools being implemented in the health system to support communication between patients with IDD and health care practitioners and the importance of tailoring tools to local settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improving the relevance and impact of decision support research: A co-production framework and water management case study

NASA Astrophysics Data System (ADS)

Smith, R.; Kasprzyk, J. R.; Dilling, L.; Basdekas, L.; Kaatz, L.

2016-12-01

In light of the unpredictable effects of climate change and population shifts, responsible resource management will require new types of information and strategies going forward. For water utilities, this means that water supply infrastructure systems must be expanded and/or managed for changes in overall supply and increased extremes. Utilities have begun seeking innovative tools and methods to support planning and decision making, but there are limited channels through which they can gain exposure to emerging tools from the research world, and for researchers to uptake important real-world planning and decision context. A transdisciplinary team of engineers, social and climate scientists, and water managers designed this study to develop and apply a co-production framework which explores the potential of an emerging decision support tool to enhance flexibility and adaptability in water utility planning. It also demonstrates how to improve the link between research and practice in the water sector. In this study we apply the co-production framework to the use of Multiobjective Evolutionary Algorithms (MOEAs). MOEAs have shown promise in being able to generate and evaluate new planning alternatives but they have had little testing or application in water utilities. Anchored by two workshops, this study (1) elicited input from water managers from six water suppliers on the Front Range of Colorado, USA, to create a testbed MOEA application, and (2) evaluated the managers' responses to multiobjective optimization results. The testbed consists of a Front Range-relevant hypothetical water supply model, the Borg MOEA, hydrology and demand scenarios, and a set of planning decisions and performance objectives that drive the link between the algorithm and the model. In this presentation we describe researcher-manager interactions at the initial workshop that served to establish relationships and provide in-depth information to researchers about regional water management context. We also describe the development of, and experiences from, the second workshop which included activities for water managers to interact directly with MOEA testbed results. Finally, we evaluate the co-production framework itself and the potential for the feedback from managers to shape future development of decision support tools.

Molecular rheology of branched polymers: decoding and exploring the role of architectural dispersity through a synergy of anionic synthesis, interaction chromatography, rheometry and modeling.

PubMed

van Ruymbeke, E; Lee, H; Chang, T; Nikopoulou, A; Hadjichristidis, N; Snijkers, F; Vlassopoulos, D

2014-07-21

An emerging challenge in polymer physics is the quantitative understanding of the influence of a macromolecular architecture (i.e., branching) on the rheological response of entangled complex polymers. Recent investigations of the rheology of well-defined architecturally complex polymers have determined the composition in the molecular structure and identified the role of side-products in the measured samples. The combination of different characterization techniques, experimental and/or theoretical, represents the current state-of-the-art. Here we review this interdisciplinary approach to molecular rheology of complex polymers, and show the importance of confronting these different tools for ensuring an accurate characterization of a given polymeric sample. We use statistical tools in order to relate the information available from the synthesis protocols of a sample and its experimental molar mass distribution (typically obtained from size exclusion chromatography), and hence obtain precise information about its structural composition, i.e. enhance the existing sensitivity limit. We critically discuss the use of linear rheology as a reliable quantitative characterization tool, along with the recently developed temperature gradient interaction chromatography. The latter, which has emerged as an indispensable characterization tool for branched architectures, offers unprecedented sensitivity in detecting the presence of different molecular structures in a sample. Combining these techniques is imperative in order to quantify the molecular composition of a polymer and its consequences on the macroscopic properties. We validate this approach by means of a new model asymmetric comb polymer which was synthesized anionically. It was thoroughly characterized and its rheology was carefully analyzed. The main result is that the rheological signal reveals fine molecular details, which must be taken into account to fully elucidate the viscoelastic response of entangled branched polymers. It is important to appreciate that, even optimal model systems, i.e., those synthesized with high-vacuum anionic methods, need thorough characterization via a combination of techniques. Besides helping to improve synthetic techniques, this methodology will be significant in fine-tuning mesoscopic tube-based models and addressing outstanding issues such as the quantitative description of the constraint release mechanism.

Codes of environmental management practice: Assessing their potential as a tool for change

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nash, J.; Ehrenfeld, J.

1997-12-31

Codes of environmental management practice emerged as a tool of environmental policy in the late 1980s. Industry and other groups have developed codes for two purposes: to change the environmental behavior of participating firms and to increase public confidence in industry`s commitment to environmental protection. This review examines five codes of environmental management practice: Responsible Care, the International Chamber of Commerce`s Business Charter for Sustainable Development, ISO 14000, the CERES Principles, and The Natural Step. The first three codes have been drafted and promoted primarily by industry; the others have been developed by non-industry groups. These codes have spurred participatingmore » firms to introduce new practices, including the institution of environmental management systems, public environmental reporting, and community advisory panels. The extent to which codes are introducing a process of cultural change is considered in terms of four dimensions: new consciousness, norms, organization, and tools. 94 refs., 3 tabs.« less

Real-Time Visualization of Network Behaviors for Situational Awareness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Best, Daniel M.; Bohn, Shawn J.; Love, Douglas V.

Plentiful, complex, and dynamic data make understanding the state of an enterprise network difficult. Although visualization can help analysts understand baseline behaviors in network traffic and identify off-normal events, visual analysis systems often do not scale well to operational data volumes (in the hundreds of millions to billions of transactions per day) nor to analysis of emergent trends in real-time data. We present a system that combines multiple, complementary visualization techniques coupled with in-stream analytics, behavioral modeling of network actors, and a high-throughput processing platform called MeDICi. This system provides situational understanding of real-time network activity to help analysts takemore » proactive response steps. We have developed these techniques using requirements gathered from the government users for which the tools are being developed. By linking multiple visualization tools to a streaming analytic pipeline, and designing each tool to support a particular kind of analysis (from high-level awareness to detailed investigation), analysts can understand the behavior of a network across multiple levels of abstraction.« less

Intimate partner violence, pregnancy and the decision for abortion.

PubMed

Williams, Gail B; Brackley, Margaret H

2009-04-01

Pregnant women whose lives are affected by intimate partner violence and unintended pregnancy are often faced with the decision for abortion. In this qualitative research, the authors explored women's experiences of unintended pregnancy and intimate partner violence (IPV) from the perspective of adult pregnant women seeking abortion. Women were assessed for intimate partner violence and study inclusion by means of two IPV screening tools. The authors collected data during one-to two-hour semi-structured interviews with eight pregnant women. At the completion of the interviews, all women were assessed for safety using an assessment of danger tool. Safety planning and referrals were provided for all women. Qualitative data collection and data analysis were guided by naturalistic inquiry to identify prevalent themes. Three major themes emerged from the data: (1) It Wasn't That Bad, (2) Then It Got Worse, and (3) If I Have the Baby He'll Come Back. Descriptive statistics were used to tabulate and describe the women's responses to the three tools.

Modeling fate and transport of "Contaminants of Emerging Concern" (CECs): is the Soil Water Assessment Tool (SWAT) the appropriate model?

USDA-ARS?s Scientific Manuscript database

Background/Question/Methods As the scientific and regulatory communities realize the significant environmental impacts and ubiquity of “contaminants of emerging concern” (CECs), it is increasingly imperative to develop quantitative assessment tools to evaluate and predict the fate and transport of...

A Conceptual Framework for Emergent Digital Literacy

ERIC Educational Resources Information Center

Neumann, Michelle M.; Finger, Glenn; Neumann, David L.

2017-01-01

As we progress in the 21st century, children learn to become proficient readers and writers of both digital and non-digital texts. Knowledge, skills, and understandings of literacy emerge through sociocultural interactions with non-digital tools (e.g., paper-printed books) and digital tools (e.g., touch screen tablets). However, debate is ongoing…

40 CFR 1.47 - Office of Solid Waste and Emergency Response.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the Agency's solid and hazardous wastes and emergency response programs. This Office has primary..., under the supervision of a Director, is responsible for the emergency and remedial response functions of...) Providing direction, guidance, and support to the Agency's non-enforcement emergency and remedial response...

International Radiation Monitoring and Information System (IRMIS)

NASA Astrophysics Data System (ADS)

Mukhopadhyay, Sanjoy; Baciu, Florian; Stowisek, Jan; Saluja, Gurdeep; Kenny, Patrick; Albinet, Franck

2017-09-01

This article describes the International Radiation Monitoring Information System (IRMIS) which was developed by the International Atomic Energy Agency (IAEA) with the goal to provide Competent Authorities, the IAEA and other international organizations with a client server based web application to share and visualize large quantities of radiation monitoring data. The data maps the areas of potential impact that can assist countries to take appropriate protective actions in an emergency. Ever since the Chernobyl nuclear power plant accident in April of 19861 European Community (EC) has worked towards collecting routine environmental radiological monitoring data from national networked monitoring systems. European Radiological Data Exchange Platform (EURDEP) was created in 19952 to that end - to provide radiation monitoring data from most European countries reported in nearly real-time. During the response operations for the Fukushima Dai-ichi nuclear power plant accident (March 2011) the IAEA Incident and Emergency Centre (IEC) managed, harmonized and shared the large amount of data that was being generated from different organizations. This task underscored the need for a system which allows sharing large volumes of radiation monitoring data in an emergency. In 2014 EURDEP started the submission of the European radiological data to the International Radiation Monitoring Information System (IRMIS) as a European Regional HUB for IRMIS. IRMIS supports the implementation of the Convention on Early Notification of a Nuclear Accident by providing a web application for the reporting, sharing, visualizing and analysing of large quantities of environmental radiation monitoring data during nuclear or radiological emergencies. IRMIS is not an early warning system that automatically reports when there are significant deviations in radiation levels or when values are detected above certain levels. However, the configuration of the visualization features offered by IRMIS may help Member States to determine where elevated gamma dose rate measurements during a radiological or nuclear emergency indicate that actions to protect the public are necessary. The data can be used to assist emergency responders determine where and when to take necessary actions to protect the public. This new web online tool supports the IAEA's Unified System for Information Exchange in Incidents and Emergencies (USIE)3, an online tool where competent authorities can access information about all emergency situations, ranging from a lost radioactive source to a full-scale nuclear emergency.

Major oil spill response coordination in the combat of spills in Bahrain waters

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, D.J.S.; James, J.D.

1985-01-01

On Aug. 25, 1980, without warning, a large oil slick invaded the north and west coasts of Bahrain. This serious incident was designated a national emergency, and a special high-level government committee was established immediately to handle the response procedure. This paper describes how the committee functioned with the private sector and the problems encountered and overcome. The lessons learned have stimulated interest in the proposed use of computers to aid combat operations as both a technical tool and an information service. In addition, this experience can guide those responsible for controlling response operations for future major oil spills inmore » coastal areas. With proper planning, a highly satisfactory cooperative organization can be established between goverment and the private sector to respond effectively, economically, and with minimum environmental damage to a major oil spill affecting coastal waters and shorelines. Part of this planning is to collate and record the major available response equipment and material packages, thereby increasing the necessary state of readiness.« less

Strange nonchaotic attractors for computation

NASA Astrophysics Data System (ADS)

Sathish Aravindh, M.; Venkatesan, A.; Lakshmanan, M.

2018-05-01

We investigate the response of quasiperiodically driven nonlinear systems exhibiting strange nonchaotic attractors (SNAs) to deterministic input signals. We show that if one uses two square waves in an aperiodic manner as input to a quasiperiodically driven double-well Duffing oscillator system, the response of the system can produce logical output controlled by such a forcing. Changing the threshold or biasing of the system changes the output to another logic operation and memory latch. The interplay of nonlinearity and quasiperiodic forcing yields logical behavior, and the emergent outcome of such a system is a logic gate. It is further shown that the logical behaviors persist even for an experimental noise floor. Thus the SNA turns out to be an efficient tool for computation.

The Potential Impact of Preventive HIV Vaccines in China: Results and Benefits of a Multi-Province Modeling Collaboration

PubMed Central

Harmon, Thomas; Guo, Wei; Stover, John; Wu, Zunyou; Kaufman, Joan; Schneider, Kammerle; Liu, Li; Feng, Liao; Schwartländer, Bernard

2015-01-01

China’s commitment to implementing established and emerging HIV/AIDS prevention and control strategies has led to substantial gains in terms of access to antiretroviral treatment and prevention services, but the evolving and multifaceted HIV/AIDS epidemic in China highlights the challenges of maintaining that response. This study presents modeling results exploring the potential impact of HIV vaccines in the Chinese context at varying efficacy and coverage rates, while further exploring the potential implications of vaccination programs aimed at reaching populations at highest risk of HIV infection. A preventive HIV vaccine would add a powerful tool to China’s response, even if not 100% efficacious or available to the full population. PMID:26344945

Mesenchymal stem cells: Emerging mechanisms of immunomodulation and therapy

PubMed Central

Glenn, Justin D; Whartenby, Katharine A

2014-01-01

Mesenchymal stem cells (MSCs) are a pleiotropic population of cells that are self-renewing and capable of differentiating into canonical cells of the mesenchyme, including adipocytes, chondrocytes, and osteocytes. They employ multi-faceted approaches to maintain bone marrow niche homeostasis and promote wound healing during injury. Biomedical research has long sought to exploit their pleiotropic properties as a basis for cell therapy for a variety of diseases and to facilitate hematopoietic stem cell establishment and stromal reconstruction in bone marrow transplantation. Early results demonstrated their usage as safe, and there was little host response to these cells. The discovery of their immunosuppressive functions ushered in a new interest in MSCs as a promising therapeutic tool to suppress inflammation and down-regulate pathogenic immune responses in graft-versus-host and autoimmune diseases such as multiple sclerosis, autoimmune diabetes, and rheumatoid arthritis. MSCs produce a large number of soluble and membrane-bound factors, some of which inhibit immune responses. However, the full range of MSC-mediated immune-modulation remains incompletely understood, as emerging reports also reveal that MSCs can adopt an immunogenic phenotype, stimulate immune cells, and yield seemingly contradictory results in experimental animal models of inflammatory disease. The present review describes the large body of literature that has been accumulated on the fascinating biology of MSCs and their complex effects on immune responses. PMID:25426250

Fast vaccine design and development based on correlates of protection (COPs)

PubMed Central

van Els, Cécile; Mjaaland, Siri; Næss, Lisbeth; Sarkadi, Julia; Gonczol, Eva; Smith Korsholm, Karen; Hansen, Jon; de Jonge, Jørgen; Kersten, Gideon; Warner, Jennifer; Semper, Amanda; Kruiswijk, Corine; Oftung, Fredrik

2014-01-01

New and reemerging infectious diseases call for innovative and efficient control strategies of which fast vaccine design and development represent an important element. In emergency situations, when time is limited, identification and use of correlates of protection (COPs) may play a key role as a strategic tool for accelerated vaccine design, testing, and licensure. We propose that general rules for COP-based vaccine design can be extracted from the existing knowledge of protective immune responses against a large spectrum of relevant viral and bacterial pathogens. Herein, we focus on the applicability of this approach by reviewing the established and up-coming COPs for influenza in the context of traditional and a wide array of new vaccine concepts. The lessons learnt from this field may be applied more generally to COP-based accelerated vaccine design for emerging infections. PMID:25424803

40 CFR 68.180 - Emergency response program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... activities and the emergency response plan is coordinated. (c) The owner or operator shall list other Federal... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.180 Emergency response program... written emergency response plan? (2) Does the plan include specific actions to be taken in response to an...

40 CFR 68.180 - Emergency response program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... activities and the emergency response plan is coordinated. (c) The owner or operator shall list other Federal... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.180 Emergency response program... written emergency response plan? (2) Does the plan include specific actions to be taken in response to an...

40 CFR 68.180 - Emergency response program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... activities and the emergency response plan is coordinated. (c) The owner or operator shall list other Federal... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.180 Emergency response program... written emergency response plan? (2) Does the plan include specific actions to be taken in response to an...

40 CFR 68.180 - Emergency response program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... activities and the emergency response plan is coordinated. (c) The owner or operator shall list other Federal... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.180 Emergency response program... written emergency response plan? (2) Does the plan include specific actions to be taken in response to an...

RMP Guidance for Chemical Distributors - Chapter 8: Emergency Response Program

EPA Pesticide Factsheets

Depending on the level of processes at your facility, part 68 may require an emergency response program: an emergency response plan, emergency response equipment procedures, employee training, and procedures to ensure the program is up-to-date.

Surveillance of Travellers: An Additional Tool for Tracking Antimalarial Drug Resistance in Endemic Countries

PubMed Central

Gharbi, Myriam; Flegg, Jennifer A.; Pradines, Bruno; Berenger, Ako; Ndiaye, Magatte; Djimdé, Abdoulaye A.; Roper, Cally; Hubert, Véronique; Kendjo, Eric; Venkatesan, Meera; Brasseur, Philippe; Gaye, Oumar; Offianan, André T.; Penali, Louis; Le Bras, Jacques; Guérin, Philippe J.; Study, Members of the French National Reference Center for Imported Malaria

2013-01-01

Introduction There are growing concerns about the emergence of resistance to artemisinin-based combination therapies (ACTs). Since the widespread adoption of ACTs, there has been a decrease in the systematic surveillance of antimalarial drug resistance in many malaria-endemic countries. The aim of this work was to test whether data on travellers returning from Africa with malaria could serve as an additional surveillance system of local information sources for the emergence of drug resistance in endemic-countries. Methodology Data were collected from travellers with symptomatic Plasmodium falciparum malaria returning from Senegal (n = 1,993), Mali (n = 2,372), Cote d’Ivoire (n = 4,778) or Cameroon (n = 3,272) and recorded in the French Malaria Reference Centre during the period 1996–2011. Temporal trends of the proportion of parasite isolates that carried the mutant genotype, pfcrt 76T, a marker of resistance to chloroquine (CQ) and pfdhfr 108N, a marker of resistance to pyrimethamine, were compared for travellers and within-country surveys that were identified through a literature review in PubMed. The in vitro response to CQ was also compared between these two groups for parasites from Senegal. Results The trends in the proportion of parasites that carried pfcrt 76T, and pfdhfr 108N, were compared for parasites from travellers and patients within-country using the slopes of the curves over time; no significant differences in the trends were found for any of the 4 countries. These results were supported by in vitro analysis of parasites from the field in Senegal and travellers returning to France, where the trends were also not significantly different. Conclusion The results have not shown different trends in resistance between parasites derived from travellers or from parasites within-country. This work highlights the value of an international database of drug responses in travellers as an additional tool to assess the emergence of drug resistance in endemic areas where information is limited. PMID:24204960

Surveillance of travellers: an additional tool for tracking antimalarial drug resistance in endemic countries.

PubMed

Gharbi, Myriam; Flegg, Jennifer A; Pradines, Bruno; Berenger, Ako; Ndiaye, Magatte; Djimdé, Abdoulaye A; Roper, Cally; Hubert, Véronique; Kendjo, Eric; Venkatesan, Meera; Brasseur, Philippe; Gaye, Oumar; Offianan, André T; Penali, Louis; Le Bras, Jacques; Guérin, Philippe J

2013-01-01

There are growing concerns about the emergence of resistance to artemisinin-based combination therapies (ACTs). Since the widespread adoption of ACTs, there has been a decrease in the systematic surveillance of antimalarial drug resistance in many malaria-endemic countries. The aim of this work was to test whether data on travellers returning from Africa with malaria could serve as an additional surveillance system of local information sources for the emergence of drug resistance in endemic-countries. Data were collected from travellers with symptomatic Plasmodium falciparum malaria returning from Senegal (n = 1,993), Mali (n = 2,372), Cote d'Ivoire (n = 4,778) or Cameroon (n = 3,272) and recorded in the French Malaria Reference Centre during the period 1996-2011. Temporal trends of the proportion of parasite isolates that carried the mutant genotype, pfcrt 76T, a marker of resistance to chloroquine (CQ) and pfdhfr 108N, a marker of resistance to pyrimethamine, were compared for travellers and within-country surveys that were identified through a literature review in PubMed. The in vitro response to CQ was also compared between these two groups for parasites from Senegal. The trends in the proportion of parasites that carried pfcrt 76T, and pfdhfr 108N, were compared for parasites from travellers and patients within-country using the slopes of the curves over time; no significant differences in the trends were found for any of the 4 countries. These results were supported by in vitro analysis of parasites from the field in Senegal and travellers returning to France, where the trends were also not significantly different. The results have not shown different trends in resistance between parasites derived from travellers or from parasites within-country. This work highlights the value of an international database of drug responses in travellers as an additional tool to assess the emergence of drug resistance in endemic areas where information is limited.

Predictive Ability of an Emergency Medical Dispatch Stroke Diagnostic Tool in Identifying Hospital-Confirmed Strokes.

PubMed

Clawson, Jeff J; Scott, Greg; Gardett, Isabel; Youngquist, Scott; Taillac, Peter; Fivaz, Conrad; Olola, Christopher

2016-08-01

Early hospital notification of a possible stroke arriving via emergency medical services (EMS) can prepare stroke center personnel for timely treatment, especially timely administration of tissue plasminogen activator. Stroke center notification from the emergency dispatch center-before responders reach the scene-may promote even earlier and faster system activation, meaning that stroke center teams may be ready to receive patients as soon as the ambulance arrives. This study evaluates the use of a Medical Priority Dispatch System (MPDS; Priority Dispatch Corp., Salt Lake City, UT) Stroke Diagnostic Tool (SDxT) to identify possible strokes early by comparing the tools' results to on-scene and hospital findings. The retrospective descriptive study utilized stroke data from 3 sources: emergency medical dispatch, EMS, and emergency department/hospital. A total of 830 cases were collected between June 2012 and December 2013, of which 603 (72.7%) had matching dispatch records. Of the 603 cases, 304 (50.4%) were handled using MPDS Stroke Protocol 28. The SDxT had an 86.4% ability (OR [95% CI]: 2.3 [1.5, 3.5]) to effectively identify strokes among all the hospital-confirmed stroke cases (sensitivity), and a 26.6% ability to effectively identify nonstrokes among all the hospital-confirmed nonstroke cases (specificity). The SDxT demonstrated a very high sensitivity, compared to similar tools used in the field and at dispatch. The specificity was somewhat low, but this was expected-and is intended in the creation of protocols to be used over the phone in emergency situations. The tool is a valuable method for identifying strokes early and may allow early hospital notification. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Efficacy of a tool to predict short-term mortality in older people presenting at emergency departments: Protocol for a multi-centre cohort study.

PubMed

Cardona, Magnolia; Lewis, Ebony T; Turner, Robin M; Alkhouri, Hatem; Asha, Stephen; Mackenzie, John; Perkins, Margaret; Suri, Sam; Holdgate, Anna; Winoto, Luis; Chang, Chan-Wei; Gallego-Luxan, Blanca; McCarthy, Sally; Kristensen, Mette R; O'Sullivan, Michael; Skjøt-Arkil, Helene; Ekmann, Anette A; Nygaard, Hanne H; Jensen, Jonas J; Jensen, Rune O; Pedersen, Jonas L; Breen, Dorothy; Petersen, John A; Jensen, Birgitte N; Mogensen, Christian Backer; Hillman, Ken; Brabrand, Mikkel

Prognostic uncertainty inhibits clinicians from initiating timely end-of-life discussions and advance care planning. This study evaluates the efficacy of the CriSTAL (Criteria for Screening and Triaging to Appropriate aLternative care) checklist in emergency departments. Prospective cohort study of patients aged ≥65 years with any diagnosis admitted via emergency departments in ten hospitals in Australia, Denmark and Ireland. Electronic and paper clinical records will be used to extract risk factors such as nursing home residency, physiological deterioration warranting a rapid response call, personal history of active chronic disease, history of hospitalisations or intensive care unit admission in the past year, evidence of proteinuria or ECG abnormalities, and evidence of frailty to be concurrently measured with Fried Score and Clinical Frailty Scale. Patients or their informal caregivers will be contacted by telephone around three months after initial assessment to ascertain survival, self-reported health, post-discharge frailty and health service utilisation since discharge. Logistic regression and bootstrapping techniques and AUROC curves will be used to test the predictive accuracy of CriSTAL for death within 90 days of admission and in-hospital death. The CriSTAL checklist is an objective and practical tool for use in emergency departments among older patients to determine individual probability of death in the short-term. Its validation in this cohort is expected to reduce clinicians' prognostic uncertainty on the time to patients' death and encourage timely end-of-life conversations to support clinical decisions with older frail patients and their families about their imminent or future care choices. Copyright © 2018 Elsevier B.V. All rights reserved.

Detecting and diagnosing hotspots for the enhanced management of hospital emergency departments in Queensland, Australia

PubMed Central

2013-01-01

Background Predictive tools are already being implemented to assist in Emergency Department bed management by forecasting the expected total volume of patients. Yet these tools are unable to detect and diagnose when estimates fall short. Early detection of hotspots, that is subpopulations of patients presenting in unusually high numbers, would help authorities to manage limited health resources and communicate effectively about emerging risks. We evaluate an anomaly detection tool that signals when, and in what way Emergency Departments in 18 hospitals across the state of Queensland, Australia, are significantly exceeding their forecasted patient volumes. Methods The tool in question is an adaptation of the Surveillance Tree methodology initially proposed in Sparks and Okugami (IntStatl 1:2–24, 2010). for the monitoring of vehicle crashes. The methodology was trained on presentations to 18 Emergency Departments across Queensland over the period 2006 to 2008. Artificial increases were added to simulated, in-control counts for these data to evaluate the tool’s sensitivity, timeliness and diagnostic capability. The results were compared with those from a univariate control chart. The tool was then applied to data from 2009, the year of the H1N1 (or ‘Swine Flu’) pandemic. Results The Surveillance Tree method was found to be at least as effective as a univariate, exponentially weighted moving average (EWMA) control chart when increases occurred in a subgroup of the monitored population. The method has advantages over the univariate control chart in that it allows for the monitoring of multiple disease groups while still allowing control of the overall false alarm rate. It is also able to detect changes in the makeup of the Emergency Department presentations, even when the total count remains unchanged. Furthermore, the Surveillance Tree method provides diagnostic information useful for service improvements or disease management. Conclusions Multivariate surveillance provides a useful tool in the management of hospital Emergency Departments by not only efficiently detecting unusually high numbers of presentations, but by providing information about which groups of patients are causing the increase. PMID:24313914

DOE Office of Scientific and Technical Information (OSTI.GOV)

Endele, Max; Etzrodt, Martin; Schroeder, Timm, E-mail: timm.schroeder@bsse.ethz.ch

Hematopoiesis is the cumulative consequence of finely tuned signaling pathways activated through extrinsic factors, such as local niche signals and systemic hematopoietic cytokines. Whether extrinsic factors actively instruct the lineage choice of hematopoietic stem and progenitor cells or are only selectively allowing survival and proliferation of already intrinsically lineage-committed cells has been debated over decades. Recent results demonstrated that cytokines can instruct lineage choice. However, the precise function of individual cytokine-triggered signaling molecules in inducing cellular events like proliferation, lineage choice, and differentiation remains largely elusive. Signal transduction pathways activated by different cytokine receptors are highly overlapping, but support themore » production of distinct hematopoietic lineages. Cellular context, signaling dynamics, and the crosstalk of different signaling pathways determine the cellular response of a given extrinsic signal. New tools to manipulate and continuously quantify signaling events at the single cell level are therefore required to thoroughly interrogate how dynamic signaling networks yield a specific cellular response. - Highlights: • Recent studies provided definite proof for lineage-instructive action of cytokines. • Signaling pathways involved in hematopoietic lineage instruction remain elusive. • New tools are emerging to quantitatively study dynamic signaling networks over time.« less

Assessment of factors influencing preservation of dignity at life's end: creation and the cross-cultural validation of the preservation of dignity card-sort tool.

PubMed

Periyakoil, Vyjeyanthi S; Noda, Arthur M; Kraemer, Helena Chmura

2010-05-01

Preserving patient dignity is a sentinel premise of palliative care. This study was conducted to gain a better understanding of factors influencing preservation of dignity in the last chapter of life. We conducted an open-ended written survey of 100 multidisciplinary providers (69% response rate) and responses were categorized to identify 2 main themes, 5 subthemes, and 10 individual factors that were used to create the preservation of dignity card-sort tool (p-DCT). The 10-item rank order tool was administered to a cohort of community dwelling Filipino Americans (n = 140, age mean = 61.3, 45% male and 55% female). A Spearman correlation matrix was constructed for all the 10 individual factors as well as the themes and subthemes based on the data generated by the subjects. The individual factors were minimally correlated with each other indicating that each factor was an independent stand-alone factor. The median, 25th and 75th percentile ranks were calculated and "s/he has self-respect" (intrinsic theme, self-esteem subtheme) emerged as the most important factor (mean rank 3.0 and median rank 2.0) followed by "others treat her/him with respect" (extrinsic theme, respect subtheme) with a mean rank = 3.6 and median = 3.0. The p-DCT is a simple, rank order card-sort tool that may help clinicians identify patients' perceptions of key factors influencing the preservation of their dignity in the last chapter of life.

Using principles from emergency management to improve emergency response plans for research animals.

PubMed

Vogelweid, Catherine M

2013-10-01

Animal research regulatory agencies have issued updated requirements for emergency response planning by regulated research institutions. A thorough emergency response plan is an essential component of an institution's animal care and use program, but developing an effective plan can be a daunting task. The author provides basic information drawn from the field of emergency management about best practices for developing emergency response plans. Planners should use the basic principles of emergency management to develop a common-sense approach to managing emergencies in their facilities.

Novel vaccine strategies against emerging viruses

PubMed Central

García-Sastre, Adolfo; Mena, Ignacio

2013-01-01

One of the main public health concerns of emerging viruses is their potential introduction into and sustained circulation among populations of immunologically naïve, susceptible hosts. The induction of protective immunity through vaccination can be a powerful tool to prevent this concern by conferring protection to the population at risk. Conventional approaches to develop vaccines against emerging pathogens have significant limitations: lack of experimental tools for several emerging viruses of concern, poor immunogenicity, safety issues, or lack of cross-protection against antigenic variants. The unpredictability of the emergence of future virus threats demands the capability to rapidly develop safe, effective vaccines. We describe some recent advances in new vaccine strategies that are being explored as alternatives to classical attenuated and inactivated vaccines, and provide examples of potential novel vaccines for emerging viruses. These approaches might be applied to the control of many other emerging pathogens. PMID:23477832

Southern states radiological emergency response laws and regulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1989-07-01

The purpose of this report is to provide a summary of the emergency response laws and regulations in place in the various states within the southern region for use by legislators, emergency response planners, the general public and all persons concerned about the existing legal framework for emergency response. SSEB expects to periodically update the report as necessary. Radiation protection regulations without emergency response provisions are not included in the summary.

Development of a self-assessment teamwork tool for use by medical and nursing students.

PubMed

Gordon, Christopher J; Jorm, Christine; Shulruf, Boaz; Weller, Jennifer; Currie, Jane; Lim, Renee; Osomanski, Adam

2016-08-24

Teamwork training is an essential component of health professional student education. A valid and reliable teamwork self-assessment tool could assist students to identify desirable teamwork behaviours with the potential to promote learning about effective teamwork. The aim of this study was to develop and evaluate a self-assessment teamwork tool for health professional students for use in the context of emergency response to a mass casualty. The authors modified a previously published teamwork instrument designed for experienced critical care teams for use with medical and nursing students involved in mass casualty simulations. The 17-item questionnaire was administered to students immediately following the simulations. These scores were used to explore the psychometric properties of the tool, using Exploratory and Confirmatory Factor Analysis. 202 (128 medical and 74 nursing) students completed the self-assessment teamwork tool for students. Exploratory factor analysis revealed 2 factors (5 items - Teamwork coordination and communication; 4 items - Information sharing and support) and these were justified with confirmatory factor analysis. Internal consistency was 0.823 for Teamwork coordination and communication, and 0.812 for Information sharing and support. These data provide evidence to support the validity and reliability of the self-assessment teamwork tool for students This self-assessment tool could be of value to health professional students following team training activities to help them identify the attributes of effective teamwork.

Social media in the emergency medicine residency curriculum: social media responses to the residents' perspective article.

PubMed

Hayes, Bryan D; Kobner, Scott; Trueger, N Seth; Yiu, Stella; Lin, Michelle

2015-05-01

In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Emergency physicians' perceptions of health information exchange.

PubMed

Shapiro, Jason S; Kannry, Joseph; Kushniruk, Andre W; Kuperman, Gilad

2007-01-01

Health information exchange (HIE) is a potentially powerful technology that can improve the quality of care delivered in emergency departments, but little is known about emergency physicians' current perceptions of HIE. This study sought to assess emergency physicians' perceived needs and knowledge of HIE. A questionnaire was developed based on heuristics from the literature and implemented in a Web-based tool. The survey was sent as a hyperlink via e-mail to 371 attending emergency physicians at 12 hospitals in New York City. The response rate was 58% (n = 216). Although 63% said more than one quarter of their patients would benefit from external health information, the barriers to obtain it without HIE are too high--85% said it was difficult or very difficult to obtain external data, taking an average of 66 minutes, 72% said that their attempts fail half of the time, and 56% currently attempt to obtain external data less than 10% of the time. When asked to create a rank-order list, electrocardiograms (ECGs) were ranked the highest, followed by discharge summaries. Respondents also chose images over written reports for ECGs and X-rays, but preferred written reports for advanced imaging and cardiac studies. There is a strong perceived need for HIE, most respondents were not aware of HIE prior to this study, and there are certain types of data and presentations of data that are preferred by emergency physicians in the New York City region.

Polio infrastructure strengthened disease outbreak preparedness and response in the WHO African Region.

PubMed

Kouadio, Koffi; Okeibunor, Joseph; Nsubuga, Peter; Mihigo, Richard; Mkanda, Pascal

2016-10-10

The continuous deployments of polio resources, infrastructures and systems for responding to other disease outbreaks in many African countries has led to a number of lessons considered as best practice that need to be documented for strengthening preparedness and response activities in future outbreaks. We reviewed and documented the influence of polio best practices in outbreak preparedness and response in Angola, Nigeria and Ethiopia. Data from relevant programmes of the WHO African Region were also analyzed to demonstrate clearly the relative contributions of PEI resources and infrastructure to effective disease outbreak preparedness and response. Polio resources including, human, financial, and logistic, tool and strategies have tremendously contributed to responding to diseases outbreaks across the African region. In Angola, Nigeria and Ethiopia, many disease epidemics including Marburg Hemorrhagic fever, Dengue fever, Ebola Virus Diseases (EVD), Measles, Anthrax and Shigella have been controlled using existing polio Eradication Initiatives resources. Polio staffs are usually deployed in occasions to supports outbreak response activities (coordination, surveillance, contact tracing, case investigation, finance, data management, etc.). Polio logistics such vehicles, laboratories were also used in the response activities to other infectious diseases. Many polio tools including micro planning, dashboard, guidelines, SOPs on preparedness and response have also benefited to other epidemic-prone diseases. The Countries' preparedness and response plan to WPV importation as well as the Polio Emergency Operation Center models were successfully used to develop, strengthen and respond to many other diseases outbreak with the implication of partners and the strong leadership and ownership of governments. This review has important implications for WHO/AFRO initiative to strengthening and improving disease outbreak preparedness and responses in the African Region in respect to the international health regulations core capacities. Copyright © 2016 World Health Organization Regional Office for Africa. Published by Elsevier Ltd.. All rights reserved.

Overcoming redundancies in bedside nursing assessments by validating a parsimonious meta-tool: findings from a methodological exercise study.

PubMed

Palese, Alvisa; Marini, Eva; Guarnier, Annamaria; Barelli, Paolo; Zambiasi, Paola; Allegrini, Elisabetta; Bazoli, Letizia; Casson, Paola; Marin, Meri; Padovan, Marisa; Picogna, Michele; Taddia, Patrizia; Chiari, Paolo; Salmaso, Daniele; Marognolli, Oliva; Canzan, Federica; Ambrosi, Elisa; Saiani, Luisa; Grassetti, Luca

2016-10-01

There is growing interest in validating tools aimed at supporting the clinical decision-making process and research. However, an increased bureaucratization of clinical practice and redundancies in the measures collected have been reported by clinicians. Redundancies in clinical assessments affect negatively both patients and nurses. To validate a meta-tool measuring the risks/problems currently estimated by multiple tools used in daily practice. A secondary analysis of a database was performed, using a cross-validation and a longitudinal study designs. In total, 1464 patients admitted to 12 medical units in 2012 were assessed at admission with the Brass, Barthel, Conley and Braden tools. Pertinent outcomes such as the occurrence of post-discharge need for resources and functional decline at discharge, as well as falls and pressure sores, were measured. Explorative factor analysis of each tool, inter-tool correlations and a conceptual evaluation of the redundant/similar items across tools were performed. Therefore, the validation of the meta-tool was performed through explorative factor analysis, confirmatory factor analysis and the structural equation model to establish the ability of the meta-tool to predict the outcomes estimated by the original tools. High correlations between the tools have emerged (from r 0.428 to 0.867) with a common variance from 18.3% to 75.1%. Through a conceptual evaluation and explorative factor analysis, the items were reduced from 42 to 20, and the three factors that emerged were confirmed by confirmatory factor analysis. According to the structural equation model results, two out of three emerged factors predicted the outcomes. From the initial 42 items, the meta-tool is composed of 20 items capable of predicting the outcomes as with the original tools. © 2016 John Wiley & Sons, Ltd.

Successful removal of strangulating metal penile ring using a dental handpiece

PubMed Central

Etetafia, Mabel Okiemute; Nwajei, Charles Onochie

2014-01-01

Background Under emergency conditions, the dental handpiece can be a useful tool for removing a strangulating penile ring. Objective To report the successful use of a dental handpiece (dental drill) to remove a strangulating penile ring in an emergency. Method A case report of a strangulating metal penile ring in a psychiatric patient who presented at the accident and emergency unit of Delta State University Teaching Hospital. Result The metal ring was removed using a diamond bur in a dental handpiece. Conclusions In case of emergency, the dental handpiece is a useful tool for removing a strangulating penile ring. PMID:25015321

Preparedness for emerging infectious diseases: pathways from anticipation to action.

PubMed

Brookes, V J; Hernández-Jover, M; Black, P F; Ward, M P

2015-07-01

Emerging and re-emerging infectious disease (EID) events can have devastating human, animal and environmental health impacts. The emergence of EIDs has been associated with interconnected economic, social and environmental changes. Understanding these changes is crucial for EID preparedness and subsequent prevention and control of EID events. The aim of this review is to describe tools currently available for identification, prioritization and investigation of EIDs impacting human and animal health, and how these might be integrated into a systematic approach for directing EID preparedness. Environmental scanning, foresight programmes, horizon scanning and surveillance are used to collect and assess information for rapidly responding to EIDs and to anticipate drivers of emergence for mitigating future EID impacts. Prioritization of EIDs - using transparent and repeatable methods - based on disease impacts and the importance of those impacts to decision-makers can then be used for more efficient resource allocation for prevention and control. Risk assessment and simulation modelling methods assess the likelihood of EIDs occurring, define impact and identify mitigation strategies. Each of these tools has a role to play individually; however, we propose integration of these tools into a framework that enhances the development of tactical and strategic plans for emerging risk preparedness.

Nursing Home Self-assessment of Implementation of Emergency Preparedness Standards.

PubMed

Lane, Sandi J; McGrady, Elizabeth

2016-08-01

Introduction Disasters often overwhelm a community's capacity to respond and recover, creating a gap between the needs of the community and the resources available to provide services. In the wake of multiple disasters affecting nursing homes in the last decade, increased focus has shifted to this vital component of the health care system. However, the long-term care sector has often fallen through the cracks in both planning and response. Problem Two recent reports (2006 and 2012) published by the US Department of Health and Human Services (DHHS), Office of Inspector General (OIG), elucidate the need for improvements in nursing homes' comprehensive emergency preparedness and response. The Center for Medicare and Medicaid Services (CMS) has developed an emergency preparedness checklist as a guidance tool and proposed emergency preparedness regulations. The purpose of this study was to evaluate the progress made in nursing home preparedness by determining the level of completion of the 70 tasks noted on the checklist. The study objectives were to: (1) determine the preparedness levels of nursing homes in North and South Carolina (USA), and (2) compare these findings with the 2012 OIG's report on nursing home preparedness to identify current gaps. A survey developed from the checklist of items was emailed to 418 North Carolina and 193 South Carolina nursing home administrators during 2014. One hundred seventeen were returned/"bounced back" as not received. Follow-up emails and phone calls were made to encourage participation. Sixty-three completed surveys and 32 partial surveys were received. Responses were compared to data obtained in a 2010 study to determine progress. Progress had been made in many of the overall planning and sheltering-in-place tasks, such as having contact information of local emergency managers as well as specifications for availability of potable water. Yet, gaps still persisted, especially in evacuation standards, interfacing with emergency management officials, establishing back-up evacuation sites and evacuation routes, identification of resident care items, and obtaining copies of state and local emergency planning regulations. Nursing homes have made progress in preparedness tasks, however, gaps persist. Compliance may prove challenging for some nursing homes, but closer integration with emergency management officials certainly is a step in the right direction. Further research that guides evacuation or shelter-in-place decision making is needed in light of persistent challenges in completing these tasks. Lane SJ , McGrady E . Nursing home self-assessment of implementation of emergency preparedness standards. Prehosp Disaster Med. 2016;31(4):422-431.

Solving the dynamic ambulance relocation and dispatching problem using approximate dynamic programming

PubMed Central

Schmid, Verena

2012-01-01

Emergency service providers are supposed to locate ambulances such that in case of emergency patients can be reached in a time-efficient manner. Two fundamental decisions and choices need to be made real-time. First of all immediately after a request emerges an appropriate vehicle needs to be dispatched and send to the requests’ site. After having served a request the vehicle needs to be relocated to its next waiting location. We are going to propose a model and solve the underlying optimization problem using approximate dynamic programming (ADP), an emerging and powerful tool for solving stochastic and dynamic problems typically arising in the field of operations research. Empirical tests based on real data from the city of Vienna indicate that by deviating from the classical dispatching rules the average response time can be decreased from 4.60 to 4.01 minutes, which corresponds to an improvement of 12.89%. Furthermore we are going to show that it is essential to consider time-dependent information such as travel times and changes with respect to the request volume explicitly. Ignoring the current time and its consequences thereafter during the stage of modeling and optimization leads to suboptimal decisions. PMID:25540476

Crisis Communication in the Area of Risk Management: The CriCoRM Project.

PubMed

Scarcella, Carmelo; Antonelli, Laura; Orizio, Grazia; Rossmann, Costanze; Ziegler, Lena; Meyer, Lisa; Garcia-Jimenez, Leonarda; Losada, Jose Carlos; Correia, Joao; Soares, Joana; Covolo, Loredana; Lirangi, Enrico; Gelatti, Umberto

2013-09-02

During the last H1N1 pandemic has emerged the importance of crisis communication as an essential part of health crisis management. The Project aims specifically to improve the understanding of crisis communication dynamics and effective tools and to allow public health institutions to communicate better with the public during health emergencies. THE PROJECT WILL PERFORM DIFFERENT ACTIVITIES: i) state of the art review; ii) identification of key stakeholders; iii) communicational analysis performed using data collected on stakeholder communication activities and their outcomes considering the lessons learnt from the analysis of the reasons for differing public reactions during pandemics; iv) improvement of the existing guidelines; v) development of Web 2.0 tools as web-platform and feed service and implementation of impact assessment algorithms; vi) organization of exercises and training on this issues. In the context of health security policies at an EU level, the project aims to find a common and innovative approach to health crisis communication that was displayed by differing reactions to the H1N1 pandemic policies. The focus on new social media tools aims to enhance the role of e-health, and the project aims to use these tools in the specific field of health institutions and citizens. The development of Web 2.0 tools for health crisis communication will allow an effective two-way exchange of information between public health institutions and citizens. An effective communication strategy will increase population compliance with public health recommendations. Significance for public healthThe specific aim of the project is to develop a European strategy approach on how to communicate with the population and with different stakeholders groups involved in the crisis management process, based on an analysis of the communication process during the H1N1 pandemic (content analysis of press releases, press coverage and forum discussions) and on interviews with key stakeholders in health crisis communication. The development of web 2.0 tools, providing rapid responses will allow real-time verification of awareness of social trends and citizens' response. Furthermore, the project would like to offer these resources to the EU Public Health Institutions and EU citizens to improve their interaction, and hence reinforce citizens' right to patient-centred health care. The project proposal has been designed in accordance with the general principles of ethics and the EU Charter of Fundamental Rights with regard to human rights, values, freedom, solidarity, and better protection of European citizens.

Crisis Communication in the Area of Risk Management: The CriCoRM Project

PubMed Central

Scarcella, Carmelo; Antonelli, Laura; Orizio, Grazia; Rossmann, Costanze; Ziegler, Lena; Meyer, Lisa; Garcia-Jimenez, Leonarda; Losada, Jose Carlos; Correia, Joao; Soares, Joana; Covolo, Loredana; Lirangi, Enrico; Gelatti, Umberto

2013-01-01

Background During the last H1N1 pandemic has emerged the importance of crisis communication as an essential part of health crisis management. The Project aims specifically to improve the understanding of crisis communication dynamics and effective tools and to allow public health institutions to communicate better with the public during health emergencies. Design and methods The Project will perform different activities: i) state of the art review; ii) identification of key stakeholders; iii) communicational analysis performed using data collected on stakeholder communication activities and their outcomes considering the lessons learnt from the analysis of the reasons for differing public reactions during pandemics; iv) improvement of the existing guidelines; v) development of Web 2.0 tools as web-platform and feed service and implementation of impact assessment algorithms; vi) organization of exercises and training on this issues. Expected impact of the study for public health In the context of health security policies at an EU level, the project aims to find a common and innovative approach to health crisis communication that was displayed by differing reactions to the H1N1 pandemic policies. The focus on new social media tools aims to enhance the role of e-health, and the project aims to use these tools in the specific field of health institutions and citizens. The development of Web 2.0 tools for health crisis communication will allow an effective two-way exchange of information between public health institutions and citizens. An effective communication strategy will increase population compliance with public health recommendations. Significance for public health The specific aim of the project is to develop a European strategy approach on how to communicate with the population and with different stakeholders groups involved in the crisis management process, based on an analysis of the communication process during the H1N1 pandemic (content analysis of press releases, press coverage and forum discussions) and on interviews with key stakeholders in health crisis communication. The development of web 2.0 tools, providing rapid responses will allow real-time verification of awareness of social trends and citizens’ response. Furthermore, the project would like to offer these resources to the EU Public Health Institutions and EU citizens to improve their interaction, and hence reinforce citizens’ right to patient-centred health care. The project proposal has been designed in accordance with the general principles of ethics and the EU Charter of Fundamental Rights with regard to human rights, values, freedom, solidarity, and better protection of European citizens. PMID:25170491

New and emerging weight management strategies for busy ambulatory settings: a scientific statement from the American Heart Association

USDA-ARS?s Scientific Manuscript database

The purpose of this statement is to provide an overview of new and emerging tools and strategies for discussing weight and assisting overweight and obese patients. Only tools and strategies that can be used practically in busy ambulatory settings are included. The goal is to provide clinicians with ...

Using quantitative disease dynamics as a tool for guiding response to avian influenza in poultry in the United States of America.

PubMed

Pepin, K M; Spackman, E; Brown, J D; Pabilonia, K L; Garber, L P; Weaver, J T; Kennedy, D A; Patyk, K A; Huyvaert, K P; Miller, R S; Franklin, A B; Pedersen, K; Bogich, T L; Rohani, P; Shriner, S A; Webb, C T; Riley, S

2014-03-01

Wild birds are the primary source of genetic diversity for influenza A viruses that eventually emerge in poultry and humans. Much progress has been made in the descriptive ecology of avian influenza viruses (AIVs), but contributions are less evident from quantitative studies (e.g., those including disease dynamic models). Transmission between host species, individuals and flocks has not been measured with sufficient accuracy to allow robust quantitative evaluation of alternate control protocols. We focused on the United States of America (USA) as a case study for determining the state of our quantitative knowledge of potential AIV emergence processes from wild hosts to poultry. We identified priorities for quantitative research that would build on existing tools for responding to AIV in poultry and concluded that the following knowledge gaps can be addressed with current empirical data: (1) quantification of the spatio-temporal relationships between AIV prevalence in wild hosts and poultry populations, (2) understanding how the structure of different poultry sectors impacts within-flock transmission, (3) determining mechanisms and rates of between-farm spread, and (4) validating current policy-decision tools with data. The modeling studies we recommend will improve our mechanistic understanding of potential AIV transmission patterns in USA poultry, leading to improved measures of accuracy and reduced uncertainty when evaluating alternative control strategies. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

Wild monkeys flake stone tools.

PubMed

Proffitt, Tomos; Luncz, Lydia V; Falótico, Tiago; Ottoni, Eduardo B; de la Torre, Ignacio; Haslam, Michael

2016-11-03

Our understanding of the emergence of technology shapes how we view the origins of humanity. Sharp-edged stone flakes, struck from larger cores, are the primary evidence for the earliest stone technology. Here we show that wild bearded capuchin monkeys (Sapajus libidinosus) in Brazil deliberately break stones, unintentionally producing recurrent, conchoidally fractured, sharp-edged flakes and cores that have the characteristics and morphology of intentionally produced hominin tools. The production of archaeologically visible cores and flakes is therefore no longer unique to the human lineage, providing a comparative perspective on the emergence of lithic technology. This discovery adds an additional dimension to interpretations of the human Palaeolithic record, the possible function of early stone tools, and the cognitive requirements for the emergence of stone flaking.

Locating ethics in data science: responsibility and accountability in global and distributed knowledge production systems

PubMed Central

2016-01-01

The distributed and global nature of data science creates challenges for evaluating the quality, import and potential impact of the data and knowledge claims being produced. This has significant consequences for the management and oversight of responsibilities and accountabilities in data science. In particular, it makes it difficult to determine who is responsible for what output, and how such responsibilities relate to each other; what ‘participation’ means and which accountabilities it involves, with regard to data ownership, donation and sharing as well as data analysis, re-use and authorship; and whether the trust placed on automated tools for data mining and interpretation is warranted (especially as data processing strategies and tools are often developed separately from the situations of data use where ethical concerns typically emerge). To address these challenges, this paper advocates a participative, reflexive management of data practices. Regulatory structures should encourage data scientists to examine the historical lineages and ethical implications of their work at regular intervals. They should also foster awareness of the multitude of skills and perspectives involved in data science, highlighting how each perspective is partial and in need of confrontation with others. This approach has the potential to improve not only the ethical oversight for data science initiatives, but also the quality and reliability of research outputs. This article is part of the themed issue ‘The ethical impact of data science’. PMID:28336799

Locating ethics in data science: responsibility and accountability in global and distributed knowledge production systems.

PubMed

Leonelli, Sabina

2016-12-28

The distributed and global nature of data science creates challenges for evaluating the quality, import and potential impact of the data and knowledge claims being produced. This has significant consequences for the management and oversight of responsibilities and accountabilities in data science. In particular, it makes it difficult to determine who is responsible for what output, and how such responsibilities relate to each other; what 'participation' means and which accountabilities it involves, with regard to data ownership, donation and sharing as well as data analysis, re-use and authorship; and whether the trust placed on automated tools for data mining and interpretation is warranted (especially as data processing strategies and tools are often developed separately from the situations of data use where ethical concerns typically emerge). To address these challenges, this paper advocates a participative, reflexive management of data practices. Regulatory structures should encourage data scientists to examine the historical lineages and ethical implications of their work at regular intervals. They should also foster awareness of the multitude of skills and perspectives involved in data science, highlighting how each perspective is partial and in need of confrontation with others. This approach has the potential to improve not only the ethical oversight for data science initiatives, but also the quality and reliability of research outputs.This article is part of the themed issue 'The ethical impact of data science'. © 2015 The Authors.

A Multi-agent Simulation Tool for Micro-scale Contagion Spread Studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koch, Daniel B

2016-01-01

Within the disaster preparedness and emergency response community, there is interest in how contagions spread person-to-person at large gatherings and if mitigation strategies can be employed to reduce new infections. A contagion spread simulation module was developed for the Incident Management Preparedness and Coordination Toolkit that allows a user to see how a geographically accurate layout of the gathering space helps or hinders the spread of a contagion. The results can inform mitigation strategies based on changing the physical layout of an event space. A case study was conducted for a particular event to calibrate the underlying simulation model. Thismore » paper presents implementation details of the simulation code that incorporates agent movement and disease propagation. Elements of the case study are presented to show how the tool can be used.« less

Validating Signs and Symptoms From An Actual Mass Casualty Incident to Characterize An Irritant Gas Syndrome Agent (IGSA) Exposure: A First Step in The Development of a Novel IGSA Triage Algorithm.

PubMed

Culley, Joan M; Richter, Jane; Donevant, Sara; Tavakoli, Abbas; Craig, Jean; DiNardi, Salvatore

2017-07-01

• Chemical exposures daily pose a significant threat to life. Rapid assessment by first responders/emergency nurses is required to reduce death and disability. Currently, no informatics tools for Irritant Gas Syndrome Agents (IGSA) exposures exist to process victims efficiently, continuously monitor for latent signs/symptoms, or make triage recommendations. • This study uses actual patient data from a chemical incident to characterize and validate signs/symptoms of an IGSA Syndrome. Validating signs/symptoms is the first step in developing new emergency department informatics tools with the potential to revolutionize the process by which emergency nurses manage triage victims of chemical incidents. Chemical exposures can pose a significant threat to life. Rapid assessment by first responders/emergency nurses is required to reduce death and disability. Currently, no informatics tools for irritant gas syndrome agents (IGSA) exposures exist to process victims efficiently, continuously monitor for latent signs/symptoms, or make triage recommendations. This study describes the first step in developing ED informatics tools for chemical incidents: validation of signs/symptoms that characterize an IGSA syndrome. Data abstracted from 146 patients treated for chlorine exposure in one emergency department during a 2005 train derailment and 152 patients not exposed to chlorine (a comparison group) were mapped to 93 possible signs/symptoms within 2 tools (WISER and CHEMM-IST) designed to assist emergency responders/emergency nurses with managing hazardous material exposures. Inferential statistics (χ 2 /Fisher's exact test) and diagnostics tests were used to examine mapped signs/symptoms of persons who were and were not exposed to chlorine. Three clusters of signs/symptoms are statistically associated with an IGSA syndrome (P < .01): respiratory (shortness of breath, wheezing, coughing, and choking); chest discomfort (tightness, pain, and burning), and eye, nose and/or throat (pain, irritation, and burning). The syndrome requires the presence of signs/symptoms from at least 2 of these clusters. The latency period must also be considered for exposed/potentially exposed persons. This study uses actual patient data from a chemical incident to characterize and validate signs/symptoms of an IGSA syndrome. Validating signs/symptoms is the first step in developing new ED informatics tools with the potential to revolutionize the process by which emergency nurses manage triage victims of chemical incidents. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Optimal Measurement Interval for Emergency Department Crowding Estimation Tools.

PubMed

Wang, Hao; Ojha, Rohit P; Robinson, Richard D; Jackson, Bradford E; Shaikh, Sajid A; Cowden, Chad D; Shyamanand, Rath; Leuck, JoAnna; Schrader, Chet D; Zenarosa, Nestor R

2017-11-01

Emergency department (ED) crowding is a barrier to timely care. Several crowding estimation tools have been developed to facilitate early identification of and intervention for crowding. Nevertheless, the ideal frequency is unclear for measuring ED crowding by using these tools. Short intervals may be resource intensive, whereas long ones may not be suitable for early identification. Therefore, we aim to assess whether outcomes vary by measurement interval for 4 crowding estimation tools. Our eligible population included all patients between July 1, 2015, and June 30, 2016, who were admitted to the JPS Health Network ED, which serves an urban population. We generated 1-, 2-, 3-, and 4-hour ED crowding scores for each patient, using 4 crowding estimation tools (National Emergency Department Overcrowding Scale [NEDOCS], Severely Overcrowded, Overcrowded, and Not Overcrowded Estimation Tool [SONET], Emergency Department Work Index [EDWIN], and ED Occupancy Rate). Our outcomes of interest included ED length of stay (minutes) and left without being seen or eloped within 4 hours. We used accelerated failure time models to estimate interval-specific time ratios and corresponding 95% confidence limits for length of stay, in which the 1-hour interval was the reference. In addition, we used binomial regression with a log link to estimate risk ratios (RRs) and corresponding confidence limit for left without being seen. Our study population comprised 117,442 patients. The time ratios for length of stay were similar across intervals for each crowding estimation tool (time ratio=1.37 to 1.30 for NEDOCS, 1.44 to 1.37 for SONET, 1.32 to 1.27 for EDWIN, and 1.28 to 1.23 for ED Occupancy Rate). The RRs of left without being seen differences were also similar across intervals for each tool (RR=2.92 to 2.56 for NEDOCS, 3.61 to 3.36 for SONET, 2.65 to 2.40 for EDWIN, and 2.44 to 2.14 for ED Occupancy Rate). Our findings suggest limited variation in length of stay or left without being seen between intervals (1 to 4 hours) regardless of which of the 4 crowding estimation tools were used. Consequently, 4 hours may be a reasonable interval for assessing crowding with these tools, which could substantially reduce the burden on ED personnel by requiring less frequent assessment of crowding. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

PubMed

Richmond, Alyson L; Sobelson, Robyn K; Cioffi, Joan P

2014-01-01

The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

"Friending Facebook?" A minicourse on the use of social media by health professionals.

PubMed

George, Daniel R

2011-01-01

Health professionals are working in an era of social technologies that empower users to generate content in real time. This article describes a 3-part continuing education minicourse called "Friending Facebook?" undertaken at Penn State Hershey Medical Center that aimed to model the functionality of current technologies in health care and encourage discussion about how health professionals might responsibly utilize social media. Fifteen health professionals participated in the course and provided written evaluation at its conclusion. The course instructor took field notes during each of the 3 classes to document emergent themes. The course received uniformly positive evaluations, and participants identified several current tools perceived as being potentially useful in their professional lives, including news aggregators, Google Alerts, and--if used responsibly--social networking sites such as Facebook. Developing innovative and appropriate programming that teaches to emerging social media technologies and ideologies will be crucial to helping the health professions adapt to a new, networked era. Medical institutions would do well to foster interprofessional-and perhaps even intergenerational-conversations to share not only the dangers and risks of social media, but also the opportunities that are emerging out of a rapidly evolving online world. Copyright © 2010 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Identification of seniors at risk (ISAR) screening tool in the emergency department: implementation using the plan-do-study-act model and validation results.

PubMed

Asomaning, Nana; Loftus, Carla

2014-07-01

To better meet the needs of older adults in the emergency department, Senior Friendly care processes, such as high-risk screening are recommended. The identification of Seniors at Risk (ISAR) tool is a 6-item validated screening tool for identifying elderly patients at risk of the adverse outcomes post-ED visit. This paper describes the implementation of the tool in the Mount Sinai Hospital emergency department using a Plan-Do-Study-Act model; and demonstrates whether the tool predicts adverse outcomes. An observational study tracked tool implementation. A retrospective chart audit was completed to collect data about elderly ED patients during 2 time periods in 2010 and 2011. Data analysis compared the characteristics of patients with positive and negative screening tool results. The identification of Seniors at Risk tool was completed for 51.6% of eligible patients, with 61.2% of patients having a positive result. Patients with positive screening results were more likely to be over age 79 (P = .003); be admitted to hospital (P < .001); have a longer mean ED length of stay (P < .001). For patients admitted to hospital, those with positive screening results had a longer mean inpatient stay (P = .012). Implementing the Idenfitication of Seniors at Risk tool was challenged by problematic compliance with tool completion. Strategies to address this included tool adaptation; and providing staff with knowledge of ED and inpatient geriatric resources and feedback on completion rates. Positive screening results predicted adverse outcomes in elderly Mount Sinai Hospital ED patients. © 2014. Published by Elsevier Inc. All rights reserved.

Justify Your Answer: The Role of Written Think Aloud in Script Concordance Testing.

PubMed

Power, Alyssa; Lemay, Jean-Francois; Cooke, Suzette

2017-01-01

Construct: Clinical reasoning assessment is a growing area of interest in the medical education literature. Script concordance testing (SCT) evaluates clinical reasoning in conditions of uncertainty and has emerged as an innovative tool in the domain of clinical reasoning assessment. SCT quantifies the degree of concordance between a learner and an experienced clinician and attempts to capture the breadth of responses of expert clinicians, acknowledging the significant yet acceptable variation in practice under situations of uncertainty. SCT has been shown to be a valid and reliable clinical reasoning assessment tool. However, as SCT provides only quantitative information, it may not provide a complete assessment of clinical reasoning. Think aloud (TA) is a qualitative research tool used in clinical reasoning assessment in which learners verbalize their thought process around an assigned task. This study explores the use of TA, in the form of written reflection, in SCT to assess resident clinical reasoning, hypothesizing that the information obtained from the written TA would enrich the quantitative data obtained through SCT. Ninety-one pediatric postgraduate trainees and 21 pediatricians from 4 Canadian training centers completed an online test consisting of 24 SCT cases immediately followed by retrospective written TA. Six of 24 cases were selected to gather TA data. These cases were chosen to allow all phases of clinical decision making (diagnosis, investigation, and treatment) to be represented in the TA data. Inductive thematic analysis was employed when systematically reviewing TA responses. Three main benefits of adding written TA to SCT were identified: (a) uncovering instances of incorrect clinical reasoning despite a correct SCT response, (b) revealing sound clinical reasoning in the context of a suboptimal SCT response, and (c) detecting question misinterpretation. Written TA can optimize SCT by demonstrating when correct examinee responses are based on guessing or uncertainty rather than robust clinical rationale. TA can also enhance SCT by allowing examinees to provide justification for responses that otherwise would have been considered incorrect and by identifying questions that are frequently misinterpreted to avoid including them in future examinations. TA also has significant value in differentiating between acceptable variations in expert clinician responses and deviance associated with faulty rationale or question misinterpretation; this could improve SCT reliability. A written TA protocol appears to be a valuable tool to assess trainees' clinical reasoning and can strengthen the quantitative assessment provided by SCT.

The Student Volunteer Army: a 'repeat emergent' emergency response organisation.

PubMed

Carlton, Sally; Mills, Colleen E

2017-10-01

This paper seeks to contribute to understanding of the factors associated with an effective emergent emergency response organisation and to provide new insights into this understudied area. It examines, through an analysis of a range of textual resources, the emergence and re-emergence of the Student Volunteer Army (SVA) during the devastating earthquakes in Canterbury, New Zealand, in 2010-11. This evaluation is conducted in relation to the four key features of an effective emergency response organisation: adaptability; direction; leadership; and communication. In addition, the paper aims to further understanding of 'emergency entrepreneurship' and thus of the values and strategies that underpin social entrepreneur organisations in times of normalcy. The paper concludes that the unique position of the SVA as a 'repeat emergent' emergency response organisation enabled it to innovate continually and to improve repeatedly its systems, relationships, and image, such that it exhibited features common to emergent and established emergency response organisations. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Visualization of protein interaction networks: problems and solutions

PubMed Central

2013-01-01

Background Visualization concerns the representation of data visually and is an important task in scientific research. Protein-protein interactions (PPI) are discovered using either wet lab techniques, such mass spectrometry, or in silico predictions tools, resulting in large collections of interactions stored in specialized databases. The set of all interactions of an organism forms a protein-protein interaction network (PIN) and is an important tool for studying the behaviour of the cell machinery. Since graphic representation of PINs may highlight important substructures, e.g. protein complexes, visualization is more and more used to study the underlying graph structure of PINs. Although graphs are well known data structures, there are different open problems regarding PINs visualization: the high number of nodes and connections, the heterogeneity of nodes (proteins) and edges (interactions), the possibility to annotate proteins and interactions with biological information extracted by ontologies (e.g. Gene Ontology) that enriches the PINs with semantic information, but complicates their visualization. Methods In these last years many software tools for the visualization of PINs have been developed. Initially thought for visualization only, some of them have been successively enriched with new functions for PPI data management and PIN analysis. The paper analyzes the main software tools for PINs visualization considering four main criteria: (i) technology, i.e. availability/license of the software and supported OS (Operating System) platforms; (ii) interoperability, i.e. ability to import/export networks in various formats, ability to export data in a graphic format, extensibility of the system, e.g. through plug-ins; (iii) visualization, i.e. supported layout and rendering algorithms and availability of parallel implementation; (iv) analysis, i.e. availability of network analysis functions, such as clustering or mining of the graph, and the possibility to interact with external databases. Results Currently, many tools are available and it is not easy for the users choosing one of them. Some tools offer sophisticated 2D and 3D network visualization making available many layout algorithms, others tools are more data-oriented and support integration of interaction data coming from different sources and data annotation. Finally, some specialistic tools are dedicated to the analysis of pathways and cellular processes and are oriented toward systems biology studies, where the dynamic aspects of the processes being studied are central. Conclusion A current trend is the deployment of open, extensible visualization tools (e.g. Cytoscape), that may be incrementally enriched by the interactomics community with novel and more powerful functions for PIN analysis, through the development of plug-ins. On the other hand, another emerging trend regards the efficient and parallel implementation of the visualization engine that may provide high interactivity and near real-time response time, as in NAViGaTOR. From a technological point of view, open-source, free and extensible tools, like Cytoscape, guarantee a long term sustainability due to the largeness of the developers and users communities, and provide a great flexibility since new functions are continuously added by the developer community through new plug-ins, but the emerging parallel, often closed-source tools like NAViGaTOR, can offer near real-time response time also in the analysis of very huge PINs. PMID:23368786

Performance Under Stress Conditions During Multidisciplinary Team Immersive Pediatric Simulations.

PubMed

Ghazali, Daniel Aiham; Darmian-Rafei, Ivan; Ragot, Stéphanie; Oriot, Denis

2018-06-01

The primary objective was to determine whether technical and nontechnical performances were in some way correlated during immersive simulation. Performance was measured among French Emergency Medical Service workers at an individual and a team level. Secondary objectives were to assess stress response through collection of physiologic markers (salivary cortisol, heart rate, the proportion derived by dividing the number of interval differences of successive normal-to-normal intervals > 50 ms by the total number of normal-to-normal intervals [pNN50], low- and high-frequency ratio) and affective data (self-reported stress, confidence, and dissatisfaction), and to correlate them to performance scores. Prospective observational study performed as part of a larger randomized controlled trial. Medical simulation laboratory. Forty-eight participants distributed among 12 Emergency Medical System teams. Individual and team performance measures and individual stress response were assessed during a high-fidelity simulation. Technical performance was assessed by the intraosseous access performance scale and the Team Average Performance Assessment Scale; nontechnical performance by the Behavioral Assessment Tool for leaders, and the Clinical Teamwork Scale. Stress markers (salivary cortisol, heart rate, pNN50, low- and high-frequency ratio) were measured both before (T1) and after the session (T2). Participants self-reported stress before and during the simulation, self-confidence, and perception of dissatisfaction with team performance, rated on a scale from 0 to 10. Scores (out of 100 total points, mean ± SD) were intraosseous equals to 65.6 ± 14.4, Team Average Performance Assessment Scale equals to 44.6 ± 18.1, Behavioral Assessment Tool equals to 49.5 ± 22.0, Clinical Teamwork Scale equals to 50.3 ± 18.5. There was a strong correlation between Behavioral Assessment Tool and Clinical Teamwork Scale (Rho = 0.97; p = 0.001), and Behavioral Assessment Tool and Team Average Performance Assessment Scale (Rho = 0.73; p = 0.02). From T1 to T2, all stress markers (salivary cortisol, heart rate, pNN50, and low- and high-frequency ratio) displayed an increase in stress level (p < 0.001 for all). Self-confidence was positively correlated with performance (Clinical Teamwork Scale: Rho = 0.47; p = 0.001, Team Average Performance Assessment Scale: Rho = 0.46; p = 0.001). Dissatisfaction was negatively correlated with performance (Rho = -0.49; p = 0.0008 with Behavioral Assessment Tool, Rho = -0.47; p = 0.001 with Clinical Teamwork Scale, Rho = -0.51; p = 0.0004 with Team Average Performance Assessment Scale). No correlation between stress response and performance was found. There was a positive correlation between leader (Behavioral Assessment Tool) and team (Clinical Teamwork Scale and Team Average Performance Assessment Scale) performances. These performance scores were positively correlated with self-confidence and negatively correlated with dissatisfaction.

Microfluidics as a new tool in radiation biology

PubMed Central

Lacombe, Jerome; Phillips, Shanna Leslie; Zenhausern, Frederic

2016-01-01

Ionizing radiations interact with molecules at the cellular and molecular levels leading to several biochemical modifications that may be responsible for biological effects on tissue or whole organisms. The study of these changes is difficult because of the complexity of the biological response(s) to radiations and the lack of reliable models able to mimic the whole molecular phenomenon and different communications between the various cell networks, from the cell activation to the macroscopic effect at the tissue or organismal level. Microfluidics, the science and technology of systems that can handle small amounts of fluids in confined and controlled environment, has been an emerging field for several years. Some microfluidic devices, even at early stages of development, may already help radiobiological research by proposing new approaches to study cellular, tissue and total-body behavior upon irradiation. These devices may also be used in clinical biodosimetry since microfluidic technology is frequently developed for integrating complex bioassay chemistries into automated user-friendly, reproducible and sensitive analyses. In this review, we discuss the use, numerous advantages, and possible future of microfluidic technology in the field of radiobiology. We will also examine the disadvantages and required improvements for microfluidics to be fully practical in radiation research and to become an enabling tool for radiobiologists and radiation oncologists. PMID:26704304

Microfluidics as a new tool in radiation biology.

PubMed

Lacombe, Jerome; Phillips, Shanna Leslie; Zenhausern, Frederic

2016-02-28

Ionizing radiations interact with molecules at the cellular and molecular levels leading to several biochemical modifications that may be responsible for biological effects on tissue or whole organisms. The study of these changes is difficult because of the complexity of the biological response(s) to radiations and the lack of reliable models able to mimic the whole molecular phenomenon and different communications between the various cell networks, from the cell activation to the macroscopic effect at the tissue or organismal level. Microfluidics, the science and technology of systems that can handle small amounts of fluids in confined and controlled environment, has been an emerging field for several years. Some microfluidic devices, even at early stages of development, may already help radiobiological research by proposing new approaches to study cellular, tissue and total-body behavior upon irradiation. These devices may also be used in clinical biodosimetry since microfluidic technology is frequently developed for integrating complex bioassay chemistries into automated user-friendly, reproducible and sensitive analyses. In this review, we discuss the use, numerous advantages, and possible future of microfluidic technology in the field of radiobiology. We will also examine the disadvantages and required improvements for microfluidics to be fully practical in radiation research and to become an enabling tool for radiobiologists and radiation oncologists. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Knowledge to Action - Understanding Natural Hazards-Induced Power Outage Scenarios for Actionable Disaster Responses

NASA Astrophysics Data System (ADS)

Kar, B.; Robinson, C.; Koch, D. B.; Omitaomu, O.

2017-12-01

The Sendai Framework for Disaster Risk Reduction 2015-2030 identified the following four priorities to prevent and reduce disaster risks: i) understanding disaster risk; ii) strengthening governance to manage disaster risk; iii) investing in disaster risk reduction for resilience and; iv) enhancing disaster preparedness for effective response, and to "Build Back Better" in recovery, rehabilitation and reconstruction. While forecasting and decision making tools are in place to predict and understand future impacts of natural hazards, the knowledge to action approach that currently exists fails to provide updated information needed by decision makers to undertake response and recovery efforts following a hazard event. For instance, during a tropical storm event advisories are released every two to three hours, but manual analysis of geospatial data to determine potential impacts of the event tends to be time-consuming and a post-event process. Researchers at Oak Ridge National Laboratory have developed a Spatial Decision Support System that enables real-time analysis of storm impact based on updated advisory. A prototype of the tool that focuses on determining projected power outage areas and projected duration of outages demonstrates the feasibility of integrating science with decision making for emergency management personnel to act in real time to protect communities and reduce risk.

[What role for paraclinical investigations within clinical trials conducted in psychiatric patients?

PubMed

Kaladjian, A; Adida, M; Simon, N; Belzeaux, R; Blin, O; Fakra, E; Azorin, J-M

2016-12-01

As in the usual care of patients, paraclinical investigations have today only a very modest role in clinical trials in psychiatry, mainly to complete the pre-therapeutical assessments prior to inclusion of subjects or to monitor treatment tolerance. Yet, the accumulation of data in neurosciences suggests the next emergence of biomarkers, whose interest is that they are closely associated to the biological disturbances underlying psychiatric illnesses, and that they are accessible by means of technological tools such as imaging devices. These tools allow to explore the effects on brain of psychotropic medications, such as antidepressants, antipsychotics, or mood stabilizers, in relation to their therapeutic action. The obtained results allow to consider the use of such biomarkers in clinical trials in addition to more conventional approaches. In particular, they could be used as targets to measure brain response to treatment in association with clinical response, to predict a therapeutic response from the neurofunctional characteristics of patients, or to establish the safety profile of drugs on the nervous system. The use of such biomarkers in clinical trials would help to better define the explored populations and their characteristics, as well as the variables to assess, and to better measure the impact of the treatments and their potential harmful effects on the nervous system. © L’Encéphale, Paris, 2016.

Wind-instrument reflection function measurements in the time domain.

PubMed

Keefe, D H

1996-04-01

Theoretical and computational analyses of wind-instrument sound production in the time domain have emerged as useful tools for understanding musical instrument acoustics, yet there exist few experimental measurements of the air-column response directly in the time domain. A new experimental, time-domain technique is proposed to measure the reflection function response of woodwind and brass-instrument air columns. This response is defined at the location of sound regeneration in the mouthpiece or double reed. A probe assembly comprised of an acoustic source and microphone is inserted directly into the air column entryway using a foam plug to ensure a leak-free fit. An initial calibration phase involves measurements on a single cylindrical tube of known dimensions. Measurements are presented on an alto saxophone and euphonium. The technique has promise for testing any musical instrument air columns using a single probe assembly and foam plugs over a range of diameters typical of air-column entryways.

40 CFR 300.215 - Title III local emergency response plans.

Code of Federal Regulations, 2014 CFR

2014-07-01

... should be closely coordinated with applicable federal ACPs and state emergency response plans. (b... POLLUTION CONTINGENCY PLAN Planning and Preparedness § 300.215 Title III local emergency response plans... are codified at 40 CFR part 355. (a) Each LEPC is to prepare an emergency response plan in accordance...

40 CFR 300.215 - Title III local emergency response plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... should be closely coordinated with applicable federal ACPs and state emergency response plans. (b... POLLUTION CONTINGENCY PLAN Planning and Preparedness § 300.215 Title III local emergency response plans... are codified at 40 CFR part 355. (a) Each LEPC is to prepare an emergency response plan in accordance...

40 CFR 300.215 - Title III local emergency response plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

... should be closely coordinated with applicable federal ACPs and state emergency response plans. (b... POLLUTION CONTINGENCY PLAN Planning and Preparedness § 300.215 Title III local emergency response plans... are codified at 40 CFR part 355. (a) Each LEPC is to prepare an emergency response plan in accordance...

29 CFR 2700.24 - Emergency response plan dispute proceedings.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 9 2013-07-01 2013-07-01 false Emergency response plan dispute proceedings. 2700.24... COMMISSION PROCEDURAL RULES Contests of Citations and Orders § 2700.24 Emergency response plan dispute... operator's emergency response plan, or any refusal by the Secretary to approve such a plan. Any referral...

29 CFR 2700.24 - Emergency response plan dispute proceedings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Emergency response plan dispute proceedings. 2700.24... COMMISSION PROCEDURAL RULES Contests of Citations and Orders § 2700.24 Emergency response plan dispute... operator's emergency response plan, or any refusal by the Secretary to approve such a plan. Any referral...

40 CFR 300.215 - Title III local emergency response plans.

Code of Federal Regulations, 2013 CFR

2013-07-01

... should be closely coordinated with applicable federal ACPs and state emergency response plans. (b... POLLUTION CONTINGENCY PLAN Planning and Preparedness § 300.215 Title III local emergency response plans... are codified at 40 CFR part 355. (a) Each LEPC is to prepare an emergency response plan in accordance...

40 CFR 300.215 - Title III local emergency response plans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... should be closely coordinated with applicable federal ACPs and state emergency response plans. (b... POLLUTION CONTINGENCY PLAN Planning and Preparedness § 300.215 Title III local emergency response plans... are codified at 40 CFR part 355. (a) Each LEPC is to prepare an emergency response plan in accordance...

RED Alert – Early warning or detection of global re-emerging infectious disease (RED)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deshpande, Alina

This is the PDF of a presentation for a webinar given by Los Alamos National Laboratory (LANL) on the early warning or detection of global re-emerging infectious disease (RED). First, there is an overview of LANL biosurveillance tools. Then, information is given about RED Alert. Next, a demonstration is given of a component prototype. RED Alert is an analysis tool that can provide early warning or detection of the re-emergence of an infectious disease at the global level, but through a local lens.

Putting the t in tools: a roadmap for implementation of new global and regional transgender guidance

PubMed Central

Wolf, R Cameron; Adams, Darrin; Dayton, Robyn; Verster, Annette; Wong, Joe; Romero, Marcela; Mazin, Rafael; Settle, Edmund; Sladden, Tim; Keatley, JoAnne

2016-01-01

Transgender (trans) activists and global health partners have collaborated to develop new tools and guidance for assessing and addressing HIV and other health needs within trans populations. Trans women experience a heavy burden of HIV and other sexually transmitted infections (STIs), high incidence of violence and difficulties accessing gender-affirming services. At the same time, little has been published on trans men's health, HIV issues, needs and experiences. Young trans people are especially marginalized and vulnerable, with few programmes and services specifically tailored to their needs. Trans-specific data and guidance are needed to adapt the global response to HIV to meet the needs of the trans population. While the needs of this group have only recently received attention, global, regional and other technical guidance documents are being developed to address these gaps. Regional blueprints for comprehensive care for trans people in Latin America, the Caribbean, and Asia and the Pacific are now available. These tools – supported by the Pan American Health Organization, World Health Organization, US President's Emergency Plan for AIDS Relief and the United Nations Development Programme, in collaboration with regional trans groups – provide a contextual map, indicating opportunities for interventions in health, HIV, violence, stigma and discrimination, social protection and human rights. Global guidance includes the World Health Organization's Policy Brief: Transgender People and HIV, and the interagency publication, Implementing Comprehensive HIV and STI Programmes with Transgender People. Community empowerment and capacity building are the focus of the new tools for global and regional transgender guidance. The goal is to strengthen and ensure community-led responses to the HIV challenge in trans populations. This article describes the new tools and guidance and considers the steps needed to use them to appropriately support and engage transgender populations within national AIDS, STI, and sexual and reproductive health responses and programmes. The time to use these tools and guidance for advocacy, strategic planning, capacity building, programme design and training is now. PMID:27431472

An integrated web system to support veterinary activities in Italy for the management of information in epidemic emergencies.

PubMed

Iannetti, S; Savini, L; Palma, D; Calistri, P; Natale, F; Di Lorenzo, A; Cerella, A; Giovannini, A

2014-03-01

The management of public health emergencies is improved by quick, exhaustive and standardized flow of data on disease outbreaks, by using specific tools for data collection, registration and analysis. In this context, the National Information System for the Notification of Outbreaks of Animal Diseases (SIMAN) has been developed in Italy to collect and share data on the notifications of outbreaks of animal diseases. SIMAN is connected through web services to the national database of animals and holdings (BDN) and has been integrated with tools for the management of epidemic emergencies. The website has been updated with a section dedicated to the contingency planning in case of epidemic emergency. EpiTrace is one such useful tool also integrated in the BDN and based on the Social Network Analysis (SNA) and on network epidemiological models. This tool gives the possibility of assessing the risk associated to holdings and animals on the basis of their trade, in order to support the veterinary services in tracing back and forward the animals in case of outbreaks of infectious diseases. Copyright © 2014 Elsevier B.V. All rights reserved.

Challenges Facing Design and Analysis Tools

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.; Broduer, Steve (Technical Monitor)

2001-01-01

The design and analysis of future aerospace systems will strongly rely on advanced engineering analysis tools used in combination with risk mitigation procedures. The implications of such a trend place increased demands on these tools to assess off-nominal conditions, residual strength, damage propagation, and extreme loading conditions in order to understand and quantify these effects as they affect mission success. Advances in computer hardware such as CPU processing speed, memory, secondary storage, and visualization provide significant resources for the engineer to exploit in engineering design. The challenges facing design and analysis tools fall into three primary areas. The first area involves mechanics needs such as constitutive modeling, contact and penetration simulation, crack growth prediction, damage initiation and progression prediction, transient dynamics and deployment simulations, and solution algorithms. The second area involves computational needs such as fast, robust solvers, adaptivity for model and solution strategies, control processes for concurrent, distributed computing for uncertainty assessments, and immersive technology. Traditional finite element codes still require fast direct solvers which when coupled to current CPU power enables new insight as a result of high-fidelity modeling. The third area involves decision making by the analyst. This area involves the integration and interrogation of vast amounts of information - some global in character while local details are critical and often drive the design. The proposed presentation will describe and illustrate these areas using composite structures, energy-absorbing structures, and inflatable space structures. While certain engineering approximations within the finite element model may be adequate for global response prediction, they generally are inadequate in a design setting or when local response prediction is critical. Pitfalls to be avoided and trends for emerging analysis tools will be described.

The utilization of bicycles in the delivery of emergency medical services: a preliminary report.

PubMed

Gorham, J F; Kramer, T S

1997-01-01

Bicycles may be useful in the delivery of out-of-hospital emergency medical services. The use of bicycles in providing emergency medical services was investigated by surveying currently existing bicycle-medic systems. Two questionnaires were developed to gain information on service areas, injuries, gear used, missions, and specific data from bicycle-medic response. Of 210 surveys mailed to bicycle-medics, 21 (10%) were completed and returned by the pre-established deadline. Of 11 surveys mailed to bicycle-medic supervisors, four (36%) were returned. Preliminary results showed that 76% of respondents are career providers and the remainder serve as volunteers. Mean age for respondents was 33 +/- 7.4 years, with 96% being males. Most teams have been in existence for three to four years. Job satisfaction was greater when participating on the bicycle crews than when not performing on the bicycle crew, t = 4.15, p = 0.0002. The teams varied in size (6-100 persons) with a mean value of 31. On the average, team size represented 10% of total number of personnel for the respective organizations. The majority of bicycle teams operate all year in all conditions. Most bicycle-medic teams were initiated for special events. Nineteen percent reported injuries while on duty or in training. Ninety percent of units that responded use existing agency protocols and have no special protocols related to the bicycle team. Eighty percent of the units are dispatched through the normal agency procedures. Eighty-five percent of respondents coordinate for transport units via dispatch. Reported response times were under two minutes for special event responses. These were within established agency response times. In approximately 25% of the responses, the patients refused transport, and another 65% of the responses were for relatively minor injuries or complaints that did not require transport to a hospital. This survey begins to characterize the utilization of bicycles as a tool to gain patient access in specialized situations. The use of bicycle-medics may be cost-effective, may help to improve employee morale, and possibly reduce employee health-care costs. Further study is needed to determine the impact of bicycle-medics on patient outcomes and response times.

The SOLUTIONS project: challenges and responses for present and future emerging pollutants in land and water resources management.

PubMed

Brack, Werner; Altenburger, Rolf; Schüürmann, Gerrit; Krauss, Martin; López Herráez, David; van Gils, Jos; Slobodnik, Jaroslav; Munthe, John; Gawlik, Bernd Manfred; van Wezel, Annemarie; Schriks, Merijn; Hollender, Juliane; Tollefsen, Knut Erik; Mekenyan, Ovanes; Dimitrov, Saby; Bunke, Dirk; Cousins, Ian; Posthuma, Leo; van den Brink, Paul J; López de Alda, Miren; Barceló, Damià; Faust, Michael; Kortenkamp, Andreas; Scrimshaw, Mark; Ignatova, Svetlana; Engelen, Guy; Massmann, Gudrun; Lemkine, Gregory; Teodorovic, Ivana; Walz, Karl-Heinz; Dulio, Valeria; Jonker, Michiel T O; Jäger, Felix; Chipman, Kevin; Falciani, Francesco; Liska, Igor; Rooke, David; Zhang, Xiaowei; Hollert, Henner; Vrana, Branislav; Hilscherova, Klara; Kramer, Kees; Neumann, Steffen; Hammerbacher, Ruth; Backhaus, Thomas; Mack, Juliane; Segner, Helmut; Escher, Beate; de Aragão Umbuzeiro, Gisela

2015-01-15

SOLUTIONS (2013 to 2018) is a European Union Seventh Framework Programme Project (EU-FP7). The project aims to deliver a conceptual framework to support the evidence-based development of environmental policies with regard to water quality. SOLUTIONS will develop the tools for the identification, prioritisation and assessment of those water contaminants that may pose a risk to ecosystems and human health. To this end, a new generation of chemical and effect-based monitoring tools is developed and integrated with a full set of exposure, effect and risk assessment models. SOLUTIONS attempts to address legacy, present and future contamination by integrating monitoring and modelling based approaches with scenarios on future developments in society, economy and technology and thus in contamination. The project follows a solutions-oriented approach by addressing major problems of water and chemicals management and by assessing abatement options. SOLUTIONS takes advantage of the access to the infrastructure necessary to investigate the large basins of the Danube and Rhine as well as relevant Mediterranean basins as case studies, and puts major efforts on stakeholder dialogue and support. Particularly, the EU Water Framework Directive (WFD) Common Implementation Strategy (CIS) working groups, International River Commissions, and water works associations are directly supported with consistent guidance for the early detection, identification, prioritisation, and abatement of chemicals in the water cycle. SOLUTIONS will give a specific emphasis on concepts and tools for the impact and risk assessment of complex mixtures of emerging pollutants, their metabolites and transformation products. Analytical and effect-based screening tools will be applied together with ecological assessment tools for the identification of toxicants and their impacts. The SOLUTIONS approach is expected to provide transparent and evidence-based candidates or River Basin Specific Pollutants in the case study basins and to assist future review of priority pollutants under the WFD as well as potential abatement options. Copyright © 2014 Elsevier B.V. All rights reserved.

Science in Emergency Response at CDC: Structure and Functions.

PubMed

Iskander, John; Rose, Dale A; Ghiya, Neelam D

2017-09-01

Recent high-profile activations of the US Centers for Disease Control and Prevention (CDC) Emergency Operations Center (EOC) include responses to the West African Ebola and Zika virus epidemics. Within the EOC, emergency responses are organized according to the Incident Management System, which provides a standardized structure and chain of command, regardless of whether the EOC activation occurs in response to an outbreak, natural disaster, or other type of public health emergency. By embedding key scientific roles, such as the associate director for science, and functions within a Scientific Response Section, the current CDC emergency response structure ensures that both urgent and important science issues receive needed attention. Key functions during emergency responses include internal coordination of scientific work, data management, information dissemination, and scientific publication. We describe a case example involving the ongoing Zika virus response that demonstrates how the scientific response structure can be used to rapidly produce high-quality science needed to answer urgent public health questions and guide policy. Within the context of emergency response, longer-term priorities at CDC include both streamlining administrative requirements and funding mechanisms for scientific research.

Assessment of workload using NASA Task Load Index in perianesthesia nursing.

PubMed

Young, Gloria; Zavelina, Lyubov; Hooper, Vallire

2008-04-01

According to the Institute of Medicine (IOM), as many as 44,000 to 98,000 people in the United States die in hospitals every year due to medical errors. Multiple physiological and psychological factors can impact the health care provider's attention span, making medical errors more likely. Some of these factors include increased workload, fatigue, cognitive overload, ineffective interpersonal communications, and faulty information processing. Postanesthesia nurses, responsible for providing care to unstable patients emerging from anesthesia with multiple life-threatening conditions, must make critical decisions on a minute-by-minute basis. The current ASPAN Patient Classification/Recommended Staffing Guidelines does not adequately take into account varying care requirements among the patients. If a tool could be found that effectively evaluated staff's workload, ongoing assessment would be enhanced and resources better used. The National Aeronautics and Space Administration-Task Load Index (NASA-TLX), a multifaceted tool for evaluating perceptual (subjective) workload, has seen extensive applications and is widely regarded as the strongest tool available for reporting perceptions of workload. This article will survey various uses of the NASA-TLX and consider the potential uses for this tool in perianesthesia nursing.

Web-Based Geospatial Tools to Address Hazard Mitigation, Natural Resource Management, and Other Societal Issues

USGS Publications Warehouse

Hearn,, Paul P.

2009-01-01

Federal, State, and local government agencies in the United States face a broad range of issues on a daily basis. Among these are natural hazard mitigation, homeland security, emergency response, economic and community development, water supply, and health and safety services. The U.S. Geological Survey (USGS) helps decision makers address these issues by providing natural hazard assessments, information on energy, mineral, water and biological resources, maps, and other geospatial information. Increasingly, decision makers at all levels are challenged not by the lack of information, but by the absence of effective tools to synthesize the large volume of data available, and to utilize the data to frame policy options in a straightforward and understandable manner. While geographic information system (GIS) technology has been widely applied to this end, systems with the necessary analytical power have been usable only by trained operators. The USGS is addressing the need for more accessible, manageable data tools by developing a suite of Web-based geospatial applications that will incorporate USGS and cooperating partner data into the decision making process for a variety of critical issues. Examples of Web-based geospatial tools being used to address societal issues follow.

Interactive, open source, travel time scenario modelling: tools to facilitate participation in health service access analysis.

PubMed

Fisher, Rohan; Lassa, Jonatan

2017-04-18

Modelling travel time to services has become a common public health tool for planning service provision but the usefulness of these analyses is constrained by the availability of accurate input data and limitations inherent in the assumptions and parameterisation. This is particularly an issue in the developing world where access to basic data is limited and travel is often complex and multi-modal. Improving the accuracy and relevance in this context requires greater accessibility to, and flexibility in, travel time modelling tools to facilitate the incorporation of local knowledge and the rapid exploration of multiple travel scenarios. The aim of this work was to develop simple open source, adaptable, interactive travel time modelling tools to allow greater access to and participation in service access analysis. Described are three interconnected applications designed to reduce some of the barriers to the more wide-spread use of GIS analysis of service access and allow for complex spatial and temporal variations in service availability. These applications are an open source GIS tool-kit and two geo-simulation models. The development of these tools was guided by health service issues from a developing world context but they present a general approach to enabling greater access to and flexibility in health access modelling. The tools demonstrate a method that substantially simplifies the process for conducting travel time assessments and demonstrate a dynamic, interactive approach in an open source GIS format. In addition this paper provides examples from empirical experience where these tools have informed better policy and planning. Travel and health service access is complex and cannot be reduced to a few static modeled outputs. The approaches described in this paper use a unique set of tools to explore this complexity, promote discussion and build understanding with the goal of producing better planning outcomes. The accessible, flexible, interactive and responsive nature of the applications described has the potential to allow complex environmental social and political considerations to be incorporated and visualised. Through supporting evidence-based planning the innovative modelling practices described have the potential to help local health and emergency response planning in the developing world.

Hepatic stellate cells: fibrogenic, regenerative or both? Heterogeneity and context are key.

PubMed

Bansal, Meena B

2016-11-01

Since their original identification, our understanding of the role of hepatic stellate cells in both health and disease continues to grow. Numerous studies have delineated the role of stellate cell activation in contributing to the pool of myofibroblasts responsible for liver fibrosis, and these have resulted in the development of a number of anti-fibrotic strategies targeting this cell. However, their potential role in liver regeneration, both initiation and termination, is also emerging and needs to be contemplated when considering targeted therapy. Perhaps what is most striking is the increasing recognition that this is not just one cell, but rather, a heterogenous population made up of a number of different subsets of cells, each with differentiated and specific functions. The tools are emerging for this dissection and are greatly needed to truly develop targeted therapies that will inhibit fibrosis while promoting liver regeneration and repair.

Molecular Imaging of Influenza and Other Emerging Respiratory Viral Infections

PubMed Central

Lawler, James; Paragas, Jason; Jahrling, Peter B.; Mollura, Daniel J.

2011-01-01

Research on the pathogenesis and therapy of influenza and other emerging respiratory viral infections would be aided by methods that directly visualize pathophysiologic processes in patients and laboratory animals. At present, imaging of diseases, such as swine-origin H1N1 influenza, is largely restricted to chest radiograph and computed tomography (CT), which can detect pulmonary structural changes in severely ill patients but are more limited in characterizing the early stages of illness, differentiating inflammation from infection or tracking immune responses. In contrast, imaging modalities, such as positron emission tomography, single photon emission CT, magnetic resonance imaging, and bioluminescence imaging, which have become useful tools for investigating the pathogenesis of a range of disease processes, could be used to advance in vivo studies of respiratory viral infections in patients and animals. Molecular techniques might also be used to identify novel biomarkers of disease progression and to evaluate new therapies. PMID:21422476

Mitochondrial network complexity emerges from fission/fusion dynamics.

PubMed

Zamponi, Nahuel; Zamponi, Emiliano; Cannas, Sergio A; Billoni, Orlando V; Helguera, Pablo R; Chialvo, Dante R

2018-01-10

Mitochondrial networks exhibit a variety of complex behaviors, including coordinated cell-wide oscillations of energy states as well as a phase transition (depolarization) in response to oxidative stress. Since functional and structural properties are often interwinded, here we characterized the structure of mitochondrial networks in mouse embryonic fibroblasts using network tools and percolation theory. Subsequently we perturbed the system either by promoting the fusion of mitochondrial segments or by inducing mitochondrial fission. Quantitative analysis of mitochondrial clusters revealed that structural parameters of healthy mitochondria laid in between the extremes of highly fragmented and completely fusioned networks. We confirmed our results by contrasting our empirical findings with the predictions of a recently described computational model of mitochondrial network emergence based on fission-fusion kinetics. Altogether these results offer not only an objective methodology to parametrize the complexity of this organelle but also support the idea that mitochondrial networks behave as critical systems and undergo structural phase transitions.

Modeling mechanical interactions in growing populations of rod-shaped bacteria

NASA Astrophysics Data System (ADS)

Winkle, James J.; Igoshin, Oleg A.; Bennett, Matthew R.; Josić, Krešimir; Ott, William

2017-10-01

Advances in synthetic biology allow us to engineer bacterial collectives with pre-specified characteristics. However, the behavior of these collectives is difficult to understand, as cellular growth and division as well as extra-cellular fluid flow lead to complex, changing arrangements of cells within the population. To rationally engineer and control the behavior of cell collectives we need theoretical and computational tools to understand their emergent spatiotemporal dynamics. Here, we present an agent-based model that allows growing cells to detect and respond to mechanical interactions. Crucially, our model couples the dynamics of cell growth to the cell’s environment: Mechanical constraints can affect cellular growth rate and a cell may alter its behavior in response to these constraints. This coupling links the mechanical forces that influence cell growth and emergent behaviors in cell assemblies. We illustrate our approach by showing how mechanical interactions can impact the dynamics of bacterial collectives growing in microfluidic traps.

Surface extra-vehicular activity emergency scenario management: Tools, procedures, and geologically related implications

NASA Astrophysics Data System (ADS)

Zea, Luis; Diaz, Alejandro R.; Shepherd, Charles K.; Kumar, Ranganathan

2010-07-01

Extra-vehicular activities (EVAs) are an essential part of human space exploration, but involve inherently dangerous procedures which can put crew safety at risk during a space mission. To help mitigate this risk, astronauts' training programs spend substantial attention on preparing for surface EVA emergency scenarios. With the help of two Mars Desert Research Station (MDRS) crews (61 and 65), wearing simulated spacesuits, the most important of these emergency scenarios were examined at three different types of locations that geologically and environmentally resemble lunar and Martian landscapes. These three platforms were analyzed geologically as well as topographically (utilizing a laser range finder with slope estimation capabilities and a slope determination software). Emergency scenarios were separated into four main groups: (1) suit issues, (2) general physiological, (3) attacks and (4) others. Specific tools and procedures were developed to address each scenario. The tools and processes were tested in the field under Mars-analog conditions with the suited subjects for feasibility and speed of execution.

Emergent mechanics, quantum and un-quantum

NASA Astrophysics Data System (ADS)

Ralston, John P.

2013-10-01

There is great interest in quantum mechanics as an "emergent" phenomenon. The program holds that nonobvious patterns and laws can emerge from complicated physical systems operating by more fundamental rules. We find a new approach where quantum mechanics itself should be viewed as an information management tool not derived from physics nor depending on physics. The main accomplishment of quantum-style theory comes in expanding the notion of probability. We construct a map from macroscopic information as data" to quantum probability. The map allows a hidden variable description for quantum states, and efficient use of the helpful tools of quantum mechanics in unlimited circumstances. Quantum dynamics via the time-dependent Shroedinger equation or operator methods actually represents a restricted class of classical Hamiltonian or Lagrangian dynamics, albeit with different numbers of degrees of freedom. We show that under wide circumstances such dynamics emerges from structureless dynamical systems. The uses of the quantum information management tools are illustrated by numerical experiments and practical applications

A self-report critical incident assessment tool for army night vision goggle helicopter operations.

PubMed

Renshaw, Peter F; Wiggins, Mark W

2007-04-01

The present study sought to examine the utility of a self-report tool that was designed as a partial substitute for a face-to-face cognitive interview for critical incidents involving night vision goggles (NVGs). The use of NVGs remains problematic within the military environment, as these devices have been identified as a factor in a significant proportion of aircraft accidents and incidents. The self-report tool was structured to identify some of the cognitive features of human performance that were associated with critical incidents involving NVGs. The tool incorporated a number of different levels of analysis, ranging from specific behavioral responses to broader cognitive constructs. Reports were received from 30 active pilots within the Australian Army using the NVG Critical Incident Assessment Tool (NVGCIAT). The results revealed a correspondence between specific types of NVG-related errors and elements of the Human Factors Analysis and Classification System (HFACS). In addition, uncertainty emerged as a significant factor associated with the critical incidents that were recalled by operators. These results were broadly consistent with previous research and provide some support for the utility of subjective assessment tools as a means of extracting critical incident-related data when face-to-face cognitive interviews are not possible. In some circumstances, the NVGCIAT might be regarded as a substitute cognitive interview protocol with some level of diagnosticity.

Isolation and quarantine during pandemic (H1N1) 2009 influenza in NSW: the operational experience of public health units.

PubMed

Binns, Philippa L; Sheppeard, Vicky; Staff, Michael P

2010-01-01

During the DELAY and CONTAIN phases of pandemic (H1N1) 2009 influenza in NSW, public health units needed to rapidly surge operations to manage the 3070 potential cases and 1894 contacts notified to them. The Incident Control System, NetEpi (the web-based multi-user access database), training to up-skill surge staff, and electronic communication were all integral to the outbreak response. Ongoing identification and training of surge staff would assist a timely and effective response to future large scale outbreaks. Investing and incorporating information technology tools into routine public health unit business to assist with communication, outbreak management and reporting will improve familiarity and capability within the network to respond to public health emergencies.

Anxiety and nicotine dependence: Emerging role of the habenulo-interpeduncular axis

PubMed Central

Molas, Susanna; DeGroot, Steven; Zhao-Shea, Rubing; Tapper, Andrew R.

2016-01-01

While innovative modern neuroscience approaches have aided in discerning brain circuitry underlying negative emotional behaviors including fear and anxiety responses, how these circuits are recruited in normal and pathological conditions remains poorly understood. Recently, genetic tools that selectively manipulate single neuronal populations have uncovered an understudied circuit, the medial habenula (mHb)-interpeduncular (IPN) axis, that modulates basal negative emotional responses. Interestingly, the mHb-IPN pathway also represents an essential circuit that signals heightened anxiety induced by nicotine withdrawal. Insights into how this circuit inter-connects with regions more classically associated with anxiety and how chronic nicotine exposure induces neuroadaptations resulting in an anxiogenic state, may thereby provide novel strategies and molecular targets for therapies that facilitate smoking cessation, as well as, anxiety relief. PMID:27890353

Non-negative Tensor Factorization for Robust Exploratory Big-Data Analytics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alexandrov, Boian; Vesselinov, Velimir Valentinov; Djidjev, Hristo Nikolov

Currently, large multidimensional datasets are being accumulated in almost every field. Data are: (1) collected by distributed sensor networks in real-time all over the globe, (2) produced by large-scale experimental measurements or engineering activities, (3) generated by high-performance simulations, and (4) gathered by electronic communications and socialnetwork activities, etc. Simultaneous analysis of these ultra-large heterogeneous multidimensional datasets is often critical for scientific discoveries, decision-making, emergency response, and national and global security. The importance of such analyses mandates the development of the next-generation of robust machine learning (ML) methods and tools for bigdata exploratory analysis.

[The importance of simulation in team training on obstetric emergencies: results of the first phase of the national plan for continuous medical training].

PubMed

Maio Matos, Francisco; Sousa Gomes, Andrea; Costa, Fernando Jorge; Santos Silva, Isabel; Carvalhas, Joana

2012-01-01

Obstetric emergencies are unexpected and random. The traditional model for medical training of these acute events has included lectures combined with sporadic clinical experiences, but this educational method has inherent limitations. Given the variety of manual skills that must be learned and high-risk environment, Obstetrics is uniquely suited for simulation. New technological educational tools provide an opportunity to learn and master technical skills needed in emergent situations as well as the opportunity to rehearse and learn from mistakes without risks to patients. The goals of this study are to assess which are the factors that trainees associate to human fallibility before and after clinical simulation based training; to compare the confidence level to solve emergent obstetric situations between interns and experts with up to 5 years of experience before and after training, and to determine the value that trainees give to simulation as a teaching tool on emergent events. 31 physicians participated at this course sessions. After the course, we verified changes in the factores that trainees associate to human fallibility, an increase in confidence level to solve emergent obstetric and an increase in the value that trainees give to simulation as a teaching tool.

The application of HIV molecular epidemiology to public health.

PubMed

Paraskevis, D; Nikolopoulos, G K; Magiorkinis, G; Hodges-Mameletzis, I; Hatzakis, A

2016-12-01

HIV is responsible for one of the largest viral pandemics in human history. Despite a concerted global response for prevention and treatment, the virus persists. Thus, urgent public health action, utilizing novel interventions, is needed to prevent future transmission events, critical to eliminating HIV. For public health planning to prove effective and successful, we need to understand the dynamics of regional epidemics and to intervene appropriately. HIV molecular epidemiology tools as implemented in phylogenetic, phylodynamic and phylogeographic analyses have proven to be powerful tools in public health planning across many studies. Numerous applications with HIV suggest that molecular methods alone or in combination with mathematical modelling can provide inferences about the transmission dynamics, critical epidemiological parameters (prevalence, incidence, effective number of infections, Re, generation times, time between infection and diagnosis), or the spatiotemporal characteristics of epidemics. Molecular tools have been used to assess the impact of an intervention and outbreak investigation which are of great public health relevance. In some settings, molecular sequence data may be more readily available than HIV surveillance data, and can therefore allow for molecular analyses to be conducted more easily. Nonetheless, classic methods have an integral role in monitoring and evaluation of public health programmes, and should supplement emerging techniques from the field of molecular epidemiology. Importantly, molecular epidemiology remains a promising approach in responding to viral diseases. Copyright © 2016 Elsevier B.V. All rights reserved.

49 CFR 1.45 - Delegations to the Director of the Office of Intelligence, Security and Emergency Response.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Intelligence, Security and Emergency Response. 1.45 Section 1.45 Transportation Office of the Secretary of... Delegations to the Director of the Office of Intelligence, Security and Emergency Response. The Director of Intelligence, Security, and Emergency Response is delegated authority to: (a) Carry out the functions related...

49 CFR 1.45 - Delegations to the Director of the Office of Intelligence, Security and Emergency Response.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Intelligence, Security and Emergency Response. 1.45 Section 1.45 Transportation Office of the Secretary of... Delegations to the Director of the Office of Intelligence, Security and Emergency Response. The Director of Intelligence, Security, and Emergency Response is delegated authority to: (a) Carry out the functions related...

49 CFR 1.45 - Delegations to the Director of the Office of Intelligence, Security and Emergency Response.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Intelligence, Security and Emergency Response. 1.45 Section 1.45 Transportation Office of the Secretary of... Delegations to the Director of the Office of Intelligence, Security and Emergency Response. The Director of Intelligence, Security, and Emergency Response is delegated authority to: (a) Carry out the functions related...

Nanotechnologies: tools for sustainability in a new wave of water treatment processes.

PubMed

Bottero, Jean-Yves; Rose, Jerome; Wiesner, Mark Robert

2006-10-01

In the environmental technology industry alone, nanomaterials will enable new means of reducing the production of industrial wastes, using resources more sparingly, remediating industrial contamination, providing potable water, and improving the efficiency of energy production. This paper discusses three new kinds of nanotechnology materials that should be developed in the future: Membranes, oxidants, and adsorbents. Nanoscale control of membrane architecture may yield membranes of greater selectivity and lower cost in both water treatment and water fabrication. Fullerene-based oxidant nanomaterials such as C60 have a high electron affinity and reactivity, and are capable of producing reactive oxygen species such as singlet oxygen and superoxides. Fullerenes might be used in engineered systems to photocatalytically oxidize organic contaminants, or inhibit or inactivate microbes. The ability to tailor surfaces can help to increase adsorbing capacities or recognize specific contaminants. The potential environmental risks are that nanomaterials could interact with biota and that their toxicity adversely may affect ecosystems. As nanochemistry emerges as an important force behind new environmental technologies, we are also presented with the responsibility of considering the environmental implications of an emerging technology at its inception and taking every precaution to ensure that these technologies develop as tools of sustainability rather than becoming future liabilities.

General guidelines for safe and expeditious international transport of samples subjected to biological dosimetry assessment.

PubMed

Di Giorgio, Marina; Radl, Analía; Taja, María R; Bubniak, Ruth; Deminge, Mayra; Sapienza, Carla; Vázquez, Marina; Baciu, Florian; Kenny, Pat

2014-06-01

It has been observed that victims of accidental overexposures show better chance of survival if they receive medical treatment early. The increased risk of scenarios involving mass casualties has stimulated the scientific community to develop tools that would help the medical doctors to treat victims. The biological dosimetry has become a routine test to estimate the dose, supplementing physical and clinical dosimetry. In case of radiation emergencies, in order to provide timely and effectively biological dosimetry assistance it is essential to guarantee an adequate transport of blood samples in principal, for providing support to countries that do not have biodosimetry laboratories. The objective of the present paper is to provide general guidelines, summarised in 10 points, for timely and proper receiving and sending of blood samples under National and International regulations, for safe and expeditious international transport. These guidelines cover the classification, packaging, marking, labelling, refrigeration and documentation requirements for the international shipping of blood samples and pellets, to provide assistance missions with a tool that would contribute with the preparedness for an effective biodosimetric response in cases of radiological or nuclear emergencies. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Diagnostic concordance between mobile interfaces and conventional workstations for emergency imaging assessment.

PubMed

Venson, José Eduardo; Bevilacqua, Fernando; Berni, Jean; Onuki, Fabio; Maciel, Anderson

2018-05-01

Mobile devices and software are now available with sufficient computing power, speed and complexity to allow for real-time interpretation of radiology exams. In this paper, we perform a multivariable user study that investigates concordance of image-based diagnoses provided using mobile devices on the one hand and conventional workstations on the other hand. We performed a between-subjects task-analysis using CT, MRI and radiography datasets. Moreover, we investigated the adequacy of the screen size, image quality, usability and the availability of the tools necessary for the analysis. Radiologists, members of several teams, participated in the experiment under real work conditions. A total of 64 studies with 93 main diagnoses were analyzed. Our results showed that 56 cases were classified with complete concordance (87.69%), 5 cases with almost complete concordance (7.69%) and 1 case (1.56%) with partial concordance. Only 2 studies presented discordance between the reports (3.07%). The main reason to explain the cause of those disagreements was the lack of multiplanar reconstruction tool in the mobile viewer. Screen size and image quality had no direct impact on the mobile diagnosis process. We concluded that for images from emergency modalities, a mobile interface provides accurate interpretation and swift response, which could benefit patients' healthcare. Copyright © 2018 Elsevier B.V. All rights reserved.

A Risk Assessment Architecture for Enhanced Engine Operation

NASA Technical Reports Server (NTRS)

Litt, Jonathan S.; Sharp. Lauren M.; Guo, Ten-Huei

2010-01-01

On very rare occasions, in-flight emergencies have occurred that required the pilot to utilize the aircraft's capabilities to the fullest extent possible, sometimes using actuators in ways for which they were not intended. For instance, when flight control has been lost due to damage to the hydraulic systems, pilots have had to use engine thrust to maneuver the plane to the ground and in for a landing. To assist the pilot in these situations, research is being performed to enhance the engine operation by making it more responsive or able to generate more thrust. Enabled by modification of the propulsion control, enhanced engine operation can increase the probability of a safe landing during an inflight emergency. However, enhanced engine operation introduces risk as the nominal control limits, such as those on shaft speed, temperature, and acceleration, are exceeded. Therefore, an on-line tool for quantifying this risk must be developed to ensure that the use of an enhanced control mode does not actually increase the overall danger to the aircraft. This paper describes an architecture for the implementation of this tool. It describes the type of data and algorithms required and the information flow, and how the risk based on engine component lifing and operability for enhanced operation is determined.

Exploring the Utility of Microblogging as a Tool for Formal Content-Based Learning in the Community College History Classroom

ERIC Educational Resources Information Center

Freels, Jeffrey W.

2015-01-01

The emergence of social media technologies (SMT) as important features of life in the twenty-first century has aroused the curiosity of teachers and scholars in higher education and given rise to numerous experiments using SMT as tools of instruction in college and university classrooms. A body of research has emerged from those experiments which…

Search Engines for Tomorrow's Scholars

ERIC Educational Resources Information Center

Fagan, Jody Condit

2011-01-01

Today's scholars face an outstanding array of choices when choosing search tools: Google Scholar, discipline-specific abstracts and index databases, library discovery tools, and more recently, Microsoft's re-launch of their academic search tool, now dubbed Microsoft Academic Search. What are these tools' strengths for the emerging needs of…

44 CFR 323.3 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) § 323.3 Responsibilities. (a) As stated in The National Plan for Emergency Preparedness, the direction... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Responsibilities. 323.3 Section 323.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF...

Establishment of Myotis myotis cell lines--model for investigation of host-pathogen interaction in a natural host for emerging viruses.

PubMed

He, Xiaocui; Korytář, Tomáš; Zhu, Yaqing; Pikula, Jiří; Bandouchova, Hana; Zukal, Jan; Köllner, Bernd

2014-01-01

Bats are found to be the natural reservoirs for many emerging viruses. In most cases, severe clinical signs caused by such virus infections are normally not seen in bats. This indicates differences in the virus-host interactions and underlines the necessity to develop natural host related models to study these phenomena. Due to the strict protection of European bat species, immortalized cell lines are the only alternative to investigate the innate anti-virus immune mechanisms. Here, we report about the establishment and functional characterization of Myotis myotis derived cell lines from different tissues: brain (MmBr), tonsil (MmTo), peritoneal cavity (MmPca), nasal epithelium (MmNep) and nervus olfactorius (MmNol) after immortalization by SV 40 large T antigen. The usefulness of these cell lines to study antiviral responses has been confirmed by analysis of their susceptibility to lyssavirus infection and the mRNA patterns of immune-relevant genes after poly I:C stimulation. Performed experiments indicated varying susceptibility to lyssavirus infection with MmBr being considerably less susceptible than the other cell lines. Further investigation demonstrated a strong activation of interferon mediated antiviral response in MmBr contributing to its resistance. The pattern recognition receptors: RIG-I and MDA5 were highly up-regulated during rabies virus infection in MmBr, suggesting their involvement in promotion of antiviral responses. The presence of CD14 and CD68 in MmBr suggested MmBr cells are microglia-like cells which play a key role in host defense against infections in the central nervous system (CNS). Thus the expression pattern of MmBr combined with the observed limitation of lyssavirus replication underpin a protective mechanism of the CNS controlling the lyssavirus infection. Overall, the established cell lines are important tools to analyze antiviral innate immunity in M. myotis against neurotropic virus infections and present a valuable tool for a broad spectrum of future investigations in cellular biology of M. myotis.

Establishment of Myotis myotis Cell Lines - Model for Investigation of Host-Pathogen Interaction in a Natural Host for Emerging Viruses

PubMed Central

He, Xiaocui; Korytář, Tomáš; Zhu, Yaqing; Pikula, Jiří; Bandouchova, Hana; Zukal, Jan; Köllner, Bernd

2014-01-01

Bats are found to be the natural reservoirs for many emerging viruses. In most cases, severe clinical signs caused by such virus infections are normally not seen in bats. This indicates differences in the virus-host interactions and underlines the necessity to develop natural host related models to study these phenomena. Due to the strict protection of European bat species, immortalized cell lines are the only alternative to investigate the innate anti-virus immune mechanisms. Here, we report about the establishment and functional characterization of Myotis myotis derived cell lines from different tissues: brain (MmBr), tonsil (MmTo), peritoneal cavity (MmPca), nasal epithelium (MmNep) and nervus olfactorius (MmNol) after immortalization by SV 40 large T antigen. The usefulness of these cell lines to study antiviral responses has been confirmed by analysis of their susceptibility to lyssavirus infection and the mRNA patterns of immune-relevant genes after poly I:C stimulation. Performed experiments indicated varying susceptibility to lyssavirus infection with MmBr being considerably less susceptible than the other cell lines. Further investigation demonstrated a strong activation of interferon mediated antiviral response in MmBr contributing to its resistance. The pattern recognition receptors: RIG-I and MDA5 were highly up-regulated during rabies virus infection in MmBr, suggesting their involvement in promotion of antiviral responses. The presence of CD14 and CD68 in MmBr suggested MmBr cells are microglia-like cells which play a key role in host defense against infections in the central nervous system (CNS). Thus the expression pattern of MmBr combined with the observed limitation of lyssavirus replication underpin a protective mechanism of the CNS controlling the lyssavirus infection. Overall, the established cell lines are important tools to analyze antiviral innate immunity in M. myotis against neurotropic virus infections and present a valuable tool for a broad spectrum of future investigations in cellular biology of M. myotis. PMID:25295526

Emergency response to mass casualty incidents in Lebanon.

PubMed

El Sayed, Mazen J

2013-08-01

The emergency response to mass casualty incidents in Lebanon lacks uniformity. Three recent large-scale incidents have challenged the existing emergency response process and have raised the need to improve and develop incident management for better resilience in times of crisis. We describe some simple emergency management principles that are currently applied in the United States. These principles can be easily adopted by Lebanon and other developing countries to standardize and improve their emergency response systems using existing infrastructure.

1996-1997 TEMA/DOE oversite annual report

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1998-01-01

The Tennessee Emergency Management Agency (TEMA) has entered into a five-year agreement with the Department of Energy (DOE) to provide emergency response activities associated with the Oak Ridge Reservation (ORR). The Agreement in Principle (AIP) delineates the duties and responsibilities of the parties. The agreement tasked TEMA with the following responsibilities: develop offsite emergency plans; conduct emergency management training; develop offsite emergency organizations; develop emergency communications; develop emergency facilities; conduct exercises and drills; provide detection and protection equipment; and develop an emergency staff. This document reports on progress on these tasks during the past year.

1996--1997 TEMA/DOE oversight annual report

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1998-06-01

The Tennessee Emergency Management Agency (TEMA) has entered into a five-year agreement with the Department of Energy (DOE) to provide emergency response activities associated with the Oak Ridge Reservation (ORR). The Agreement in Principle (AIP) delineates the duties and responsibilities of the parties. The agreement tasked TEMA with the following responsibilities: develop offsite emergency plans; conduct emergency management training; develop offsite emergency organizations; develop emergency communications; develop emergency facilities; conduct exercises and drills; provide detection and protection equipment; and develop an emergency staff. This report describes progress on the 14 deliverables connected with this contract.

Identifying Preschool Children At-Risk of Later Reading Difficulties: Evaluation of two Emergent Literacy Screening Tools

PubMed Central

Wilson, Shauna B.; Lonigan, Christopher J.

2012-01-01

Emergent literacy skills are predictive of children’s early reading success, and literacy achievement in early schooling declines more rapidly for children who are below-average readers. It is therefore important for teachers to identify accurately children at risk for later reading difficulty so children can be exposed to good emergent literacy interventions. In this study, 176 preschoolers were administered two screening tools, the Revised Get Ready to Read! (GRTR-R) and the Individual Growth and Development Indicators (IGDIs), and a diagnostic measure at two time points. Receiver operating characteristic curve analyses revealed that at optimal cut scores, GRTR-R provided more accurate classification of children’s overall emergent literacy skills than did IGDIs. However, neither measure was particularly good at classifying specific emergent literacy skills. PMID:19822699

Development of the triage, monitoring and treatment Handbook for Members of the Public Affected by Radiological Terrorism - A European Response

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kruse, P.; Rojas-Palma, C.

2007-07-01

European national emergency response plans have long been focused on accidents at nuclear power plants. Recently, the possible threats by disaffected groups have shifted the focus to being prepared also for malevolent use of radiation that are aimed at creating disruption and panic in the society. The casualties will most likely be members of the public. According to the scenario, the number of affected people can vary from a few to mass casualties. The radiation exposure can range from very low to substantial, possibly combined with conventional injuries. There is a need to develop practicable tools for the adequate responsemore » to such acts and more specifically to address European guidelines for triage, monitoring and treatment of exposed people. Although European countries have developed emergency response plans for nuclear accidents they have not all made plans for handling malevolent use of radioactive material. Indeed, there is a need to develop practical guidance on emergency response and medical treatment of the public affected by malevolent acts. Generic guidance on this topic has been published by international organisations. They are, however, not operational documents to be used in emergency situations. The Triage, Monitoring and Treatment (TMT) Handbook aims to strengthen the European ability to efficiently respond to malevolent acts in terms of protecting and treating exposed people. Part of the Handbook is also devoted to public information and communication issues which would contribute to public reassurance in emergency situations. The Handbook will be drafted by European and international experts before it is circulated to all emergency response institutions in Europe that would be a part of the handling of malevolent acts using radioactive material. The institutions would be given a 6 months consultation time with encouragement to test the draft Handbook in national exercises. A workshop will allow feedback from these end users on the content, structure and usefulness of the Handbook before a final version is produced. In order to achieve the project's objectives a consortium has been drawn together including, Belgian Nuclear Research Centre, the Norwegian Radiation Protection Authority, Radiation and Nuclear Safety Authority of Finland, the UK Health Protection Agency, the Central Laboratory for Radiological Protection of Poland and the World Health Organisation. Enviros Consulting is acting as the technical secretariat for the project. The Handbook will aim to harmonise the approaches to handling malevolent acts across Europe. This harmonisation will have an added value on the public confidence in authorities since differing approaches in neighbouring countries could lead to public confusion and mistrust. (authors)« less

Assessment of Factors Influencing Preservation of Dignity at Life's End: Creation and the Cross-Cultural Validation of the Preservation of Dignity Card-Sort Tool

PubMed Central

Noda, Arthur M.; Chmura Kraemer, Helena

2010-01-01

Abstract Background Preserving patient dignity is a sentinel premise of palliative care. This study was conducted to gain a better understanding of factors influencing preservation of dignity in the last chapter of life. Methods We conducted an open-ended written survey of 100 multidisciplinary providers (69% response rate) and responses were categorized to identify 2 main themes, 5 subthemes, and 10 individual factors that were used to create the preservation of dignity card-sort tool (p-DCT). The 10-item rank order tool was administered to a cohort of community dwelling Filipino Americans (n = 140, age mean = 61.3, 45% male and 55% female). A Spearman correlation matrix was constructed for all the 10 individual factors as well as the themes and subthemes based on the data generated by the subjects. Results The individual factors were minimally correlated with each other indicating that each factor was an independent stand-alone factor. The median, 25th and 75th percentile ranks were calculated and “s/he has self-respect” (intrinsic theme, self-esteem subtheme) emerged as the most important factor (mean rank 3.0 and median rank 2.0) followed by “others treat her/him with respect” (extrinsic theme, respect subtheme) with a mean rank = 3.6 and median = 3.0. Conclusion The p-DCT is a simple, rank order card-sort tool that may help clinicians identify patients' perceptions of key factors influencing the preservation of their dignity in the last chapter of life. PMID:20420549

Mechanisms of yeast stress tolerance and its manipulation for efficient fuel ethanol production.

PubMed

Zhao, X Q; Bai, F W

2009-10-12

Yeast strains of Saccharomyces cerevisiae have been extensively studied in recent years for fuel ethanol production, in which yeast cells are exposed to various stresses such as high temperature, ethanol inhibition, and osmotic pressure from product and substrate sugars as well as the inhibitory substances released from the pretreatment of lignocellulosic biomass. An in-depth understanding of the mechanism of yeast stress tolerance contributes to breeding more robust strains for ethanol production, especially under very high gravity conditions. Taking advantage of the "omics" technology, the stress response and defense mechanism of yeast cells during ethanol fermentation were further explored, and the newly emerged tools such as genome shuffling and global transcription machinery engineering have been applied to breed stress resistant yeast strains for ethanol production. In this review, the latest development of stress tolerance mechanisms was focused, and improvement of yeast stress tolerance by both random and rational tools was presented.

Role of Sonographic Imaging in Occupational Therapy Practice

PubMed Central

2015-01-01

Occupational therapy practice is grounded in the delivery of occupation-centered, patient-driven treatments that engage clients in the process of doing to improve health. As emerging technologies, such as medical imaging, find their way into rehabilitation practice, it is imperative that occupational therapy practitioners assess whether and how these tools can be incorporated into treatment regimens that are dually responsive to the medical model of health care and to the profession’s foundation in occupation. Most medical imaging modalities have a discrete place in occupation-based intervention as outcome measures or for patient education; however, sonographic imaging has the potential to blend multiple occupational therapy practice forms to document treatment outcomes, inform clinical reasoning, and facilitate improved functional performance when used as an accessory tool in direct intervention. Use of medical imaging is discussed as it relates to occupational foundations and the professional role within the context of providing efficient, effective patient-centered rehabilitative care. PMID:25871607

Prognostic markers of pediatric meningococcal sepsis.

PubMed

Briassoulis, George; Galani, Angeliki

2014-09-01

Having available tools to determine the prognosis of pediatric meningococcal sepsis at admission to the Intensive Care Unit or during the course of the disease constitutes a clinical necessity. Recently, new readily measurable circulating biomarkers have been described as an additional tool for severity classification and prediction of mortality in meningococcal disease. These biomarkers have been associated with increased risk of mortality scores and a number of organ failures in heterogeneous samples of critically ill children. In future, genetic markers may be used for identification of high-risk patients by creating prediction rules for clinical course and sequelae, and potentially provide more insight in the complex immune response in meningococcal sepsis. We briefly summarize the data pointing at the emerging genome-wide expression profiling studies and review the prognostic value of the main markers investigated in pediatric meningococcal sepsis putting them in the current frame of sepsis in general.

Risk analysis and bovine tuberculosis, a re-emerging zoonosis.

PubMed

Etter, Eric; Donado, Pilar; Jori, Ferran; Caron, Alexandre; Goutard, Flavie; Roger, François

2006-10-01

The widespread of immunodeficiency with AIDS, the consequence of poverty on sanitary protection and information at both individual and state levels lead control of tuberculosis (TB) to be one of the priorities of World Health Organization programs. The impact of bovine tuberculosis (BTB) on humans is poorly documented. However, BTB remains a major problem for livestock in developing countries particularly in Africa and wildlife is responsible for the failure of TB eradication programs. In Africa, the consumption of raw milk and raw meat, and the development of bushmeat consumption as a cheap source of proteins, represent one of the principal routes for human contaminations with BTB. The exploration of these different pathways using tools as participatory epidemiology allows the risk analysis of the impact of BTB on human health in Africa. This analysis represents a management support and decision tool in the study and the control of zoonotic BTB.

Moving beyond too little, too late: managing emerging infectious diseases in wild populations requires international policy and partnerships

USGS Publications Warehouse

Voyles, Jamie; Kilpatrick, A. Marm; Collins, James P.; Fisher, Matthew C.; Frick, Winifred F.; McCallum, Hamish I.; Willis, Craig K.R.; Blehert, David S.; Murray, Kris A.; Puschendorf, Robert; Rosenblum, Erica Bree; Bolker, Benjamin M.; Cheng, Tina L.; Langwig, Kate E.; Linder, Daniel L.; Toothman, Mary; Wilber, Mark Q.; Briggs, Cheryl J.

2015-01-01

Emerging infectious diseases (EIDs) are on the rise due to multiple factors, including human facilitated movement of pathogens, broad-scale landscape changes, and perturbations to ecological systems (Jones et al. 2008; Fisher et al. 2012). Epidemics in wildlife are problematic because they can lead to pathogen spillover to new host organisms, erode biodiversity and threaten ecosystems that sustain human societies (Fisher et al. 2012; Kilpatrick 2011). There have been recent calls for large-scale research approaches to combat threats EIDs pose to wildlife (Sleeman 2013). While it is true that developing new analytical models, diagnostic assays and molecular tools will significantly avance outr abilities to respond to disease threats, we also propose that addressing difficult problems in EIDs will require considerable shofts in international health policy and infrastructure. While there are currently international organizations responsbile for rapidly initiating and coordinating preventative measures to control infectious diseases in human, livestock, and arable systems, there are few comparable instiutions that have the authority to implement transnational responses to EIDs in wildlife. This absence of well-developed infastructure hampers the rapid responses necessary to mitigate international spread of EIDs.

Social media as a risk communication tool following Typhoon Haiyan.

PubMed

Cool, Christine Tiffany; Claravall, Marie Chantal; Hall, Julie Lyn; Taketani, Keisuke; Zepeda, John Paul; Gehner, Monika; Lawe-Davies, Olivia

2015-01-01

In the aftermath of Typhoon Haiyan, the World Health Organization (WHO) Representative Office in the Philippines had no social media presence to share timely, relevant public health information. Risk communication is essential to emergency management for public health message dissemination. As social media sites, such as Facebook, are popular in the Philippines, these were adopted for risk communication during the response to Haiyan. The WHO Representative Office in the Philippines established Facebook, Twitter and Instagram accounts. Thirty days after these social medial channels were established, a gradual increase in followers was observed. Facebook saw the largest increase in followers which occurred as posted content gradually evolved from general public health information to more pro-active public health intervention and preparedness messaging. This included information on key health interventions encouraging followers to adopt protective behaviours to mitigate public health threats that frequently occur after a disaster. During the response to Haiyan, creating a social media presence, raising a follower base and developing meaningful messages and content was possible. This event underscored the importance of building a social media strategy in non-emergency times and supported the value of developing public health messages and content that both educates and interests the general public.

The role of certified nursing assistants in nursing homes.

PubMed

Pennington, Karen; Scott, Jill; Magilvy, Kathy

2003-11-01

OBJECTIVE Pilot study to examine the experiences of the certified nursing assistants (CNAs) in Colorado nursing homes. CNAs provide 80% to 90% of the care to residents in nursing homes. Their reported turnover rate is as high as 400% in some studies, and the potential pool of CNAs is dwindling. As the demand for CNAs increases, their experiences must be understood to effectively address recruitment and retention issues. Minimally structured interviews of 12 CNAs in 6 Colorado nursing homes and observations of care provided were conducted. Atlas/Ti software was used as a data management tool for analyzing and coding data. The overriding theme that emerged from the interviews was "we love our jobs." Three patterns of thought and behavior emerged: attributes of the CNA, working conditions of the CNA, and future success of the CNA and the nursing home. Issues important to CNAs revolved around basic motivational factors, such as job enrichment opportunities, personal growth opportunities, recognition, responsibility, and sense of achievement. Leadership must become creative and build on that base, providing CNAs with job mobility, job enrichment opportunities, recognition, and increased job responsibility, producing positive outcomes not only for the CNA but also for the resident and the facility.

Assessment of knowledge and attitude before and after a health education program in East Madurai primary school teachers with regard to emergency management of avulsed teeth.

PubMed

Taranath, M; Senaikarasi, R M; Manchanda, Kavita

2017-01-01

Children attend primary school from as early as 6 years to the mixed dentition stage of about 9 years and spend most of their time in school along with the teachers. School teachers are likely to be among the first to see a child immediately after an injury has occurred, and their knowledge regarding emergency procedures is critical to ensure good prognosis of the clinical treatment. The purpose of the study was to evaluate, by means of a questionnaire, the primary school teacher's knowledge and attitude with regard to emergency management of traumatized avulsed teeth and to test the effectiveness of a health education tool. A total of 214 primary school teachers from 24 government schools, in and around East Madurai Panchayat, participated in a 3-month long study. Baseline data were collected using a pretested questionnaire in the 1st month. Based on that data, a health educational tool was prepared. The final assessment was made using the same questionnaire in the 3rd month. Baseline data and final data were compared using Z-test. The knowledge level of 70.83% of primary school teachers was in the very good category after the health education tool, which was initially nil. Similarly, the attitude level also raised drastically with 0.90% initially in the very good category, and after the health education tool, it was 41.20%. From this study, the importance of the need for the steps to increase the knowledge about the emergency management of avulsion is clearly understood. Thus, the main implication of the study is that a health educational tool regarding the emergency management of avulsion is necessary for the primary school teachers during their teacher training program.

Emergency Physicians’ Perceptions of Health Information Exchange

PubMed Central

Shapiro, Jason S.; Kannry, Joseph; Kushniruk, Andre W.; Kuperman, Gilad

2007-01-01

Background Health information exchange (HIE) is a potentially powerful technology that can improve the quality of care delivered in emergency departments, but little is known about emergency physicians’ current perceptions of HIE. Objectives This study sought to assess emergency physicians’ perceived needs and knowledge of HIE. Methods A questionnaire was developed based on heuristics from the literature and implemented in a Web-based tool. The survey was sent as a hyperlink via e-mail to 371 attending emergency physicians at 12 hospitals in New York City. Results The response rate was 58% (n = 216). Although 63% said more than one quarter of their patients would benefit from external health information, the barriers to obtain it without HIE are too high—85% said it was difficult or very difficult to obtain external data, taking an average of 66 minutes, 72% said that their attempts fail half of the time, and 56% currently attempt to obtain external data less than 10% of the time. When asked to create a rank-order list, electrocardiograms (ECGs) were ranked the highest, followed by discharge summaries. Respondents also chose images over written reports for ECGs and X-rays, but preferred written reports for advanced imaging and cardiac studies. Conclusion There is a strong perceived need for HIE, most respondents were not aware of HIE prior to this study, and there are certain types of data and presentations of data that are preferred by emergency physicians in the New York City region. PMID:17712079

Practical Applications for Earthquake Scenarios Using ShakeMap

NASA Astrophysics Data System (ADS)

Wald, D. J.; Worden, B.; Quitoriano, V.; Goltz, J.

2001-12-01

In planning and coordinating emergency response, utilities, local government, and other organizations are best served by conducting training exercises based on realistic earthquake situations-ones that they are most likely to face. Scenario earthquakes can fill this role; they can be generated for any geologically plausible earthquake or for actual historic earthquakes. ShakeMap Web pages now display selected earthquake scenarios (www.trinet.org/shake/archive/scenario/html) and more events will be added as they are requested and produced. We will discuss the methodology and provide practical examples where these scenarios are used directly for risk reduction. Given a selected event, we have developed tools to make it relatively easy to generate a ShakeMap earthquake scenario using the following steps: 1) Assume a particular fault or fault segment will (or did) rupture over a certain length, 2) Determine the magnitude of the earthquake based on assumed rupture dimensions, 3) Estimate the ground shaking at all locations in the chosen area around the fault, and 4) Represent these motions visually by producing ShakeMaps and generating ground motion input for loss estimation modeling (e.g., FEMA's HAZUS). At present, ground motions are estimated using empirical attenuation relationships to estimate peak ground motions on rock conditions. We then correct the amplitude at that location based on the local site soil (NEHRP) conditions as we do in the general ShakeMap interpolation scheme. Finiteness is included explicitly, but directivity enters only through the empirical relations. Although current ShakeMap earthquake scenarios are empirically based, substantial improvements in numerical ground motion modeling have been made in recent years. However, loss estimation tools, HAZUS for example, typically require relatively high frequency (3 Hz) input for predicting losses, above the range of frequencies successfully modeled to date. Achieving full-synthetic ground motion estimates that will substantially improve over empirical relations at these frequencies will require developing cost-effective numerical tools for proper theoretical inclusion of known complex ground motion effects. Current efforts underway must continue in order to obtain site, basin, and deeper crustal structure, and to characterize and test 3D earth models (including attenuation and nonlinearity). In contrast, longer period synthetics (>2 sec) are currently being generated in a deterministic fashion to include 3D and shallow site effects, an improvement on empirical estimates alone. As progress is made, we will naturally incorporate such advances into the ShakeMap scenario earthquake and processing methodology. Our scenarios are currently used heavily in emergency response planning and loss estimation. Primary users include city, county, state and federal government agencies (e.g., the California Office of Emergency Services, FEMA, the County of Los Angeles) as well as emergency response planners and managers for utilities, businesses, and other large organizations. We have found the scenarios are also of fundamental interest to many in the media and the general community interested in the nature of the ground shaking likely experienced in past earthquakes as well as effects of rupture on known faults in the future.

State Emergency Response Commissions

EPA Pesticide Factsheets

The Governor of each state has designated a State Emergency Response Commission (SERC) that is responsible for implementing the Emergency Planning and Community Right-to-Know Act (EPCRA) provisions within its state.

Community response grids: using information technology to help communities respond to bioterror emergencies.

PubMed

Jaeger, Paul T; Fleischmann, Kenneth R; Preece, Jennifer; Shneiderman, Ben; Wu, Philip Fei; Qu, Yan

2007-12-01

Access to accurate and trusted information is vital in preparing for, responding to, and recovering from an emergency. To facilitate response in large-scale emergency situations, Community Response Grids (CRGs) integrate Internet and mobile technologies to enable residents to report information, professional emergency responders to disseminate instructions, and residents to assist one another. CRGs use technology to help residents and professional emergency responders to work together in community response to emergencies, including bioterrorism events. In a time of increased danger from bioterrorist threats, the application of advanced information and communication technologies to community response is vital in confronting such threats. This article describes CRGs, their underlying concepts, development efforts, their relevance to biosecurity and bioterrorism, and future research issues in the use of technology to facilitate community response.

40 CFR Appendix F to Part 112 - Facility-Specific Response Plan

Code of Federal Regulations, 2011 CFR

2011-07-01

... of Contents 1.0Model Facility-Specific Response Plan 1.1Emergency Response Action Plan 1.2Facility.... EC01MR92.015 1.1Emergency Response Action Plan Several sections of the response plan shall be co-located... sections shall be called the Emergency Response Action Plan. The Agency intends that the Action Plan...

49 CFR 172.604 - Emergency response telephone number.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Emergency response telephone number. 172.604... telephone number. (a) A person who offers a hazardous material for transportation must provide an emergency response telephone number, including the area code, for use in an emergency involving the hazardous...

Towards an Integrated Flood Preparedness and Response: Centralized Data Access, Analysis, and Visualization

NASA Astrophysics Data System (ADS)

Demir, I.; Krajewski, W. F.

2014-12-01

Recent advances in internet and cyberinfrastucture technologies have provided the capability to understand the hydrological and meteorological systems at space and time scales that are critical for making accurate understanding and prediction of flooding, and emergency preparedness. A novel example of a cyberinfrastructure platform for flood preparedness and response is the Iowa Flood Center's Iowa Flood Information System (IFIS). IFIS is a one-stop web-platform to access community-based flood conditions, forecasts, visualizations, inundation maps and flood-related data, information, and applications. An enormous volume of real-time observational data from a variety of sensors and remote sensing resources (radars, rain gauges, stream sensors, etc.) and complex flood inundation models are staged on a user-friendly maps environment that is accessible to the general public. IFIS has developed into a very successful tool used by agencies, decision-makers, and the general public throughout Iowa to better understand their local watershed and their personal and community flood risk, and to monitor local stream and river levels. IFIS helps communities make better-informed decisions on the occurrence of floods, and alerts communities in advance to help minimize flood damages. IFIS is widely used by general public in Iowa and the Midwest region with over 120,000 unique users, and became main source of information for many newspapers and TV stations in Iowa. IFIS has features for general public to improve emergency preparedness, and for decision makers to support emergency response and recovery efforts. IFIS is also a great platform for educators and local authorities to educate students and public on flooding with games, easy to use interactive environment, and data rich system.

Use of a trigger tool to detect adverse drug reactions in an emergency department.

PubMed

de Almeida, Silvana Maria; Romualdo, Aruana; de Abreu Ferraresi, Andressa; Zelezoglo, Giovana Roberta; Marra, Alexandre R; Edmond, Michael B

2017-11-15

Although there are systems for reporting adverse drug reactions (ADR), these safety events remain under reported. The low-cost, low-tech trigger tool method is based on the detection of events through clues, and it seems to increase the detection of adverse events compared to traditional methodologies. This study seeks to estimate the prevalence of adverse reactions to drugs in patients seeking care in the emergency department. Retrospective study from January to December, 2014, applying the Institute for Healthcare Improvement (IHI) trigger tool methodology for patients treated at the emergency room of a tertiary care hospital. The estimated prevalence of adverse reactions in patients presenting to the emergency department was 2.3% [CI 95 1.3% to 3.3%]; 28.6% of cases required hospitalization at an average cost of US$ 5698.44. The most common triggers were hydrocortisone (57% of the cases), diphenhydramine (14%) and fexofenadine (14%). Anti-infectives (19%), cardiovascular agents (14%), and musculoskeletal drugs (14%) were the most common causes of adverse reactions. According to the Naranjo Scale, 71% were classified as possible and 29% as probable. There was no association between adverse reactions and age and sex in the present study. The use of the trigger tool to identify adverse reactions in the emergency department was possible to identify a prevalence of 2.3%. It showed to be a viable method that can provide a better understanding of adverse drug reactions in this patient population.

How to Better Prepare Your Community for a Chemical Emergency: A Guide for State, Tribal and Local Agencies

EPA Pesticide Factsheets

This guide provides an overview of EPCRA requirements for State Emergency Response Commissions, Tribal Emergency Response Commissions, Local Emergency Planning Committees, and Tribal Emergency Planning Committees.

Systematic review of surveillance systems and methods for early detection of exotic, new and re-emerging diseases in animal populations.

PubMed

Rodríguez-Prieto, V; Vicente-Rubiano, M; Sánchez-Matamoros, A; Rubio-Guerri, C; Melero, M; Martínez-López, B; Martínez-Avilés, M; Hoinville, L; Vergne, T; Comin, A; Schauer, B; Dórea, F; Pfeiffer, D U; Sánchez-Vizcaíno, J M

2015-07-01

In this globalized world, the spread of new, exotic and re-emerging diseases has become one of the most important threats to animal production and public health. This systematic review analyses conventional and novel early detection methods applied to surveillance. In all, 125 scientific documents were considered for this study. Exotic (n = 49) and re-emerging (n = 27) diseases constituted the most frequently represented health threats. In addition, the majority of studies were related to zoonoses (n = 66). The approaches found in the review could be divided in surveillance modalities, both active (n = 23) and passive (n = 5); and tools and methodologies that support surveillance activities (n = 57). Combinations of surveillance modalities and tools (n = 40) were also found. Risk-based approaches were very common (n = 60), especially in the papers describing tools and methodologies (n = 50). The main applications, benefits and limitations of each approach were extracted from the papers. This information will be very useful for informing the development of tools to facilitate the design of cost-effective surveillance strategies. Thus, the current literature review provides key information about the advantages, disadvantages, limitations and potential application of methodologies for the early detection of new, exotic and re-emerging diseases.

Geospatial Information is the Cornerstone of Effective Hazards Response

USGS Publications Warehouse

Newell, Mark

2008-01-01

Every day there are hundreds of natural disasters world-wide. Some are dramatic, whereas others are barely noticeable. A natural disaster is commonly defined as a natural event with catastrophic consequences for living things in the vicinity. Those events include earthquakes, floods, hurricanes, landslides, tsunami, volcanoes, and wildfires. Man-made disasters are events that are caused by man either intentionally or by accident, and that directly or indirectly threaten public health and well-being. These occurrences span the spectrum from terrorist attacks to accidental oil spills. To assist in responding to natural and potential man-made disasters, the U.S. Geological Survey (USGS) has established the Geospatial Information Response Team (GIRT) (http://www.usgs.gov/emergency/). The primary purpose of the GIRT is to ensure rapid coordination and availability of geospatial information for effective response by emergency responders, and land and resource managers, and for scientific analysis. The GIRT is responsible for establishing monitoring procedures for geospatial data acquisition, processing, and archiving; discovery, access, and delivery of data; anticipating geospatial needs; and providing relevant geospatial products and services. The GIRT is focused on supporting programs, offices, other agencies, and the public in mission response to hazards. The GIRT will leverage the USGS Geospatial Liaison Network and partnerships with the Department of Homeland Security (DHS), National Geospatial-Intelligence Agency (NGA), and Northern Command (NORTHCOM) to coordinate the provisioning and deployment of USGS geospatial data, products, services, and equipment. The USGS geospatial liaisons will coordinate geospatial information sharing with State, local, and tribal governments, and ensure geospatial liaison back-up support procedures are in place. The GIRT will coordinate disposition of USGS staff in support of DHS response center activities as requested by DHS. The GIRT is a standing team that is available during all hazard events and is on high alert during the hurricane season from June through November each year. To track all of the requirements and data acquisitions processed through the team, the GIRT will use the new Emergency Request Track (ER Track) tool. Currently, the ER Track is only available to USGS personnel.

40 CFR 1.47 - Office of Solid Waste and Emergency Response.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Office of Solid Waste and Emergency... ORGANIZATION AND GENERAL INFORMATION Headquarters § 1.47 Office of Solid Waste and Emergency Response. The Office of Solid Waste and Emergency Response (OSWER), under the supervision of the Assistant...

40 CFR 1.47 - Office of Solid Waste and Emergency Response.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Office of Solid Waste and Emergency... ORGANIZATION AND GENERAL INFORMATION Headquarters § 1.47 Office of Solid Waste and Emergency Response. The Office of Solid Waste and Emergency Response (OSWER), under the supervision of the Assistant...

49 CFR 172.604 - Emergency response telephone number.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Emergency response telephone number. 172.604... telephone number. (a) A person who offers a hazardous material for transportation must provide an emergency response telephone number, including the area code, for use in the event of an emergency involving the...

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

...] Notice of Request for Extension of Approval of an Information Collection; Emergency Management Response... approval of an information collection associated with the Emergency Management Response System. DATES: We...: For information on the Emergency Management Response System, contact Dr. Steven Finch, Senior Staff...

Yeast Toxicogenomics: Genome-Wide Responses to Chemical Stresses with Impact in Environmental Health, Pharmacology, and Biotechnology

PubMed Central

dos Santos, Sandra C.; Teixeira, Miguel Cacho; Cabrito, Tânia R.; Sá-Correia, Isabel

2012-01-01

The emerging transdisciplinary field of Toxicogenomics aims to study the cell response to a given toxicant at the genome, transcriptome, proteome, and metabolome levels. This approach is expected to provide earlier and more sensitive biomarkers of toxicological responses and help in the delineation of regulatory risk assessment. The use of model organisms to gather such genomic information, through the exploitation of Omics and Bioinformatics approaches and tools, together with more focused molecular and cellular biology studies are rapidly increasing our understanding and providing an integrative view on how cells interact with their environment. The use of the model eukaryote Saccharomyces cerevisiae in the field of Toxicogenomics is discussed in this review. Despite the limitations intrinsic to the use of such a simple single cell experimental model, S. cerevisiae appears to be very useful as a first screening tool, limiting the use of animal models. Moreover, it is also one of the most interesting systems to obtain a truly global understanding of the toxicological response and resistance mechanisms, being in the frontline of systems biology research and developments. The impact of the knowledge gathered in the yeast model, through the use of Toxicogenomics approaches, is highlighted here by its use in prediction of toxicological outcomes of exposure to pesticides and pharmaceutical drugs, but also by its impact in biotechnology, namely in the development of more robust crops and in the improvement of yeast strains as cell factories. PMID:22529852

InaSAFE applications in disaster preparedness

NASA Astrophysics Data System (ADS)

Pranantyo, Ignatius Ryan; Fadmastuti, Mahardika; Chandra, Fredy

2015-04-01

Disaster preparedness activities aim to reduce the impact of disasters by being better prepared to respond when a disaster occurs. In order to better anticipate requirements during a disaster, contingency planning activities can be undertaken prior to a disaster based on a realistic disaster scenario. InaSAFE is a tool that can inform this process. InaSAFE is a free and open source software that estimates the impact to people and infrastructure from potential hazard scenarios. By using InaSAFE, disaster managers can develop scenarios of disaster impacts (people and infrastructures affected) to inform their contingency plan and emergency response operation plan. While InaSAFE provides the software framework exposure data and hazard data are needed as inputs to run this software. Then InaSAFE can be used to forecast the impact of the hazard scenario to the exposure data. InaSAFE outputs include estimates of the number of people, buildings and roads are affected, list of minimum needs (rice and clean water), and response checklist. InaSAFE is developed by Indonesia's National Disaster Management Agency (BNPB) and the Australian Government, through the Australia-Indonesia Facility for Disaster Reduction (AIFDR), in partnership with the World Bank - Global Facility for Disaster Reduction and Recovery (GFDRR). This software has been used in many parts of Indonesia, including Padang, Maumere, Jakarta, and Slamet Mountain for emergency response and contingency planning.

Infrastructure to Support Ultra High Throughput Biodosimetry Screening after a Radiological Event

PubMed Central

Garty, G.; Karam, P.A.; Brenner, D. J.

2011-01-01

Purpose After a large-scale radiological event, there will be a pressing need to assess, within a few days, the radiation doses received by tens or hundreds of thousands of individuals. This is for triage, to prevent treatment locations from being overwhelmed, in what is sure to be a resource limited scenario, as well as to facilitate dose-dependent treatment decisions. In addition there are psychosocial considerations, in that active reassurance of minimal exposure is a potentially effective antidote to mass panic, as well as long-term considerations, to facilitate later studies of cancer and other long-term disease risks. Materials and Methods As described elsewhere in this issue, we are developing a Rapid Automated Biodosimetry Tool (RABiT). The RABiT allows high throughput analysis of thousands of blood samples per day, providing a dose estimate that can be used to support clinical triage and treatment decisions. Results Development of the RABiT has motivated us to consider the logistics of incorporating such a system into the existing emergency response scenarios of a large metropolitan area. We present here a view of how one or more centralized biodosimetry readout devices might be incorporated into an infrastructure in which fingerstick blood samples are taken at many distributed locations within an affected city or region and transported to centralized locations. Conclusions High throughput biodosimetry systems offer the opportunity to perform biodosimetric assessments on a large number of persons. As such systems reach a high level of maturity, emergency response scenarios will need to be tweaked to make use of these powerful tools. This can be done relatively easily within the framework of current scenarios. PMID:21675819

Emergency department team communication with the patient: the patient's perspective.

PubMed

McCarthy, Danielle M; Ellison, Emily P; Venkatesh, Arjun K; Engel, Kirsten G; Cameron, Kenzie A; Makoul, Gregory; Adams, James G

2013-08-01

Effective communication is important for the delivery of quality care. The Emergency Department (ED) environment poses significant challenges to effective communication. The objective of this study was to determine patients' perceptions of their ED team's communication skills. This was a cross-sectional study in an urban, academic ED. Patients completed the Communication Assessment Tool for Teams (CAT-T) survey upon ED exit. The CAT-T was adapted from the psychometrically validated Communication Assessment Tool (CAT) to measure patient perceptions of communication with a medical team. The 14 core CAT-T items are associated with a 5-point scale (5 = excellent); results are reported as the percent of participants who responded "excellent." Responses were analyzed for differences based on age, sex, race, and operational metrics (wait time, ED daily census). There were 346 patients identified; the final sample for analysis was 226 patients (53.5% female, 48.2% Caucasian), representing a response rate of 65.3%. The scores on CAT-T items (reported as % "excellent") ranged from 50.0% to 76.1%. The highest-scoring items were "let me talk without interruptions" (76.1%), "talked in terms I could understand" (75.2%), and "treated me with respect" (74.3%). The lowest-scoring item was "encouraged me to ask questions" (50.0%). No differences were noted based on patient sex, race, age, wait time, or daily census of the ED. The patients in this study perceived that the ED teams were respectful and allowed them to talk without interruptions; however, lower ratings were given for items related to actively engaging the patient in decision-making and asking questions. Copyright © 2013 Elsevier Inc. All rights reserved.

Need for integrative thinking to fight against emerging infectious diseases. Proceedings of the 5th seminar on emerging infectious diseases, March 22, 2016 - current trends and proposals.

PubMed

Burdet, C; Guégan, J-F; Duval, X; Le Tyrant, M; Bergeron, H; Manuguerra, J-C; Raude, J; Leport, C; Zylberman, P

2018-02-01

We present here the proceedings of the 5th seminar on emerging infectious diseases, held in Paris on March 22nd, 2016, with seven priority proposals that can be outlined as follows: encourage research on the prediction, screening and early detection of new risks of infection; develop research and surveillance concerning transmission of pathogens between animals and humans, with their reinforcement in particular in intertropical areas ("hot-spots") via public support; pursue aid development and support in these areas of prevention and training for local health personnel, and foster risk awareness in the population; ensure adapted patient care in order to promote adherence to treatment and to epidemic propagation reduction measures; develop greater awareness and better education among politicians and healthcare providers, in order to ensure more adapted response to new types of crises; modify the logic of governance, drawing from all available modes of communication and incorporating new information-sharing tools; develop economic research on the fight against emerging infectious diseases, taking into account specific driving factors in order to create a balance between preventive and curative approaches. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A bioassay for studying behavioural responses of the common bed bug, Cimex lectularius (Hemiptera: Cimicidae) to bed bug-derived volatiles.

PubMed

Weeks, E N I; Logan, J G; Gezan, S A; Woodcock, C M; Birkett, M A; Pickett, J A; Cameron, M M

2011-02-01

The common bed bug, Cimex lectularius (Hemiptera: Cimicidae), has recently re-emerged in increasing numbers, distribution and intensity of infestation in many countries. Current control relies on the application of residual pesticides; but, due to the development of insecticide resistance, there is a need for new tools and techniques. Semiochemicals (behaviour and physiology modifying chemicals) could be exploited for management of bed bugs. However, in order to identify semiochemicals that can be utilised in monitoring or control, a suitable olfactometer is needed that enables the study of the responses of bed bugs to volatile chemicals. Previous studies have used olfactometers that do not separate olfactory responses from responses to physical contact. In this study, a still-air olfactometer was used to measure behavioural responses to different bed bug-derived volatiles presented in an odour pot. Bed bugs were significantly more likely to visit the area above the odour pot first, and more frequently, in the presence of volatiles from bed bug-exposed paper but not in the presence of volatiles from conspecific bed bugs. Bed bug activity was found to be dependent on the presence of the volatiles from bed bug-exposed paper, the time during the scotophase and the sex of the insect being tested. The still-air olfactometer could be used to test putative semiochemicals, which would allow an understanding of their behavioural role in bed bug ecology. Ultimately, this could lead to the identification of new semiochemical tools for bed bug monitoring and control.

The Virtual Learning Commons: An Emerging Technology for Learning About Emerging Technologies

NASA Astrophysics Data System (ADS)

Pennington, D. D.; Del Rio, N.; Fierro, C.; Gandara, A.; Garcia, A.; Garza, J.; Giandoni, M.; Ochoa, O.; Padilla, E.; Salamah, S.

2013-12-01

The Virtual Learning Commons (VLC), funded by the National Science Foundation Office of Cyberinfrastructure CI-Team Program, is a combination of semantic, visualization, and social media tools that support knowledge sharing and innovation across research disciplines. The explosion of new scientific tools and techniques challenges the ability of researchers to be aware of emerging technologies that might benefit them. Even when aware, it can be difficult to understand enough about emerging technologies to become potential adopters or re-users. Often, emerging technologies have little documentation, especially about the context of their use. The VLC tackles this challenge by providing mechanisms for individuals and groups of researchers to collectively organize Web resources through social bookmarking, and engage each other around those collections in order to a) learn about potentially relevant technologies that are emerging; and b) get feedback from other researchers on innovative ideas and designs. Concurrently, developers of emerging technologies can learn about potential users and the issues they encounter, and they can analyze the impact of their tools on other projects. The VLC aims to support the 'fuzzy front end' of innovation, where novel ideas emerge and there is the greatest potential for impact on research design. It is during the fuzzy front end that conceptual collisions across disciplines and exposure to diverse perspectives provide opportunity for creative thinking that can lead to inventive outcomes. This presentation will discuss the innovation theories that have informed design of the VLC, and hypotheses about the flow of information in virtual settings that can enable the process of innovation. The presentation will include a brief demonstration of key capabilities within the VLC that enable learning about emerging technologies, including the technologies that are presented in this session.

The Exposome: A New Frontier for Education.

PubMed

Dennis, Kristine K; Jones, Dean P

2016-09-01

The historic debate of nature vs. nurture has emerged as a central yin-yang of contemporary health and disease research. The Human Genome Project provided the capability to define the nature of an individual by one's genetic sequence. But tools are not available to sequence lifelong exposures (i.e., the nurture of an individual). Many believe that nurture has an even greater role than genetics in determining lifelong success, health, and well-being. In contemporary terminology, the cumulative measure of environmental influences and associated biological responses throughout the life span is termed the "exposome." This includes all external exposures from the environment, diet, behavior, societal influences and infections, and also cumulative biological responses to exposures and endogenous processes. Pursuit of a Human Exposome Project is a vision worthy of our youth: development of strategies and tools will require the brightest and most imaginative. Incorporation of the exposome into education curricula will foster discussion, development of interest, improvement of skills, and promotion of critical thinking to prepare students for civically engaged lives, ongoing study, and future career opportunities. The long-term vision is that sequencing the exposome will support better understanding of healthful and harmful lifelong exposures and lead to improved opportunity for the health and prosperity of all.