Secure, Autonomous, Intelligent Controller for Integrating Distributed Emergency Response Satellite Operations

NASA Astrophysics Data System (ADS)

Ivancic, W. D.; Paulsen, P. E.; Miller, E. M.; Sage, S. P.

This report describes a Secure, Autonomous, and Intelligent Controller for Integrating Distributed Emergency Response Satellite Operations. It includes a description of current improvements to existing Virtual Mission Operations Center technology being used by US Department of Defense and originally developed under NASA funding. The report also highlights a technology demonstration performed in partnership with the United States Geological Service for Earth Resources Observation and Science using DigitalGlobe® satellites to obtain space-based sensor data.

Unmanned and Unattended Response Capability for Homeland Defense

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

BENNETT, PHIL C.

2002-11-01

An analysis was conducted of the potential for unmanned and unattended robotic technologies for forward-based, immediate response capabilities that enables access and controlled task performance. The authors analyze high-impact response scenarios in conjunction with homeland security organizations, such as the NNSA Office of Emergency Response, the FBI, the National Guard, and the Army Technical Escort Unit, to cover a range of radiological, chemical and biological threats. They conducted an analysis of the potential of forward-based, unmanned and unattended robotic technologies to accelerate and enhance emergency and crisis response by Homeland Defense organizations. Response systems concepts were developed utilizing new technologiesmore » supported by existing emerging threats base technologies to meet the defined response scenarios. These systems will pre-position robotic and remote sensing capabilities stationed close to multiple sites for immediate action. Analysis of assembled systems included experimental activities to determine potential efficacy in the response scenarios, and iteration on systems concepts and remote sensing and robotic technologies, creating new immediate response capabilities for Homeland Defense.« less

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.

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.

An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario.

PubMed

Mew, E J; Ritchie, S D; VanderBurgh, D; Beardy, J L; Gordon, J; Fortune, M; Mamakwa, S; Orkin, A M

2017-01-01

Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. We aimed to understand emergency response systems, services, and training in remote NAN communities. We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013. Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2011 CFR

2011-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2010 CFR

2010-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2014 CFR

2014-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2012 CFR

2012-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

42 CFR 51d.4 - What information is required in the application?

Code of Federal Regulations, 2013 CFR

2013-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

Secure, Autonomous, Intelligent Controller for Integrating Distributed Emergency Response Satellite Operations

NASA Technical Reports Server (NTRS)

Ivancic, William D.; Paulsen, Phillip E.; Miller, Eric M.; Sage, Steen P.

2013-01-01

This report describes a Secure, Autonomous, and Intelligent Controller for Integrating Distributed Emergency Response Satellite Operations. It includes a description of current improvements to existing Virtual Mission Operations Center technology being used by US Department of Defense and originally developed under NASA funding. The report also highlights a technology demonstration performed in partnership with the United States Geological Service for Earth Resources Observation and Science using DigitalGlobe(Registered TradeMark) satellites to obtain space-based sensor data.

Emerging & re-emerging infections in India: An overview

PubMed Central

Dikid, T.; Jain, S.K.; Sharma, A.; Kumar, A.; Narain, J.P.

2013-01-01

The incidence of emerging infectious diseases in humans has increased within the recent past or threatens to increase in the near future. Over 30 new infectious agents have been detected worldwide in the last three decades; 60 per cent of these are of zoonotic origin. Developing countries such as India suffer disproportionately from the burden of infectious diseases given the confluence of existing environmental, socio-economic, and demographic factors. In the recent past, India has seen outbreaks of eight organisms of emerging and re-emerging diseases in various parts of the country, six of these are of zoonotic origin. Prevention and control of emerging infectious diseases will increasingly require the application of sophisticated epidemiologic and molecular biologic technologies, changes in human behaviour, a national policy on early detection of and rapid response to emerging infections and a plan of action. WHO has made several recommendations for national response mechanisms. Many of these are in various stages of implementation in India. However, for a country of size and population of India, the emerging infections remain a real and present danger. A meaningful response must approach the problem at the systems level. A comprehensive national strategy on infectious diseases cutting across all relevant sectors with emphasis on strengthened surveillance, rapid response, partnership building and research to guide public policy is needed. PMID:24056553

Emerging & re-emerging infections in India: an overview.

PubMed

Dikid, T; Jain, S K; Sharma, A; Kumar, A; Narain, J P

2013-01-01

The incidence of emerging infectious diseases in humans has increased within the recent past or threatens to increase in the near future. Over 30 new infectious agents have been detected worldwide in the last three decades; 60 per cent of these are of zoonotic origin. Developing countries such as India suffer disproportionately from the burden of infectious diseases given the confluence of existing environmental, socio-economic, and demographic factors. In the recent past, India has seen outbreaks of eight organisms of emerging and re-emerging diseases in various parts of the country, six of these are of zoonotic origin. Prevention and control of emerging infectious diseases will increasingly require the application of sophisticated epidemiologic and molecular biologic technologies, changes in human behaviour, a national policy on early detection of and rapid response to emerging infections and a plan of action. WHO has made several recommendations for national response mechanisms. Many of these are in various stages of implementation in India. However, for a country of size and population of India, the emerging infections remain a real and present danger. A meaningful response must approach the problem at the systems level. A comprehensive national strategy on infectious diseases cutting across all relevant sectors with emphasis on strengthened surveillance, rapid response, partnership building and research to guide public policy is needed.

Using social network analysis to understand Missouri's system of public health emergency planners.

PubMed

Harris, Jenine K; Clements, Bruce

2007-01-01

Effective response to large-scale public health threats requires well-coordinated efforts among individuals and agencies. While guidance is available to help states put emergency planning programs into place, little has been done to evaluate the human infrastructure that facilitates successful implementation of these programs. This study examined the human infrastructure of the Missouri public health emergency planning system in 2006. The Center for Emergency Response and Terrorism (CERT) at the Missouri Department of Health and Senior Services has responsibility for planning, guiding, and funding statewide emergency response activities. Thirty-two public health emergency planners working primarily in county health departments contract with CERT to support statewide preparedness. We surveyed the planners to determine whom they communicate with, work with, seek expertise from, and exchange guidance with regarding emergency preparedness in Missouri. Most planners communicated regularly with planners in their region but seldom with planners outside their region. Planners also reported working with an average of 12 local entities (e.g., emergency management, hospitals/ clinics). Planners identified the following leaders in Missouri's public health emergency preparedness system: local public health emergency planners, state epidemiologists, the state vaccine and grant coordinator, regional public health emergency planners, State Emergency Management Agency area coordinators, the state Strategic National Stockpile coordinator, and Federal Bureau of Investigation Weapons of Mass Destruction coordinators. Generally, planners listed few federal-level or private-sector individuals in their emergency preparedness networks. While Missouri public health emergency planners maintain large and varied emergency preparedness networks, there are opportunities for strengthening existing ties and seeking additional connections.

Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community.

PubMed

VanderBurgh, D; Jamieson, R; Beardy, J; Ritchie, S D; Orkin, A

2014-01-01

Community-based first aid training is the collaborative development of locally relevant emergency response training. The Sachigo Lake Wilderness Emergency Response Education Initiative was developed, delivered, and evaluated through two intensive 5-day first aid courses. Sachigo Lake First Nation is a remote Aboriginal community of 450 people in northern Ontario, Canada, with no local paramedical services. These courses were developed in collaboration with the community, with a goal of building community capacity to respond to medical emergencies. Most first aid training programs rely on standardized curriculum developed for urban and rural contexts with established emergency response systems. Delivering effective community-based first aid training in a remote Aboriginal community required specific adaptations to conventional first aid educational content and pedagogy. Three key lessons emerged during this program that used collaborative principles to adapt conventional first aid concepts and curriculum: (1) standardized approaches may not be relevant nor appropriate; (2) relationships between course participants and the people they help are relevant and important; (3) curriculum must be attentive to existing informal and formal emergency response systems. These lessons may be instructive for the development of other programs in similar settings.

Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel.

PubMed

Wolkow, Alexander; Ferguson, Sally; Aisbett, Brad; Main, Luana

2015-01-01

Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel) that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextualize the significance of such responses to assist emergency service agencies monitor the health of their personnel. The available literature suggests that sleep restriction across multiple work days can disrupt cytokine and cortisol levels, deteriorate mood and elicit simultaneous physiological and psychological responses. However, research concerning the interaction between such responses is limited and inconclusive. Therefore, it is unknown if a psycho-physiological relationship exists and as a result, it is currently not feasible for agencies to monitor sleep restriction related stress based on psycho- physiological interactions. Sleep restriction does however, appear to be a major stressor contributing to physiological and psychological responses and thus, warrants further investigation. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Assessing and improving cross-border chemical incident preparedness and response across Europe.

PubMed

Stewart-Evans, James; Hall, Lisbeth; Czerczak, Slawomir; Manley, Kevin; Dobney, Alec; Hoffer, Sally; Pałaszewska-Tkacz, Anna; Jankowska, Agnieszka

2014-11-01

Good practices in emergency preparedness and response for chemical incidents include practices specific to the different functions of exposure assessment (e.g., within the monitoring function, the use of mobile monitoring equipment; within the modelling function, the use of rapid dispersion models with integrated mapping software) and generic practices to engage incident response stakeholders to maximise exposure assessment capabilities (e.g., sharing protocols and pre-prepared information and multi-agency training and exercising). Such practices can optimise cross-border collaboration. A wide range of practices have been implemented across MSs during chemical incident response, particularly during incidents that have cross-border and trans-boundary impacts. This paper proposes a self-assessment methodology to enable MSs, or organisations within MSs, to examine exposure assessment capabilities and communication pathways between exposure assessors and public health risk assessors. Where gaps exist, this methodology provides links to good practices that could improve response, communication and collaboration across local, regional and national borders. A fragmented approach to emergency preparedness for chemical incidents is a major obstacle to improving cross-border exposure assessment. There is no one existing body or structure responsible for all aspects of chemical incident preparedness and response in the European Union. Due to the range of different organisations and networks involved in chemical incident response, emergency preparedness needs to be drawn together. A number of recommendations are proposed, including the use of networks of experts which link public health risk assessors with experts in exposure assessment, in order to coordinate and improve chemical incident emergency preparedness. The EU's recent Decision on serious cross-border threats to health aims to facilitate MSs' compliance with the International Health Regulations, which require reporting and communication regarding significant chemical incidents. This provides a potential route to build on in order to improve chemical incident preparedness and response across Europe. Copyright © 2014 Elsevier Ltd. All rights reserved.

Using Geo-Data Corporately on the Response Phase of Emergency Management

NASA Astrophysics Data System (ADS)

Demir Ozbek, E.; Ates, S.; Aydinoglu, A. C.

2015-08-01

Response phase of emergency management is the most complex phase in the entire cycle because it requires cooperation between various actors relating to emergency sectors. A variety of geo-data is needed at the emergency response such as; existing data provided by different institutions and dynamic data collected by different sectors at the time of the disaster. Disaster event is managed according to elaborately defined activity-actor-task-geodata cycle. In this concept, every activity of emergency response is determined with Standard Operation Procedure that enables users to understand their tasks and required data in any activity. In this study, a general conceptual approach for disaster and emergency management system is developed based on the regulations to serve applications in Istanbul Governorship Provincial Disaster and Emergency Directorate. The approach is implemented to industrial facility explosion example. In preparation phase, optimum ambulance locations are determined according to general response time of the ambulance to all injury cases in addition to areas that have industrial fire risk. Management of the industrial fire case is organized according to defined actors, activities, and working cycle that describe required geo-data. A response scenario was prepared and performed for an industrial facility explosion event to exercise effective working cycle of actors. This scenario provides using geo-data corporately between different actors while required data for each task is defined to manage the industrial facility explosion event. Following developing web technologies, this scenario based approach can be effective to use geo-data on the web corporately.

The application of mobile satellite services to emergency response communications

NASA Technical Reports Server (NTRS)

Freibaum, J.

1980-01-01

The application of an integrated satellite/terrestrial emergency response communications system in disaster relief operations is discussed. Large area coverage communications capability, full-time availability, a high degree of mobility, plus reliability, are pointed out as criteria for an effective emergency communications system. Response time is seen as a major factor determining the possible survival and/or protection of property. These criteria, can not be met by existing communications systems and complete blackouts were experienced during the past decades caused by either interruption or destruction of existing power lines, and overload or inadequacy of remaining lines. Several emergency cases, caused by either hurricanes, tornados, or floods, during which communication via satellite was instrumental to inform rescue and relief teams, are described in detail. Seismic Risk Maps and charts of Major Tectonic Plates Earthquake Epicenters are given, and it is noted that, 35 percent of the U.S. population is living in critical areas. National and international agreements for the implementation of a satellite-aided global Search and Rescue Program is mentioned. Technological and economic breakthroughs are still needed in large multibeam antennas, switching circuits, and low cost mobile ground terminals. A pending plan of NASA to initiate a multiservice program in 1982/83, with a Land Mobile Satellite capability operating in the 806 - 890 MHz band as a major element, may help to accelerate the needed breakthroughs.

Leveraging Emerging Technology to Maintain Corporate Situational Awareness

DTIC Science & Technology

2008-06-01

Abstract and Outline for 13th ICCRTS For the paper entitled: Leveraging Emerging Technology to Maintain Corporate ...Situational Awareness Topics: Topic 5. Organizational Issues Topic 4. Cognitive and Social Issues Topic: 2 Networks and Networking Mr. José...for the collection of information is estimated to average 1 hour per response , including the time for reviewing instructions, searching existing data

A two-stage optimization model for emergency material reserve layout planning under uncertainty in response to environmental accidents.

PubMed

Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Liu, Rentao; Wang, Peng

2016-06-05

In the emergency management relevant to pollution accidents, efficiency emergency rescues can be deeply influenced by a reasonable assignment of the available emergency materials to the related risk sources. In this study, a two-stage optimization framework is developed for emergency material reserve layout planning under uncertainty to identify material warehouse locations and emergency material reserve schemes in pre-accident phase coping with potential environmental accidents. This framework is based on an integration of Hierarchical clustering analysis - improved center of gravity (HCA-ICG) model and material warehouse location - emergency material allocation (MWL-EMA) model. First, decision alternatives are generated using HCA-ICG to identify newly-built emergency material warehouses for risk sources which cannot be satisfied by existing ones with a time-effective manner. Second, emergency material reserve planning is obtained using MWL-EMA to make emergency materials be prepared in advance with a cost-effective manner. The optimization framework is then applied to emergency management system planning in Jiangsu province, China. The results demonstrate that the developed framework not only could facilitate material warehouse selection but also effectively provide emergency material for emergency operations in a quick response. Copyright © 2016. Published by Elsevier B.V.

Law, liability, and public health emergencies.

PubMed

Hoffman, Sharona; Goodman, Richard A; Stier, Daniel D

2009-06-01

According to many experts, a public health emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the public health and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and clinics, vaccine manufacturers, governmental authorities, and many others. Conducting response activities in emergency circumstances may give rise to numerous issues of liability, and medical professionals and other potential responders have expressed concern about liability exposure. Providers may face inadequate resources, an insufficient number of qualified personnel, overwhelming demand for services, and other barriers to providing optimal treatment, which could lead to injury or even death in some cases. This article describes the different theories of liability that may be used by plaintiffs and the sources of immunity that are available to public health emergency responders in the public sector, private sector, and as volunteers. It synthesizes the existing immunity landscape and analyzes its gaps. Finally, the authors suggest consideration of the option of a comprehensive immunity provision that addresses liability protection for all health care providers during public health emergencies and that, consequently, assists in improving community emergency response efforts.

Emergency responders' critical infrared (ERCI)

NASA Astrophysics Data System (ADS)

Konsin, Larry S.

2004-08-01

Emergency Responders (Fire, Police, Medical, and Emergency Management) face a high risk of injury or death. Even before September 11, 2001, public and private organizations have been driven to better protect Emergency Responders through education, training and improved technology. Recent research on Emergency Responder safety, health risks, and personal protective requirements, shows infrared (IR) imaging as a critical need. Today"s Emergency Responders are increasingly challenged to do more, facing demands requiring technological assistance and/or solutions. Since the introduction of Fire Service IR imaging in the mid 1990s, applications have increased. Emergency response IR is no longer just seeing through smoke to find victims or the seat of a fire. Many more mission critical needs now exist across the broad spectrum of emergency response. At the same time, Emergency Responder injuries and deaths are increasing. The Office of Domestic Preparedness (ODP) has also recognized IR imaging as critical in protecting our communities -- and in preventing many of the injuries and deaths of Emergency Responders. Currently, only 25% of all fire departments (or less than 7% of individual firefighters) have IR imaging. Availability to Police, EMS and Emergency Management is even lower. Without ERCI, Emergency Responders and our communities are at risk.

Awareness of Emerging Wireless Technologies: Ad-hoc and Personal Area Networks Standards and Emerging Technologies (Sensibilisation a l’emergence des technologies sans fil: technologies emergeantes et normes de reseaux personnels et ad-hoc)

DTIC Science & Technology

2007-04-01

for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data...Control Organization NRL Navy Research Laboratory nrtPS Non-real- time Polling Services OFDM Orthogonal frequency division multiplex OFDMA...Routeur IDentifier RTG RTO Task Group RTO Research & Technology Organization rtPS Real- time Polling Services SC Single-carrier modulation

Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses' perceptions in hospitals in Mecca, Saudi Arabia

PubMed Central

Alzahrani, Fuad; Kyratsis, Yiannis

2017-01-01

Objectives To assess hospital emergency nurses' self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca. Design Cross-sectional online survey with primary data collection and non-probabilistic purposive sample conducted in late 2014. Setting All 4 public hospitals in Mecca, Saudi Arabia. Participants 106 registered nurses in hospital emergency departments. Main outcome measure Awareness, knowledge, skills and perceptions of emergency nurses in Mecca with regard to mass gathering disaster preparedness. Results Although emergency nurses' clinical role awareness in disaster response was reported to be high, nurses reported limited knowledge and awareness of the wider emergency and disaster preparedness plans, including key elements of their hospital strategies for managing a mass gathering disaster. Over half of the emergency nurses in Mecca's public hospitals had not thoroughly read the plan, and almost 1 in 10 were not even aware of its existence. Emergency nurses reported seeing their main role as providing timely general clinical assessment and care; however, fewer emergency nurses saw their role as providing surveillance, prevention, leadership or psychological care in a mass gathering disaster, despite all these broader roles being described in the hospitals' emergency disaster response plans. Emergency nurses' responses to topics where there are often misconceptions on appropriate disaster management indicated a significant knowledge deficit with only 1 in 3 nurses at best or 1 in 6 at worst giving correct answers. Respondents identified 3 key training initiatives as opportunities to further develop their professional skills in this area: (1) hospital education sessions, (2) the Emergency Management Saudi Course, (3) bespoke short courses in disaster management. Conclusions Recommendations are suggested to help enhance clinical and educational efforts in disaster preparedness. PMID:28400457

Prehospital care in Hong Kong.

PubMed

Lo, C B; Lai, K K; Mak, K P

2000-09-01

A quick and efficient prehospital emergency response depends on immediate ambulance dispatch, patient assessment, triage, and transport to hospital. During 1999, the Ambulance Command of the Hong Kong Fire Services Department responded to 484,923 calls, which corresponds to 1329 calls each day. Cooperation between the Fire Services Department and the Hospital Authority exists at the levels of professional training of emergency medical personnel, quality assurance, and a coordinated disaster response. In response to the incident at the Hong Kong International Airport in the summer of 1999, when an aircraft overturned during landing, the pre-set quota system was implemented to send patients to designated accident and emergency departments. Furthermore, the 'first crew at the scene' model has been adopted, whereby the command is established and triage process started by the first ambulance crew members to reach the scene. The development of emergency protocols should be accompanied by good field-to-hospital and interhospital communication, the upgrading of decision-making skills, a good monitoring and auditing structure, and commitment to training and skills maintenance.

Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada.

PubMed

Curran, Jeffrey; Ritchie, Stephen D; Beardy, Jackson; VanderBurgh, David; Born, Karen; Lewko, John; Orkin, Aaron M

2018-02-04

(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. The purpose of this study was to understand the characteristics of medical emergencies and to conceptualize and present a framework for what a medical emergency is for one remote Indigenous community in northwestern Ontario, in order to inform the development of CBEC training. (2) Methods: This study adhered to the principles of community-based participatory research and realist evaluation; it was an integrated component of the formative evaluation of the second Sachigo Lake Wilderness Emergency Response Education Initiative (SLWEREI) training course in 2012. Twelve members of Sachigo Lake First Nation participated in the training course, along with local nursing staff, police officers, community Elders, and course instructors (n = 24 total), who participated in interviews, focus groups, and a collaborative discussion of local health issues in the development of the SLWEREI. (3) Results: The qualitative results are organized into sections that describe the types of local health emergencies and the informal response system of community members in addressing these emergencies. Prominent themes of health adversity that emerged were an inability to manage chronic conditions and fears of exacerbations, the lack of capacity for addressing mental illness, and the high prevalence of injury for community members. (4) Discussion: A three-point framework of what constitutes local perceptions of an emergency emerged from the findings in this study: (1) a sense of isolation; (2) a condition with a potentially adverse outcome; and (3) a need for help.

Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada

PubMed Central

Curran, Jeffrey; Ritchie, Stephen D.; Beardy, Jackson; VanderBurgh, David; Born, Karen; Lewko, John; Orkin, Aaron M.

2018-01-01

(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. The purpose of this study was to understand the characteristics of medical emergencies and to conceptualize and present a framework for what a medical emergency is for one remote Indigenous community in northwestern Ontario, in order to inform the development of CBEC training. (2) Methods: This study adhered to the principles of community-based participatory research and realist evaluation; it was an integrated component of the formative evaluation of the second Sachigo Lake Wilderness Emergency Response Education Initiative (SLWEREI) training course in 2012. Twelve members of Sachigo Lake First Nation participated in the training course, along with local nursing staff, police officers, community Elders, and course instructors (n = 24 total), who participated in interviews, focus groups, and a collaborative discussion of local health issues in the development of the SLWEREI. (3) Results: The qualitative results are organized into sections that describe the types of local health emergencies and the informal response system of community members in addressing these emergencies. Prominent themes of health adversity that emerged were an inability to manage chronic conditions and fears of exacerbations, the lack of capacity for addressing mental illness, and the high prevalence of injury for community members. (4) Discussion: A three-point framework of what constitutes local perceptions of an emergency emerged from the findings in this study: (1) a sense of isolation; (2) a condition with a potentially adverse outcome; and (3) a need for help. PMID:29401706

Rethinking our approach to gender and disasters: Needs, responsibilities, and solutions.

PubMed

Montano, Samantha; Savitt, Amanda

2016-01-01

To explore how the existing literature has discussed the vulnerability and needs of women in a disaster context. It will consider the literature's suggestions of how to minimize vulnerability and address the needs of women, including who involved in emergency management should be responsible for such efforts. Empirical journal articles and book chapters from disaster literature were collected that focused on "women" or "gender," and their results and recommendations were analyzed. This review found existing empirical research on women during disasters focuses on their vulnerabilities more than their needs. Second, when researchers do suggest solutions, they tend not to be comprehensive or supported by empirical evidence. Finally, it is not clear from existing research who is responsible for addressing these needs and implementing solutions. Future research should study the intersection of gender and disasters in terms of needs and solutions including who is responsible for implementing solutions.

75 FR 78336 - Finding of No Significant Impact From the Expansion, Renovation, Operation and Maintenance of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-15

... Proposed Action would involve demolition of existing structures, GSA shall engage an Asbestos Hazard Emergency Response Act certified inspector to inspect all structures to be demolished. If Regulated Asbestos...

Radiological/Nuclear Human Monitoring Tabletop Exercise: Recommendations and Lessons Identified.

PubMed

Chauhan, Vinita; Duncan, Devin; Wilkins, Ruth C

2017-06-01

Health Canada is the lead department for coordinating the federal response to a Canadian nuclear emergency event. The framework to manage a radiological consequence is outlined in the Federal Nuclear Emergency Plan (FNEP). In 2014, a full scale exercise (FSX) was held to test the capacity of the federal government to handle a nuclear facility emergency disaster in Canada. The FSX provided a means to demonstrate the integration of various departments and agencies in response to such an event, and although a number of task teams within FNEP were tested, the capacity to monitor humans for exposure post-event was not played out fully. To address this, a table top exercise (TTX) was held in 2015 that brought together experts from human monitoring groups (HMGs) in partnership with Provincial and Municipal emergency response organizations. The TTX took the form of a facilitated discussion centered around two types of radiological/nuclear (RN) emergency scenarios that commenced post-release. The purpose of the exercise was to integrate these communities and identify knowledge gaps in policies and concepts of operations pertaining to the human monitoring aspects of RN events including biodosimetry, bioassay, portal monitors, whole body counting, and the provision of personal dosimetry. It also tested the interoperability between first responders/receivers and Federal, Provincial, and Municipal emergency response organizations. The end outcome was the identification of clear knowledge gaps in existing and newly developed concepts of operation in the human population monitoring response to an RN emergency in Canada; these and possible recommendations are captured in this report.

Performance Requirements for Emergency Responder Interoperable and Compatible Electronic Safety Equipment

NASA Technical Reports Server (NTRS)

Greenberg, Paul S.

2012-01-01

Firefighters and other emergency response personnel are presented with an increasing array of technologies to improve their health and safety. This includes real-time bidirectional communication, navigation and positional information, data on physiological and metabolic functions, as well as data on their surrounding environment. The emerging challenge is to integrate these elements into a practical system, addressing such features as power, data transfer, and inter-element coordination and communication. In many respects, NASA has addressed these aspects in the context of Extra Vehicular Activity (EVA). The EVA environment shares many common attributes with that of emergency response scenarios. A similar situation exists in terms of the need for interoperability among the various system sub-elements. A brief overview is presented on the similarities and differences in these two applications, as well as the technical approach adopted by NASA in terms of system design philosophy.

A Novel Space Partitioning Algorithm to Improve Current Practices in Facility Placement

PubMed Central

Jimenez, Tamara; Mikler, Armin R; Tiwari, Chetan

2012-01-01

In the presence of naturally occurring and man-made public health threats, the feasibility of regional bio-emergency contingency plans plays a crucial role in the mitigation of such emergencies. While the analysis of in-place response scenarios provides a measure of quality for a given plan, it involves human judgment to identify improvements in plans that are otherwise likely to fail. Since resource constraints and government mandates limit the availability of service provided in case of an emergency, computational techniques can determine optimal locations for providing emergency response assuming that the uniform distribution of demand across homogeneous resources will yield and optimal service outcome. This paper presents an algorithm that recursively partitions the geographic space into sub-regions while equally distributing the population across the partitions. For this method, we have proven the existence of an upper bound on the deviation from the optimal population size for sub-regions. PMID:23853502

Are we ready for terrorism? Emergency medical technicians' and paramedics' training and self-perceived competence since September 11.

PubMed

Clawson, Art; Menachemi, Nir; Kim, Unho; Brooks, Robert G

2007-01-01

The US continues to be a target for terrorist activities that threaten the lives of the populace. Training on preparedness and response for emergency medical technicians (EMTs) and paramedics is critical to the success of an early response to any such attack. Previous surveys have suggested that terrorism-specific training has been modest at best since September 11. In order to gain further insight into emergency personnel's level of training and competence, we sent surveys to 4,000 EMTs and paramedics in the state of Florida in late 2005 and early 2006. Results show a much higher level of training than previously reported from other states and suggest a direct correlation between the amount and type of training and self-reported competence. Our results suggest that most emergency personnel are receiving terrorism-specific training, but gaps in competencies exist and require the attention of educators and policymakers.

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.

Commander’s Emergency Response Program: A Flawed Metric

DTIC Science & Technology

2012-12-06

the U.S. Department of State created the Office of the Coordinator for Reconstruction and Stabilization ( S /CRS). The mission for this office...effectiveness for reconstruction and stability projects and operations. The Department of Defense Directive 3000.5 was issued on November 2005. It...average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and

Special population planner 4 : an open source release.

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

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

2008-01-01

Emergencies like Hurricane Katrina and the recent California wildfires underscore the critical need to meet the complex challenge of planning for individuals with special needs and for institutionalized special populations. People with special needs and special populations often have difficulty responding to emergencies or taking protective actions, and emergency responders may be unaware of their existence and situations during a crisis. Special Population Planner (SPP) is an ArcGIS-based emergency planning system released as an open source product. SPP provides for easy production of maps, reports, and analyses to develop and revise emergency response plans. It includes tools to manage amore » voluntary registry of data for people with special needs, integrated links to plans and documents, tools for response planning and analysis, preformatted reports and maps, and data on locations of special populations, facility and resource characteristics, and contacts. The system can be readily adapted for new settings without programming and is broadly applicable. Full documentation and a demonstration database are included in the release.« less

Improving Team Performance for Public Health Preparedness.

PubMed

Peck, Megan; Scullard, Mickey; Hedberg, Craig; Moilanen, Emily; Radi, Deborah; Riley, William; Bowen, Paige Anderson; Petersen-Kroeber, Cheryl; Stenberg, Louise; Olson, Debra K

2017-02-01

Between May 2010 and September 2011, the University of Minnesota School of Public Health partnered with the Minnesota Department of Health (MDH) to assess the effect of exercises on team performance during public health emergency response. Participants were divided into 3 research teams exposed to various levels of intervention. Groups consisted of a control group that was given standard MDH training exercises, a didactic group exposed to team dynamics and communication training, and a treatment group that received the didactic training in addition to a post-exercise facilitated debriefing. To assess differences in team performance, teams engaged in 15 functional exercises. Differences in team performance across the 3 groups were identified, although there was no trend in team performance over time for any of the groups. Groups demonstrated fluctuation in team performance during the study period. Attitudinal surveys demonstrated an increase in workplace satisfaction and confidence in training among all groups throughout the study period. Findings from this research support that a critical link exists between training type and team performance during public health emergency response. This research supports that intentional teamwork training for emergency response workers is essential for effective public health emergency response. (Disaster Med Public Health Preparedness. 2017;11:7-10).

Medical and radiological aspects of emergency preparedness and response at SevRAO facilities.

PubMed

Savkin, M N; Sneve, M K; Grachev, M I; Frolov, G P; Shinkarev, S M; Jaworska, A

2008-12-01

Regulatory cooperation between the Norwegian Radiation Protection Authority and the Federal Medical Biological Agency (FMBA) of the Russian Federation has the overall goal of promoting improvements in radiation protection in Northwest Russia. One of the projects in this programme has the objectives to review and improve the existing medical emergency preparedness capabilities at the sites for temporary storage of spent nuclear fuel and radioactive waste. These are operated by SevRAO at Andreeva Bay and in Gremikha village on the Kola Peninsula. The work is also intended to provide a better basis for regulation of emergency response and medical emergency preparedness at similar facilities elsewhere in Russia. The purpose of this paper is to present the main results of that project, implemented by the Burnasyan Federal Medical Biophysical Centre. The first task was an analysis of the regulatory requirements and the current state of preparedness for medical emergency response at the SevRAO facilities. Although Russian regulatory documents are mostly consistent with international recommendations, some distinctions lead to numerical differences in operational intervention criteria under otherwise similar conditions. Radiological threats relating to possible accidents, and related gaps in the regulation of SevRAO facilities, were also identified. As part of the project, a special exercise on emergency medical response on-site at Andreeva Bay was prepared and carried out, and recommendations were proposed after the exercise. Following fruitful dialogue among regulators, designers and operators, special regulatory guidance has been issued by FMBA to account for the specific and unusual features of the SevRAO facilities. Detailed sections relate to the prevention of accidents, and emergency preparedness and response, supplementing the basic Russian regulatory requirements. Overall it is concluded that (a) the provision of medical and sanitary components of emergency response at SevRAO facilities is a priority task within the general system of emergency preparedness; (b) there is an effective and improving interaction between SevRAO and the local medical institutions of FMBA and other territorial medical units; (c) the infrastructure of emergency response at SevRAO facilities has been created and operates within the framework of Russian legal and normative requirements. Further proposals have been made aimed at increasing the effectiveness of the available system of emergency preparedness and response, and to promote interagency cooperation.

Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses' perceptions in hospitals in Mecca, Saudi Arabia.

PubMed

Alzahrani, Fuad; Kyratsis, Yiannis

2017-04-11

To assess hospital emergency nurses' self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca. Cross-sectional online survey with primary data collection and non-probabilistic purposive sample conducted in late 2014. All 4 public hospitals in Mecca, Saudi Arabia. 106 registered nurses in hospital emergency departments. Awareness, knowledge, skills and perceptions of emergency nurses in Mecca with regard to mass gathering disaster preparedness. Although emergency nurses' clinical role awareness in disaster response was reported to be high, nurses reported limited knowledge and awareness of the wider emergency and disaster preparedness plans, including key elements of their hospital strategies for managing a mass gathering disaster. Over half of the emergency nurses in Mecca's public hospitals had not thoroughly read the plan, and almost 1 in 10 were not even aware of its existence. Emergency nurses reported seeing their main role as providing timely general clinical assessment and care; however, fewer emergency nurses saw their role as providing surveillance, prevention, leadership or psychological care in a mass gathering disaster, despite all these broader roles being described in the hospitals' emergency disaster response plans. Emergency nurses' responses to topics where there are often misconceptions on appropriate disaster management indicated a significant knowledge deficit with only 1 in 3 nurses at best or 1 in 6 at worst giving correct answers. Respondents identified 3 key training initiatives as opportunities to further develop their professional skills in this area: (1) hospital education sessions, (2) the Emergency Management Saudi Course, (3) bespoke short courses in disaster management. Recommendations are suggested to help enhance clinical and educational efforts in disaster preparedness. 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/.

E-Commerce Infusion into Business Education--Encompassing the Realities of an Emerging Business Model.

ERIC Educational Resources Information Center

Morrison, James L.; Oladunjoye, Ganiyu Titi

2002-01-01

A survey of 287 business faculty found that few were infusing electronic commerce topics into existing curricula despite its growing use in business. Responses were similar regardless of faculty gender, region, and program size or level. (SK)

40 CFR 300.135 - Response operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... exposure; the potential impact on human health, welfare, and safety and the environment; whether the...; priorities for protecting human health and welfare and the environment; and appropriate cost documentation... possible public health emergency exists, the OSC/RPM should notify the Department of Health and Human...

40 CFR 300.135 - Response operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... exposure; the potential impact on human health, welfare, and safety and the environment; whether the...; priorities for protecting human health and welfare and the environment; and appropriate cost documentation... possible public health emergency exists, the OSC/RPM should notify the Department of Health and Human...

Identifying Emerging Hybrid Adversaries

DTIC Science & Technology

2012-01-01

average 1 hour per response , including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed...SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT Same as Report (SAR) 18. NUMBER OF PAGES 12 19a. NAME OF RESPONSIBLE PERSON a. REPORT...an extended engage- ment area to get into the close fight.4 In addition, they will employ a wide range of capabilities including cyber, social media

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.

Role of State Tsunami Geoscientists during Emergency Response Activities: Example from the State of California (USA) during September 29, 2009, Samoa Tsunami Event

NASA Astrophysics Data System (ADS)

Wilson, R. I.; Dengler, L. A.; Goltz, J. D.; Legg, M.; Miller, K. M.; Parrish, J. G.; Whitmore, P.

2009-12-01

California tsunami geoscientists work closely with federal, state and local government emergency managers to help prepare coastal communities for potential impacts from a tsunami before, during, and after an event. For teletsunamis, as scientific information (forecast model wave heights, first-wave arrival times, etc.) from NOAA’s West Coast and Alaska’s Tsunami Warning Center is made available, state-level emergency managers must help convey this information in a concise and comprehendible manner to local officials who ultimately determine the appropriate response activities for their jurisdictions. During the Samoa Tsunami Advisory for California on September 29, 2009, geoscientists from the California Geological Survey and Humboldt State University assisted the California Emergency Management Agency in this information transfer by providing technical assistance during teleconference meetings with NOAA and other state and local emergency managers prior to the arrival of the tsunami. State geoscientists gathered additional background information on anticipated tidal conditions and wave heights for areas not covered by NOAA’s forecast models. The participation of the state geoscientists in the emergency response process resulted in clarifying which regions were potentially at-risk, as well as those having a low risk from the tsunami. Future tsunami response activities for state geoscientists include: 1) working closely with NOAA to simplify their tsunami alert messaging and expand their forecast modeling coverage, 2) creation of “playbooks” containing information from existing tsunami scenarios for local emergency managers to reference during an event, and 3) development of a state-level information “clearinghouse” and pre-tsunami field response team to assist local officials as well as observe and report tsunami effects.

The Leader-Clinician Advocate in Advancing Student Clinical Learning.

PubMed

Bleich, Michael R

2017-03-01

The visionary, think-ahead leader realizes a responsibility to ensure that a steady pipeline of qualified professionals exists. In the settings where they lead, academic partnerships can ensure that students are socialized and adequately prepared for existing and emerging job roles. Concept-based learning, NCLEX-RN test plans, and 12 strategies to ensure leader-clinician engagement with students are presented. J Contin Educ Nurs. 2017;48(3):99-101. Copyright 2017, SLACK Incorporated.

Psychological Pathways Linking Social Support to Health Outcomes: A Visit with the “Ghosts” of Research Past, Present, and Future

PubMed Central

Uchino, Bert N.; Bowen, Kimberly; Carlisle, McKenzie; Birmingham, Wendy

2012-01-01

Contemporary models postulate the importance of psychological mechanisms linking perceived and received social support to physical health outcomes. In this review, we examine studies that directly tested the potential psychological mechanisms responsible for links between social support and health-relevant physiological processes (1980s to 2010). Inconsistent with existing theoretical models, no evidence was found that psychological mechanisms such as depression, perceived stress, and other affective processes are directly responsible for links between support and health. We discuss the importance of considering statistical/design issues, emerging conceptual perspectives, and limitations of our existing models for future research aimed at elucidating the psychological mechanisms responsible for links between social support and physical health outcomes. PMID:22326104

Investigation of Slow-wave Activity Saturation during Surgical Anesthesia Reveals a Signature of Neural Inertia in Humans.

PubMed

Warnaby, Catherine E; Sleigh, Jamie W; Hight, Darren; Jbabdi, Saad; Tracey, Irene

2017-10-01

Previously, we showed experimentally that saturation of slow-wave activity provides a potentially individualized neurophysiologic endpoint for perception loss during anesthesia. Furthermore, it is clear that induction and emergence from anesthesia are not symmetrically reversible processes. The observed hysteresis is potentially underpinned by a neural inertia mechanism as proposed in animal studies. In an advanced secondary analysis of 393 individual electroencephalographic data sets, we used slow-wave activity dose-response relationships to parameterize slow-wave activity saturation during induction and emergence from surgical anesthesia. We determined whether neural inertia exists in humans by comparing slow-wave activity dose responses on induction and emergence. Slow-wave activity saturation occurs for different anesthetics and when opioids and muscle relaxants are used during surgery. There was wide interpatient variability in the hypnotic concentrations required to achieve slow-wave activity saturation. Age negatively correlated with power at slow-wave activity saturation. On emergence, we observed abrupt decreases in slow-wave activity dose responses coincident with recovery of behavioral responsiveness in ~33% individuals. These patients are more likely to have lower power at slow-wave activity saturation, be older, and suffer from short-term confusion on emergence. Slow-wave activity saturation during surgical anesthesia implies that large variability in dosing is required to achieve a targeted potential loss of perception in individual patients. A signature for neural inertia in humans is the maintenance of slow-wave activity even in the presence of very-low hypnotic concentrations during emergence from anesthesia.

Abortive Spontaneous Egg Activation: An Emerging Biological Threat for the Existence of Mammals.

PubMed

Prasad, Shilpa; Tiwari, Meenakshi; Chaube, Shail K

2017-06-01

Mammals are important for balancing the natural ecosystem, but in the past few decades, several species have rapidly been entered under threatened category worldwide. The environmental changes, loss of natural habitats, human activities, and thereby stress are responsible for a gradual decline in reproductive outcome. Stress induces generation of reactive oxygen species (ROS). High physiological level of ROS drives abortive spontaneous egg activation (SEA), while beyond the physiological level causes oxidative stress (OS). The OS induces apoptosis and deteriorates egg quality that limits reproductive outcome. The reduced reproductive outcome is one of the major causes for gradual decline in population size of several mammalian species. Despite having several conservation programs, a gradual decline in species reproductive outcome and their population size is the serious concern for the existence of threatened mammalian species. Thus, it is important to identify and prevent the underlying causes responsible for abortive SEA, which could be an emerging problem for several mammalian species that are threatened or at the verge of extinction.

The Emergence of Flood Insurance in Canada: Navigating Institutional Uncertainty.

PubMed

Thistlethwaite, Jason

2017-04-01

Flood insurance has remained unavailable in Canada based on an assessment that it lacks economic viability. In response to Canada's costliest flood event to date in 2013, the Canadian insurance industry has started to develop a framework to expand existing property insurance to cover flood damage. Research on flood insurance has overlooked why and how insurance systems transition to expand insurance coverage without evidence of economic viability. This article will address this gap through a case study on the emergence of flood insurance in Canada, and the approach to its expansion. Between 2013 and 2016, insurance industry officials representing over 60% of premiums collected in Canada were interviewed. These interviews revealed that flood insurance is being expanded in response to institutional pressure, specifically external stakeholder expectations that the insurance industry will adopt a stronger role in managing flood risk through coverage of flood damage. Further evidence of this finding is explored by assessing the emergence of a unique flood insurance model that involves a risk-adjusted and optional product along with an expansion of government policy supporting flood risk mitigation. This approach attempts to balance industry concerns about economic viability with institutional pressure to reduce flood risk through insurance. This analysis builds on existing research by providing the first scholarly analysis of flood insurance in Canada, important "empirical" teeth to existing conceptual analysis on the availability of flood insurance, and the influence of institutional factors on risk analysis within the insurance sector. © 2016 Society for Risk Analysis.

Changing tracks as situations change: humanitarian and health response along the Liberia-Côte d'Ivoire border.

PubMed

Derderian, Katharine

2014-10-01

In recent years, protracted crises and fragile post-conflict settings have challenged the co-existence, and even the linear continuum, of relief and development aid. Forced migration has tested humanitarian and development paradigms where sudden-onset emergencies, violence and displacement arise alongside ongoing development work. Drawing on Médecins Sans Frontières interventions in the region from December 2010 to May 2011, this paper examines aid and healthcare responses to displacement in Côte d'Ivoire and Liberia; it focuses on challenges to the maintenance of preparedness for such foreseeable emergencies and to adaptation in response to changing situations of displacement and insecurity. This 'backsliding' from development to emergency remains a substantial challenge to aid; yet, in exactly such cases, it also presents the opportunity to ensure access to medical care that is much more urgently needed in times of crisis, including the suspension of user fees for medical care. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

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.

Patient handover in the emergency department: 'How' is as important as 'what'.

PubMed

de Lange, Santel; van Eeden, Ilze; Heyns, Tanya

2018-01-01

We explored the existing patient handover practices between emergency care practitioners and healthcare professionals in the emergency department. In the emergency department, patient handover between emergency care practitioner's and healthcare professionals is a complex process involving multiple functions, such as the transfer of information, responsibility and accountability from one person to another. We used a qualitative study design. Emergency care practitioners and healthcare professionals were identified using purposive and convenience sampling data. Data were collected through unstructured participant observation. We conducted 20 observation sessions, varying between 15 and 20min. The data were analysed using a creative hermeneutic approach. The 'how' or manner of patient handover observed between emergency care practitioners and health professionals was perceived as important. A diagnosis of disrespectful behaviour was made which could negatively influence patient handover and ultimately patient outcome. Disrespectful behaviour stemmed from the two signs that supported the diagnosis: task-orientated behaviour and the use of indigenous language. Involving the emergency care practitioners and healthcare professionals in observing and analysing the existing patient handover practices in the ED raised their awareness of the current workplace culture. Transforming behaviour from disrespectful to respectful should include greeting one another, listening attentively to the patient handover and include emergency care practitioners, patients and their significant other in the handover process that should be conducted in a commonly understood language. Emergency care practitioners and healthcare professionals should recognise that during patient handover 'how' is as important as 'what'. Copyright © 2017 Elsevier Ltd. All rights reserved.

75 FR 69672 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... exists, the minimum content for an application, and reporting requirements for recipients of such funding... types of substance abuse and mental health emergency response grants: Immediate awards and Intermediate... assessment, other data and related budgetary detail. The Intermediate awards have no predefined budget limit...

Surveillance for pneumonic plague in the United States during an international emergency: a model for control of imported emerging diseases.

PubMed Central

Fritz, C. L.; Dennis, D. T.; Tipple, M. A.; Campbell, G. L.; McCance, C. R.; Gubler, D. J.

1996-01-01

In September 1994, in response to a reported epidemic of plague in India, the Centers for Disease Control and Prevention (CDC) enhanced surveillance in the United States for imported pneumonic plague. Plague information materials were rapidly developed and distributed to U.S. public health officials by electronic mail, facsimile, and expedited publication. Information was also provided to medical practitioners and the public by recorded telephone messages and facsimile transmission. Existing quarantine protocols were modified to effect active surveillance for imported plague cases at U.S. airports. Private physicians and state and local health departments were relied on in a passive surveillance system to identify travelers with suspected plague not detected at airports. From September 27 to October 27, the surveillance system identified 13 persons with suspected plague; no case was confirmed. This coordinated response to an international health emergency may serve as a model for detecting other emerging diseases and preventing their importation. PMID:8964057

Surveillance for pneumonic plague in the United States during an international emergency: a model for control of imported emerging diseases.

PubMed

Fritz, C L; Dennis, D T; Tipple, M A; Campbell, G L; McCance, C R; Gubler, D J

1996-01-01

In September 1994, in response to a reported epidemic of plague in India, the Centers for Disease Control and Prevention (CDC) enhanced surveillance in the United States for imported pneumonic plague. Plague information materials were rapidly developed and distributed to U.S. public health officials by electronic mail, facsimile, and expedited publication. Information was also provided to medical practitioners and the public by recorded telephone messages and facsimile transmission. Existing quarantine protocols were modified to effect active surveillance for imported plague cases at U.S. airports. Private physicians and state and local health departments were relied on in a passive surveillance system to identify travelers with suspected plague not detected at airports. From September 27 to October 27, the surveillance system identified 13 persons with suspected plague; no case was confirmed. This coordinated response to an international health emergency may serve as a model for detecting other emerging diseases and preventing their importation.

Emergency management response to a warning-level Alaska-source tsunami impacting California: Chapter J in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Miller, Kevin M.; Long, Kate

2013-01-01

This chapter is directed towards two audiences: Firstly, it targets nonemergency management readers, providing them with insight on the process and challenges facing emergency managers in responding to tsunami Warning, particularly given this “short fuse” scenario. It is called “short fuse” because there is only a 5.5-hour window following the earthquake before arrival of the tsunami within which to evaluate the threat, disseminate alert and warning messages, and respond. This action initiates a period when crisis communication is of paramount importance. An additional dynamic that is important to note is that within 15 minutes of the earthquake, the National Oceanic and Atmospheric Administration (NOAA) and the National Weather Service (NWS) will issue alert bulletins for the entire Pacific Coast. This is one-half the time actually presented by recent tsunamis from Japan, Chile, and Samoa. Second, the chapter provides emergency managers at all levels with insights into key considerations they may need to address in order to augment their existing plans and effectively respond to tsunami events. We look at emergency management response to the tsunami threat from three perspectives:“Top Down” (Threat analysis and Alert/Warning information from the Federal agency charged with Alert and Warning) “Bottom Up” (Emergency management’s Incident Command approach to responding to emergencies and disasters based on the needs of impacted local jurisdictions) “Across Time” (From the initiating earthquake event through emergency response) We focus on these questions: What are the government roles, relationships, and products that support Tsunami Alert and Warning dissemination? (Emergency Planning and Preparedness.) What roles, relationships, and products support emergency management response to Tsunami Warning and impact? (Engendering prudent public safety response.) What are the key emergency management activities, considerations, and challenges brought out by the SAFRR tsunami scenario? (Real emergencies) How do these activities, considerations, and challenges play out as the tsunami event unfolds across the “life” of the event? (Lessons)

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.

Reported provision of analgesia to patients with acute abdominal pain in Canadian paediatric emergency departments.

PubMed

Poonai, Naveen; Cowie, Allyson; Davidson, Chloe; Benidir, Andréanne; Thompson, Graham C; Boisclair, Philippe; Harman, Stuart; Miller, Michael; Butter, Andreana; Lim, Rod; Ali, Samina

2016-09-01

Evidence exists that analgesics are underutilized, delayed, and insufficiently dosed for emergency department (ED) patients with acute abdominal pain. For physicians practicing in a Canadian paediatric ED setting, we (1) explored theoretical practice variation in the provision of analgesia to children with acute abdominal pain; (2) identified reasons for withholding analgesia; and (3) evaluated the relationship between providing analgesia and surgical consultation. Physician members of Paediatric Emergency Research Canada (PERC) were prospectively surveyed and presented with three scenarios of undifferentiated acute abdominal pain to assess management. A modified Dillman's Tailored Design method was used to distribute the survey from June to July 2014. Overall response rate was 74.5% (149/200); 51.7% of respondents were female and mean age was 44 (SD 8.4) years. The reported rates of providing analgesia for case scenarios representative of renal colic, appendicitis, and intussusception, were 100%, 92.1%, and 83.4%, respectively, while rates of providing intravenous opioids were 85.2%, 58.6%, and 12.4%, respectively. In all 60 responses where the respondent indicated they would obtain a surgical consultation, analgesia would be provided. In the 35 responses where analgesia would be withheld, 21 (60%) believed pain was not severe enough, while 5 (14.3%) indicated it would obscure a surgical condition. Pediatric emergency physicians self-reported rates of providing analgesia for acute abdominal pain scenarios were higher than previously reported, and appeared unrelated to request for surgical consultation. However, an unwillingness to provide opioid analgesia, belief that analgesia can obscure a surgical condition, and failure to take self-reported pain at face value remain, suggesting that the need exists for further knowledge translation efforts.

A Review of Current and Emerging Approaches to Pain Management in the Emergency Department.

PubMed

Todd, Knox H

2017-12-01

Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches. For some of these therapies, sparse evidence exists to support their efficacy for emergency department use. The purpose of this paper is to review historical trends and emerging approaches to emergency department analgesia, with a particular focus on the USA and Canada. We conducted a qualitative review of past and current descriptive studies of emergency department pain practice, as well as clinical trials of emerging pain treatment modalities. The review considers the increasing use of non-opioid and multimodal analgesic therapies, including migraine therapies, regional anesthesia, subdissociative-dose ketamine, nitrous oxide, intravenous lidocaine and gabapentinoids, as well as broad programmatic initiatives promoting the use of non-opioid analgesics and nonpharmacologic interventions. While migraine therapies, regional anesthesia, nitrous oxide and subdissociative-dose ketamine are supported by a relatively robust evidence base, data supporting the emergency department use of intravenous lidocaine, gabapentinoids and various non-pharmacologic analgesic interventions remain sparse. Additional research on the relative safety and efficacy of non-opioid approaches to emergency department analgesia is needed. Despite a limited research base, it is likely that non-opioid analgesic modalities will be employed with increasing frequency. A new generation of emergency physicians is seeking additional training in pain medicine and increasing dialogue between emergency medicine and pain medicine researchers, educators and clinicians could contribute to better management of emergency department pain.

Making the Personal Visible: Emotion in the Nursery

ERIC Educational Resources Information Center

Davis, Belinda; Dunn, Rosemary

2018-01-01

In Birth-2 early childhood education and care (ECEC) settings, where evidence-based practices are still emerging, tensions exist about what it means to be an infant educator. While it is widely accepted that infants require responsive, supportive and care, relationships between educators and infants in early childhood settings necessarily involve…

Financing Lifelong Learning for All: An International Perspective. Working Paper.

ERIC Educational Resources Information Center

Burke, Gerald

Recent international discussions provide information on various countries' responses to lifelong learning, including the following: (1) existing unmet needs and emerging needs for education and training; (2) funds required compared with what was provided; and (3) methods for acquiring additional funds, among them efficiency measures leading to…

District Leadership Supporting PLC Implementation in a Rapid Growth District

ERIC Educational Resources Information Center

Tinsley, Laurie

2016-01-01

A growing body of work has emerged regarding the responsibilities required of district leaders in establishing plans that initiate and create conditions for sustainability of continuous improvement achieved through a systemic reform structure such as professional learning communities. However, limited research exists in respect to sustaining…

Changing the paradigm of emergency response: The need for first-care providers.

PubMed

Bobko, Joshua P; Kamin, Richard

2015-01-01

There is a major gap in the security of the critical infrastructure - civilian medical response to atypical emergencies. Clear evidence demonstrates that, despite ongoing improvements to the first-responder system, there exists an inherent delay in the immediate medical care at the scene of an emergency. This delay can only be reduced through a societal shift in reliance on police and fire response and by extending the medical system into all communities. Additionally, through analysis of military data, it is known that immediately addressing the common injury patterns following a traumatic event will save lives. The predictable nature of these injuries, coupled with an unavoidable delay in the arrival of first responders, necessitates the need for immediate care on scene. Initial care is often rendered by bystanders, typically armed only with basic first-aid training based on medical emergencies and does not adequately address the traumatic injury patterns seen in disasters. Implementing an approach similar to the American Cardiac Arrest Act can improve outcomes to traumatic events. This paper analyses the latest data on active shooter incidents and proposes that the creation of a network of trauma-trained medic extenders would improve all communities' resilience to catastrophic disaster.

Secure Utilization of Beacons and UAVs in Emergency Response Systems for Building Fire Hazard

PubMed Central

Seo, Seung-Hyun; Choi, Jung-In; Song, Jinseok

2017-01-01

An intelligent emergency system for hazard monitoring and building evacuation is a very important application area in Internet of Things (IoT) technology. Through the use of smart sensors, such a system can provide more vital and reliable information to first-responders and also reduce the incidents of false alarms. Several smart monitoring and warning systems do already exist, though they exhibit key weaknesses such as a limited monitoring coverage and security, which have not yet been sufficiently addressed. In this paper, we propose a monitoring and emergency response method for buildings by utilizing beacons and Unmanned Aerial Vehicles (UAVs) on an IoT security platform. In order to demonstrate the practicability of our method, we also implement a proof of concept prototype, which we call the UAV-EMOR (UAV-assisted Emergency Monitoring and Response) system. Our UAV-EMOR system provides the following novel features: (1) secure communications between UAVs, smart sensors, the control server and a smartphone app for security managers; (2) enhanced coordination between smart sensors and indoor/outdoor UAVs to expand real-time monitoring coverage; and (3) beacon-aided rescue and building evacuation. PMID:28946659

Is there a doctor in the house? Standards of physician availability for laboring women.

PubMed

Minkoff, Howard; Ecker, Jeffrey

2010-09-01

Unexpected emergencies requiring urgent intervention can arise in the course of labor even among uncomplicated pregnancies in low-risk women. The possibility of such emergencies requires that responsible practitioners be available for management. The recent National Institutes of Health-sponsored consensus conference on vaginal birth after cesarean delivery highlighted this issue in discussing alternate standards of "ready" and "immediate" availability. The merits, feasibility, and ethics of alternate systems for coverage of all laboring women have not been widely or previously discussed and are considered in this opinion. Although there are potential advantages to having a responsible practitioner immediately available, logistic and economic considerations will make immediate availability unfeasible in all centers and systems, particularly on smaller services where distance or other factors may limit the option of consolidation (ie, the merging of different hospitals' obstetric services). We discuss training, systems, and planning to optimize response to emergencies in all systems, whether practitioners are readily or immediately available. Finally, we suggest that the ethical principle of respect for autonomy argues that particularly where alternate systems exist, practitioners and patients discuss the details, merits, and limitations of individual centers' clinical systems and plans for responding to emergencies.

Secure Utilization of Beacons and UAVs in Emergency Response Systems for Building Fire Hazard.

PubMed

Seo, Seung-Hyun; Choi, Jung-In; Song, Jinseok

2017-09-25

An intelligent emergency system for hazard monitoring and building evacuation is a very important application area in Internet of Things (IoT) technology. Through the use of smart sensors, such a system can provide more vital and reliable information to first-responders and also reduce the incidents of false alarms. Several smart monitoring and warning systems do already exist, though they exhibit key weaknesses such as a limited monitoring coverage and security, which have not yet been sufficiently addressed. In this paper, we propose a monitoring and emergency response method for buildings by utilizing beacons and Unmanned Aerial Vehicles (UAVs) on an IoT security platform. In order to demonstrate the practicability of our method, we also implement a proof of concept prototype, which we call the UAV-EMOR (UAV-assisted Emergency Monitoring and Response) system. Our UAV-EMOR system provides the following novel features: (1) secure communications between UAVs, smart sensors, the control server and a smartphone app for security managers; (2) enhanced coordination between smart sensors and indoor/outdoor UAVs to expand real-time monitoring coverage; and (3) beacon-aided rescue and building evacuation.

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

Lesperance, Ann M.; Miller, James S.

The ability to ensure adequate numbers of medical staff represents a crucial part of the medical response to any disaster. However, healthcare worker absenteeism during disasters, especially in the event of an attack of biological terrorism or an epidemic such as pandemic influenza, is a serious concern. Though a significant rate of absenteeism is often included as a baseline assumption in emergency planning, published reports on strategies to minimize absenteeism are comparatively few. This report documents interviews with managers and emergency response planners at hospitals and public health agencies and reviews existing survey data on healthcare worker absenteeism and studiesmore » of disasters to glean lessons about the needs of healthcare workers during those disasters. Based on this research, expected rates of absenteeism and individual determinants of absenteeism are presented along with recommendations of steps that hospitals, emergency medical services departments, public health organizations, and government agencies can take to meet the needs of healthcare workers and minimize absenteeism during a biological event.« less

Assistive Technologies and Issues Relating to Privacy, Ethics and Security

NASA Astrophysics Data System (ADS)

Martin, Suzanne; Bengtsson, Johan E.; Dröes, Rose-Marie

Emerging technologies provide the opportunity to develop innovative sustainable service models, capable of supporting adults with dementia at home. Devices range from simple stand-alone components that can generate a responsive alarm call to complex interoperable systems that even can be remotely controlled. From these complex systems the paradigm of the ubiquitous or ambient smart home has emerged, integrating technology, environmental design and traditional care provision. The service context is often complex, involving a variety of stakeholders and a range of interested agencies. Against this backdrop, as anecdotal evidence and government policies spawn further innovation it is critical that due consideration is given to the potential ethical ramifications at an individual, organisational and societal level. Well-grounded ethical thinking and proactive ethical responses to this innovation are required. Explicit policy and practice should therefore emerge which engenders confidence in existing supported living option schemes for adults with dementia and informs further innovation.

Reducing ambulance response times using discrete event simulation.

PubMed

Wei Lam, Sean Shao; Zhang, Zhong Cheng; Oh, Hong Choon; Ng, Yih Ying; Wah, Win; Hock Ong, Marcus Eng

2014-01-01

The objectives of this study are to develop a discrete-event simulation (DES) model for the Singapore Emergency Medical Services (EMS), and to demonstrate the utility of this DES model for the evaluation of different policy alternatives to improve ambulance response times. A DES model was developed based on retrospective emergency call data over a continuous 6-month period in Singapore. The main outcome measure is the distribution of response times. The secondary outcome measure is ambulance utilization levels based on unit hour utilization (UHU) ratios. The DES model was used to evaluate different policy options in order to improve the response times, while maintaining reasonable fleet utilization. Three policy alternatives looking at the reallocation of ambulances, the addition of new ambulances, and alternative dispatch policies were evaluated. Modifications of dispatch policy combined with the reallocation of existing ambulances were able to achieve response time performance equivalent to that of adding 10 ambulances. The median (90th percentile) response time was 7.08 minutes (12.69 minutes). Overall, this combined strategy managed to narrow the gap between the ideal and existing response time distribution by 11-13%. Furthermore, the median UHU under this combined strategy was 0.324 with an interquartile range (IQR) of 0.047 versus a median utilization of 0.285 (IQR of 0.051) resulting from the introduction of additional ambulances. Response times were shown to be improved via a more effective reallocation of ambulances and dispatch policy. More importantly, the response time improvements were achieved without a reduction in the utilization levels and additional costs associated with the addition of ambulances. We demonstrated the effective use of DES as a versatile platform to model the dynamic system complexities of Singapore's national EMS systems for the evaluation of operational strategies to improve ambulance response times.

Human resources for health: lessons from the cholera outbreak in Papua New Guinea

PubMed Central

Bieb, Sibauk; Clark, Geoff; Miller, Geoff; MacIntyre, Raina; Zwi, Anthony

2013-01-01

Issue Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals. Context Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services. Action We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt. Outcome Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population. Discussion In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency. PMID:24319607

Human resources for health: lessons from the cholera outbreak in Papua New Guinea.

PubMed

Rosewell, Alexander; Bieb, Sibauk; Clark, Geoff; Miller, Geoff; MacIntyre, Raina; Zwi, Anthony

2013-01-01

Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals. Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services. We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt. Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population. In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency.

Use of a Novel Airway Kit and Simulation in Resident Training on Emergent Pediatric Airways.

PubMed

Melzer, Jonathan M; Hamersley, Erin R S; Gallagher, Thomas Q

2017-06-01

Objective Development of a novel pediatric airway kit and implementation with simulation to improve resident response to emergencies with the goal of improving patient safety. Methods Prospective study with 9 otolaryngology residents (postgraduate years 1-5) from our tertiary care institution. Nine simulated pediatric emergency airway drills were carried out with the existing system and a novel portable airway kit. Response times and time to successful airway control were noted with both the extant airway system and the new handheld kit. Results were analyzed to ensure parametric data and compared with t tests. A Bonferroni adjustment indicated that an alpha of 0.025 was needed for significance. Results Use of the airway kit significantly reduced the mean time of resident arrival by 47% ( P = .013) and mean time of successful intubation by 50% ( P = .007). Survey data indicated 100% improved resident comfort with emergent airway scenarios with use of the kit. Discussion Times to response and meaningful intervention were significantly reduced with implementation of the handheld airway kit. Use of simulation training to implement the new kit improved residents' comfort and airway skills. This study describes an affordable novel mobile airway kit and demonstrates its ability to improve response times. Implications for Practice The low cost of this airway kit makes it a tenable option even for smaller hospitals. Simulation provides a safe and effective way to familiarize oneself with novel equipment, and, when possible, realistic emergent airway simulations should be used to improve provider performance.

Evaluation of avian paramyxovirus serotypes 2 to 10 as vaccine vectors in chickens previously immunized against Newcastle disease virus.

PubMed

Tsunekuni, Ryota; Hikono, Hirokazu; Saito, Takehiko

2014-08-15

Newcastle disease virus (NDV), also known as avian paramyxovirus (APMV) serotype 1, is used as a vaccine vector to express the hemagglutinin protein of avian influenza (AI) virus. However, use of live NDV recombinant vaccines expressing AI virus hemagglutinin is not desirable in emergency vaccination programs to control severe AI outbreaks in chickens, because commercial chickens often possess pre-existing NDV immunity induced by routine vaccination. Therefore, a novel vaccine vector is required for emergency vaccination of chickens to control AI during outbreaks. We investigated whether candidate APMV strains could be used as vaccine vectors that could evade the pre-existing immunity acquired by chickens through NDV vaccination and that would replicate in the mucosal tissues where AI virus primarily replicates. To this end, we examined strains of APMV serotypes 2 to 10 for their immunogenicity and replication in chickens with pre-existing immunity to NDV. APMV serotypes 2, 6, and 10 were the least cross-reactive to antibodies to NDV in hemagglutination inhibition and/or virus neutralization tests. Virus replication in mucosal tissues, as well as antibody response after oculonasal inoculation, was observed when 7-week-old chickens were challenged with APMV of serotype 2, 6, or 10. The APMV also replicated in mucosal tissues and induced antibody responses in chickens that had been vaccinated twice with NDV before challenge. These results warrant further study to develop vaccine vectors based on APMV serotype 2, 6, or 10 for emergency vaccination of chickens against AI. Copyright © 2014 Elsevier B.V. All rights reserved.

U.S. national response assets for radiological incidents.

PubMed

Remick, Alan L; Crapo, John L; Woodruff, Charles R

2005-11-01

The federal government has had the ability to respond to incidents of national significance for decades. Since 11 September 2001, there have been enhancements to existing federal assets and the creation of new federal assets. This presentation will provide an overview of the more significant federal assets. Pivotal to a response of national significance is the U.S. Department of Energy (DOE) Federal Radiological Monitoring and Assessment Center, which organizes and coordinates federal agency monitoring activities during an emergency. DOE manages the Federal Radiological Monitoring and Assessment Center during the emergency phase, and the Environmental Protection Agency (EPA) manages the response during the recovery phase once the emergency is terminated. EPA monitoring teams provide support during both the emergency and recovery phases of an emergency. Other DOE teams are available to respond to major nuclear power plant events, transportation accidents, or terrorism events involving the use of radiological materials, including the Radiological Assistance Program, the Aerial Measuring System, the National Atmospheric Release Advisory Center, and the Radiation Emergency Assistance Center/Training Site. For incidents involving a nuclear weapon, an improvised nuclear device, or a radiological dispersal device, DOE assets such as the Nuclear Emergency Support Team and the Accident Response Group could provide capabilities for weapon or device search, recovery, and removal. The Radiological Triage System harnesses the weapons scientists and engineers at the DOE national laboratories to provide gamma spectroscopy interpretation for agencies responding to an incident. In recent years, National Guard Weapons of Mass Destruction-Civil Support Teams have been created to support state and local response to terrorism events. The Civil Support Teams normally come under direct control of the state and can respond without requiring authorization from the U.S. Department of Defense (DoD). Changes brought about by the events of September 11 also extend to changing federal response policy and planning. Therefore, the Catastrophic Incident Response Annex to the National Response Plan is discussed. DoD also provides specifically designated radiological response capabilities that can be utilized within the guidelines of the National Response Plan. While optimally designed to support military missions, these resources also help provide for a well-equipped set of national assets to temporarily support and augment the local, state, and federal civil agencies that have primary authority and responsibility for domestic disaster assistance. The military's role in domestic emergencies is well defined in military regulations, as well as the national plan.

a Study of Co-Planing Technology of Spaceborne, Airborne and Ground Remote Sensing Detecting Resource, Driven by Disaster Emergency Task

NASA Astrophysics Data System (ADS)

Yu, F.; Chen, H.; Tu, K.; Wen, Q.; He, J.; Gu, X.; Wang, Z.

2018-04-01

Facing the monitoring needs of emergency responses to major disasters, combining the disaster information acquired at the first time after the disaster and the dynamic simulation result of the disaster chain evolution process, the overall plan for coordinated planning of spaceborne, airborne and ground observation resources have been designed. Based on the analysis of the characteristics of major disaster observation tasks, the key technologies of spaceborne, airborne and ground collaborative observation project are studied. For different disaster response levels, the corresponding workflow tasks are designed. On the basis of satisfying different types of disaster monitoring demands, the existing multi-satellite collaborative observation planning algorithms are compared, analyzed, and optimized.

[Current state of measures to deal with natural disasters at public universities].

PubMed

Hirouchi, Tomoko; Tanka, Mamoru; Shimada, Ikuko; Yoshimoto, Yoshinobu; Sato, Atsushi

2012-03-01

The responsibility of a university after a large-scale, natural disaster is to secure the safety of students' and local residents' lives. The present study investigated the current state of measures at public universities to deal with natural disasters in coordination with the local community. A survey was administered at 77 public universities in Japan from March 25 to May 10, 2011. The survey included questions on the existence of local disaster evacuation sites, a disaster manual, disaster equipment storage, emergency drinking water, and food storage. A total of 51% of universities had designated local evacuation sites. Based on responses for the remaining questions, universities with and without the designated disaster response solutions accounted for 42% and 57%, respectively, for disaster manuals; 55% and 33%, respectively, for disaster equipment; 32% and 13%, respectively, for disaster drinking water storage; and 26% and 7%, respectively, for emergency food storage. A majority of public universities have not created disaster manuals, regardless of whether they have a local evacuation site. The survey results also indicated that most universities have no storage of disaster equipment or emergency supplies.

Dana-Farber Cancer Institute: Discovery of Resistance Mechanisms | Office of Cancer Genomics

Cancer.gov

Resistance to targeted therapy is emerging as a bottleneck to achieving durable drug responses in cancer. The goal of the CTD2 Center at Dana Farber Cancer Institute is to identify mechanisms of resistance for both existing therapeutics as well as for emerging targets even prior to the identification of lead compounds. They aim to use this information to inform combinatorial treatments. In representative examples they have found that YAP1 leads to resistance after KRAS targeting and that PRKACA mediates resistance to HER2 therapy.

ASTER and USGS EROS disaster response: emergency imaging after Hurricane Katrina

USGS Publications Warehouse

Duda, Kenneth A.; Abrams, Michael

2005-01-01

The value of remotely sensed imagery during times of crisis is well established, and the increasing spatial and spectral resolution in newer systems provides ever greater utility and ability to discriminate features of interest (International Charter, Space and Major Disasters, 2005). The existing suite of sensors provides an abundance of data, and enables warning alerts to be broadcast for many situations in advance. In addition, imagery acquired soon after an event occurs can be used to assist response and remediation teams in identifying the extent of the affected area and the degree of damage. The data characteristics of the Advanced Spaceborne Thermal Emission and Refl ection Radiometer (ASTER) are well-suited for monitoring natural hazards and providing local and regional views after disaster strikes. For this reason, and because of the system fl exibility in scheduling high-priority observations, ASTER is often tasked to support emergency situations. The Emergency Response coordinators at the United States Geological Survey (USGS) Center for Earth Resources Observation and Science (EROS) work closely with staff at the National Aeronautics and Space Administration (NASA) Land Processes Distributed Active Archive Center (LP DAAC) at EROS and the ASTER Science Team as they fulfi ll their mission to acquire and distribute data during critical situations. This article summarizes the role of the USGS/EROS Emergency Response coordinators, and provides further discussion of ASTER data and the images portrayed on the cover of this issue

Cellular-based preemption system

NASA Technical Reports Server (NTRS)

Bachelder, Aaron D. (Inventor)

2011-01-01

A cellular-based preemption system that uses existing cellular infrastructure to transmit preemption related data to allow safe passage of emergency vehicles through one or more intersections. A cellular unit in an emergency vehicle is used to generate position reports that are transmitted to the one or more intersections during an emergency response. Based on this position data, the one or more intersections calculate an estimated time of arrival (ETA) of the emergency vehicle, and transmit preemption commands to traffic signals at the intersections based on the calculated ETA. Additional techniques may be used for refining the position reports, ETA calculations, and the like. Such techniques include, without limitation, statistical preemption, map-matching, dead-reckoning, augmented navigation, and/or preemption optimization techniques, all of which are described in further detail in the above-referenced patent applications.

Emergency response facilities including primary and secondary prevention strategies across 79 professional football clubs in England.

PubMed

Malhotra, Aneil; Dhutia, Harshil; Gati, Sabiha; Yeo, Tee-Joo; Finocchiaro, Gherardo; Keteepe-Arachi, Tracey; Richards, Thomas; Walker, Mike; Birt, Robin; Stuckey, David; Robinson, Laurence; Tome, Maite; Beasley, Ian; Papadakis, Michael; Sharma, Sanjay

2017-06-14

To assess the emergency response planning and prevention strategies for sudden cardiac arrest (SCA) across a wide range of professional football clubs in England. A written survey was sent to all professional clubs in the English football league, namely the Premiership, Championship, League 1 and League 2. Outcomes included: (1) number of clubs performing cardiac screening and frequency of screening; (2) emergency planning and documentation; (3) automated external defibrillator (AED) training and availability; and (4) provision of emergency services at sporting venues. 79 clubs (86%) responded to the survey. 100% clubs participated in cardiac screening. All clubs had AEDs available on match days and during training sessions. 100% Premiership clubs provided AED training to designated staff. In contrast, 30% of lower division clubs with AEDs available did not provide formal training. Most clubs (n=66; 83%) reported the existence of an emergency action plan for SCA but formal documentation was variable. All clubs in the Premiership and League 1 provided an ambulance equipped for medical emergencies on match days compared with 75% of clubs in the Championship and 66% in League 2. The majority of football clubs in England have satisfactory prevention strategies and emergency response planning in line with European recommendations. Additional improvements such as increasing awareness of European guidelines for emergency planning, AED training and mentorship with financial support to lower division clubs are necessary to further enhance cardiovascular safety of athletes and spectators and close the gap between the highest and lower divisions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Early response to the emergence of influenza A(H7N9) virus in humans in China: the central role of prompt information sharing and public communication.

PubMed

Vong, Sirenda; O'Leary, Michael; Feng, Zijian

2014-04-01

In 2003, China's handling of the early stages of the epidemic of severe acute respiratory syndrome (SARS) was heavily criticized and generally considered to be suboptimal. Following the SARS outbreak, China made huge investments to improve surveillance, emergency preparedness and response capacity and strengthen public health institutions. In 2013, the return on these investments was evaluated by investigating China's early response to the emergence of avian influenza A(H7N9) virus in humans. Clusters of human infection with a novel influenza virus were detected in China - by national surveillance of pneumonia of unknown etiology - on 26 February 2013. On 31 March 2013, China notified the World Health Organization (WHO) of the first recorded human infections with A(H7N9) virus. Poultry markets - which were rapidly identified as a major source of transmission of A(H7N9) to humans - were closed down in the affected areas. Surveillance in humans and poultry was heightened and technical guidelines were quickly updated and disseminated. The health authorities collaborated with WHO in risk assessments and risk communication. New cases were reported promptly and publicly. The relevant infrastructures, surveillance systems and response capacity need to be strengthened in preparation for future emergencies caused by emerging or existing disease threats. Results of risk assessments and other data should be released promptly and publicly and such release should not jeopardize future publication of the data in scientific journals. Coordination between public health and veterinary services would be stronger during an emergency if these services had already undertaken joint preparedness planning.

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

PubMed

Lee, Andrew C K; Phillips, Wendy; Challen, Kirsty; Goodacre, Steve

2012-10-19

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

The Biology of Emergency Medicine: what have 30 years meant for Rosen's original concepts?

PubMed

Zink, Brian J

2011-03-01

In 1979 Peter Rosen, MD, a leading academic figure in the developing field of emergency medicine (EM), wrote an article, "The Biology of Emergency Medicine," in response to criticism from other specialties and medical leaders that there was no unique biology of EM that would qualify it as a legitimate medical specialty. This essay received much attention at the time and served as rallying cry for emergency physicians (EPs) who were trying to find their places in the house of medicine and especially in medical schools and academic teaching hospitals. Thirty years later, the opposition that prompted many of Rosen's strongly worded impressions and observations on the biology of EM, clinical emergency department (ED) practice, education, and research has largely faded. Many of Rosen's predictions on the eventual success of EM have come true. However, core issues that existed then continue to present challenges for academic EM and clinical emergency practice. © 2011 by the Society for Academic Emergency Medicine.

A protocol for a pragmatic randomized controlled trial evaluating outcomes of emergency nurse practitioner service.

PubMed

Jennings, Natasha; Gardner, Glenn; O'Reilly, Gerard

2014-09-01

To evaluate emergency nurse practitioner service effectiveness on outcomes related to quality of care and service responsiveness. Increasing service pressures in the emergency setting have resulted in the adoption of service innovation models; the most common and rapidly expanding of these is the emergency nurse practitioner. The delivery of high quality patient care in the emergency department is one of the most important service indicators to be measured in health services today. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this model in outcomes related to safety and quality of patient care. Pragmatic randomized controlled trial at one site with 260 participants. This protocol describes a definitive prospective randomized controlled trial, which will examine the impact of emergency nurse practitioner service on key patient care and service indicators. The study control will be standard emergency department care. The intervention will be emergency nurse practitioner service. The primary outcome measure is pain score reduction and time to analgesia. Secondary outcome measures are waiting time, number of patients who did not wait, length of stay in the emergency department and representations within 48 hours. Scant research enquiry evaluating emergency nurse practitioner service on patient effectiveness and service responsiveness exists currently. This study is a unique trial that will test the effectiveness of the emergency nurse practitioner service on patients who present to the emergency department with pain. The research will provide an opportunity to further evaluate emergency nurse practitioner models of care and build research capacity into the workforce. Trial registration details: Australian and New Zealand Clinical Trials Registry dated 18th August 2013, ACTRN12613000933752. © 2014 John Wiley & Sons Ltd.

Safeguarding production agriculture and natural ecosystems against biological terrorism. A U.S. Department of Agriculture emergency response framework.

PubMed

Sequeira, R

1999-01-01

Foreign pest introductions and outbreaks represent threats to agricultural productivity and ecosystems, and, thus, to the health and national security of the United States. It is advisable to identify relevant techniques and bring all appropriate strategies to bear on the problem of controlling accidentally and intentionally introduced pest outbreaks. Recent political shifts indicate that the U.S. may be at increased risk for biological terrorism. The existing emergency-response strategies of the Animal and Plant Health Inspection Services (APHIS) will evolve to expand activities in coordination with other emergency management agencies. APHIS will evolve its information superstructure to include extensive application of simulation models for forecasting, meteorological databases and analysis, systems analysis, geographic information systems, satellite image analysis, remote sensing, and the training of specialized cadres within the emergency-response framework capable of managing the necessary information processing and analysis. Finally, the threat of key pests ranked according to perceived risk will be assessed with mathematical models and "what-if" scenarios analyzed to determine impact and mitigation practices. An infrastructure will be maintained that periodically surveys ports and inland regions for the presence of exotic pest threats and will identify trend abnormalities. This survey and monitoring effort will include cooperation from industry groups, federal and state organizations, and academic institutions.

Nuclear and radiological emergencies: Building capacity in medical physics to support response.

PubMed

Berris, Theocharis; Nüsslin, Fridtjof; Meghzifene, Ahmed; Ansari, Armin; Herrera-Reyes, Eduardo; Dainiak, Nicholas; Akashi, Makoto; Gilley, Debbie; Ohtsuru, Akira

2017-10-01

Medical physicists represent a valuable asset at the disposal of a structured and planned response to nuclear or radiological emergencies (NREs), especially in the hospital environment. The recognition of this fact led the International Atomic Energy Agency (IAEA) and the International Organization for Medical Physics (IOMP) to start a fruitful collaboration aiming to improve education and training of medical physicists so that they may support response efforts in case of NREs. Existing shortcomings in specific technical areas were identified through international consultations supported by the IAEA and led to the development of a project aiming at preparing a specific and standardized training package for medical physicists in support to NREs. The Project was funded through extra-budgetary contribution from Japan within the IAEA Nuclear Safety Action Plan. This paper presents the work accomplished through that project and describes the current steps and future direction for enabling medical physicists to better support response to NREs. Copyright © 2017 Associazione Italiana di Fisica Medica. All rights reserved.

The management in response to marine oil spill from ships in China: A systematic review.

PubMed

Xiong, Shangao; Long, Hualou; Tang, Guoping; Wan, Jun; Li, Hongyuan

2015-07-15

Historical trends about marine ship-source oil spill incidents from 1990 to 2010 in China were analyzed, and it provided an overview of the status quo of China's management in response to marine oil spill from ships. The Chinese government has issued a series of laws on marine environmental protection since 1982, and promulgated many regulations to prevent and tackle ship-source oil spill. At present, the oil spill emergency response system established in China has five levels: the national level, sea level, provincial level, port level, and ship level. China has demonstrated its ability to control and remove small-scale oil spill from ships in port area and near-shore coastal waters, and also paid attention to related research and development projects. Although China has made significant progress in managing shipping oil spill, challenges still exist, including strengthening oil spill emergency cooperation, enhancing China's response capability, and improving relevant research and development projects. Copyright © 2015 Elsevier Ltd. All rights reserved.

Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice.

PubMed

Bjurling-Sjöberg, Petronella; Wadensten, Barbro; Pöder, Ulrika; Jansson, Inger; Nordgren, Lena

2017-03-01

This study aimed to describe and explain teamwork and factors that influence team processes in everyday practice in an intensive care unit (ICU) from a staff perspective. The setting was a Swedish ICU. Data were collected from 38 ICU staff in focus groups with registered nurses, assistant nurses, and anaesthetists, and in one individual interview with a physiotherapist. Constant comparative analysis according to grounded theory was conducted, and to identify the relations between the emerged categories, the paradigm model was applied. The core category to emerge from the data was "balancing intertwined responsibilities." In addition, eleven categories that related to the core category emerged. These categories described and explained the phenomenon's contextual conditions, causal conditions, and intervening conditions, as well as the staff actions/interactions and the consequences that arose. The findings indicated that the type of teamwork fluctuated due to circumstantial factors. Based on the findings and on current literature, strategies that can optimise interprofessional teamwork are presented. The analysis generated a conceptual model, which aims to contribute to existing frameworks by adding new dimensions about perceptions of team processes within an ICU related to staff actions/interactions. This model may be utilised to enhance the understanding of existing contexts and processes when designing and implementing interventions to facilitate teamwork in the pursuit of improving healthcare quality and patient safety.

Treatment of palliative care emergencies by prehospital emergency physicians in Germany: an interview based investigation.

PubMed

Wiese, C H R; Bartels, U E; Ruppert, D; Marung, H; Luiz, T; Graf, B M; Hanekop, G G

2009-06-01

Palliative care medical emergencies as a consequence of advanced cancer account for approximately 3% of all prehospital emergency cases. Therefore, prehospital emergency physicians (EP) are confronted with 'end of life decisions'. No educational content exists concerning palliative medicine in emergency medicine curricula. Over the course of 6 months, we interviewed 150 EPs about their experiences in 'end of life decisions' using a specific questionnaire. The total response rate was 69% (n = 104). Most of the interviewed EPs (89%, n = 93) had been confronted with palliative care medical emergencies and expressed uncertainties in dealing with these difficult situations, especially in the area of psychosocial care of the patients (50%). The emergency treatment of palliative care patients can become a particular challenge for any EP. A large percentage of interviewed EPs felt uncertain about aspects of social care and in the assessment of decisions at the end of life. Further information and training are necessary to amenable EPs to provide adequate patient-oriented care to palliative care patients and their relatives in emergency situations.

Federal and State Responses to the Emergency Response Communications Program. Draft Report, March 1979.

DTIC Science & Technology

1979-06-01

expansion of terrestrial system meets all planned needs i Department of Housing Under review and Urban Development Department of Interior No baseline...be a suitable addition to table 1.1. SI The cost and available federal support will be important to P the states and will have an effect on our total...Repeater ə Jsystems to expand the system coverage. The attached map shows the existing program and future expansion . II, TECHNICAL DESCRIPTION - i |A

The Emergence of Genetic Counseling in Sweden: Examples from Eugenics and Medical Genetics.

PubMed

Björkman, Maria

2015-09-01

This paper examines the intertwined relations between eugenics and medical genetics from a Swedish perspective in the 1940s and 1950s. The Swedish case shows that a rudimentary form of genetic counseling emerged within eugenic practices in the applications of the Swedish Sterilization Act of 1941, here analyzed from the phenomenon of "heredophobia" (ärftlighetsskräck). At the same time genetic counseling also existed outside eugenic practices, within the discipline of medical genetics. The paper argues that a demand for genetic counseling increased in the 1940s and 1950s in response to a sense of reproductive responsibility engendered by earlier eugenic discourse. The paper also questions the claim made by theoreticians of biopolitics that biological citizens have emerged only during the last decades, especially in neoliberal societies. From the Swedish case it is possible to argue that this had already happened earlier in relation to the proliferation of various aspects of eugenics to the public.

Elements of resilience after the World Trade Center disaster: reconstituting New York City's Emergency Operations Centre.

PubMed

Kendra, James M; Wachtendorf, Tricia

2003-03-01

In this paper we examine the reconstitution of the Emergency Operations Centre (EOC) after its destruction in the World Trade Center attack, using that event to highlight several features of resilience. The paper summarises basic EOC functions, and then presents conceptions of resilience as understood from several disciplinary perspectives, noting that work in these fields has sought to understand how a natural or social system that experiences disturbance sustains its functional processes. We observe that, although the physical EOC facility was destroyed, the organisation that had been established to manage crises in New York City continued, enabling a response that drew on the resources of New York City and neighbouring communities, states and the federal government. Availability of resources--which substituted for redundancy of personnel, equipment and space--pre-existing relationships that eased communication challenges as the emergency developed and the continuation of organisational patterns of response integration and role assignments were among the factors that contributed to resilience following the attack.

AGARD standard aeroelastic configurations for dynamic response. Candidate configuration I.-wing 445.6

NASA Technical Reports Server (NTRS)

Yates, E. Carson, Jr.

1987-01-01

To promote the evaluation of existing and emerging unsteady aerodynamic codes and methods for applying them to aeroelastic problems, especially for the transonic range, a limited number of aerodynamic configurations and experimental dynamic response data sets are to be designated by the AGARD Structures and Materials Panel as standards for comparison. This set is a sequel to that established several years ago for comparisons of calculated and measured aerodynamic pressures and forces. This report presents the information needed to perform flutter calculations for the first candidate standard configuration for dynamic response along with the related experimental flutter data.

"We Are Strangers Walking Into Their Life-Changing Event": How Prehospital Providers Manage Emergency Calls at the End of Life.

PubMed

Waldrop, Deborah P; Clemency, Brian; Lindstrom, Heather A; Clemency Cordes, Colleen

2015-09-01

Emergency 911 calls are often made when the end stage of an advanced illness is accompanied by alarming symptoms and substantial anxiety for family caregivers, particularly when an approaching death is not anticipated. How prehospital providers (paramedics and emergency medical technicians) manage emergency calls near death influences how and where people will die, if their end-of-life choices are upheld and how appropriately health care resources are used. The purpose of this study was to explore and describe how prehospital providers assess and manage end-of-life emergency calls. In-depth and in-person interviews were conducted with 43 prehospital providers. Interviews were audiotaped, transcribed, and entered into ATLAS.ti for data management and coding. Qualitative data analysis involved systematic and axial coding to identify and describe emergent themes. Four themes illustrate the nature and dynamics of emergency end-of-life calls: 1) multifocal assessment (e.g., of the patient, family, and environment), 2) family responses (e.g., emotional, behavioral), 3) conflicts (e.g., missing do-not-resuscitate order, patient-family conflicts), and 4) management of the dying process (e.g., family witnessed resuscitation or asking family to leave, decisions about hospital transport). After a rapid comprehensive multifocal assessment, family responses and the existence of conflicts mediate decision making about possible interventions. The importance of managing symptom crises and stress responses that accompany the dying process is particularly germane to quality care at life's end. The results suggest the importance of increasing prehospital providers' abilities to uphold advance directives and patients' end-of-life wishes while managing family emotions near death. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Emergency response and field observation activities of geoscientists in California (USA) during the September 29, 2009, Samoa Tsunami

NASA Astrophysics Data System (ADS)

Wilson, Rick I.; Dengler, Lori A.; Goltz, James D.; Legg, Mark R.; Miller, Kevin M.; Ritchie, Andy; Whitmore, Paul M.

2011-07-01

State geoscientists (geologists, geophysicists, seismologists, and engineers) in California work closely with federal, state and local government emergency managers to help prepare coastal communities for potential impacts from a tsunami before, during, and after an event. For teletsunamis, as scientific information (forecast model wave heights, first-wave arrival times, etc.) from NOAA's West Coast and Alaska Tsunami Warning Center is made available, federal- and state-level emergency managers must help convey this information in a concise, comprehensible and timely manner to local officials who ultimately determine the appropriate response activities for their jurisdictions. During the September 29, 2009 Tsunami Advisory for California, government geoscientists assisted the California Emergency Management Agency by providing technical assistance during teleconference meetings with NOAA and other state and local emergency managers prior to the arrival of the tsunami. This technical assistance included background information on anticipated tidal conditions when the tsunami was set to arrive, wave height estimates from state-modeled scenarios for areas not covered by NOAA's forecast models, and clarifying which regions of the state were at greatest risk. Over the last year, state geoscientists have started to provide additional assistance: 1) working closely with NOAA to simplify their tsunami alert messaging and expand their forecast modeling coverage; 2) creating "playbooks" containing information from existing tsunami scenarios for local emergency managers to reference during an event; and, 3) developing a state-level information "clearinghouse" and pre-tsunami field response team to assist local officials as well as observe and report tsunami effects. Activities of geoscientists were expanded during the more recent Tsunami Advisory on February 27, 2010, including deploying a geologist from the California Geological Survey as a field observer who provided information back to emergency managers.

The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa.

PubMed

Newton, P R; Naidoo, R; Brysiewicz, P

2015-09-19

 Emergency medical services (EMS) are sometimes required to respond to cases that are later found not to be emergencies, resulting in high levels of inappropriate responses. This study evaluated the extent to which this occurs.  All cases dispatched over 72 hours by the eThekwini EMS in Durban, South Africa, were prospectively enrolled in a quantitative descriptive study. Vehicle control forms containing dispatch data were matched and compared with patient report forms containing epidemiological and clinical data to describe the nature and extent of inappropriate responses based on patient need. Data were subjected to simple descriptive analysis, correlations and χ2 testing.  A total of 1 385 cases met the study inclusion criteria. Marked variations existed between dispatch and on-scene priority settings, most notably in the highest priority 'red-code' category, which constituted >56% of cases dispatched yet accounted for <2% at the scene (p<0.001). Conversely, >80% of 'red-code' dispatches required a lower priority response. When comparing resource allocation according to patient interventional needs, >58% of cases required either no intervention or transport only and almost 36% required basic life support intervention only (p<0.001). Moreover, <12% of advanced life support dispatches were for patients found to be 'red code' at the scene.  There is a significant mismatch between the dispatch of EMS resources and actual patient need in the eThekwini district, with significantly high levels of inappropriate emergency responses.

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.

Farm Mapping to Assist, Protect, and Prepare Emergency Responders: Farm MAPPER.

PubMed

Reyes, Iris; Rollins, Tami; Mahnke, Andrea; Kadolph, Christopher; Minor, Gerald; Keifer, Matthew

2014-01-01

Responders such as firefighters and emergency medical technicians who respond to farm emergencies often face complex and unknown environments. They may encounter hazards such as fuels, solvents, pesticides, caustics, and exploding gas storage cylinders. Responders may be unaware of dirt roads within the farm that can expedite their arrival at critical sites or snow-covered manure pits that act as hidden hazards. A response to a farm, unless guided by someone familiar with the operation, may present a risk to responders and post a challenge in locating the victim. This project explored the use of a Web-based farm-mapping application optimized for tablets and accessible via easily accessible on-site matrix barcodes, or quick response codes (QR codes), to provide emergency responders with hazard and resource information to agricultural operations. Secured portals were developed for both farmers and responders, allowing both parties to populate and customize farm maps with icons. Data were stored online and linked to QR codes attached to mailbox posts where emergency responders may read them with a mobile device. Mock responses were conducted on dairy farms to test QR code linking efficacy, Web site security, and field usability. Findings from farmer usability tests showed willingness to enter data as well as ease of Web site navigation and data entry even with farmers who had limited computer knowledge. Usability tests with emergency responders showed ease of QR code connectivity to the farm maps and ease of Web site navigation. Further research is needed to improve data security as well as assess the program's applicability to nonfarm environments and integration with existing emergency response systems. The next phases of this project will expand the program for regional and national use, develop QR code-linked, Web-based extrication guidance for farm machinery for victim entrapment rescue, and create QR code-linked online training videos and materials for limited English proficient immigrant farm workers.

Law enforcement attitudes toward overdose prevention and response.

PubMed

Green, Traci C; Zaller, Nickolas; Palacios, Wilson R; Bowman, Sarah E; Ray, Madeline; Heimer, Robert; Case, Patricia

2013-12-01

Law enforcement is often the first to respond to medical emergencies in the community, including overdose. Due to the nature of their job, officers have also witnessed first-hand the changing demographic of drug users and devastating effects on their community associated with the epidemic of nonmedical prescription opioid use in the United States. Despite this seminal role, little data exist on law enforcement attitudes toward overdose prevention and response. We conducted key informant interviews as part of a 12-week Rapid Assessment and Response (RAR) process that aimed to better understand and prevent nonmedical prescription opioid use and overdose deaths in locations in Connecticut and Rhode Island experiencing overdose "outbreaks." Interviews with 13 law enforcement officials across three study sites were analyzed to uncover themes on overdose prevention and naloxone. Findings indicated support for law enforcement involvement in overdose prevention. Hesitancy around naloxone administration by laypersons was evident. Interview themes highlighted officers' feelings of futility and frustration with their current overdose response options, the lack of accessible local drug treatment, the cycle of addiction, and the pervasiveness of easily accessible prescription opioid medications in their communities. Overdose prevention and response, which for some officers included law enforcement-administered naloxone, were viewed as components of community policing and good police-community relations. Emerging trends, such as existing law enforcement medical interventions and Good Samaritan Laws, suggest the need for broader law enforcement engagement around this pressing public health crisis, even in suburban and small town locations, to promote public safety. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Law enforcement attitudes toward overdose prevention and response

PubMed Central

Green, Traci C.; Zaller, Nickolas; Palacios, Wilson R.; Bowman, Sarah E.; Ray, Madeline; Heimer, Robert; Case, Patricia

2014-01-01

Background Law enforcement is often the first to respond to medical emergencies in the community, including overdose. Due to the nature of their job, officers have also witnessed first-hand the changing demographic of drug users and devastating effects on their community associated with the epidemic of nonmedical prescription opioid use in the United States. Despite this seminal role, little data exist on law enforcement attitudes toward overdose prevention and response. Methods We conducted key informant interviews as part of a 12-week Rapid Assessment and Response (RAR) process that aimed to better understand and prevent nonmedical prescription opioid use and overdose deaths in locations in Connecticut and Rhode Island experiencing overdose “outbreaks.” Interviews with 13 law enforcement officials across three study sites were analyzed to uncover themes on overdose prevention and naloxone. Results Findings indicated support for law enforcement involvement in overdose prevention. Hesitancy around naloxone administration by laypersons was evident. Interview themes highlighted officers’ feelings of futility and frustration with their current overdose response options, the lack of accessible local drug treatment, the cycle of addiction, and the pervasiveness of easily accessible prescription opioid medications in their communities. Overdose prevention and response, which for some officers included law enforcement-administered naloxone, were viewed as components of community policing and good police-community relations. Conclusion Emerging trends, such as existing law enforcement medical interventions and Good Samaritan Laws, suggest the need for broader law enforcement engagement around this pressing public health crisis, even in suburban and small town locations, to promote public safety. PMID:24051061

[Considering the current state of fire safety in Taiwan's care environment from the perspective of the nation's worst recent hospital fire].

PubMed

Tseng, Wei-Wen; Shih, Chung-Liang; Chien, Shen-Wen

2013-04-01

Taiwan's worst hospital fire in history on October 23rd, 2012 at Sinying Hospital's Bei-Men Branch resulted in 13 elderly patient deaths and over 70 injuries. The heavy casualties were due in part to the serious condition of patients. Some patients on life-support machines were unable to move or be moved. This disaster highlights the issue of fire safety in small-scale hospitals that have transformed existing hospital space into special care environments for elderly patients. Compared with medical centers and general hospitals, these small-scale health facilities are ill equipped to deal properly with fire safety management and emergency response issues due to inadequate fire protection facilities, fire safety equipment, and human resources. Small-scale facilities that offer health care and medical services to mostly immobile patients face fire risks that differ significantly from general health care facilities. This paper focuses on fire risks in small-scale facilities and suggests a strategy for fire prevention and emergency response procedures, including countermeasures for fire risk assessment, management, and emergency response, in order to improve fire safety at these institutions in Taiwan.

The evolution of Earth Observation satellites in Europe and its impact on the performance of emergency response services

NASA Astrophysics Data System (ADS)

Denis, Gil; de Boissezon, Hélène; Hosford, Steven; Pasco, Xavier; Montfort, Bruno; Ranera, Franck

2016-10-01

The paper reviews the evolution of Earth Observation systems in Europe and Worldwide and analyses the potential impact of their performance in support of emergency response services. Earth Observation satellites play already a significant role in supporting the action of first responders in case of major disasters. The main principle is the coordinated use of satellites in order to ensure a rapid response and the timely delivery of images and geospatial information of the area affected by the event. The first part of the paper reviews the main instruments and evaluates their current performance. The International Charter ;Space and Major Disasters;, signed in October 2000, was the first international initiative aimed at establishing a unified system for the acquisition of space data. The charter is a cooperation agreement between space agencies and operators of space systems. At regional level, a similar instrument exists in Asia: Sentinel-Asia. In the frame of the European programme Copernicus, the emergency management service was launched in 2009. Geo-information products derived from space imagery are delivered during all phases of the emergency management cycle, in either rush or non-rush mode, free of charge for the users. In both cases, the capacities were historically drawn from national missions, funded with public money and directly operated by the space agencies or by national operators.

The role of law in addressing mental health-related aspects of disasters and promoting resilience.

PubMed

Rutkow, Lainie

2012-01-01

Law plays a critical role in emergency preparedness and disaster response by establishing an infrastructure for the response and facilitating coordination among the federal, state, and local governments. Once a disaster occurs, certain legal mechanisms are activated to ensure that individuals' needs for mental health care are met, both for pre-existing and emergent conditions. This includes the rapid deployment of mental health care personnel and the implementation of crisis counseling programs in affected regions. By facilitating an influx of resources, including personnel, supplies, and financial assistance, the law can help communities quickly rebound and return to a sense of normal. Drawing on examples from the United States, this article illustrates the diverse ways in which the law simultaneously addresses mental health-related aspects of disasters and promotes resilience within affected communities.

Emergency Medicine and the Underage Athlete

PubMed Central

Martin, David E.

1994-01-01

Most high school and some collegiate athletes are legal minors. In civil matters, the law treats minors (usually individuals under the age of 18 years) uniquely. Limitations exist on a minor's ability to enter into contracts, make determinations regarding medical care, and bear responsibility for personal actions. Medical professionals are often unclear on matters relating to the provision of medical care to minors. The purpose of this discourse is to present selected legal issues in the context of two fictional case studies. Case 1 presents issues regarding the definition of emergency medical conditions and the related emergency medical doctrine. Case 2 provides an example of an acute medical concern which fails to fall under emergency medical classification but rather provides a context for discussing the mature minor doctrine. Both cases are analyzed in light of these doctrines in addition to other pertinent legal considerations. PMID:16558280

The development of global vaccine stockpiles

PubMed Central

Yen, Catherine; Hyde, Terri B; Costa, Alejandro J; Fernandez, Katya; Tam, John S; Hugonnet, Stéphane; Huvos, Anne M; Duclos, Philippe; Dietz, Vance J; Burkholder, Brenton T

2016-01-01

Global vaccine stockpiles, in which vaccines are reserved for use when needed for emergencies or supply shortages, have effectively provided countries with the capacity for rapid response to emergency situations, such as outbreaks of yellow fever and meningococcal meningitis. The high cost and insufficient supply of many vaccines, including oral cholera vaccine and pandemic influenza vaccine, have prompted discussion on expansion of the use of vaccine stockpiles to address a wider range of emerging and re-emerging diseases. However, the decision to establish and maintain a vaccine stockpile is complex and must take account of disease and vaccine characteristics, stockpile management, funding, and ethical concerns, such as equity. Past experience with global vaccine stockpiles provide valuable information about the processes for their establishment and maintenance. In this Review we explored existing literature and stockpile data to discuss the lessons learned and to inform the development of future vaccine stockpiles. PMID:25661473

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

BEARS: a multi-mission anomaly response system

NASA Astrophysics Data System (ADS)

Roberts, Bryce A.

2009-05-01

The Mission Operations Group at UC Berkeley's Space Sciences Laboratory operates a highly automated ground station and presently a fleet of seven satellites, each with its own associated command and control console. However, the requirement for prompt anomaly detection and resolution is shared commonly between the ground segment and all spacecraft. The efficient, low-cost operation and "lights-out" staffing of the Mission Operations Group requires that controllers and engineers be notified of spacecraft and ground system problems around the clock. The Berkeley Emergency Anomaly and Response System (BEARS) is an in-house developed web- and paging-based software system that meets this need. BEARS was developed as a replacement for an existing emergency reporting software system that was too closedsource, platform-specific, expensive, and antiquated to expand or maintain. To avoid these limitations, the new system design leverages cross-platform, open-source software products such as MySQL, PHP, and Qt. Anomaly notifications and responses make use of the two-way paging capabilities of modern smart phones.

Layperson trauma training in low- and middle-income countries: a review.

PubMed

Callese, Tyler E; Richards, Christopher T; Shaw, Pamela; Schuetz, Steven J; Issa, Nabil; Paladino, Lorenzo; Swaroop, Mamta

2014-07-01

Prehospital trauma systems are rudimentary in many low- and middle-income countries (LMICs) and require laypersons to stabilize and transport injured patients. The World Health Organization recommends educating layperson first responders as an essential step in the development of Emergency Medical Services systems in LMICs. This systematic review examines trauma educational initiatives for layperson first responders in resource-poor settings. Layperson first-responder training and education program publications were identified using PubMed MEDLINE and Scopus databases. Articles addressing physicians, professional Emergency Medical Services training, or epidemiologic descriptions were excluded. Publications were assessed by independent reviewers, and those included underwent thematic analysis. Thirteen publications met inclusion criteria. Four themes emerged regarding the development of layperson first-responder training programs: (1) An initial needs assessment of a region's existing trauma system of care and laypersons' baseline emergency care knowledge focuses subsequent educational interventions; (2) effective programs adapt to and leverage existing resources; (3) training methods should anticipate participants with low levels of education and literacy; and (4) postimplementation evaluation allows for curriculum improvement. Technology, such as online and remote learning platforms, can be used to operationalize each theme. Successful training programs for layperson first responders in LMICs identify and maximize existing resources are adaptable to learners with little formal education and are responsive to postimplementation evaluation. Educational platforms that leverage technology to deliver content may facilitate first-responder trauma education in underresourced areas. Themes identified can inform the development of trauma systems of care to decrease mortality and physiological severity scores in trauma patients in LMICs. Copyright © 2014 Elsevier Inc. All rights reserved.

40 CFR Table 7 to Subpart Zzzz of... - Requirements for Reports

Code of Federal Regulations, 2014 CFR

2014-07-01

... submit a . . . The report must contain . . . You must submit the report . . . 1. Existing non-emergency, non-black start stationary RICE 100≤HP≤500 located at a major source of HAP; existing non-emergency, non-black start stationary CI RICE >500 HP located at a major source of HAP; existing non-emergency...

40 CFR Table 7 to Subpart Zzzz of... - Requirements for Reports

Code of Federal Regulations, 2013 CFR

2013-07-01

... submit a . . . The report must contain . . . You must submit the report . . . 1. Existing non-emergency, non-black start stationary RICE 100≤HP≤500 located at a major source of HAP; existing non-emergency, non-black start stationary CI RICE >500 HP located at a major source of HAP; existing non-emergency...

Social media responses to the Annals of Emergency Medicine residents' perspective article on multiple mini-interviews.

PubMed

Joshi, Nikita K; Yarris, Lalena M; Doty, Christopher I; Lin, Michelle

2014-09-01

In May 2014, Annals of Emergency Medicine continued a successful 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 "Does the Multiple Mini-Interview Address Stakeholder Needs? An Applicant's Perspective" by Phillips and Garmel. This dialogue included Twitter conversations, a live videocast with the authors and other experts, and detailed discussions on the ALiEM Web site's comment section. This summary article serves the dual purpose of reporting the qualitative thematic analysis from a global online discussion and the Web analytics for our novel multimodal approach. Social media technologies provide a unique opportunity to engage with a diverse audience to detect existing and new emerging themes. Such technologies allow rapid hypothesis generation for future research and enable more accelerated knowledge translation. Copyright © 2014 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

A suggested approach to the selection of chemical and biological protective clothing--meeting industry and emergency response needs for protection against a variety of hazards.

PubMed

Stull, Jeffrey O

2004-01-01

The paper describes the development of a comprehensive decision logic for selection and use of biological and chemical protective clothing (BCPC). The decision logic recognizes the separate areas of BCPC use among emergency, biological, and chemical hazards. The proposed decision logic provides a system for type classifying BCPC in terms of its compliance with existing standards (for emergency applications), the overall clothing integrity, and the material barrier performance. Type classification is offered for garments, gloves, footwear, and eye/face protection devices. On the basis of multiple, but simply designed flowcharts, the type of BCPC appropriate for specific biological and chemical hazards can be selected. The decision logic also provides supplemental considerations for choosing appropriate BCPC features.

The butterfly effect: parasite diversity, environment, and emerging disease in aquatic wildlife.

PubMed

Adlard, Robert D; Miller, Terrence L; Smit, Nico J

2015-04-01

Aquatic wildlife is increasingly subjected to emerging diseases often due to perturbations of the existing dynamic balance between hosts and their parasites. Accelerating changes in environmental factors, together with anthropogenic translocation of hosts and parasites, act synergistically to produce hard-to-predict disease outcomes in freshwater and marine systems. These outcomes are further complicated by the intimate links between diseases in wildlife and diseases in humans and domestic animals. Here, we explore the interactions of parasites in aquatic wildlife in terms of their biodiversity, their response to environmental change, their emerging diseases, and the contribution of humans and domestic animals to parasitic disease outcomes. This work highlights the clear need for interdisciplinary approaches to ameliorate disease impacts in aquatic wildlife systems. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Northern Forest Futures Project: A forward look at forest conditions in the northern United States

Treesearch

W. Keith Moser; Stephen R. Shifley

2012-01-01

Forests and forest ecosystems provide a critical array of benefits, from clean air and water to commercial products to open space. The forests and their ability to provide desired benefi ts constantly change in response to natural forces, human decisions, and human needs. The complexity and rate of change demand a rigorous evaluation of existing and emerging natural...

Scenarios for Russian Agricultural Development to 2021

DTIC Science & Technology

2011-12-01

dependence on government intervention in both good times and bad, and an unwieldy, inefficient bureaucracy strained to effectively carry out the myriad...information is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data sources, gathering and...issue analysis. Emerging issue analysis begins with the premise that problems develop gradually over time , and are often ignored until they reach

44 CFR 16.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.150 Program...

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

Emerging Patient-Driven Health Care Models: An Examination of Health Social Networks, Consumer Personalized Medicine and Quantified Self-Tracking

PubMed Central

Swan, Melanie

2009-01-01

A new class of patient-driven health care services is emerging to supplement and extend traditional health care delivery models and empower patient self-care. Patient-driven health care can be characterized as having an increased level of information flow, transparency, customization, collaboration and patient choice and responsibility-taking, as well as quantitative, predictive and preventive aspects. The potential exists to both improve traditional health care systems and expand the concept of health care though new services. This paper examines three categories of novel health services: health social networks, consumer personalized medicine and quantified self-tracking. PMID:19440396

Advanced Atmospheric Modeling for Emergency Response.

NASA Astrophysics Data System (ADS)

Fast, Jerome D.; O'Steen, B. Lance; Addis, Robert P.

1995-03-01

Atmospheric transport and diffusion models are an important part of emergency response systems for industrial facilities that have the potential to release significant quantities of toxic or radioactive material into the atmosphere. An advanced atmospheric transport and diffusion modeling system for emergency response and environmental applications, based upon a three-dimensional mesoscale model, has been developed for the U.S. Department of Energy's Savannah River Site so that complex, time-dependent flow fields not explicitly measured can be routinely simulated. To overcome some of the current computational demands of mesoscale models, two operational procedures for the advanced atmospheric transport and diffusion modeling system are described including 1) a semiprognostic calculation to produce high-resolution wind fields for local pollutant transport in the vicinity of the Savannah River Site and 2) a fully prognostic calculation to produce a regional wind field encompassing the southeastern United States for larger-scale pollutant problems. Local and regional observations and large-scale model output are used by the mesoscale model for the initial conditions, lateral boundary conditions, and four-dimensional data assimilation procedure. This paper describes the current status of the modeling system and presents two case studies demonstrating the capabilities of both modes of operation. While the results from the case studies shown in this paper are preliminary and certainly not definitive, they do suggest that the mesoscale model has the potential for improving the prognostic capabilities of atmospheric modeling for emergency response at the Savannah River Site. Long-term model evaluation will be required to determine under what conditions significant forecast errors exist.

Fortune favours the brave: Movement responses shape demographic dynamics in strongly competing populations.

PubMed

Potts, Jonathan R; Petrovskii, Sergei V

2017-05-07

Animal movement is a key mechanism for shaping population dynamics. The effect of interactions between competing animals on a population's survival has been studied for many decades. However, interactions also affect an animal's subsequent movement decisions. Despite this, the indirect effect of these decisions on animal survival is much less well-understood. Here, we incorporate movement responses to foreign animals into a model of two competing populations, where inter-specific competition is greater than intra-specific competition. When movement is diffusive, the travelling wave moves from the stronger population to the weaker. However, by incorporating behaviourally induced directed movement towards the stronger population, the weaker one can slow the travelling wave down, even reversing its direction. Hence movement responses can switch the predictions of traditional mechanistic models. Furthermore, when environmental heterogeneity is combined with aggressive movement strategies, it is possible for spatially segregated co-existence to emerge. In this situation, the spatial patterns of the competing populations have the unusual feature that they are slightly out-of-phase with the environmental patterns. Finally, incorporating dynamic movement responses can also enable stable co-existence in a homogeneous environment, giving a new mechanism for spatially segregated co-existence. Copyright © 2017 Elsevier Ltd. All rights reserved.

Commercial Airline In-Flight Emergency: Medical Student Response and Review of Medicolegal Issues.

PubMed

Bukowski, Josh H; Richards, John R

2016-01-01

As the prevalence of air travel increases, in-flight medical emergencies occur more frequently. A significant percentage of these emergencies occur when there is no certified physician, nurse, or paramedic onboard. During these situations, flight crews might enlist the help of noncertified passengers, such as medical students, dentists, or emergency medical technicians in training. Although Good Samaritan laws exist, many health care providers are unfamiliar with the limited legal protections and resources provided to them after responding to an in-flight emergency. A 78-year-old woman lost consciousness and became pulseless onboard a commercial aircraft. No physician was available. A medical student responded and coordinated care with the flight crew, ground support physician, and other passengers. After receiving a packet (4 g) of sublingual sucrose and 1 L i.v. crystalloid, the patient regained pulses and consciousness. The medical student made the decision not to divert the aircraft based on the patient's initial response to therapy and, 45 min later, the patient had normal vital signs. Upon landing, she was met and taken by paramedics to the nearest emergency department for evaluation of her collapse. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians are the most qualified to assist in-flight emergencies, but they might not be aware of the medicolegal risks involved with in-flight care, the resources available, and the role of the flight crew in liability and decision making. This case, which involved a medical student who was not given explicit protection under Good Samaritan laws, illustrates the authority of the flight crew during these events and highlights areas of uncertainty in the legislation for volunteer medical professionals. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

40 CFR Table 7 to Subpart Zzzz of... - Requirements for Reports

Code of Federal Regulations, 2011 CFR

2011-07-01

... submit a ... The report must contain ... You must submit the report ... 1. Existing non-emergency, non-black start stationary RICE 100 ≤ HP ≤ 500 located at a major source of HAP; existing non-emergency, non-black start stationary CI RICE > 500 HP located at a major source of HAP; existing non-emergency 4SRB...

40 CFR Table 7 to Subpart Zzzz of... - Requirements for Reports

Code of Federal Regulations, 2012 CFR

2012-07-01

... submit a ... The report must contain ... You must submit the report ... 1. Existing non-emergency, non-black start stationary RICE 100 ≤ HP ≤ 500 located at a major source of HAP; existing non-emergency, non-black start stationary CI RICE > 500 HP located at a major source of HAP; existing non-emergency 4SRB...

Iterated Prisoner’s Dilemma contains strategies that dominate any evolutionary opponent

PubMed Central

Press, William H.; Dyson, Freeman J.

2012-01-01

The two-player Iterated Prisoner’s Dilemma game is a model for both sentient and evolutionary behaviors, especially including the emergence of cooperation. It is generally assumed that there exists no simple ultimatum strategy whereby one player can enforce a unilateral claim to an unfair share of rewards. Here, we show that such strategies unexpectedly do exist. In particular, a player X who is witting of these strategies can (i) deterministically set her opponent Y’s score, independently of his strategy or response, or (ii) enforce an extortionate linear relation between her and his scores. Against such a player, an evolutionary player’s best response is to accede to the extortion. Only a player with a theory of mind about his opponent can do better, in which case Iterated Prisoner’s Dilemma is an Ultimatum Game. PMID:22615375

Emergency physician perceptions of shared decision-making.

PubMed

Kanzaria, Hemal K; Brook, Robert H; Probst, Marc A; Harris, Dustin; Berry, Sandra H; Hoffman, Jerome R

2015-04-01

Despite the potential benefits of shared decision-making (SDM), its integration into emergency care is challenging. Emergency physician (EP) perceptions about the frequency with which they use SDM, its potential to reduce medically unnecessary diagnostic testing, and the barriers to employing SDM in the emergency department (ED) were investigated. As part of a larger project examining beliefs on overtesting, questions were posed to EPs about SDM. Qualitative analysis of two multispecialty focus groups was done exploring decision-making around resource use to generate survey items. The survey was then pilot-tested and revised to focus on advanced diagnostic imaging and SDM. The final survey was administered to EPs recruited at four emergency medicine (EM) conferences and 15 ED group meetings. This report addresses responses regarding SDM. A purposive sample of 478 EPs from 29 states were approached, of whom 435 (91%) completed the survey. EPs estimated that, on average, multiple reasonable management options exist in over 50% of their patients and reported employing SDM with 58% of such patients. Respondents perceived SDM as a promising solution to reduce overtesting. However, despite existing research to the contrary, respondents also commonly cited beliefs that 1) "many patients prefer that the physician decides," 2) "when offered a choice, many patients opt for more aggressive care than they need," and 3) "it is too complicated for patients to know how to choose." Most surveyed EPs believe SDM is a potential high-yield solution to overtesting, but many perceive patient-related barriers to its successful implementation. © 2015 by the Society for Academic Emergency Medicine.

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

Uplifting Fear Appeals: Considering the Role of Hope in Fear-Based Persuasive Messages.

PubMed

Nabi, Robin L; Myrick, Jessica Gall

2018-01-09

Fear appeal research has focused, understandably, on fear as the primary emotion motivating attitude and behavior change. However, while the threat component of fear appeals associates with fear responses, a fear appeals' efficacy component likely associates with a different emotional experience: hope. Drawing from appraisal theories of emotion in particular, this article theorizes about the role of hope in fear appeals, testing hypotheses with two existing data sets collected within the context of sun safety messages. In both studies, significant interactions between hope and self-efficacy emerged to predict behavioral intentions. Notable main effects for hope also emerged, though with less consistency. Further, these effects persisted despite controlling for the four cognitions typically considered central to fear appeal effectiveness. These results, consistent across two samples, support the claim that feelings of hope in response to fear appeals contribute to their persuasive success. Implications for developing a recursive model of fear appeal processing are discussed.

Rational Design of Pathogen-Mimicking Amphiphilic Materials as Nanoadjuvants

NASA Astrophysics Data System (ADS)

Ulery, Bret D.; Petersen, Latrisha K.; Phanse, Yashdeep; Kong, Chang Sun; Broderick, Scott R.; Kumar, Devender; Ramer-Tait, Amanda E.; Carrillo-Conde, Brenda; Rajan, Krishna; Wannemuehler, Michael J.; Bellaire, Bryan H.; Metzger, Dennis W.; Narasimhan, Balaji

2011-12-01

An opportunity exists today for cross-cutting research utilizing advances in materials science, immunology, microbial pathogenesis, and computational analysis to effectively design the next generation of adjuvants and vaccines. This study integrates these advances into a bottom-up approach for the molecular design of nanoadjuvants capable of mimicking the immune response induced by a natural infection but without the toxic side effects. Biodegradable amphiphilic polyanhydrides possess the unique ability to mimic pathogens and pathogen associated molecular patterns with respect to persisting within and activating immune cells, respectively. The molecular properties responsible for the pathogen-mimicking abilities of these materials have been identified. The value of using polyanhydride nanovaccines was demonstrated by the induction of long-lived protection against a lethal challenge of Yersinia pestis following a single administration ten months earlier. This approach has the tantalizing potential to catalyze the development of next generation vaccines against diseases caused by emerging and re-emerging pathogens.

Molecular evolution and emergence of avian gammacoronaviruses.

PubMed

Jackwood, Mark W; Hall, David; Handel, Andreas

2012-08-01

Coronaviruses, which are single stranded, positive sense RNA viruses, are responsible for a wide variety of existing and emerging diseases in humans and other animals. The gammacoronaviruses primarily infect avian hosts. Within this genus of coronaviruses, the avian coronavirus infectious bronchitis virus (IBV) causes a highly infectious upper-respiratory tract disease in commercial poultry. IBV shows rapid evolution in chickens, frequently producing new antigenic types, which adds to the multiple serotypes of the virus that do not cross protect. Rapid evolution in IBV is facilitated by strong selection, large population sizes and high genetic diversity within hosts, and transmission bottlenecks between hosts. Genetic diversity within a host arises primarily by mutation, which includes substitutions, insertions and deletions. Mutations are caused both by the high error rate, and limited proof reading capability, of the viral RNA-dependent RNA-polymerase, and by recombination. Recombination also generates new haplotype diversity by recombining existing variants. Rapid evolution of avian coronavirus IBV makes this virus extremely difficult to diagnose and control, but also makes it an excellent model system to study viral genetic diversity and the mechanisms behind the emergence of coronaviruses in their natural host. Copyright © 2012 Elsevier B.V. All rights reserved.

Challenges of Managing Animals in Disasters in the U.S.

PubMed Central

Heath, Sebastian E.; Linnabary, Robert D.

2015-01-01

Simple Summary This article describes common challenges to managing animals in disasters in the US, summarizes how some of these challenges are being met and makes recommendations on how to overcome others. Many predictable adverse situations affecting animals and their owners can be prevented when communities develop a comprehensive emergency management strategy that integrates animal care into planning, preparedness, mitigation, and recovery activities, as well as response. Abstract Common to many of the repeated issues surrounding animals in disasters in the U.S. is a pre-existing weak animal health infrastructure that is under constant pressure resulting from pet overpopulation. Unless this root cause is addressed, communities remain vulnerable to similar issues with animals they and others have faced in past disasters. In the US the plight of animals in disasters is frequently viewed primarily as a response issue and frequently handled by groups that are not integrated with the affected community’s emergency management. In contrast, animals, their owners, and communities would greatly benefit from integrating animal issues into an overall emergency management strategy for the community. There is no other factor contributing as much to human evacuation failure in disasters that is under the control of emergency management when a threat is imminent as pet ownership. Emergency managers can take advantage of the bond people have with their animals to instill appropriate behavior amongst pet owners in disasters. PMID:26479228

Humanitarian response: improving logistics to save lives.

PubMed

McCoy, Jessica

2008-01-01

Each year, millions of people worldwide are affected by disasters, underscoring the importance of effective relief efforts. Many highly visible disaster responses have been inefficient and ineffective. Humanitarian agencies typically play a key role in disaster response (eg, procuring and distributing relief items to an affected population, assisting with evacuation, providing healthcare, assisting in the development of long-term shelter), and thus their efficiency is critical for a successful disaster response. The field of disaster and emergency response modeling is well established, but the application of such techniques to humanitarian logistics is relatively recent. This article surveys models of humanitarian response logistics and identifies promising opportunities for future work. Existing models analyze a variety of preparation and response decisions (eg, warehouse location and the distribution of relief supplies), consider both natural and manmade disasters, and typically seek to minimize cost or unmet demand. Opportunities to enhance the logistics of humanitarian response include the adaptation of models developed for general disaster response; the use of existing models, techniques, and insights from the literature on commercial supply chain management; the development of working partnerships between humanitarian aid organizations and private companies with expertise in logistics; and the consideration of behavioral factors relevant to a response. Implementable, realistic models that support the logistics of humanitarian relief can improve the preparation for and the response to disasters, which in turn can save lives.

Emerging strategies in the management of essential tremor

PubMed Central

Hedera, Peter

2016-01-01

Currently available therapies for essential tremor (ET) provide sufficient control only for less than a half of patients and many unmet needs exist. This is in part due to the empiric nature of existing treatment options and persisting uncertainties about the pathogenesis of ET. The emerging concept of ET as a possible neurodegenerative disorder, better understanding of associated biochemical changes, including alterations in the γ-aminobutyric acid (GABA)-ergic system and gap junctions, and the identification of the role of the leucine-rich repeat and immunoglobulin-like domain-containing 1 (LINGO-1) gene in ET pathogenesis suggest new avenues for more targeted therapies. Here we review the most promising new approaches to treating ET, including allosteric modulation of GABA receptors and modifications of the LINGO-1 pathway. Medically refractory tremor can be successfully treated by high-frequency deep brain stimulation (DBS) of the ventral intermediate nucleus, but surgical therapies are also fraught with limitations due to adverse effects of stimulation and the loss of therapeutic response. The selection of additional thalamic and extrathalamic targets for electrode placements and the development of a closed-loop DBS system enabling automatic adjustment of stimulation parameters in response to changes in electrophysiologic brain activity are also reviewed. Tremor cancellation methods using exoskeleton and external hand-held devices are also briefly discussed. PMID:28382111

Improving menstrual hygiene management in emergency contexts: literature review of current perspectives.

PubMed

VanLeeuwen, Crystal; Torondel, Belen

2018-01-01

Management of menstruation in contexts of humanitarian emergencies can be challenging. A lack of empirical research about effective interventions which improve menstrual hygiene management (MHM) among female populations in humanitarian emergencies and a lack of clarity about which sectors within a humanitarian response should deliver MHM interventions can both be attributable to the lack of clear guidance on design and delivery of culturally appropriate MHM intervention in settings of humanitarian emergencies. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts in order to describe the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations' menstrual needs. A structured-search strategy was conducted for peer-reviewed and gray literature to identify studies, published reports, guidelines, and policy papers related to menstrual response in emergency humanitarian contexts. Of the 51 articles included in the review, 16 were peer-reviewed papers and 35 were gray literature. Most of the literature agreed that hardware interventions should focus on the supply of adequate material (not only absorbent material but also other supportive material) and adequate sanitation facilities, with access to water and private space for washing, changing, drying, and disposing menstrual materials. Software interventions should focus on education in the usage of materials to manage menstruation hygienically and education about the female body's biological processes. There was clear agreement that the needs of the target population should be assessed before designing any intervention. Although there is insight about which factors should be included in an effective menstrual hygiene intervention, there is insufficient empirical evidence to establish which interventions are most effective in humanitarian emergencies and which sectors should be responsible for the coordination and implementation of such. Increased monitoring and evaluation studies of interventions should be completed and publicly shared, in order to feed evidence-based guidelines in the humanitarian sector.

Improving menstrual hygiene management in emergency contexts: literature review of current perspectives

PubMed Central

VanLeeuwen, Crystal; Torondel, Belen

2018-01-01

Management of menstruation in contexts of humanitarian emergencies can be challenging. A lack of empirical research about effective interventions which improve menstrual hygiene management (MHM) among female populations in humanitarian emergencies and a lack of clarity about which sectors within a humanitarian response should deliver MHM interventions can both be attributable to the lack of clear guidance on design and delivery of culturally appropriate MHM intervention in settings of humanitarian emergencies. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts in order to describe the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations’ menstrual needs. A structured-search strategy was conducted for peer-reviewed and gray literature to identify studies, published reports, guidelines, and policy papers related to menstrual response in emergency humanitarian contexts. Of the 51 articles included in the review, 16 were peer-reviewed papers and 35 were gray literature. Most of the literature agreed that hardware interventions should focus on the supply of adequate material (not only absorbent material but also other supportive material) and adequate sanitation facilities, with access to water and private space for washing, changing, drying, and disposing menstrual materials. Software interventions should focus on education in the usage of materials to manage menstruation hygienically and education about the female body’s biological processes. There was clear agreement that the needs of the target population should be assessed before designing any intervention. Although there is insight about which factors should be included in an effective menstrual hygiene intervention, there is insufficient empirical evidence to establish which interventions are most effective in humanitarian emergencies and which sectors should be responsible for the coordination and implementation of such. Increased monitoring and evaluation studies of interventions should be completed and publicly shared, in order to feed evidence-based guidelines in the humanitarian sector. PMID:29692636

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

The emergence of an ethical duty to disclose genetic research results: international perspectives.

PubMed

Knoppers, Bartha Maria; Joly, Yann; Simard, Jacques; Durocher, Francine

2006-11-01

The last decade has witnessed the emergence of international ethics guidelines discussing the importance of disclosing global and also, in certain circumstances, individual genetic research results to participants. This discussion is all the more important considering the advent of pharmacogenomics and the increasing incidence of 'translational' genetic research in the post-genomic era. We surveyed both the literature and the ethical guidelines using selective keywords. We then analyzed our data using a qualitative method approach and singled out countries or policies that were representative of certain positions. From our findings, we conclude that at the international level, there now exists an ethical duty to return individual genetic research results subject to the existence of proof of validity, significance and benefit. Even where these criteria are met, the right of the research participant not to know also has to be taken into consideration. The existence of an ethical duty to return individual genetic research results begs several other questions: Who should have the responsibility of disclosing such results and when? To whom should the results be disclosed? How? Finally, will this ethical 'imperative' become a legally recognized duty as well?

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.

Measures of emergency preparedness contributing to nursing home resilience.

PubMed

Lane, Sandi J; McGrady, Elizabeth

2017-12-13

Resilience approaches have been successfully applied in crisis management, disaster response, and high reliability organizations and have the potential to enhance existing systems of nursing home disaster preparedness. This study's purpose was to determine how the Center for Medicare and Medicaid Services (CMS) "Emergency Preparedness Checklist Recommended Tool for Effective Health Care Facility Planning" contributes to organizational resilience by identifying the benchmark resilience items addressed by the CMS Emergency Preparedness Checklist and items not addressed by the CMS Emergency Preparedness Checklist, and to recommend tools and processes to improve resilience for nursing homes. The CMS Emergency Preparedness Checklist items were compared to the Resilience Benchmark Tool items; similar items were considered matches. Resilience Benchmark Tool items with no CMS Emergency Preparedness Checklist item matches were considered breaches in nursing home resilience. The findings suggest that the CMS Emergency Preparedness Checklist can be used to measure some aspects of resilience, however, there were many resilience factors not addressed. For nursing homes to prepare and respond to crisis situations, organizations need to embrace a culture that promotes individual resilience-related competencies that when aggregated enable the organization to improve its resiliency. Social workers have the skills and experience to facilitate this change.

A Profile of Indian Health Service Emergency Departments.

PubMed

Bernard, Kenneth; Hasegawa, Kohei; Sullivan, Ashley; Camargo, Carlos

2017-06-01

The Indian Health Service provides health care to eligible American Indians and Alaskan Natives. No published data exist on emergency services offered by this unique health care system. We seek to determine the characteristics and capabilities of Indian Health Service emergency departments (EDs). All Indian Health Service EDs were surveyed about demographics and operational characteristics for 2014 with the National Emergency Department Inventory survey (available at http://www.emnet-nedi.org/). Of the forty eligible sites, there were 34 respondents (85% response rate). Respondents reported a total of 637,523 ED encounters, ranging from 521 to 63,200 visits per site. Overall, 85% (95% confidence interval 70% to 94%) had continuous physician coverage. Of all physicians staffing the ED, a median of 13% (interquartile range 0% to 50%) were board certified or board prepared in emergency medicine. Overall, 50% (95% confidence interval 34% to 66%) of respondents reported that their ED was operating over capacity. Indian Health Service EDs varied widely in visit volume, with many operating over capacity. Most were not staffed by board-certified or -prepared emergency physicians. Most lacked access to specialty consultation and telemedicine capabilities. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Exploring genetic responsibility for the self, family and kin in the case of hereditary raised cholesterol.

PubMed

Weiner, Kate

2011-06-01

This paper explores the notion of genetic responsibility, i.e. the responsibility to know and manage one's own genome for oneself and the sake of others, focusing particularly on responsibilities to family and kin. It also considers wider ideas about the emergence of new forms of biological subjectivities with which the concept of genetic responsibility is associated. The paper draws on a UK-based study concerned with lay constructions of familial hypercholesterolaemia (FH), a treatable inherited form of high cholesterol, which involved qualitative interviews with 31 people with the condition recruited through a specialist outpatient clinic. The paper is an attempt to open out discussions about the significance of genetic responsibility and biological subjectivity. I argue that in this study, FH was not associated with a notable family narrative of illness or a strongly defined specific disease community, and no clear sense emerged of obligations to kin or others derived through genetic risks or genetic connections. While responsibilities concerned with the welfare of oneself and one's existing offspring were enunciated, obligations to other potential or actual kin, e.g. to tell and encourage kin to manage their risks, were much less clearly defined. Drawing on these findings, I start to address questions about the pervasiveness of genetic responsibility and genetic identity and the contexts in which they might be significant. Copyright © 2010 Elsevier Ltd. All rights reserved.

Twenty-five years of HIV: lessons for low prevalence scenarios.

PubMed

Sawires, Sharif; Birnbaum, Nina; Abu-Raddad, Laith; Szekeres, Greg; Gayle, Jacob

2009-07-01

During the initial quarter century since the discovery of HIV, international response has focused on high prevalence scenarios and concentrated epidemics. Until recently, the theoretical underpinnings of HIV prevention were largely based on these responses-the assumption that inadequate responses to concentrated epidemics within low prevalence populations could rapidly lead to generalized epidemics. The limits of these assumptions for HIV prevention in low prevalence scenarios have become evident. While examples of rapid HIV diffusion in once low prevalence scenarios exist, emergence of generalized epidemics are less likely for much of the world. This paper reviews several key issues and advances in biomedical and behavioural HIV prevention to date and highlights relevance to low prevalence scenarios.

Emergency planning for sudden cardiac events in North Carolina high schools.

PubMed

Monroe, Anna; Rosenbaum, Daryl A; Davis, Stephen

2009-01-01

This study evaluates the state of emergency planning for sudden cardiac arrest (SCA) in North Carolina high schools, primarily focusing on the existence and characteristics of written plans and the presence of automated external defibrillators (AEDs). All athletic directors listed in the 2007-2008 North Carolina High School Athletic Association Directory were surveyed via an online survey to determine their level of planning and preparation for SCA. Completed surveys were received from 36.7% (138/376) of the schools. Emergency action plans (EAPs) existed in 55.8% (n = 77) of high schools and were significantly less likely to be present in Divisions 1 and 2 (p < 0.01) than in Divisions 3 and 4 which have higher enrollment. EAPs included aims to initiate CPR within one minute (80.5%), and targets to defibrillate within three-five minutes (66.2%) as recommended by recent guidelines from the National Athletic Trainers Association. AEDs were present in 72.5% (n = 100) of the responding schools, and the presence of an AED was related to the presence of an EAP (p < 0.01). Schools in Division 1 were less likely to possess an AED (p < 0.01) than schools in the larger divisions. Of schools without AEDs, 39.5% (n = 15) reported children or adults attending or working at the school who were at risk for heart disease. Lack of funding was the most commonly reported barrier to obtaining an AED. A low response rate and self-reported data may have biased results in favor of those who adopted plans or purchased an AED. The majority of responding schools possessed both an EAP and an AED and reported that they met several current recommended guidelines for emergency preparedness for SCA. These results for North Carolina high schools are similar to reports from other states. Significant room for improvement exists, however, as the number of schools without an EAP or AED is still relatively large and some important components of emergency planning are lacking in the EAPs.

Autonomous mission planning and scheduling: Innovative, integrated, responsive

NASA Technical Reports Server (NTRS)

Sary, Charisse; Liu, Simon; Hull, Larry; Davis, Randy

1994-01-01

Autonomous mission scheduling, a new concept for NASA ground data systems, is a decentralized and distributed approach to scientific spacecraft planning, scheduling, and command management. Systems and services are provided that enable investigators to operate their own instruments. In autonomous mission scheduling, separate nodes exist for each instrument and one or more operations nodes exist for the spacecraft. Each node is responsible for its own operations which include planning, scheduling, and commanding; and for resolving conflicts with other nodes. One or more database servers accessible to all nodes enable each to share mission and science planning, scheduling, and commanding information. The architecture for autonomous mission scheduling is based upon a realistic mix of state-of-the-art and emerging technology and services, e.g., high performance individual workstations, high speed communications, client-server computing, and relational databases. The concept is particularly suited to the smaller, less complex missions of the future.

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.

Network Analysis Identifies Proinflammatory Plasma Cell Polarization for Secretion of ISG15 in Human Autoimmunity

PubMed Central

Care, Matthew A.; Stephenson, Sophie J.; Barnes, Nicholas A.; Fan, Im; Zougman, Alexandre; El-Sherbiny, Yasser M.; Vital, Edward M.; Westhead, David R.; Tooze, Reuben M.

2016-01-01

Plasma cells (PCs) as effectors of humoral immunity produce Igs to match pathogenic insult. Emerging data suggest more diverse roles exist for PCs as regulators of immune and inflammatory responses via secretion of factors other than Igs. The extent to which such responses are preprogrammed in B-lineage cells or can be induced in PCs by the microenvironment is unknown. In this study, we dissect the impact of IFNs on the regulatory networks of human PCs. We show that core PC programs are unaffected, whereas PCs respond to IFNs with distinctive transcriptional responses. The IFN-stimulated gene 15 (ISG15) system emerges as a major transcriptional output induced in a sustained fashion by IFN-α in PCs and linked both to intracellular conjugation and ISG15 secretion. This leads to the identification of ISG15-secreting plasmablasts/PCs in patients with active systemic lupus erythematosus. Thus, ISG15-secreting PCs represent a distinct proinflammatory PC subset providing an Ig-independent mechanism of PC action in human autoimmunity. PMID:27357150

The development of global vaccine stockpiles.

PubMed

Yen, Catherine; Hyde, Terri B; Costa, Alejandro J; Fernandez, Katya; Tam, John S; Hugonnet, Stéphane; Huvos, Anne M; Duclos, Philippe; Dietz, Vance J; Burkholder, Brenton T

2015-03-01

Global vaccine stockpiles, in which vaccines are reserved for use when needed for emergencies or supply shortages, have effectively provided countries with the capacity for rapid response to emergency situations, such as outbreaks of yellow fever and meningococcal meningitis. The high cost and insufficient supply of many vaccines, including oral cholera vaccine and pandemic influenza vaccine, have prompted discussion on expansion of the use of vaccine stockpiles to address a wider range of emerging and re-emerging diseases. However, the decision to establish and maintain a vaccine stockpile is complex and must take account of disease and vaccine characteristics, stockpile management, funding, and ethical concerns, such as equity. Past experience with global vaccine stockpiles provide valuable information about the processes for their establishment and maintenance. In this Review we explored existing literature and stockpile data to discuss the lessons learned and to inform the development of future vaccine stockpiles. Copyright © 2015 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd. All rights reserved.

Investigation of a Graphical CONOPS Development Environment for Agile Systems Engineering

DTIC Science & Technology

2009-10-30

their first session, the team, using ACS, identifies potential stakeholders within the DHS, the CDC, state emergency response agencies, city governments ...variety of government and private sector institutions for new systems, modifications to existing systems and for mapping out operational strategies...irspace syst em," in 11th Confer ence on Aviation, Range, and Ae rospace, 2004, The Boeing Company and Lockheed Martin Corporation , " CONOPS for the syst

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

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...

77 FR 153 - Passenger Train Emergency Systems II

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-03

... emergency exits and the path to the nearest exit in the dark. Existing signage inside some passenger... and markings in the dark. Debriefing and Critique FRA is proposing a modification to the existing... standard satisfactorily addresses matters related to emergency signage, exit path marking, and egress...

Health systems organization for emergency care.

PubMed

Pedroto, Isabel; Amaro, Pedro; Romãozinho, José Manuel

2013-10-01

The increasing number of acute and severe digestive diseases presenting to hospital emergency departments, mainly related with an ageing population, demands an appropriate answer from health systems organization, taking into account the escalating pressure on cost reduction. However, patients expect and deserve a response that is appropriate, effective, efficient and safe. The huge variety of variables which can influence the evolution of such cases warranting intensive monitoring, and the coordination and optimization of a range of human and technical resources involved in the care of these high-risk patients, requires their admission in hospital units with conveniently equipped facilities, as is done for heart attack and stroke patients. Little information of gastroenterology emergencies as a function of structure, processes and outcome is available at the organizational level. Surveys that have been conducted in different countries just assess local treatment outcome and question the organizational structure and existing resources but its impact on the outcome is not clear. Most studies address the problem of upper gastrointestinal bleeding and the out-of-hours endoscopy services in the hospital setting. The demands placed on emergency (part of the overall continuum of care) are obvious, as are the needs for the efficient use of resources and processes to improve the quality of care, meaning data must cover the full care cycle. Gastrointestinal emergencies, namely gastrointestinal bleeding, must be incorporated into the overall emergency response as is done for heart attack and stroke. This chapter aims to provide a review of current literature/evidence on organizational health system models towards a better management of gastroenterology emergencies and proposes a research agenda. Copyright © 2013 Elsevier Ltd. All rights reserved.

Emergency health planning.

PubMed

HARDMAN, A C

1962-12-01

This paper outlines the development of emergency health planning as a function of government. Ten provinces have the basic responsibility for the organization, preparation and operation of medical, nursing, hospital and public health services in an emergency. The Department of National Health and Welfare is responsible for the provision of advice and assistance to the provincial and municipal governments in such matters. Eight provinces have now hired full-time planning staffs to co-ordinate the health planning of the Provincial Departments of Health and Provincial Emergency Measures Organization.Four major programs have been established. The first program provides for the continuity of leadership and guidance by health authorities at the federal, provincial and municipal level. Essential records have been developed and emergency legislation prepared. This program, however, will be of little use unless health services are organized at the municipal level. In this organizational program, advice and assistance have been provided to existing hospitals and departments of health in the conduct of disaster planning. The efforts of these agencies are co-ordinated by municipal health authorities into a community disaster plan. The third program deals with information and education of the general public and the health workers. This program is designed to make the family unit self-sufficient for up to seven days and the health worker prepared to undertake his emergency role. The first three programs are directed to the organization and training of manpower; the fourth program provides the necessary supplies. From the national medical stockpile of $18,000,000, some $12,000,000 has been received, packaged for long-term storage and distributed to regional depots across the country. To ensure their ready availability in time of emergency an agreement has been reached with seven provinces for the release of hospital disaster kits.

Emergency psychiatric care for children and adolescents: a literature review.

PubMed

Janssens, Astrid; Hayen, Sarah; Walraven, Vera; Leys, Mark; Deboutte, Dirk

2013-09-01

Over the years, increasing numbers of children and adolescents have sought help for acute psychiatric problems. The responses to this treatment-seeking behavior are heterogeneous in different settings and nations. This review aimed to provide an answer to the questions "which care should be offered to children and adolescents presenting with a psychiatric emergency or crisis and how should it be organized." We committed a literature review to find out if any recommendations can be made regarding the organization of emergency care for children and adolescents with acute mental health problems. The lack of a clear definition of emergencies or urgencies hampered this review; we note the differences between adult and child or adolescent psychiatry. The theoretical models of care found in the literature are built up from several process and structural components, which we describe in greater detail. Furthermore, we review the main service delivery models that exist for children and adolescents. Currently, emergency psychiatric care for children and adolescents is practiced within a wide range of care models. There is no consensus on recommended care or recommended setting for this population. More research is needed to make exact recommendations on the standardization of psychiatric care for young people in emergency settings.

Opportunistic immunisation in the emergency department: a survey of staff knowledge, opinion and practices.

PubMed

Philips, Leanne; Young, Jeanine; Williams, Lesley A; Cooke, Marie; Rickard, Claire

2014-05-01

The aim of this study was to identify (a) emergency department staff knowledge, opinion and practices in relation to childhood vaccines and opportunistic immunisation in the emergency department and (b) differences between nursing and medical staff knowledge, opinion and self reported practices. A self-administered, cross-sectional survey was offered to a convenience sample of medical and nursing staff (n=86) working in a tertiary paediatric emergency department. Variables of interest were described using frequencies and odds ratios to report differences between medical and nursing staff responses. An 87% survey response was achieved. The majority of staff agreed that childhood vaccines were safe (96%), effective (99%) and necessary (97%). Less than half (45%) of the staff correctly identified that there is no association between measles, mumps and rubella (MMR) vaccine and autism. Medical staff were more likely than nurses to disagree that giving multiple vaccines overloads the immune system (p<0.01), or that complementary therapies reduced the need for a child to be vaccinated (p<0.006). These knowledge deficits exist despite a reported awareness of immunisation resources. The majority (96%) of those surveyed reported that the Australian Immunisation Handbook was as a useful resource. Overall, the majority of staff agreed vaccines are safe, effective and necessary. This study highlighted that staff knowledge deficits and misconceptions about vaccines and vaccine management may be barriers to promoting opportunistic immunisation practices in ED. Copyright © 2014 College of Emergency Nursing Australasia Ltd. All rights reserved.

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

PubMed

Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas

2011-08-01

Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

Toward high value sensing: monolayer-protected metal nanoparticles in multivariable gas and vapor sensors.

PubMed

Potyrailo, Radislav A

2017-08-29

For detection of gases and vapors in complex backgrounds, "classic" analytical instruments are an unavoidable alternative to existing sensors. Recently a new generation of sensors, known as multivariable sensors, emerged with a fundamentally different perspective for sensing to eliminate limitations of existing sensors. In multivariable sensors, a sensing material is designed to have diverse responses to different gases and vapors and is coupled to a multivariable transducer that provides independent outputs to recognize these diverse responses. Data analytics tools provide rejection of interferences and multi-analyte quantitation. This review critically analyses advances of multivariable sensors based on ligand-functionalized metal nanoparticles also known as monolayer-protected nanoparticles (MPNs). These MPN sensing materials distinctively stand out from other sensing materials for multivariable sensors due to their diversity of gas- and vapor-response mechanisms as provided by organic and biological ligands, applicability of these sensing materials for broad classes of gas-phase compounds such as condensable vapors and non-condensable gases, and for several principles of signal transduction in multivariable sensors that result in non-resonant and resonant electrical sensors as well as material- and structure-based photonic sensors. Such features should allow MPN multivariable sensors to be an attractive high value addition to existing analytical instrumentation.

Chimpanzee adenoviral vectors as vaccines for outbreak pathogens

PubMed Central

2017-01-01

ABSTRACT The 2014–15 Ebola outbreak in West Africa highlighted the potential for large disease outbreaks caused by emerging pathogens and has generated considerable focus on preparedness for future epidemics. Here we discuss drivers, strategies and practical considerations for developing vaccines against outbreak pathogens. Chimpanzee adenoviral (ChAd) vectors have been developed as vaccine candidates for multiple infectious diseases and prostate cancer. ChAd vectors are safe and induce antigen-specific cellular and humoral immunity in all age groups, as well as circumventing the problem of pre-existing immunity encountered with human Ad vectors. For these reasons, such viral vectors provide an attractive platform for stockpiling vaccines for emergency deployment in response to a threatened outbreak of an emerging pathogen. Work is already underway to develop vaccines against a number of other outbreak pathogens and we will also review progress on these approaches here, particularly for Lassa fever, Nipah and MERS. PMID:29083948

Development of an accommodative smartphone app for medical guidelines in pediatric emergencies.

PubMed

Schmucker, Michael; Heid, Jörn; Haag, Martin

2014-01-01

One of the outcomes of a training concept for physicians and nurses concerning pediatric emergencies at the Heidelberg University Hospital was that the work and procedures in childhood emergencies could be simplified by replacing the existing paper-based guidelines with a smartphone app. Since the project funds for this were already used up, a group of students from the master program "Medical Informatics" of Heidelberg and Heilbronn Universities took over the development of the app. Particular attention was given to the need for compatibility with the variety of devices (device size and screen resolution) and platform independence. The guidelines themselves were scripted in HTML5, JavaScript and CSS (responsive web design); managed by a container programmed in Sencha Touch. Even though the app is not yet available in the App-Store due to the limited timeframe, the students gained a great deal of valuable experience in developing platform independent software for mobile devices.

Illustrating anticipatory life cycle assessment for emerging photovoltaic technologies.

PubMed

Wender, Ben A; Foley, Rider W; Prado-Lopez, Valentina; Ravikumar, Dwarakanath; Eisenberg, Daniel A; Hottle, Troy A; Sadowski, Jathan; Flanagan, William P; Fisher, Angela; Laurin, Lise; Bates, Matthew E; Linkov, Igor; Seager, Thomas P; Fraser, Matthew P; Guston, David H

2014-09-16

Current research policy and strategy documents recommend applying life cycle assessment (LCA) early in research and development (R&D) to guide emerging technologies toward decreased environmental burden. However, existing LCA practices are ill-suited to support these recommendations. Barriers related to data availability, rapid technology change, and isolation of environmental from technical research inhibit application of LCA to developing technologies. Overcoming these challenges requires methodological advances that help identify environmental opportunities prior to large R&D investments. Such an anticipatory approach to LCA requires synthesis of social, environmental, and technical knowledge beyond the capabilities of current practices. This paper introduces a novel framework for anticipatory LCA that incorporates technology forecasting, risk research, social engagement, and comparative impact assessment, then applies this framework to photovoltaic (PV) technologies. These examples illustrate the potential for anticipatory LCA to prioritize research questions and help guide environmentally responsible innovation of emerging technologies.

44 CFR 16.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the... facilities accessible to and usable by individuals with handicaps; (2) In the case of historic preservation...

Stochastic Coloured Petrinet Based Healthcare Infrastructure Interdependency Model

NASA Astrophysics Data System (ADS)

Nukavarapu, Nivedita; Durbha, Surya

2016-06-01

The Healthcare Critical Infrastructure (HCI) protects all sectors of the society from hazards such as terrorism, infectious disease outbreaks, and natural disasters. HCI plays a significant role in response and recovery across all other sectors in the event of a natural or manmade disaster. However, for its continuity of operations and service delivery HCI is dependent on other interdependent Critical Infrastructures (CI) such as Communications, Electric Supply, Emergency Services, Transportation Systems, and Water Supply System. During a mass casualty due to disasters such as floods, a major challenge that arises for the HCI is to respond to the crisis in a timely manner in an uncertain and variable environment. To address this issue the HCI should be disaster prepared, by fully understanding the complexities and interdependencies that exist in a hospital, emergency department or emergency response event. Modelling and simulation of a disaster scenario with these complexities would help in training and providing an opportunity for all the stakeholders to work together in a coordinated response to a disaster. The paper would present interdependencies related to HCI based on Stochastic Coloured Petri Nets (SCPN) modelling and simulation approach, given a flood scenario as the disaster which would disrupt the infrastructure nodes. The entire model would be integrated with Geographic information based decision support system to visualize the dynamic behaviour of the interdependency of the Healthcare and related CI network in a geographically based environment.

A synthetic method for atmospheric diffusion simulation and environmental impact assessment of accidental pollution in the chemical industry in a WEBGIS context.

PubMed

Ni, Haochen; Rui, Yikang; Wang, Jiechen; Cheng, Liang

2014-09-05

The chemical industry poses a potential security risk to factory personnel and neighboring residents. In order to mitigate prospective damage, a synthetic method must be developed for an emergency response. With the development of environmental numeric simulation models, model integration methods, and modern information technology, many Decision Support Systems (DSSs) have been established. However, existing systems still have limitations, in terms of synthetic simulation and network interoperation. In order to resolve these limitations, the matured simulation model for chemical accidents was integrated into the WEB Geographic Information System (WEBGIS) platform. The complete workflow of the emergency response, including raw data (meteorology information, and accident information) management, numeric simulation of different kinds of accidents, environmental impact assessments, and representation of the simulation results were achieved. This allowed comprehensive and real-time simulation of acute accidents in the chemical industry. The main contribution of this paper is that an organizational mechanism of the model set, based on the accident type and pollutant substance; a scheduling mechanism for the parallel processing of multi-accident-type, multi-accident-substance, and multi-simulation-model; and finally a presentation method for scalar and vector data on the web browser on the integration of a WEB Geographic Information System (WEBGIS) platform. The outcomes demonstrated that this method could provide effective support for deciding emergency responses of acute chemical accidents.

A Synthetic Method for Atmospheric Diffusion Simulation and Environmental Impact Assessment of Accidental Pollution in the Chemical Industry in a WEBGIS Context

PubMed Central

Ni, Haochen; Rui, Yikang; Wang, Jiechen; Cheng, Liang

2014-01-01

The chemical industry poses a potential security risk to factory personnel and neighboring residents. In order to mitigate prospective damage, a synthetic method must be developed for an emergency response. With the development of environmental numeric simulation models, model integration methods, and modern information technology, many Decision Support Systems (DSSs) have been established. However, existing systems still have limitations, in terms of synthetic simulation and network interoperation. In order to resolve these limitations, the matured simulation model for chemical accidents was integrated into the WEB Geographic Information System (WEBGIS) platform. The complete workflow of the emergency response, including raw data (meteorology information, and accident information) management, numeric simulation of different kinds of accidents, environmental impact assessments, and representation of the simulation results were achieved. This allowed comprehensive and real-time simulation of acute accidents in the chemical industry. The main contribution of this paper is that an organizational mechanism of the model set, based on the accident type and pollutant substance; a scheduling mechanism for the parallel processing of multi-accident-type, multi-accident-substance, and multi-simulation-model; and finally a presentation method for scalar and vector data on the web browser on the integration of a WEB Geographic Information System (WEBGIS) platform. The outcomes demonstrated that this method could provide effective support for deciding emergency responses of acute chemical accidents. PMID:25198686

Seismic instrumentation of buildings

USGS Publications Warehouse

Çelebi, Mehmet

2000-01-01

The purpose of this report is to provide information on how and why we deploy seismic instruments in and around building structures. The recorded response data from buildings and other instrumented structures can be and are being primarily used to facilitate necessary studies to improve building codes and therefore reduce losses of life and property during damaging earthquakes. Other uses of such data can be in emergency response situations in large urban environments. The report discusses typical instrumentation schemes, existing instrumentation programs, the steps generally followed in instrumenting a structure, selection and type of instruments, installation and maintenance requirements and data retrieval and processing issues. In addition, a summary section on how recorded response data have been utilized is included. The benefits from instrumentation of structural systems are discussed.

Enablers and Barriers to Community Engagement in Public Health Emergency Preparedness: A Literature Review.

PubMed

Ramsbottom, Anna; O'Brien, Eleanor; Ciotti, Lucrezio; Takacs, Judit

2018-04-01

Public health emergency preparedness (PHEP) all too often focusses only on institutional capabilities, including their technical expertise and political influence, while overlooking community capabilities. However, the success of institutional emergency preparedness plans depends upon communities and institutions working together to ensure successful anticipation, response and recovery. Broader community engagement is therefore recommended worldwide. This literature review was carried out to identify enablers and barriers to community and institutional synergies in emergency preparedness. Searches were undertaken across bibliographic databases and grey literature sources. The literature identified was qualitative in nature. A qualitative, 'best fit' framework approach using a pre-existing framework was used to analyse the literature, whereby themes were added and changed as analysis progressed. A working definition of community was identified, based on a 'whole community' approach, inclusive of the whole multitude of stakeholders including community residents and emergency management staff. Given the diversity in community make-up, the types of emergencies that could be faced, the socio-economic, environmental and political range of communities, there are no set practices that will be effective for all communities. The most effective way of engaging communities in emergency preparedness is context-dependent and the review did draw out some important key messages for institutions to consider.

Evaluation of the immunogenicity of the dabigatran reversal agent idarucizumab during Phase I studies

PubMed Central

Norris, Stephen; Ramael, Steven; Ikushima, Ippei; Haazen, Wouter; Harada, Akiko; Moschetti, Viktoria; Imazu, Susumu; Reilly, Paul A.; Lang, Benjamin; Stangier, Joachim

2017-01-01

Aims Idarucizumab, a humanized monoclonal anti‐dabigatran antibody fragment, is effective in emergency reversal of dabigatran anticoagulation. Pre‐existing and treatment‐emergent anti‐idarucizumab antibodies (antidrug antibodies; ADA) may affect the safety and efficacy of idarucizumab. This analysis characterized the pre‐existing and treatment‐emergent ADA and assessed their impact on the pharmacokinetics and pharmacodynamics (PK/PD) of idarucizumab. Methods Data were pooled from three Phase I, randomized, double‐blind idarucizumab studies in healthy Caucasian subjects; elderly, renally impaired subjects; and healthy Japanese subjects. In plasma sampled before and after idarucizumab dosing, ADA were detected and titrated using a validated electrochemiluminescence method. ADA epitope specificities were examined using idarucizumab and two structurally related molecules. Idarucizumab PK/PD data were compared for subjects with and without pre‐existing ADA. Results Pre‐existing ADA were found in 33 out of 283 individuals (11.7%), seven of whom had intermittent ADA. Titres of pre‐existing and treatment‐emergent ADA were low, estimated equivalent to <0.3% of circulating idarucizumab after a 5 g dose. Pre‐existing ADA had no impact on dose‐normalized idarucizumab maximum plasma levels and exposure and, although data were limited, no impact on the reversal of dabigatran‐induced anticoagulation by idarucizumab. Treatment‐emergent ADA were detected in 20 individuals (19 out of 224 treated [8.5%]; 1 out of 59 received placebo [1.7%]) and were transient in ten. The majority had specificity primarily toward the C‐terminus of idarucizumab. There were no adverse events indicative of immunogenic reactions. Conclusion Pre‐existing and treatment‐emergent ADA were present at extremely low levels relative to the idarucizumab dosage under evaluation. The PK/PD of idarucizumab appeared to be unaffected by the presence of pre‐existing ADA. PMID:28230262

U.S. Army War College Guide to National Security Issues. Volume 2. National Security Policy and Strategy

DTIC Science & Technology

2012-06-01

1998 National War College paper entitled “U.S. National Se- curity Structure: A New Model for the 21st Century” defines the national security community ...fueled by revolu- tions in communications and information management, the emergence of a truly global market and world economy, the primacy of economic...collection of information is estimated to average 1 hour per response, including the time for reviewing instructions , searching existing data sources

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

Early development and the emergence of individual differences in behavior among littermates of wild rabbit pups.

PubMed

Rödel, Heiko G; Bautista, Amando; Roder, Manuel; Gilbert, Caroline; Hudson, Robyn

2017-05-01

The ontogeny of associated individual differences in behavior and physiology during early postnatal life, and in particular the emergence of such differences among litter siblings, has been hardly explored in mammals under natural conditions. We studied such within-litter differences in behavior in European rabbit pups Oryctolagus cuniculus prior to weaning, and whether and how these differences co-varied with other individual characteristics such as postnatal body temperature and early growth. The study was conducted under semi-natural conditions in a colony of rabbits of wild origin, where the young were born and developed in nursery burrows. We equipped two siblings per litter with interscapular skin temperature loggers on postnatal day 2 and recorded temperature profiles for 48h. Individual body (skin) temperatures of pups within litters were repeatable across time, indicating the existence of consistent individual differences. Such differences within litters were associated with relative differences in pre-weaning growth, revealing that relatively warmer pups showed a greater increase in body mass during the nest period. Between postnatal days 12 and 17, after the pups had reached a developmental stage of greater mobility, we carried out different behavioral tests: a handling-restraint test, an open field test and a jump-down test from a platform. Individual responses in the former two tests were associated, as those pups showing a quicker struggling response to restraint during handling also exhibited greater exploratory activity in the open field. This correlation across contexts suggests the existence of personality types in wild rabbits at an early developmental stage. Furthermore, pups' behavioral responses were strongly associated with their relative within-litter body mass at testing. Animals with a lower body mass compared to their siblings showed a relatively quicker struggle response to handling restraint and covered a relatively larger distance in the open field, suggesting greater reactivity and responsiveness of relatively lighter pups in these tests. In contrast, relatively heavier pups jumped sooner from the platform, which may have been due to their greater physical maturation. In conclusion, our study shows that individual differences in behavior and associated differences in body temperature and growth are already present during early postnatal life, although such relationships can be easily overlooked, as they predominantly emerge as relative differences among littermates. Copyright © 2017 Elsevier Inc. All rights reserved.

The livelihoods of Haitian health-care providers after the january 2010 earthquake: a pilot study of the economic and quality-of-life impact of emergency relief.

PubMed

Haar, Rohini J; Naderi, Sassan; Acerra, John R; Mathias, Maxwell; Alagappan, Kumar

2012-03-02

An effective international response to a disaster requires cooperation and coordination with the existing infrastructure. In some cases, however, international relief efforts can compete with the local work force and affect the balance of health-care systems already in place. This study seeks to evaluate the impact of the international humanitarian response to the 12 January 2010 earthquake on Haitian health-care providers (HHP). Fifty-nine HHPs were surveyed in August of 2010 using a modified World Health Organization Quality of Life-Brief questionnaire (WHOQoL-B) that included questions on respondents' workload before the earthquake, immediately after, and presently. The study population consisted of physicians, nurses, and technicians at public hospitals, non-governmental organization (NGO) clinics, and private offices in Port-au-Prince, Haiti. Following the earthquake, public hospital and NGO providers reported a significant increase in their workload (15 of 17 and 22 of 26 respondents, respectively). Conversely, 12 of 16 private providers reported a significant decrease in workload (p < 0.0001). Although all groups reported working a similar number of hours prior to the earthquake (average 40 h/week), they reported working significantly different amounts following the earthquake. Public hospital and NGO providers averaged more than 50 h/week, and private providers averaged just over 33 h/week of employment (p < 0.001).Health-care providers working at public hospitals and NGOs, however, had significantly lower scores on the WHOQoL-B when answering questions about their environment (p < 0.001), and in open-ended responses often commented about the lack of potable water and poor access to toilets. Providers from all groups expressed dissatisfaction with the scope and quality of care provided at public hospitals and NGO clinics, as well as disappointment with the reduction in patient volume at private practices. The emergency medical response to the January 2010 earthquake in Haiti had the unintended consequence of poorly distributing work among HHPs. To create a robust health-care system in the long term while meeting short-term needs, humanitarian responses should seek to better integrate existing systems and involve local providers in the design and implementation of an emergency program.

An exploration of screening protocols for intimate partner violence in healthcare facilities: a qualitative study.

PubMed

Williams, Jessica R; Halstead, Valerie; Salani, Deborah; Koermer, Natasha

2017-08-01

Explore different methods by which intimate partner violence screening practices are implemented in clinic and emergency settings and better understand barriers and facilitators. Healthcare visits provide an opportunity for providers to identify and provide assistance to victims of intimate partner violence. However, wide variation exists in the implementation of screening and response protocols. In addition, providers experience barriers and facilitators to intimate partner violence screening and response. A comprehensive understanding of these factors is necessary to improve the role that providers play in detection and intervention of intimate partner violence. Qualitative descriptive research design. Sixteen healthcare facilities were recruited from a large metropolitan area in the USA. Data were collected through semi-structured, in-depth interviews with individuals knowledgeable about intimate partner violence screening and response within their facility. Data were analysed using directive content analysis. Major themes and patterns concerning intimate partner violence screening and response were identified within the following areas: procedural characteristics, barriers, facilitators and additional needs. Patient-provider communication and operational/facility characteristics emerged as critical aspects that impact the successful implementation of intimate partner violence screening and response programmes. Differences were found between clinic and emergency settings stemming from variations in health delivery models. Results provide important information on how healthcare facilities implement intimate partner violence screening and response, suggestions for practice improvement and directions for future interventions. Additional guidance is needed to ensure intimate partner violence identification, and response procedures are effective and tailored to needs of patients, providers and the facility. Nurses are in a strategic position to play a pivotal role in identification of and response to intimate partner violence. It is essential that nurses are cognizant of this, and understand the actions they can take to assist patients who have been victims of intimate partner violence. Recommendations on how to do this are provided. © 2016 John Wiley & Sons Ltd.

Patient-Centred Coordinated Care in Times of Emerging Diseases and Epidemics. Contribution of the IMIA Working Group on Patient Safety.

PubMed

Borycki, E; Cummings, E; Dexheimer, J W; Gong, Y; Kennebeck, S; Kushniruk, A; Kuziemsky, C; Saranto, K; Weber, J; Takeda, H

2015-08-13

In this paper the researchers describe how existing health information technologies (HIT) can be repurposed and new technologies can be innovated to provide patient-centered care to individuals affected by new and emerging diseases. The researchers conducted a focused review of the published literature describing how HIT can be used to support safe, patient-centred, coordinated care to patients who are affected by Ebola (an emerging disease). New and emerging diseases present opportunities for repurposing existing technologies and for stimulating the development of new HIT innovation. Innovative technologies may be developed such as new software used for tracking patients during new or emerging disease outbreaks or by repurposing and extending existing technologies so they can be used to support patients, families and health professionals who may have been exposed to a disease. The paper describes the development of new technologies and the repurposing and extension of existing ones (such as electronic health records) using the most recent outbreak of Ebola as an example.

42 CFR 51d.5 - How is an emergency determined to exist?

Code of Federal Regulations, 2014 CFR

2014-10-01

... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

42 CFR 51d.5 - How is an emergency determined to exist?

Code of Federal Regulations, 2012 CFR

2012-10-01

... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

42 CFR 51d.5 - How is an emergency determined to exist?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

42 CFR 51d.5 - How is an emergency determined to exist?

Code of Federal Regulations, 2013 CFR

2013-10-01

... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

Should cities hosting mass gatherings invest in public health surveillance and planning? Reflections from a decade of mass gatherings in Sydney, Australia

PubMed Central

Thackway, Sarah; Churches, Timothy; Fizzell, Jan; Muscatello, David; Armstrong, Paul

2009-01-01

Background Mass gatherings have been defined by the World Health Organisation as "events attended by a sufficient number of people to strain the planning and response resources of a community, state or nation". This paper explores the public health response to mass gatherings in Sydney, the factors that influenced the extent of deployment of resources and the utility of planning for mass gatherings as a preparedness exercise for other health emergencies. Discussion Not all mass gatherings of people require enhanced surveillance and additional response. The main drivers of extensive public health planning for mass gatherings reflect geographical spread, number of international visitors, event duration and political and religious considerations. In these instances, the implementation of a formal risk assessment prior to the event with ongoing daily review is important in identifying public health hazards. Developing and utilising event-specific surveillance to provide early-warning systems that address the specific risks identified through the risk assessment process are essential. The extent to which additional resources are required will vary and depend on the current level of surveillance infrastructure. Planning the public health response is the third step in preparing for mass gatherings. If the existing public health workforce has been regularly trained in emergency response procedures then far less effort and resources will be needed to prepare for each mass gathering event. The use of formal emergency management structures and co-location of surveillance and planning operational teams during events facilitates timely communication and action. Summary One-off mass gathering events can provide a catalyst for innovation and engagement and result in opportunities for ongoing public health planning, training and surveillance enhancements that outlasted each event. PMID:19735577

California Earthquake Clearinghouse: Advocating for, and Advancing, Collaboration and Technology Interoperability, Between the Scientific and Emergency Response Communities, to Produce Actionable Intelligence for Situational Awareness, and Decision Support

NASA Astrophysics Data System (ADS)

Rosinski, A.; Beilin, P.; Colwell, J.; Hornick, M.; Glasscoe, M. T.; Morentz, J.; Smorodinsky, S.; Millington, A.; Hudnut, K. W.; Penn, P.; Ortiz, M.; Kennedy, M.; Long, K.; Miller, K.; Stromberg, M.

2015-12-01

The Clearinghouse provides emergency management and response professionals, scientific and engineering communities with prompt information on ground failure, structural damage, and other consequences from significant seismic events such as earthquakes or tsunamis. Clearinghouse activations include participation from Federal, State and local government, law enforcement, fire, EMS, emergency management, public health, environmental protection, the military, public and non-governmental organizations, and private sector. For the August 24, 2014 S. Napa earthquake, over 100 people from 40 different organizations participated during the 3-day Clearinghouse activation. Every organization has its own role and responsibility in disaster response; however all require authoritative data about the disaster for rapid hazard assessment and situational awareness. The Clearinghouse has been proactive in fostering collaboration and sharing Essential Elements of Information across disciplines. The Clearinghouse-led collaborative promotes the use of standard formats and protocols to allow existing technology to transform data into meaningful incident-related content and to enable data to be used by the largest number of participating Clearinghouse partners, thus providing responding personnel with enhanced real-time situational awareness, rapid hazard assessment, and more informed decision-making in support of response and recovery. The Clearinghouse efforts address national priorities outlined in USGS Circular 1242, Plan to Coordinate NEHRP post-earthquake investigations and S. 740-Geospatial Data Act of 2015, Sen. Orrin Hatch (R-UT), to streamline and coordinate geospatial data infrastructure, maximizing geospatial data in support of the Robert T. Stafford Act. Finally, the US Dept. of Homeland Security, Geospatial Management Office, recognized Clearinghouse's data sharing efforts as a Best Practice to be included in the forthcoming 2015 HLS Geospatial Concept of Operations.

Should cities hosting mass gatherings invest in public health surveillance and planning? Reflections from a decade of mass gatherings in Sydney, Australia.

PubMed

Thackway, Sarah; Churches, Timothy; Fizzell, Jan; Muscatello, David; Armstrong, Paul

2009-09-08

Mass gatherings have been defined by the World Health Organisation as "events attended by a sufficient number of people to strain the planning and response resources of a community, state or nation". This paper explores the public health response to mass gatherings in Sydney, the factors that influenced the extent of deployment of resources and the utility of planning for mass gatherings as a preparedness exercise for other health emergencies. Not all mass gatherings of people require enhanced surveillance and additional response. The main drivers of extensive public health planning for mass gatherings reflect geographical spread, number of international visitors, event duration and political and religious considerations. In these instances, the implementation of a formal risk assessment prior to the event with ongoing daily review is important in identifying public health hazards.Developing and utilising event-specific surveillance to provide early-warning systems that address the specific risks identified through the risk assessment process are essential. The extent to which additional resources are required will vary and depend on the current level of surveillance infrastructure.Planning the public health response is the third step in preparing for mass gatherings. If the existing public health workforce has been regularly trained in emergency response procedures then far less effort and resources will be needed to prepare for each mass gathering event. The use of formal emergency management structures and co-location of surveillance and planning operational teams during events facilitates timely communication and action. One-off mass gathering events can provide a catalyst for innovation and engagement and result in opportunities for ongoing public health planning, training and surveillance enhancements that outlasted each event.

Modeling the Emergence of Lexicons in Homesign Systems

PubMed Central

Richie, Russell; Yang, Charles; Coppola, Marie

2014-01-01

It is largely acknowledged that natural languages emerge from not just human brains, but also from rich communities of interacting human brains (Senghas, 2005). Yet the precise role of such communities and such interaction in the emergence of core properties of language has largely gone uninvestigated in naturally emerging systems, leaving the few existing computational investigations of this issue at an artificial setting. Here we take a step towards investigating the precise role of community structure in the emergence of linguistic conventions with both naturalistic empirical data and computational modeling. We first show conventionalization of lexicons in two different classes of naturally emerging signed systems: (1) protolinguistic “homesigns” invented by linguistically isolated Deaf individuals, and (2) a natural sign language emerging in a recently formed rich Deaf community. We find that the latter conventionalized faster than the former. Second, we model conventionalization as a population of interacting individuals who adjust their probability of sign use in response to other individuals' actual sign use, following an independently motivated model of language learning (Yang 2002, 2004). Simulations suggest that a richer social network, like that of natural (signed) languages, conventionalizes faster than a sparser social network, like that of homesign systems. We discuss our behavioral and computational results in light of other work on language emergence, and other work of behavior on complex networks. PMID:24482343

Decontamination of mass casualties--re-evaluating existing dogma.

PubMed

Levitin, Howard W; Siegelson, Henry J; Dickinson, Stanley; Halpern, Pinchas; Haraguchi, Yoshikura; Nocera, Anthony; Turineck, David

2003-01-01

The events of 11 September 2001 became the catalyst for many to shift their disaster preparedness efforts towards mass-casualty incidents. Emergency responders, healthcare workers, emergency managers, and public health officials worldwide are being tasked to improve their readiness by acquiring equipment, providing training and implementing policy, especially in the area of mass-casualty decontamination. Accomplishing each of these tasks requires good information, which is lacking. Management of the incident scene and the approach to victim care varies throughout the world and is based more on dogma than scientific data. In order to plan effectively for and to manage a chemical, mass-casualty event, we must critically assess the criteria upon which we base our response. This paper reviews current standards surrounding the response to a release of hazardous materials that results in massive numbers of exposed human survivors. In addition, a significant effort is made to prepare an international perspective on this response. Preparations for the 24-hour threat of exposure of a community to hazardous material are a community responsibility for first-responders and the hospital. Preparations for a mass-casualty event related to a terrorist attack are a governmental responsibility. Reshaping response protocols and decontamination needs on the differences between vapor and liquid chemical threats can enable local responders to effectively manage a chemical attack resulting in mass casualties. Ensuring that hospitals have adequate resources and training to mount an effective decontamination response in a rapid manner is essential.

Measuring Workplace Climate in Community Clinics and Health Centers.

PubMed

Friedberg, Mark W; Rodriguez, Hector P; Martsolf, Grant R; Edelen, Maria O; Vargas Bustamante, Arturo

2016-10-01

The effectiveness of community clinics and health centers' efforts to improve the quality of care might be modified by clinics' workplace climates. Several surveys to measure workplace climate exist, but their relationships to each other and to distinguishable dimensions of workplace climate are unknown. To assess the psychometric properties of a survey instrument combining items from several existing surveys of workplace climate and to generate a shorter instrument for future use. We fielded a 106-item survey, which included items from 9 existing instruments, to all clinicians and staff members (n=781) working in 30 California community clinics and health centers, receiving 628 responses (80% response rate). We performed exploratory factor analysis of survey responses, followed by confirmatory factor analysis of 200 reserved survey responses. We generated a new, shorter survey instrument of items with strong factor loadings. Six factors, including 44 survey items, emerged from the exploratory analysis. Two factors (Clinic Workload and Teamwork) were independent from the others. The remaining 4 factors (staff relationships, quality improvement orientation, managerial readiness for change, and staff readiness for change) were highly correlated, indicating that these represented dimensions of a higher-order factor we called "Clinic Functionality." This 2-level, 6-factor model fit the data well in the exploratory and confirmatory samples. For all but 1 factor, fewer than 20 survey responses were needed to achieve clinic-level reliability >0.7. Survey instruments designed to measure workplace climate have substantial overlap. The relatively parsimonious item set we identified might help target and tailor clinics' quality improvement efforts.

Measuring Workplace Climate in Community Clinics and Health Centers

PubMed Central

Friedberg, Mark W.; Rodriguez, Hector P.; Martsolf, Grant; Edelen, Maria Orlando; Vargas-Bustamante, Arturo

2018-01-01

Background The effectiveness of community clinics and health centers’ efforts to improve the quality of care might be modified by clinics’ workplace climates. Several surveys to measure workplace climate exist, but their relationships to each other and to distinguishable dimensions of workplace climate are unknown. Objective To assess the psychometric properties of a survey instrument combining items from several existing surveys of workplace climate and to generate a shorter instrument for future use. Methods We fielded a 106-item survey, which included items from 9 existing instruments, to all clinicians and staff members (n=781) working in 30 California community clinics and health centers, receiving 628 responses (80% response rate). We performed exploratory factor analysis of survey responses, followed by confirmatory factor analysis of 200 reserved survey responses. We generated a new, shorter survey instrument of items with strong factor loadings. Results Six factors, including 44 survey items, emerged from the exploratory analysis. Two factors (Clinic Workload and Teamwork) were independent from the others. The remaining 4 factors (Staff Relationships, Quality Improvement Orientation, Managerial Readiness for Change, and Staff Readiness for Change) were highly correlated, indicating that these represented dimensions of a higher-order factor we called “Clinic Functionality.” This two-level, six-factor model fit the data well in the exploratory and confirmatory samples. For all but one factor, fewer than 20 survey responses were needed to achieve clinic-level reliability >0.7. Conclusion Survey instruments designed to measure workplace climate have substantial overlap. The relatively parsimonious item set we identified might help target and tailor clinics’ quality improvement efforts. PMID:27326549

Emergency physicians' risk attitudes in acute decompensated heart failure patients.

PubMed

McCausland, Julie B; Machi, Mari S; Yealy, Donald M

2010-01-01

Despite the existence of various clinical prediction rules, no data exist defining what frequency of death or serious nonfatal outcomes comprises a realistic "low-risk" group for clinicians. This exploratory study sought to identify emergency physicians' (EPs) definition of low-risk acute decompensated heart failure (ADHF) emergency department (ED) patients. Surveys were mailed to full-time physicians (n = 88) in a multihospital EP group in southwestern Pennsylvania between December 2004 and February 2005. Participation was voluntary, and each EP was asked to define low risk (low risk of all-cause 30-day death and low risk of either hospital death or other serious medical complications) and choose a risk threshold at which they might consider outpatient management for those with ADHF. A range of choices was offered (<0.5, <1, <2, <3, <4, and <5%), and demographic data were collected. The response rate was 80%. Physicians defined low risk both for all-cause 30-day death and for hospital death or other serious complications, at <1% (38.8 and 40.3%, respectively). The decision threshold to consider outpatient therapy was <0.5% risk both for all-cause 30-day death (44.6%) and for hospital death or serious medical complications (44.4%). Emergency physicians in this exploratory study define low-risk ADHF patients as having less than a 1% risk of 30-day death or inpatient death or complications. They state a desire to have and use an ADHF clinical prediction rule that can identify low-risk ADHF patients who have less than a 0.5% risk of 30-day death or inpatient death or complications. (c) 2010 by the Society for Academic Emergency Medicine.

Optimal qualifications, staffing and scope of practice for first responder nurses in disaster.

PubMed

Yin, Huahua; He, Haiyan; Arbon, Paul; Zhu, Jingci; Tan, Jing; Zhang, Limei

2012-01-01

To explore: the selection criteria for first responder nurses during disaster; scope of practice for disaster relief nurses; appropriate nurse - medical practitioner ratio at the disaster site. Nurses are key members of disaster response medical teams. A scarcity of literature exists relating to nurses attending disasters, their qualifications, experience, scope of practice and appropriate staffing ratios. Qualitative and quantitative data were collected via survey using self-developed questionnaires. Participants were 95 medical workers, who participated in emergency rescue teams following the 2008 Wenchuan earthquake in China. A response rate of 93·7% achieved. The questionnaire included questions relating to nurses: previous experience in disaster relief; scope of practice at the disaster site; optimal ratio of medical practitioners to nurses in disaster relief teams. Following a disaster, first responder nurses considered most suitable were those with at least three years clinical experience, particularly in the emergency department or having emergency rescue skills training. The scope of practice for disaster relief nurses was different to that of nurses working in a hospital. The majority of participants reported insufficient nurses during the relief effort, concluding the optimal ratio of medical practitioner to nurse should range between 1:1-1:2 depending on the task and situation. At the scene of disaster, the preferred first responder nurses were nurses: with emergency rescue training; experienced in the emergency department; with at least three years clinical experience. The scope of practice for first responder nurses needs to be extended. Appropriate nurse - medical practitioner ratios in responding medical teams is dependant on the specific medical requirements of the disaster. The recommendations made by this study provide a guide to ensure that nurses can contribute effectively as essential members of first responder emergency disaster relief teams. © 2011 Blackwell Publishing Ltd.

Designing Mobile Applications for Emergency Response: Citizens Acting as Human Sensors.

PubMed

Romano, Marco; Onorati, Teresa; Aedo, Ignacio; Diaz, Paloma

2016-03-19

When an emergency occurs, citizens can be a helpful support for the operation centers involved in the response activities. As witnesses to a crisis, they initially can share updated and detailed information about what is going on. Moreover, thanks to the current technological evolution people are able to quickly and easily gather rich information and transmit it through different communication channels. Indeed, modern mobile devices embed several sensors such as GPS receivers, Wi-Fi, accelerometers or cameras that can transform users into well-equipped human sensors. For these reasons, emergency organizations and small and medium enterprises have demonstrated a growing interest in developing smart applications for reporting any exceptional circumstances. In this paper, we present a practical study about this kind of applications for identifying both limitations and common features. Based on a study of relevant existent contributions in this area and our personal direct experience in developing and evaluating emergency management solutions, our aim is to propose several findings about how to design effective and efficient mobile emergency notification applications. For this purpose we have exploited the basic sensors of modern mobile devices and the users' aptitude for using them. The evaluation consists of a practical and a theoretical part. In the practical part, we have simulated a traffic accident as closely as possible to a real scenario, with a victim lying on the ground near a car in the middle of a street. For the theoretical part, we have interviewed some emergency experts for collecting their opinions about the utility of the proposed solution. Results from this evaluation phase confirm the positive impact that EN application have for both operators' and citizens' perspective. Moreover, we collected several findings useful for future design challenges in the same area, as shown in the final redesign of the proposed application.

Specialist availability in emergencies: contributions of response times and the use of ad hoc coverage in New York State.

PubMed

Rabin, Elaine; Patrick, Lisa

2016-04-01

Nationwide, hospitals struggle to maintain specialist on-call coverage for emergencies. We seek to further understand the issue by examining reliability of scheduled coverage and the role of ad hoc coverage when none is scheduled. An anonymous electronic survey of all emergency department (ED) directors of a large state. Overall and for 10 specialties, respondents were asked to estimate on-call coverage extent and "reliability" (frequency of emergency response in a clinically useful time frame: 2 hours), and use and effect of ad hoc emergency coverage to fill gaps. Descriptive statistics were performed using Fisher exact and Wilcoxon sign rank tests for significance. Contact information was obtained for 125 of 167 ED directors. Sixty responded (48%), representing 36% of EDs. Forty-six percent reported full on-call coverage scheduled for all specialties. Forty-six percent reported consistent reliability. Coverage and reliability were strongly related (P<.01; 33% reported both), and larger ED volume correlated with both (P<.01). Ninety percent of hospitals that had gaps in either employed ad hoc coverage, significantly improving coverage for 8 of 10 specialties. For all but 1 specialty, more than 20% of hospitals reported that specialists are "Never", "Rarely" or "Sometimes" reliable (more than 50% for cardiovascular surgery, hand surgery and ophthalmology). Significant holes in scheduled on-call specialist coverage are compounded by frequent unreliability of on-call specialists, but partially ameliorated by ad hoc specialist coverage. Regionalization may help because a 2-tiered system may exist: larger hospitals have more complete, reliable coverage. Better understanding of specialists' willingness to treat emergencies ad hoc without taking formal call will suggest additional remedies. Copyright © 2015 Elsevier Inc. All rights reserved.

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

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...

Initial experience in setting up a medical student first responder scheme in South Central England.

PubMed

Seligman, William H; Ganatra, Sameer; England, David; Black, John J M

2016-02-01

Prehospital emergency medicine (PHEM) is a recently recognised subspecialty of emergency medicine, and anaesthetics, intensive care and acute medicine, in the UK, and yet it receives little to no mention in many undergraduate medical curricula. However, there is growing interest in PHEM among medical students and junior doctors. Several programmes are in existence across the UK that serve to provide teaching and exposure of prehospital care to medical students and junior doctors. However, relatively few students are able to gain significant first-hand experience of treating patients in the prehospital phase. In this short report, we discuss our experience of launching the student first responder (SFR) scheme across three counties in the Thames Valley. Medical students are trained by the regional ambulance service and respond to life-threatening medical emergencies in an ambulance response vehicle. The scheme is likely to benefit the ambulance service by providing a wider pool of trained volunteer first responders able to attend to emergency calls, to benefit patients by providing a quick response at their time of need, and to benefit medical students by providing first-hand experience of medical emergencies in the community. In its first 15 months of operation, SFRs were dispatched to 343 incidents. This scheme can serve as a training model for other ambulance services and medical schools across the UK. 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/

The varieties of immunological experience: of pathogens, stress, and dendritic cells.

PubMed

Pulendran, Bali

2015-01-01

In the 40 years since their discovery, dendritic cells (DCs) have been recognized as central players in immune regulation. DCs sense microbial stimuli through pathogen-recognition receptors (PRRs) and decode, integrate, and present information derived from such stimuli to T cells, thus stimulating immune responses. DCs can also regulate the quality of immune responses. Several functionally specialized subsets of DCs exist, but DCs also display functional plasticity in response to diverse stimuli. In addition to sensing pathogens via PRRs, emerging evidence suggests that DCs can also sense stress signals, such as amino acid starvation, through ancient stress and nutrient sensing pathways, to stimulate adaptive immunity. Here, I discuss these exciting advances in the context of a historic perspective on the discovery of DCs and their role in immune regulation. I conclude with a discussion of emerging areas in DC biology in the systems immunology era and suggest that the impact of DCs on immunity can be usefully contextualized in a hierarchy-of-organization model in which DCs, their receptors and signaling networks, cell-cell interactions, tissue microenvironment, and the host macroenvironment represent different levels of the hierarchy. Immunity or tolerance can then be represented as a complex function of each of these hierarchies.

Emergency assessment of post-fire debris-flow hazards for the 2013 Powerhouse fire, southern California

USGS Publications Warehouse

Staley, Dennis M.; Smoczyk, Gregory M.; Reeves, Ryan R.

2013-01-01

Wildfire dramatically alters the hydrologic response of a watershed such that even modest rainstorms can produce dangerous flash floods and debris flows. Existing empirical models were used to predict the probability and magnitude of debris-flow occurrence in response to a 10-year recurrence interval rainstorm for the 2013 Powerhouse fire near Lancaster, California. Overall, the models predict a relatively low probability for debris-flow occurrence in response to the design storm. However, volumetric predictions suggest that debris flows that occur may entrain a significant volume of material, with 44 of the 73 basins identified as having potential debris-flow volumes between 10,000 and 100,000 cubic meters. These results suggest that even though the likelihood of debris flow is relatively low, the consequences of post-fire debris-flow initiation within the burn area may be significant for downstream populations, infrastructure, and wildlife and water resources. Given these findings, we recommend that residents, emergency managers, and public works departments pay close attention to weather forecasts and National-Weather-Service-issued Debris Flow and Flash Flood Outlooks, Watches, and Warnings and that residents adhere to any evacuation orders.

Stem/progenitor cells in pituitary organ homeostasis and tumourigenesis

PubMed Central

Manshaei, Saba

2018-01-01

Evidence for the presence of pituitary gland stem cells has been provided over the last decade using a combination of approaches including in vitro clonogenicity assays, flow cytometric side population analysis, immunohistochemical analysis and genetic approaches. These cells have been demonstrated to be able to self-renew and undergo multipotent differentiation to give rise to all hormonal lineages of the anterior pituitary. Furthermore, evidence exists for their contribution to regeneration of the organ and plastic responses to changing physiological demand. Recently, stem-like cells have been isolated from pituitary neoplasms raising the possibility that a cytological hierarchy exists, in keeping with the cancer stem cell paradigm. In this manuscript, we review the evidence for the existence of pituitary stem cells, their role in maintaining organ homeostasis and the regulation of their differentiation. Furthermore, we explore the emerging concept of stem cells in pituitary tumours and their potential roles in these diseases. PMID:28855316

A regional, market oriented governance for disaster management: A new planning approach.

PubMed

Blackstone, Erwin A; Hakim, Simon; Meehan, Brian

2017-10-01

This paper proposes a regional competitive governance and management of response and recovery from disasters. It presents problems experienced in major disasters, analyzes the failures, and suggests how a competitive system that relies on private and volunteer regional leaders, personnel, and capital can improve preparation, response and recovery efforts over the existing government system. A Public Choice approach is adopted to explain why government often fails, and how regional governance may be socially more efficient than the existing federal- state-local funded and managed disaster system. The paper suggests that the federal role might change from both funding and supplying aid in disasters to merely funding disaster recovery efforts. When a disaster occurs, available businesses and government resources in the region can be utilized under a competitive system. These resources could replace existing federal and state inventories and emergency personnel. An independent regionally controlled and managed council, which also develops its own financial resources, and local volunteer leaders are key for success. The paper suggests a new planning method that utilizes the statistical Factor Analysis methodology to derive an efficient organizational and functional model to confront disasters. Copyright © 2017 Elsevier Ltd. All rights reserved.

Disaster waste management: a review article.

PubMed

Brown, Charlotte; Milke, Mark; Seville, Erica

2011-06-01

Depending on their nature and severity, disasters can create large volumes of debris and waste. The waste can overwhelm existing solid waste management facilities and impact on other emergency response and recovery activities. If poorly managed, the waste can have significant environmental and public health impacts and can affect the overall recovery process. This paper presents a system overview of disaster waste management based on existing literature. The main literature available to date comprises disaster waste management plans or guidelines and isolated case studies. There is ample discussion on technical management options such as temporary storage sites, recycling, disposal, etc.; however, there is little or no guidance on how these various management options are selected post-disaster. The literature does not specifically address the impact or appropriateness of existing legislation, organisational structures and funding mechanisms on disaster waste management programmes, nor does it satisfactorily cover the social impact of disaster waste management programmes. It is envisaged that the discussion presented in this paper, and the literature gaps identified, will form a basis for future comprehensive and cohesive research on disaster waste management. In turn, research will lead to better preparedness and response to disaster waste management problems. Copyright © 2011 Elsevier Ltd. All rights reserved.

Disaster waste management: A review article

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

Brown, Charlotte, E-mail: charlotte.brown@pg.canterbury.ac.nz; Milke, Mark, E-mail: mark.milke@canterbury.ac.nz; Seville, Erica, E-mail: erica.seville@canterbury.ac.nz

2011-06-15

Depending on their nature and severity, disasters can create large volumes of debris and waste. The waste can overwhelm existing solid waste management facilities and impact on other emergency response and recovery activities. If poorly managed, the waste can have significant environmental and public health impacts and can affect the overall recovery process. This paper presents a system overview of disaster waste management based on existing literature. The main literature available to date comprises disaster waste management plans or guidelines and isolated case studies. There is ample discussion on technical management options such as temporary storage sites, recycling, disposal, etc.;more » however, there is little or no guidance on how these various management options are selected post-disaster. The literature does not specifically address the impact or appropriateness of existing legislation, organisational structures and funding mechanisms on disaster waste management programmes, nor does it satisfactorily cover the social impact of disaster waste management programmes. It is envisaged that the discussion presented in this paper, and the literature gaps identified, will form a basis for future comprehensive and cohesive research on disaster waste management. In turn, research will lead to better preparedness and response to disaster waste management problems.« less

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...

75 FR 31787 - Agency Information Collection Activities: Existing Collection; Emergency Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-04

... EQUAL EMPLOYMENT OPPORTUNITY COMMISSION Agency Information Collection Activities: Existing Collection; Emergency Extension AGENCY: Equal Employment Opportunity Commission. ACTION: Notice of... Paperwork Reduction Act, the Equal Employment Opportunity Commission (EEOC or Commission) announces that it...

Emerging Role of the Unfolded Protein Response in Tumor Immunosurveillance.

PubMed

Vanacker, Hélène; Vetters, Jessica; Moudombi, Lyvia; Caux, Christophe; Janssens, Sophie; Michallet, Marie-Cécile

2017-07-01

Disruption of endoplasmic reticulum (ER) homeostasis results in ER stress and activation of the unfolded protein response (UPR). This response alleviates cell stress, and is activated in both tumor cells and tumor infiltrating immune cells. The UPR plays a dual function in cancer biology, acting as a barrier to tumorigenesis at the premalignant stage, while fostering cancer maintenance in established tumors. In infiltrating immune cells, the UPR has been involved in both immunosurveillance and immunosuppressive functions. This review aims to decipher the role of the UPR at different stages of tumorigenesis and how the UPR shapes the balance between immunosurveillance and immune escape. This knowledge may improve existing UPR-targeted therapies and the design of novel strategies for cancer treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Neural systems implicated in obesity as an addictive disorder: from biological to behavioral mechanisms.

PubMed

Schulte, Erica M; Yokum, Sonja; Potenza, Marc N; Gearhardt, Ashley N

2016-01-01

Contributing factors to obesity have been identified, yet prevention and treatment efforts have had limited long-term success. It has recently been suggested that some individuals may experience an addictive-like response to certain foods, such as losing control over consumption and continued consumption despite negative consequences. In support, shared biological and behavioral features seem to exist between "food addiction" and traditional substance-use disorders. "Food addiction" may be another important contributor to obesity. The current chapter reviews existing literature regarding neural systems implicated similarly in obesity and addiction, discusses unique considerations for addictive-like eating, and proposes directions for future research regarding "food addiction" as an emerging construct for addiction medicine. © 2016 Elsevier B.V. All rights reserved.

Thermal shielding of an emerging active region

NASA Astrophysics Data System (ADS)

Régnier, S.

2012-08-01

Context. The interaction between emerging active regions and the pre-existing coronal magnetic field is important for better understanding the mechanisms of storage and release of magnetic energy from the convection zone to the high corona. Aims: We describe the first steps of an emerging active region within a pre-existing quiet-Sun corona in terms of the thermal and magnetic structure. Methods: We used unprecedented spatial, temporal and spectral coverage from the Atmospheric Imager Assembly (AIA) and from the Helioseismic and Magnetic Imager (HMI) on board the Solar Dynamics Observatory (SDO). Results: Starting on 30 May 2010 at 17:00 UT, we followed the emerging active region AR11076 within a quiet-Sun region for 8 h. Using several SDO/AIA filters that cover temperatures from 50 000 K to 10 MK, we show that the emerging process is characterised by a thermal shield at the interface between the emerging flux and pre-existing quiet-Sun corona. Conclusions: The active region 11076 is a peculiar example of an emerging active region because (i) the polarities emerge in a photospheric quiet-Sun region near a supergranular-like distribution, and (ii) the polarities that form the bipolar emerging structure do not rotate with respect to each other, which indicates a slight twist in the emerging flux bundle. There is a thermal shield at the interface between the emerging active region and the pre-existing quiet-Sun region. The thermal shielding structure deduced from all SDO/AIA channels is strongly asymmetric between the two polarities of the active region, suggesting that the heating mechanism for one polarity is probably magnetic reconnection, whilst it is caused by increasing magnetic pressure for the opposite polarity. Appendix A and two movies are available in electronic form at http://www.aanda.org

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.

A preliminary report on resident emergency psychiatry training from a survey of psychiatry chief residents.

PubMed

Bennett, Jeffrey I; Dzara, Kristina; Mazhar, Mir Nadeem; Behere, Aniruddh

2011-03-01

The Accreditation Council for Graduate Medical Education (ACGME) requirements stipulate that psychiatry residents need to be educated in the area of emergency psychiatry. Existing research investigating the current state of this training is limited, and no research to date has assessed whether the ACGME Residency Review Committee requirements for psychiatry residency training are followed by psychiatry residency training programs. We administered, to chief resident attendees of a national leadership conference, a 24-item paper survey on the types and amount of emergency psychiatry training provided by their psychiatric residency training programs. Descriptive statistics were used in the analysis. Of 154 surveys distributed, 111 were returned (72% response rate). Nearly one-third of chief resident respondents indicated that more than 50% of their program's emergency psychiatry training was provided during on-call periods. A minority indicated that they were aware of the ACGME program requirements for emergency psychiatry training. While training in emergency psychiatry occurred in many programs through rotations-different from the on-call period-direct supervision was available during on-call training only about one-third of the time. The findings suggest that about one-third of psychiatry residency training programs do not adhere to the ACGME standards for emergency psychiatry training. Enhanced knowledge of the ACGME requirements may enhance psychiatry residents' understanding on how their programs are fulfilling the need for more emergency psychiatry training. Alternative settings to the on-call period for emergency psychiatry training are more likely to provide for direct supervision.

Clinician Attitudes Toward Adoption of Pediatric Emergency Telemedicine in Rural Hospitals.

PubMed

Ray, Kristin N; Felmet, Kathryn A; Hamilton, Melinda F; Kuza, Courtney C; Saladino, Richard A; Schultz, Brian R; Watson, R Scott; Kahn, Jeremy M

2017-04-01

Although there is growing evidence regarding the utility of telemedicine in providing care for acutely ill children in underserved settings, adoption of pediatric emergency telemedicine remains limited, and little data exist to inform implementation efforts. Among clinician stakeholders, we examined attitudes regarding pediatric emergency telemedicine, including barriers to adoption in rural settings and potential strategies to overcome these barriers. Using a sequential mixed-methods approach, we first performed semistructured interviews with clinician stakeholders using thematic content analysis to generate a conceptual model for pediatric emergency telemedicine adoption. Based on this model, we then developed and fielded a survey to further examine attitudes regarding barriers to adoption and strategies to improve adoption. Factors influencing adoption of pediatric emergency telemedicine were identified and categorized into 3 domains: contextual factors (such as regional geography, hospital culture, and individual experience), perceived usefulness of pediatric emergency telemedicine, and perceived ease of use of pediatric emergency telemedicine. Within the domains of perceived usefulness and perceived ease of use, belief in the relative advantage of telemedicine was the most pronounced difference between telemedicine proponents and nonproponents. Strategies identified to improve adoption of telemedicine included patient-specific education, clinical protocols for use, decreasing response times, and simplifying the technology. More effective adoption of pediatric emergency telemedicine among clinicians will require addressing perceived usefulness and perceived ease of use in the context of local factors. Future studies should examine the impact of specific identified strategies on adoption of pediatric emergency telemedicine and patient outcomes in rural settings.

Transfusion service disaster planning.

PubMed

Bundy, K L; Foss, M L; Stubbs, J R

2008-01-01

The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is "in charge," planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.

Performance Assessment of Communicable Disease Surveillance in Disasters: A Systematic Review

PubMed Central

Babaie, Javad; Ardalan, Ali; Vatandoost, Hasan; Goya, Mohammad Mehdi; Akbarisari, Ali

2015-01-01

Background: This study aimed to identify the indices and frameworks that have been used to assess the performance of communicable disease surveillance (CDS) in response to disasters and other emergencies, including infectious disease outbreaks. Method: In this systematic review, PubMed, Google Scholar, Scopus, ScienceDirect, ProQuest databases and grey literature were searched until the end of 2013. All retrieved titles were examined in accordance with inclusion criteria. Abstracts of the relevant titles were reviewed and eligible abstracts were included in a list for data abstraction. Finally, the study variables were extracted. Results: Sixteen articles and one book were found relevant to our study objectives. In these articles, 31 criteria and 35 indicators were used or suggested for the assessment/evaluation of the performance of surveillance systems in disasters. The Centers for Disease Control (CDC) updated guidelines for the evaluation of public health surveillance systems were the most widely used. Conclusion: Despite the importance of performance assessment in improving CDS in response to disasters, there is a lack of clear and accepted frameworks. There is also no agreement on the use of existing criteria and indices. The only relevant framework is the CDC guideline, which is a common framework for assessing public health surveillance systems as a whole. There is an urgent need to develop appropriate frameworks, criteria, and indices for specifically assessing the performance of CDS in response to disasters and other emergencies, including infectious diseases outbreaks. Key words: Disasters, Emergencies, Communicable Diseases, Surveillance System, Performance Assessment PMID:25774323

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.

Use of after action reports (AARs) to promote organizational and systems learning in emergency preparedness.

PubMed

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

2012-08-01

Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The "lessons-learned" approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the "Lessons Learned Information Sharing (LLIS.gov)" system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strove to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed.

Use of human immunoglobulins as an anti-infective treatment: the experience so far and their possible re-emerging role.

PubMed

Bozzo, Jordi; Jorquera, Juan I

2017-06-01

Pooled human immunoglobulins (IGs) are prepared from plasma obtained from healthy donors as a concentrated antibody-containing solution. In addition, high-titer IGs (hyperimmune) against a specific pathogen can be obtained from vaccinated or convalescing donors. Currently, IGs can be used for the treatment of a variety of infections for which no specific therapy exists or that remain difficult to treat. Moreover, the recent pathogen outbreaks for which there is no approved treatment have renewed attention to the role of convalescent plasma and IGs. Areas covered: In this review, a historical perspective of the use of sera and IGs in humans as anti-infective agents (any viral, bacterial, parasitic infection), excluding immunodeficient patients, is presented from early development to the latest clinical studies. A Medline search was conducted to examine the peer-reviewed literature, with no date limits. Expert commentary: Human pooled plasma-derived IG products benefit from the polyclonal response of every individual donor and from the interindividual variability in such response. The trend to increased availability of vaccines for infectious diseases also opens new potential applications of hyperimmune IGs for emerging or re-emerging infectious diseases (e.g.: Ebola, Zika, Dengue), for the prevention and treatment in the general population, healthcare personnel and caregivers.

Use of After Action Reports (AARs) to Promote Organizational and Systems Learning in Emergency Preparedness

PubMed Central

Savoia, Elena; Agboola, Foluso; Biddinger, Paul D.

2012-01-01

Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The “lessons-learned” approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the “Lessons Learned Information Sharing (LLIS.gov)” system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strived to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed. PMID:23066408

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.

Automated external defibrillators in Washington State high schools

PubMed Central

Rothmier, Justin D; Drezner, Jonathan A; Harmon, Kimberly G

2007-01-01

Background The placement of automated external defibrillators (AEDs) in schools and public sporting venues is a growing national trend. Objective To determine the prevalence and use of AEDs in Washington State high schools and to examine the existing emergency preparedness for sudden cardiac arrest (SCA). Design Cross‐sectional survey. Setting High schools in Washington State. Participants The principal at each high school in the Washington Interscholastic Activities Association (n = 407) was invited to complete a web‐based questionnaire using the National Registry for AED Use in Sports (http://www.AEDSPORTS.com). Main outcome measurements The primary outcome measures studied included AED prevalence and location, funding for AEDs, AED training of school personnel, coordination of AED placement with local emergency response agencies, and prior AED use. Results 118 schools completed the survey (29% response rate). 64 (54%) of the schools have at least one AED on school grounds (mean 1.6, range 1–4). The likelihood of AED placement increased with larger school size (p = 0.044). 60% of AEDs were funded by donations, 27% by the school district and 11% by the school or athletic department itself. Coaches (78%) were the most likely to receive AED training, followed by administrators (72%), school nurses (70%) and teachers (48%). Only 25% of schools coordinated the implementation of AEDs with an outside medical agency and only 6% of schools coordinated with the local emergency medical system. One school reported having used an AED previously to treat SCA in a basketball official who survived after a single shock. The estimated probability of AED use to treat SCA was 1 in 154 schools per year. Conclusions Over half of Washington State high schools have an AED on school grounds. AED use occurred in <1% of schools annually and was effective in the treatment of SCA. Funding of AED programmes was mostly through private donations, with little coordination with local emergency response teams. Significant improvement is needed in structuring emergency response plans and training targeted rescuers for an SCA in the high‐school setting. PMID:17289857

How is the fitness landscaped upon which life evolves selected?

NASA Astrophysics Data System (ADS)

Deem, Michael

2008-03-01

We investigate the selective forces that promote the emergence of modularity in nature. We demonstrate the spontaneous emergence of modularity in a population of individuals that evolve in a changing environment. We show that the level of modularity correlates with the rapidity and severity of environmental change. The modularity arises as a synergistic response to the noise in the environment in the presence of horizontal gene transfer. We suggest that the hierarchical structure observed in the natural world may be a broken symmetry state, which generically results from evolution in a changing environment. The existence of such structure, therefore, need not necessarily rest on intelligent design or the anthropic principle. 1) J. Sun and M. W. Deem, Phys. Rev. Lett., to appear., arXiv:0710.3436

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.

Effective leadership within hospice and specialist palliative care units.

PubMed

Barker, L

2000-01-01

In this study the Repertory Grid interview technique was used to investigate constructs of leadership held by a group of male and female senior managers from within hospice and Specialist Palliative Care Units (SPCUs) in the UK. The themes that emerged were compared with those from existing research models of leadership. Men and women in these roles describe different constructs of effective leadership. The women's constructs that emerged were predominantly transformational, whilst the men's were predominantly transactional. Themes were also identified in this study, which differed from previous studied, i.e. those of political and environment awareness and the valuing of others' views regardless of their status. These themes do not feature highly in other research, and may be in response to the environment within which hospice and specialist palliative care functions.

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

44 CFR 6.72 - Effective date of new system of records or alteration of an existing system of records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Effective date of new system of records or alteration of an existing system of records. 6.72 Section 6.72 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL IMPLEMENTATION OF THE PRIVACY ACT OF 1974 Report on New...

75 FR 20429 - Amended Authorizations of Emergency Use of Certain Antiviral Drugs Zanamivir and Oseltamivir...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... public health emergency exists involving Swine Influenza A (now called 2009-H1N1 flu) that affects or has... Acting Secretary) determined that a public health emergency exists involving Swine Influenza A (now known as 2009 H1N1 Influenza A or 2009 H1N1 flu) that affects, or has the significant potential to affect...

A Review of State Public Health Emergency Declarations in Peru: 2014-2016.

PubMed

Bambarén, Celso; Alatrista, Maria Del Socorro

2018-04-01

Peru has different legal mechanisms of emergency, one of which is the Public Health Emergency that is applicable when: there is high-risk for, or the existence of an outbreak, epidemic, or pandemic; the occurrence of cases of a disease classified as eliminated or eradicated; the occurrence of emerging or re-emerging infectious diseases with high epidemic potential; the occurrence of rapid disseminated epidemics that simultaneously affect more than one department; as well as the existence of an event that affects the continuity of health services. From July 2014 to December 2016, 23 Public Health Emergencies were declared, out of which 57% were in the high-risk or existence of epidemics, 30% were due to some natural or anthropic events that generate a sudden decrease in the operative capacity of health services, and 13% were due to the existence of a rapid spreading epidemic that could affect more than one department in the country. The risk or occurrence of epidemiological outbreaks, mainly of Dengue, was the main cause of emergency declaration. One-hundred and forty million US dollars were allocated to implement the action plans that were part of the declaration, of which 72% was used to keep the operational capacity of health services and 28% to vector and epidemiological control measures. Bambarén C , Alatrista MdS . A review of state public health emergency declarations in Peru: 2014-2016. Prehosp Disaster Med. 2018;33(2):197-200.

Surface Response to Regional Uplift of Madagascar Reveals Short Wavelength Dynamic Topography

NASA Astrophysics Data System (ADS)

Stephenson, S.; White, N.

2016-12-01

The physiography of Madagascar is characterized by high elevation but low relief topography with 42% of the landscape at an elevation grgeater than 500 m. Eocene marine limestones crop out at an elevation of 400 m, extensive low relief erosion surfaces capped by laterites occur at elevations of up to 2 km, and longitudinal river profiles are disequilibrated. Together, these observations suggest that Madagascar underwent regional uplift in Neogene times. Inverse modeling of drainage networks suggests that regional uplift is diachronous and has occurred on wavelengths of 1000 km. The existence of deeply incised river channels together with low-temperature thermochronologic measurements (i.e. AFT, AHe) implies that erosion occurred in response to regional Neogene uplift. Admittance analysis of long wavelength free-air gravity and topography shows that admittance, Z = 45 ± 5 mGal/km. The history of Neogene volcanism and a lack of significant tectonic shortening both suggest that uplift is dynamically supported. Here we present a suite of U-Th dates of emergent coral reef deposits from northern Madagascar, whose margins are sometimes considered `stable'. Elevation of these coeval coral reefs decreases from 7.2 m at the northern tip of Madagascar to sea level 100 km to the south. The existence of a spatial gradient suggests that differential vertical motions occurred during Late Quaternary times. These results raise significant questions about the reliability both of emergent coral reefs as global sea-level markers and the length-scale of variations in dynamic topography.

Nutrition and sustainability: an emerging food policy discourse.

PubMed

Lang, Tim; Barling, David

2013-02-01

It is well known that food has a considerable environmental impact. Less attention has been given to mapping and analysing the emergence of policy responses. This paper contributes to that process. It summarises emerging policy development on nutrition and sustainability, and explores difficulties in their integration. The paper describes some policy thinking at national, European and international levels of governance. It points to the existence of particular policy hotspots such as meat and dairy, sustainable diets and waste. Understanding the environmental impact of food systems challenges nutrition science to draw upon traditions of thinking which have recently been fragmented. These perspectives (life sciences, social and environmental) are all required if policy engagement and clarification is to occur. Sustainability issues offer opportunities for nutrition science and scientists to play a more central role in the policy analysis of future food systems. The task of revising current nutrition policy advice to become sustainable diet advice needs to begin at national and international levels.

A Descriptive Analysis of US Prehospital Care Response to Law Enforcement Tactical Incidents.

PubMed

Aberle, Sara J; Lohse, Christine M; Sztajnkrycer, Matthew D

2015-01-01

Law enforcement tactical incidents involve high-risk operations that exceed the capabilities of regular, uniformed police. Despite the existence of tactical teams for 50 years, little is known about the frequency or nature of emergency medical services (EMS) response to tactical events in the United States. The purpose of this study was to perform a descriptive analysis of tactical events reported to a national EMS database. Descriptive analysis of the 2012 National Emergency Medical Services Information System (NEMSIS) Public Release research data set, containing EMS emergency response data from 41 states. A total of 17,479,328 EMS events were reported, of which 3,953 events were coded as "Activation-Tactical or SWAT Specialty Service/Response Team." The most common level of prehospital care present on scene was basic life support (55.2%). The majority (72.3%) of tactical incident activations involved a single patient; mass casualty incidents occurred in 0.5% of events. The most common EMS response locations were homes (48.4%), streets or highways (37.0%), and public buildings (6.3%). The mean age of treated patients was 44.1 years ± 22.0 years; 3.5% of tactical incident activation patients were aged 8 years or less. Injuries were coded as firearm assault in 14.8% and as chemical exposure in 8.9% of events. Cardiac arrest occurred in 5.1% of patients, with the majority (92.2%) occurring prior to EMS arrival. The primary symptoms reported by EMS personnel were pain (37.4%), change in responsiveness (13.1%), and bleeding (8.1%). Advanced airway procedures occurred in 30 patients. No patients were documented as receiving tourniquets or needle thoracostomy. Approximately 11 EMS responses in support of law enforcement tactical operations occur daily in the United States. The majority occur in homes and involve a single patient. Advanced airway procedures are required in a minority of patients. Cardiac arrest is rare and occurs prior to EMS response in the majority of cases. Better understanding of the nature and location of EMS responses to tactical incidents is required to develop consistent EMS policies in support of law enforcement tactical operations. 2015.

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.

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.

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.

Organisation of emergency transfer in maternity care in the Netherlands.

PubMed

Wiegers, Therese A; de Borst, Julia

2013-08-01

to gain more insight in the perceptions and experiences of care providers and clients with the organisation of emergency transfer in maternity care, with regard to transportation, responsibilities and communication between caregivers. in the Netherlands a woman with an uncomplicated pregnancy can choose to give birth at home, assisted by her own midwife. However, when complications arise, she needs to be referred to a hospital. In case of an emergency this referral must be effectuated quickly, often with ambulance support. a mixed methods' study consisting of semi-structured interviews and surveys. qualitative data of the current organisation of emergency transfer in maternity care, including experiences of caregivers were collected through 21 semi-structured interviews. On the basis of the qualitative data questionnaires for a survey were developed. These questionnaires were sent to 181 caregiver organisations and an unknown number of clients. The response among caregivers was 108 (60%), the response among clients was 42. the overall result from the interviews as well as from the questionnaires is that at the personal level cooperation is often adequate, but mostly informal. Care providers from different professions explained in the study that in emergency situations they usually know how to find each other but they are not always aware of existing agreements or protocols, are unsure of each other's competencies and do not always know what to expect from other care providers. Looking back at their experiences the majority of the clients responded that they were taken very good care of at the hospital. because transfer of care from one care provider to another during labour or birth is not unusual in the Dutch maternity care system it is necessary for care providers involved in this transfer to know and trust each other, to be able to give an adequate reaction when needed. Recommendations given are to devise a protocol for midwives when calling an ambulance dispatch centre, to improve the knowledge about each other, for instance by providing combined courses for emergency obstetrics, preferably at the regional level, so people who actually may work together can train together, and to improve the referral process from midwife to obstetrician. Copyright © 2013 Elsevier Ltd. All rights reserved.

Development of an automated speech recognition interface for personal emergency response systems

PubMed Central

Hamill, Melinda; Young, Vicky; Boger, Jennifer; Mihailidis, Alex

2009-01-01

Background Demands on long-term-care facilities are predicted to increase at an unprecedented rate as the baby boomer generation reaches retirement age. Aging-in-place (i.e. aging at home) is the desire of most seniors and is also a good option to reduce the burden on an over-stretched long-term-care system. Personal Emergency Response Systems (PERSs) help enable older adults to age-in-place by providing them with immediate access to emergency assistance. Traditionally they operate with push-button activators that connect the occupant via speaker-phone to a live emergency call-centre operator. If occupants do not wear the push button or cannot access the button, then the system is useless in the event of a fall or emergency. Additionally, a false alarm or failure to check-in at a regular interval will trigger a connection to a live operator, which can be unwanted and intrusive to the occupant. This paper describes the development and testing of an automated, hands-free, dialogue-based PERS prototype. Methods The prototype system was built using a ceiling mounted microphone array, an open-source automatic speech recognition engine, and a 'yes' and 'no' response dialog modelled after an existing call-centre protocol. Testing compared a single microphone versus a microphone array with nine adults in both noisy and quiet conditions. Dialogue testing was completed with four adults. Results and discussion The microphone array demonstrated improvement over the single microphone. In all cases, dialog testing resulted in the system reaching the correct decision about the kind of assistance the user was requesting. Further testing is required with elderly voices and under different noise conditions to ensure the appropriateness of the technology. Future developments include integration of the system with an emergency detection method as well as communication enhancement using features such as barge-in capability. Conclusion The use of an automated dialog-based PERS has the potential to provide users with more autonomy in decisions regarding their own health and more privacy in their own home. PMID:19583876

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...

The process of implementation of emergency care units in Brazil.

PubMed

O'Dwyer, Gisele; Konder, Mariana Teixeira; Reciputti, Luciano Pereira; Lopes, Mônica Guimarães Macau; Agostinho, Danielle Fernandes; Alves, Gabriel Farias

2017-12-11

To analyze the process of implementation of emergency care units in Brazil. We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the urgency network.

The process of implementation of emergency care units in Brazil

PubMed Central

O'Dwyer, Gisele; Konder, Mariana Teixeira; Reciputti, Luciano Pereira; Lopes, Mônica Guimarães Macau; Agostinho, Danielle Fernandes; Alves, Gabriel Farias

2017-01-01

ABSTRACT OBJECTIVE To analyze the process of implementation of emergency care units in Brazil. METHODS We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. RESULTS Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. CONCLUSIONS The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the urgency network. PMID:29236876

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.

Medical examiners, coroners, and biologic terrorism: a guidebook for surveillance and case management.

PubMed

Nolte, Kurt B; Hanzlick, Randy L; Payne, Daniel C; Kroger, Andrew T; Oliver, William R; Baker, Andrew M; McGowan, Dennis E; DeJong, Joyce L; Bell, Micahel R; Guarner, Jeannette; Shieh, Wun-Ju; Zaki, Sherif R

2004-06-11

Medical examiners and coroners (ME/Cs) are essential public health partners for terrorism preparedness and response. These medicolegal investigators support both public health and public safety functions and investigate deaths that are sudden, suspicious, violent, unattended, and unexplained. Medicolegal autopsies are essential for making organism-specific diagnoses in deaths caused by biologic terrorism. This report has been created to 1) help public health officials understand the role of ME/Cs in biologic terrorism surveillance and response efforts and 2) provide ME/Cs with the detailed information required to build capacity for biologic terrorism preparedness in a public health context. This report provides background information regarding biologic terrorism, possible biologic agents, and the consequent clinicopathologic diseases, autopsy procedures, and diagnostic tests as well as a description of biosafety risks and standards for autopsy precautions. ME/Cs' vital role in terrorism surveillance requires consistent standards for collecting, analyzing, and disseminating data. Familiarity with the operational, jurisdictional, and evidentiary concerns involving biologic terrorism-related death investigation is critical to both ME/Cs and public health authorities. Managing terrorism-associated fatalities can be expensive and can overwhelm the existing capacity of ME/Cs. This report describes federal resources for funding and reimbursement for ME/C preparedness and response activities and the limited support capacity of the federal Disaster Mortuary Operational Response Team. Standards for communication are critical in responding to any emergency situation. This report, which is a joint collaboration between CDC and the National Association of Medical Examiners (NAME), describes the relationship between ME/Cs and public health departments, emergency management agencies, emergency operations centers, and the Incident Command System.

Emergency Response of Iranian Hospitals Against Disasters: A Practical Framework for Improvement.

PubMed

Janati, Ali; Sadeghi-Bazargani, Homayoun; Hasanpoor, Edris; Sokhanvar, Mobin; HaghGoshyie, Elaheh; Salehi, Abdollah

2018-04-01

Hospital emergency management is a continuous process that requires monolithic integration of planning and response attempts with local and national schemes. The aim of the current study is to evaluate emergency response by hospitals against potential disasters in Tabriz, north-west Iran. A cross-sectional study was conducted in the city of Tabriz, in Iran, in 2016. The study population included all hospitals in Tabriz. A total of 18 hospitals were assessed. The hospital emergency response checklist was used to collect data. Tool components included command and control, communication, safety and security, triage, surge capacity, continuity of essential services, human resources, logistics and supply management, and post-disaster recovery. Data entry and analysis were carried out using SPSS software (version 20). The results showed that the emergency response rate of hospitals was 54.26% in Tabriz. The lowest response rates were for Shafaa hospital (18.89%) and the highest response rates were for Razi Hospital (91.67%). The components of hospital emergency response were assessed to be between 48.07% (surge capacity) and 58.95% (communication). On the basis of the World Health Organization checklist, the emergency response rate for hospitals in Tabriz was only 54.26%. Therefore, hospital emergency responses against disasters have to be improved and must be made to reach 100%. It is essential to design a comprehensive framework for hospital emergency response. (Disaster Med Public Health Preparedness. 2018;12:166-171).

An Alternative for Emergency Preemption of Traffic Lights

NASA Technical Reports Server (NTRS)

Foster, Conrad; Bachelder, Aaron

2006-01-01

An electronic communication-and-control system has been developed as a prototype of advanced means of automatically modifying the switching of traffic lights to give priority to emergency vehicles. This system could be used alternatively or in addition to other emergency traffic-light-preemption systems, including a variety of systems now in use as well as two proposed systems described in "Systems Would Preempt Traffic Lights for Emergency Vehicles" (NPO-30573), NASA Tech Briefs, Vol. 28, No. 10 (October 2004), page 36. Unlike those prior systems that depend on detection of sounds and/or lights emitted by emergency vehicles, this system is not subject to severe range limitations. This system can be retrofitted into any pre-existing traffic-light-control system, without need to modify that system other than to make a minimal number of wire connections between the two systems. This system comprises several subsystems, including a transponder and interface circuitry on each emergency vehicle, a monitoring and control unit at each intersection equipped with traffic lights, and a wide-area two-way radio communication network that connects the emergency vehicles and intersection units. Computers in the various intersections and vehicle units run special-purpose software that implements the traffic- light-preemption scheme. The operations of the intersection and vehicle units are synchronized by use of Global Positioning System (GPS) timing signals. The transponder in each vehicle estimates its own position and velocity by use of GPS signals, deductive ("dead") reckoning, data from the onboard diagnostic (OBD) computer of the vehicle, and/or triangulation of beacon signals. When the operator of an emergency vehicle turns on its flashing lights and sirens in response to a request for an emergency response, the transponder unit goes into action, reading the OBD data to determine speed and acceleration, and reading and gathering further navigational data as described above. The position, velocity, and acceleration data are combined with vehicle-identification data in a prescribed format, and the resulting set of data is transmitted to the intersections within communication range of the transponder.

Emergency Preparedness and Disaster Response: There's An App for That.

PubMed

Bachmann, Daniel J; Jamison, Nathan K; Martin, Andrew; Delgado, Jose; Kman, Nicholas E

2015-10-01

Smartphone applications (or apps) are becoming increasingly popular with emergency responders and health care providers, as well as the public as a whole. There are thousands of medical apps available for Smartphones and tablet computers, with more added each day. These include apps to view textbooks, guidelines, medication databases, medical calculators, and radiology images. Hypothesis/Problem With an ever expanding catalog of apps that relate to disaster medicine, it is hard for both the lay public and responders to know where to turn for effective Smartphone apps. A systematic review of these apps was conducted. A search of the Apple iTunes store (Version 12; Apple Inc.; Cupertino, California USA) was performed using the following terms obtained from the PubMed Medical Subject Headings Database: Emergency Preparedness, Emergency Responders, Disaster, Disaster Planning, Disaster Medicine, Bioterrorism, Chemical Terrorism, Hazardous Materials (HazMat), and the Federal Emergency Management Agency (FEMA). After excluding any unrelated apps, a working list of apps was formed and categorized based on topics. Apps were grouped based on applicability to responders, the lay public, or regional preparedness, and were then ranked based on iTunes user reviews, value, relevance to audience, and user interface. This search revealed 683 applications and was narrowed to 219 based on relevance to the field. After grouping the apps as described above, and subsequently ranking them, the highest quality apps were determined from each group. The Community Emergency Response Teams and FEMA had the best apps for National Disaster Medical System responders. The Centers for Disease Control and Prevention (CDC) had high-quality apps for emergency responders in a variety of fields. The National Library of Medicine's Wireless Information System for Emergency Responders (WISER) app was an excellent app for HazMat responders. The American Red Cross had the most useful apps for natural disasters. Numerous valuable apps for public use, including alert apps, educational apps, and a well-made regional app, were also identified. Smartphone applications are fast becoming essential to emergency responders and the lay public. Many high-quality apps existing in various price ranges and serving different populations were identified. This field is changing rapidly and it deserves continued analysis as more apps are developed.

49 CFR 211.45 - Petitions for emergency waiver of safety rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... imminent threat of, an emergency event or an emergency situation. For purposes of this section, the terms “emergency event” and “emergency situation” mean a natural or manmade disaster, such as a hurricane, flood... number. (c) Determining the existence of an emergency event or an emergency situation. If the...

A scalable healthcare information system based on a service-oriented architecture.

PubMed

Yang, Tzu-Hsiang; Sun, Yeali S; Lai, Feipei

2011-06-01

Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.

Airborne exposure limits for chemical and biological warfare agents: is everything set and clear?

PubMed

Sabelnikov, Alex; Zhukov, Vladimir; Kempf, C Ruth

2006-08-01

Emergency response strategies (guidelines) for biological, chemical, nuclear, or radiological terrorist events should be based on scientifically established exposure limits for all the agents or materials involved. In the case of a radiological terrorist event, emergency response guidelines (ERG) have been worked out. In the case of a terrorist event with the use of chemical warfare (CW) agents the situation is not that clear, though the new guidelines and clean-up values are being generated based on re-evaluation of toxicological and risk data. For biological warfare (BW) agents, such guidelines do not yet exist. In this paper the current status of airborne exposure limits (AELs) for chemical and biological warfare (CBW) agents are reviewed. Particular emphasis is put on BW agents that lack such data. An efficient, temporary solution to bridge the gap in experimental infectious data and to set provisional AELs for BW agents is suggested. It is based on mathematically generated risks of infection for BW agents grouped by their alleged ID50 values in three categories: with low, intermediate and high ID50 values.

Use of aspartame-based sweetener tablets in emergency dosimetry using EPR.

PubMed

Maghraby, A; Salama, E

2010-06-01

Accident dosimetry aims to evaluate the unplanned radiation doses delivered to individuals through one of the objects exist in the area of the accident. The gamma dose response of free radicals generated in irradiated aspartame tablets and its usability for emergency dosimetry was studied. EPR spectra of unirradiated and irradiated aspartame-based sweetener were recorded. Two signals arise after irradiating, S(1) at g (S(1)) = 2.00229 +/- 0.00097 and S(2) at g (S(2)) = 2.00262 +/- 0.00088. Some EPR parameters were studied for radiation-induced radicals in aspartame sweeteners tablets, such as the microwave saturation behaviour, the effect of magnetic field modulation amplitude on the peak-to-peak height and peak-to-peak line width for both of S(1) and S(2). Responses of S(1) and S(2) to different radiation doses were studied and resulted in linear relationships, radicals persistence curves were plotted over a 49-d storage period. It was found that Aspartame sweeteners tablets are useful in the range from 0.96 to 39.96 Gy. Radiation-induced radicals possess reasonable stability.

Ebola Preparedness Planning and Collaboration by Two Health Systems in Wisconsin, September to December 2014.

PubMed

Leonhardt, Kathryn Kraft; Keuler, Megan; Safdar, Nasia; Hunter, Paul

2016-08-01

We describe the collaborative approach used by 2 health systems in Wisconsin to plan and prepare for the threat of Ebola virus disease. This was a descriptive study of the preparedness planning, infection prevention, and collaboration with public health agencies undertaken by 2 health systems in Wisconsin between September and December 2014. The preparedness approach used by the 2 health systems relied successfully on their robust infrastructure for planning and infection prevention. In the setting of rapidly evolving guidance and unprecedented fear regarding Ebola, the 2 health systems enhanced their response through collaboration and coordination with each other and government public health agencies. Key lessons learned included the importance of a rigorous planning process, robust infection prevention practices, and coalitions between public and private health sectors. The potential threat of Ebola virus disease stimulated emergency preparedness in which acute care facilities played a leading role in the public health response. Leveraging the existing expertise of health systems is essential when faced with emerging infectious diseases. (Disaster Med Public Health Preparedness. 2016;10:691-697).

Evolution and Design Governing Signal Precision and Amplification in a Bacterial Chemosensory Pathway

PubMed Central

Espinosa, Leon; Baronian, Grégory; Molle, Virginie; Mauriello, Emilia M. F.; Brochier-Armanet, Céline; Mignot, Tâm

2015-01-01

Understanding the principles underlying the plasticity of signal transduction networks is fundamental to decipher the functioning of living cells. In Myxococcus xanthus, a particular chemosensory system (Frz) coordinates the activity of two separate motility systems (the A- and S-motility systems), promoting multicellular development. This unusual structure asks how signal is transduced in a branched signal transduction pathway. Using combined evolution-guided and single cell approaches, we successfully uncoupled the regulations and showed that the A-motility regulation system branched-off an existing signaling system that initially only controlled S-motility. Pathway branching emerged in part following a gene duplication event and changes in the circuit structure increasing the signaling efficiency. In the evolved pathway, the Frz histidine kinase generates a steep biphasic response to increasing external stimulations, which is essential for signal partitioning to the motility systems. We further show that this behavior results from the action of two accessory response regulator proteins that act independently to filter and amplify signals from the upstream kinase. Thus, signal amplification loops may underlie the emergence of new connectivity in signal transduction pathways. PMID:26291327

Corporate social responsibility for nanotechnology oversight.

PubMed

Kuzma, Jennifer; Kuzhabekova, Aliya

2011-11-01

Growing public concern and uncertainties surrounding emerging technologies suggest the need for socially-responsible behavior of companies in the development and implementation of oversight systems for them. In this paper, we argue that corporate social responsibility (CSR) is an important aspect of nanotechnology oversight given the role of trust in shaping public attitudes about nanotechnology and the lack of data about the health and environmental risks of nanoproducts. We argue that CSR is strengthened by the adoption of stakeholder-driven models and attention to moral principles in policies and programs. In this context, we examine drivers of CSR, contextual and leadership factors that influence CSR, and strategies for CSR. To illustrate these concepts, we discuss existing cases of CSR-like behavior in nanotechnology companies, and then provide examples of how companies producing nanomedicines can exhibit morally-driven CSR behavior.

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.

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

Design and development of a mobile system for supporting emergency triage.

PubMed

Michalowski, W; Slowinski, R; Wilk, S; Farion, K J; Pike, J; Rubin, S

2005-01-01

Our objective was to design and develop a mobile clinical decision support system for emergency triage of different acute pain presentations. The system should interact with existing hospital information systems, run on mobile computing devices (handheld computers) and be suitable for operation in weak-connectivity conditions (with unstable connections between mobile clients and a server). The MET (Mobile Emergency Triage) system was designed following an extended client-server architecture. The client component, responsible for triage decision support, is built as a knowledge-based system, with domain ontology separated from generic problem solving methods and used for the automatic creation of a user interface. The MET system is well suited for operation in the Emergency Department of a hospital. The system's external interactions are managed by the server, while the MET clients, running on handheld computers are used by clinicians for collecting clinical data and supporting triage at the bedside. The functionality of the MET client is distributed into specialized modules, responsible for triaging specific types of acute pain presentations. The modules are stored on the server, and on request they can be transferred and executed on the mobile clients. The modular design provides for easy extension of the system's functionality. A clinical trial of the MET system validated the appropriateness of the system's design, and proved the usefulness and acceptance of the system in clinical practice. The MET system captures the necessary hospital data, allows for entry of patient information, and provides triage support. By operating on handheld computers, it fits into the regular emergency department workflow without introducing any hindrances or disruptions. It supports triage anytime and anywhere, directly at the point of care, and also can be used as an electronic patient chart, facilitating structured data collection.

Music training relates to the development of neural mechanisms of selective auditory attention.

PubMed

Strait, Dana L; Slater, Jessica; O'Connell, Samantha; Kraus, Nina

2015-04-01

Selective attention decreases trial-to-trial variability in cortical auditory-evoked activity. This effect increases over the course of maturation, potentially reflecting the gradual development of selective attention and inhibitory control. Work in adults indicates that music training may alter the development of this neural response characteristic, especially over brain regions associated with executive control: in adult musicians, attention decreases variability in auditory-evoked responses recorded over prefrontal cortex to a greater extent than in nonmusicians. We aimed to determine whether this musician-associated effect emerges during childhood, when selective attention and inhibitory control are under development. We compared cortical auditory-evoked variability to attended and ignored speech streams in musicians and nonmusicians across three age groups: preschoolers, school-aged children and young adults. Results reveal that childhood music training is associated with reduced auditory-evoked response variability recorded over prefrontal cortex during selective auditory attention in school-aged child and adult musicians. Preschoolers, on the other hand, demonstrate no impact of selective attention on cortical response variability and no musician distinctions. This finding is consistent with the gradual emergence of attention during this period and may suggest no pre-existing differences in this attention-related cortical metric between children who undergo music training and those who do not. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Population density and racial differences in the performance of emergency medical services.

PubMed

David, Guy; Harrington, Scott E

2010-07-01

This paper analyzes the existence and scope of possible racial differences/disparities in the provision of emergency medical services (EMS) response capability (time from dispatch to arrival at the scene and level of training of the responding team) using data on approximately 120,000 cardiac incidents in the state of Mississippi during 1995-2004. The conceptual framework and empirical analysis focus on the likely effects of population density on the efficient production of EMS as a local public good subject to congestion, and on the need to control adequately for population density to avoid bias in testing for racial differences. Models that control for aggregate population density at the county-level indicate "reverse" disparities: faster estimated response times for African-Americans than for whites. When a refined county-level measure of population density is used that incorporates differences in African-American and white population density by Census tract, the reverse disparity in response times disappears. There also is little or no evidence of race-related differences in the certification level of EMS responders. However, there is evidence that, controlling for response time, African-Americans on average were significantly more likely to be deceased than whites upon EMS arrival at the scene. The overall results are germane to the debate over the scope of conditioning variables that should be included when testing for racial disparities in health care.

78 FR 14592 - Proposed Extension of Existing Information Collection; Emergency Mine Evacuation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... DEPARTMENT OF LABOR Mine Safety and Health Administration [OMB Control No. 1219-0141] Proposed Extension of Existing Information Collection; Emergency Mine Evacuation AGENCY: Mine Safety and Health... requirements on respondents can be properly assessed. Currently, the Mine Safety and Health Administration is...

Where is the evidence for emergency planning: a scoping review.

PubMed

Challen, Kirsty; Lee, Andrew C K; Booth, Andrew; Gardois, Paolo; Woods, Helen Buckley; Goodacre, Steve W

2012-07-23

Recent terrorist attacks and natural disasters have led to an increased awareness of the importance of emergency planning. However, the extent to which emergency planners can access or use evidence remains unclear. The aim of this study was to identify, analyse and assess the location, source and quality of emergency planning publications in the academic and UK grey literature. We conducted a scoping review, using as data sources for academic literature Embase, Medline, Medline in Process, Psychinfo, Biosis, Science Citation Index, Cinahl, Cochrane library and Clinicaltrials.gov. For grey literature identification we used databases at the Health Protection Agency, NHS Evidence, British Association of Immediate Care Schemes, Emergency Planning College and the Health and Safety Executive, and the websites of UK Department of Health Emergency Planning Division and UK Resilience.Aggregative synthesis was used to analyse papers and documents against a framework based on a modified FEMA Emergency Planning cycle. Of 2736 titles identified from the academic literature, 1603 were relevant. 45% were from North America, 27% were commentaries or editorials and 22% were event reports.Of 192 documents from the grey literature, 97 were relevant. 76% of these were event reports.The majority of documents addressed emergency planning and response. Very few documents related to hazard analysis, mitigation or capability assessment. Although a large body of literature exists, its validity and generalisability is unclear There is little evidence that this potential evidence base has been exploited through synthesis to inform policy and practice. The type and structure of evidence that would be of most value of emergency planners and policymakers has yet to be identified.

Hidden phase in parent Fe-pnictide superconductors

NASA Astrophysics Data System (ADS)

Ali, Khadiza; Adhikary, Ganesh; Thakur, Sangeeta; Patil, Swapnil; Mahatha, Sanjoy K.; Thamizhavel, A.; De Ninno, Giovanni; Moras, Paolo; Sheverdyaeva, Polina M.; Carbone, Carlo; Petaccia, Luca; Maiti, Kalobaran

2018-02-01

We investigate the origin of exoticity in Fe-based systems via studying the fermiology of CaFe2As2 employing angle-resolved photoemission spectroscopy. While the Fermi surfaces (FSs) at 200 K and 31 K are observed to exhibit two-dimensional and three-dimensional (3D) topology, respectively, the FSs at intermediate temperatures reveal the emergence of the 3D topology at a temperature much lower than the structural and magnetic phase transition temperature (170 K, for the sample under scrutiny). This leads to the conclusion that the evolution of FS topology is not directly driven by the structural transition. In addition, we discover the existence in ambient conditions of energy bands related to the cT phase. These bands are distinctly resolved in the high-photon energy spectra exhibiting strong Fe 3 d character. They gradually move to higher binding energies due to thermal compression with cooling, leading to the emergence of 3D topology in the Fermi surface. These results reveal the so-far hidden existence of a cT phase under ambient conditions, which is argued to lead to quantum fluctuations responsible for the exotic electronic properties in Fe-pnictide superconductors.

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...

Edge Singularities and Quasilong-Range Order in Nonequilibrium Steady States.

PubMed

De Nardis, Jacopo; Panfil, Miłosz

2018-05-25

The singularities of the dynamical response function are one of the most remarkable effects in many-body interacting systems. However in one dimension these divergences only exist strictly at zero temperature, making their observation very difficult in most cold atomic experimental settings. Moreover the presence of a finite temperature destroys another feature of one-dimensional quantum liquids: the real space quasilong-range order in which the spatial correlation functions exhibit power-law decay. We consider a nonequilibrium protocol where two interacting Bose gases are prepared either at different temperatures or chemical potentials and then joined. We show that the nonequilibrium steady state emerging at large times around the junction displays edge singularities in the response function and quasilong-range order.

Edge Singularities and Quasilong-Range Order in Nonequilibrium Steady States

NASA Astrophysics Data System (ADS)

De Nardis, Jacopo; Panfil, Miłosz

2018-05-01

The singularities of the dynamical response function are one of the most remarkable effects in many-body interacting systems. However in one dimension these divergences only exist strictly at zero temperature, making their observation very difficult in most cold atomic experimental settings. Moreover the presence of a finite temperature destroys another feature of one-dimensional quantum liquids: the real space quasilong-range order in which the spatial correlation functions exhibit power-law decay. We consider a nonequilibrium protocol where two interacting Bose gases are prepared either at different temperatures or chemical potentials and then joined. We show that the nonequilibrium steady state emerging at large times around the junction displays edge singularities in the response function and quasilong-range order.

Water Interfaces, Solvation, and Spectroscopy

NASA Astrophysics Data System (ADS)

Geissler, Phillip L.

2013-04-01

Liquid water consistently expands our appreciation of the rich statistical mechanics that can emerge from simple molecular constituents. Here I review several interrelated areas of recent work on aqueous systems that aim to explore and explain this richness by revealing molecular arrangements, their thermodynamic origins, and the timescales on which they change. Vibrational spectroscopy of OH stretching features prominently in these discussions, with an emphasis on efforts to establish connections between spectroscopic signals and statistics of intermolecular structure. For bulk solutions, the results of these efforts largely verify and enrich existing physical pictures of hydrogen-bond network connectivity, dynamics, and response. For water at interfaces, such pictures are still emerging. As an important example I discuss the solvation of small ions at the air-water interface, whose surface propensities challenge a basic understanding of how aqueous fluctuations accommodate solutes in heterogeneous environments.

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

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...

The responsible subject in the global age.

PubMed

Pulcini, Elena

2010-09-01

The first thesis of this article is that the concept of responsibility takes on an unprecedented meaning in the twentieth century resulting from the emergence of a new dimension of the other: to be responsible comes to mean not just to account for oneself in relation to the other, but also to take the other into account, to take care of the other-what I call responsibility towards (the other). The main reason for this change consists in the emergence of global risks and the necessity, as underlined by Hans Jonas, to be responsible for the destiny of the world and future generations. The problem, as explored in the article's second thesis, is that this implies the existence of a subject who is capable of responsibility. Jonas's insights on this point are insufficient, since he only recognizes duty as the fundament for his ethics of responsibility and thus neglects the problem of motivation. This is a particularly crucial problem today as we are witnessing the presence of a pathological subject, characterized by a split in his faculties (between doing and imagining, knowing and feeling). To underline this fact, this article makes use of Günther Anders's reflections, which provide a psycho-anthropological analysis of the subject, showing his pathologies and the necessity, from a moral perspective, to overcome his scission. Finally, this author suggests, as the article's third thesis, that this overcoming is the necessary fundament for the perception of risk, which in turn reinstates the subject's perception of his own vulnerability. Responsibility thus finds a motivation, which is neither altruistic nor duty-centred, in the awareness of our own vulnerability and the bond with the destiny of humankind as a whole.

18 CFR 376.208 - Effect upon existing Commission requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Effect upon existing Commission requirements. 376.208 Section 376.208 Conservation of Power and Water Resources FEDERAL ENERGY...; OPERATIONS DURING EMERGENCY CONDITIONS Commission Operation During Emergency Conditions § 376.208 Effect upon...

18 CFR 376.208 - Effect upon existing Commission requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Effect upon existing Commission requirements. 376.208 Section 376.208 Conservation of Power and Water Resources FEDERAL ENERGY...; OPERATIONS DURING EMERGENCY CONDITIONS Commission Operation During Emergency Conditions § 376.208 Effect upon...

18 CFR 376.208 - Effect upon existing Commission requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Effect upon existing Commission requirements. 376.208 Section 376.208 Conservation of Power and Water Resources FEDERAL ENERGY...; OPERATIONS DURING EMERGENCY CONDITIONS Commission Operation During Emergency Conditions § 376.208 Effect upon...

18 CFR 376.208 - Effect upon existing Commission requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Effect upon existing Commission requirements. 376.208 Section 376.208 Conservation of Power and Water Resources FEDERAL ENERGY...; OPERATIONS DURING EMERGENCY CONDITIONS Commission Operation During Emergency Conditions § 376.208 Effect upon...

18 CFR 376.208 - Effect upon existing Commission requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Effect upon existing Commission requirements. 376.208 Section 376.208 Conservation of Power and Water Resources FEDERAL ENERGY...; OPERATIONS DURING EMERGENCY CONDITIONS Commission Operation During Emergency Conditions § 376.208 Effect upon...

Development of Emergent Math and Literacy Skills.

ERIC Educational Resources Information Center

Malofeeva, Elena V.; Ciancio, Dennis; Day, Jeanne D.

The purpose of the present study was to determine whether individual differences in children's learning of emergent mathematics and literacy skills existed, and, if they did exist, whether they could be predicted from different child/environment characteristics. Eighty-one three- to five-year-old children took pretests, received training at four…

Scientific Visualization in Mathematics and Science Teaching.

ERIC Educational Resources Information Center

Thomas, David A., Ed.

Science and mathematics educators are expected to use existing educational technologies effectively and to keep informed about emerging technologies that might become important educational tools in the not-so-distant future. This monograph offers some help in that regard by highlighting a number of existing and emerging educational technologies.…

High intensity scenario training of military medical students to increase learning capacity and management of stress response.

PubMed

Mueller, Genevieve R; Moloff, Alan L; Wedmore, Ian S; Schoeff, Jonathan E; Laporta, Anthony J

2012-01-01

A delicate balance exists between a beneficial stress response that enhances memory and recall performance and a detrimental high stress response that impairs memory and learning. Repetitive training in stressful situations enables people to lower their stress levels from the detrimental range to a more beneficial one.1 This is particularly true for physicians in training as they seek to achieve advanced skills and knowledge in the fields of triage, emergency medicine, and surgery prior to graduation. This need is significant for medical students entering military service after graduation. We theorize that military medical students can advance their proficiencies through an Intensive Skills Week (ISW) prior to entering their third and forth year rotations. To test this theory, Rocky Vista University will hold a week long high-intensity first-responder, emergency medicine and surgical training course, facilitated by military medical physicians, to further students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). We also see the possible benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or not feasible. Stress, cortisol, medical student, enhanced learning, scenario, high intensity. 2012.

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

Musa, R. Abdullah; Heni, Siti; Harjanto, Meddy, E-mail: mharja@gmail.com

Sukowati site which is operated by Production Sharing Contract (PSC) Joint Operating Body Pertamina Petrochina East Java (JOB P-PEJ) located at Bojonegoro regency East Java Province. This site is close to densely populated settlements with approximately 6,010 people within a radius less than 600 m. The fluid produced have a dangerous potential to the above mention community, due to accompanying of hydrogen sulphide gas (H2S) with a concentration about 0.6% – 2% from the total gas produced. In 2006, there was incident of gas leak from drilling development well of Sukowati # 5. The incident made the surrounding community panicmore » due to lack of preparedness and awareness. Learning from the incident, the company together with the government and local communities initiated to make improvements through the disaster management system approach. The efforts are carried out in accordance with the 4 (four) periods in a continuous cycle consist of (1) mitigation; (2) preparation; (3) response and (4) recovery. Emergency response drills conducted regularly at least once a year, its main purpose is to find out the results of the implementation of the existing disaster management. The results of the drills showed an increase in public awareness and responsiveness to emergency situations caused by the operational failures of oil and gas exploration and production activities near their settlement.« less

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.

Metastability and emergent performance of dynamic interceptive actions.

PubMed

Pinder, Ross A; Davids, Keith; Renshaw, Ian

2012-09-01

Adaptive patterning of human movement is context specific and dependent on interacting constraints of the performer-environment relationship. Flexibility of skilled behaviour is predicated on the capacity of performers to move between different states of movement organisation to satisfy dynamic task constraints, previously demonstrated in studies of visual perception, bimanual coordination, and an interceptive combat task. Metastability is a movement system property that helps performers to remain in a state of relative coordination with their performance environments, poised between multiple co-existing states (stable and distinct movement patterns or responses). The aim of this study was to examine whether metastability could be exploited in externally paced interceptive actions in fast ball sports, such as cricket. Here we report data on metastability in performance of multi-articular hitting actions by skilled junior cricket batters (n=5). Participants' batting actions (key movement timings and performance outcomes) were analysed in four distinct performance regions varied by ball pitching (bounce) location. Results demonstrated that, at a pre-determined distance to the ball, participants were forced into a meta-stable region of performance where rich and varied patterns of functional movement behaviours emerged. Participants adapted the organisation of responses, resulting in higher levels of variability in movement timing in this performance region, without detrimental effects on the quality of interceptive performance outcomes. Findings provide evidence for the emergence of metastability in a dynamic interceptive action in cricket batting. Flexibility and diversity of movement responses were optimised using experiential knowledge and careful manipulation of key task constraints of the specific sport context. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Using an emergency response infrastructure to help women who experience gender-based violence in Gujarat, India.

PubMed

Newberry, Jennifer A; Mahadevan, Swaminatha; Gohil, Narendrasinh; Jamshed, Roma; Prajapati, Jashvant; Rao, Gv Ramana; Strehlow, Matthew

2016-05-01

Many women who experience gender-based violence may never seek any formal help because they do not feel safe or confident that they will receive help if they try. A public-private-academic partnership in Gujarat, India, established a toll-free telephone helpline - called 181 Abhayam - for women experiencing gender-based violence. The partnership used existing emergency response service infrastructure to link women to phone counselling, nongovernmental organizations (NGOs) and government programmes. In India, the lifetime prevalence of gender-based violence is 37.2%, but less than 1% of women will ever seek help beyond their family or friends. Before implementation of the helpline, there were no toll-free helplines or centralized coordinating systems for government programmes, NGOs and emergency response services. In February 2014, the helpline was launched across Gujarat. In the first 10 months, the helpline assisted 9767 individuals, of which 8654 identified themselves as women. Of all calls, 79% (7694) required an intervention by phone or in person on the day they called and 43% (4190) of calls were by or for women experiencing violence. Despite previous data that showed women experiencing gender-based violence rarely sought help from formal sources, women in Gujarat did use the helpline for concerns across the spectrum of gender-based violence. However, for evaluating the impact of the helpline, the operational definitions of concern categories need to be further clarified. The initial triage system for incoming calls was advantageous for handling high call volumes, but may have contributed to dropped calls.

Clinical handover of patients arriving by ambulance to the emergency department - a literature review.

PubMed

Bost, Nerolie; Crilly, Julia; Wallis, Marianne; Patterson, Elizabeth; Chaboyer, Wendy

2010-10-01

To provide a critical review of research on clinical handover between the ambulance service and emergency department (ED) in hospitals. Data base and hand searches were conducted using the keywords ambulance, handover, handoff, emergency department, emergency room, ER, communication, and clinical handover. Data were extracted, summarised and critically assessed to provide evidence of current clinical handover processes. From 252 documents, eight studies fitted the inclusion criteria of clinical handover and the ambulance to ED patient transfer. Three themes were identified in the review: (1) important information may be missed during clinical handover; (2) structured handovers that include both written and verbal components may improve information exchange; (3) multidisciplinary education about the clinical handover process may encourage teamwork, a shared common language and a framework for minimum patient information to be transferred from the ambulance service to the hospital ED. Knowledge gaps exist concerning handover information, consequences of poor handover, transfer of responsibility, staff perception of handovers, staff training and evaluation of recommended strategies to improve clinical handover. Evidence of strategies being implemented and further research is required to examine the ongoing effects of implementing the strategies. Copyright © 2009 Elsevier Ltd. All rights reserved.

Biological conservation law as an emerging functionality in dynamical neuronal networks.

PubMed

Podobnik, Boris; Jusup, Marko; Tiganj, Zoran; Wang, Wen-Xu; Buldú, Javier M; Stanley, H Eugene

2017-11-07

Scientists strive to understand how functionalities, such as conservation laws, emerge in complex systems. Living complex systems in particular create high-ordered functionalities by pairing up low-ordered complementary processes, e.g., one process to build and the other to correct. We propose a network mechanism that demonstrates how collective statistical laws can emerge at a macro (i.e., whole-network) level even when they do not exist at a unit (i.e., network-node) level. Drawing inspiration from neuroscience, we model a highly stylized dynamical neuronal network in which neurons fire either randomly or in response to the firing of neighboring neurons. A synapse connecting two neighboring neurons strengthens when both of these neurons are excited and weakens otherwise. We demonstrate that during this interplay between the synaptic and neuronal dynamics, when the network is near a critical point, both recurrent spontaneous and stimulated phase transitions enable the phase-dependent processes to replace each other and spontaneously generate a statistical conservation law-the conservation of synaptic strength. This conservation law is an emerging functionality selected by evolution and is thus a form of biological self-organized criticality in which the key dynamical modes are collective.

Biological conservation law as an emerging functionality in dynamical neuronal networks

PubMed Central

Podobnik, Boris; Tiganj, Zoran; Wang, Wen-Xu; Buldú, Javier M.

2017-01-01

Scientists strive to understand how functionalities, such as conservation laws, emerge in complex systems. Living complex systems in particular create high-ordered functionalities by pairing up low-ordered complementary processes, e.g., one process to build and the other to correct. We propose a network mechanism that demonstrates how collective statistical laws can emerge at a macro (i.e., whole-network) level even when they do not exist at a unit (i.e., network-node) level. Drawing inspiration from neuroscience, we model a highly stylized dynamical neuronal network in which neurons fire either randomly or in response to the firing of neighboring neurons. A synapse connecting two neighboring neurons strengthens when both of these neurons are excited and weakens otherwise. We demonstrate that during this interplay between the synaptic and neuronal dynamics, when the network is near a critical point, both recurrent spontaneous and stimulated phase transitions enable the phase-dependent processes to replace each other and spontaneously generate a statistical conservation law—the conservation of synaptic strength. This conservation law is an emerging functionality selected by evolution and is thus a form of biological self-organized criticality in which the key dynamical modes are collective. PMID:29078286

Emergency Department Staff Beliefs About Self-Harm: A Thematic Framework Analysis.

PubMed

Koning, Kate Louise; McNaught, Angela; Tuffin, Keith

2017-11-03

To explore the beliefs and attitudes of emergency department staff about self-harm behaviour. Existing studies looking at views regarding self-harm rely solely on the information provided by medical and nursing staff using a questionnaire format. No studies currently consider ancillary staff members' beliefs about self-harm, even though they also work with these patients. A thematic framework analysis of interview transcripts was carried out. Individual semi-structured interviews were conducted from December 2015 to February 2016. Fifteen medical, nursing, and ancillary staff members from a large, tertiary emergency department participated. There were 5 major themes identified-causes of self-harm are multifactorial; beliefs about self-harm can change over time; emergency departments should only focus on the physical; self-harm occurs on a spectrum; and the system has failed. The results suggest participants felt ill-prepared and lacking in appropriate training to help patients that self-harm, and furthermore they have little faith in the mental health system. Staff beliefs and attitudes may change over time with exposure to patients who self-harm, possibly becoming more positive in response to a greater understanding of why the self-harm behaviour is occurring.

Modulation for emergent networks: serotonin and dopamine.

PubMed

Weng, Juyang; Paslaski, Stephen; Daly, James; VanDam, Courtland; Brown, Jacob

2013-05-01

In autonomous learning, value-sensitive experiences can improve the efficiency of learning. A learning network needs be motivated so that the limited computational resources and the limited lifetime are devoted to events that are of high value for the agent to compete in its environment. The neuromodulatory system of the brain is mainly responsible for developing such a motivation system. Although reinforcement learning has been extensively studied, many existing models are symbolic whose internal nodes or modules have preset meanings. Neural networks have been used to automatically generate internal emergent representations. However, modeling an emergent motivational system for neural networks is still a great challenge. By emergent, we mean that the internal representations emerge autonomously through interactions with the external environments. This work proposes a generic emergent modulatory system for emergent networks, which includes two subsystems - the serotonin system and the dopamine system. The former signals a large class of stimuli that are intrinsically aversive (e.g., stress or pain). The latter signals a large class of stimuli that are intrinsically appetitive (e.g., pleasure or sweet). We experimented with this motivational system for two settings. The first is a visual recognition setting to investigate how such a system can learn through interactions with a teacher, who does not directly give answers, but only punishments and rewards. The second is a setting for wandering in the presence of a friend and a foe. Copyright © 2012 Elsevier Ltd. All rights reserved.

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...

Public-private implementation of integrated emergency response services: Case study of GVK Emergency Management and Research Institute in Karnataka, India.

PubMed

Sriram, Veena M; Gururaj, Gopalkrishna; Hyder, Adnan A

2017-12-01

Emergency medical services are important to the functioning of health systems, but these services tend to be neglected in low- and middle-income countries, such as India. In recent years, several models of pre-hospital emergency medical services have emerged in India. Research on these models holds important lessons for existing and future emergency medical service programs in low- and middle-income countries. Our objective was to provide a comprehensive description of the organizational structure and service delivery model of a public-private partnership in the southern Indian state of Karnataka, GVK Emergency Management and Research Institute, with a particular focus on its operations in Bengaluru. A case study methodology was used to explore systematically the organizational model of GVK Emergency Management and Research Institute in Karnataka. Qualitative data were collected through an in-person site visit to GVK Emergency Management and Research Institute headquarters in Bengaluru in July 2013. Three sources were used: in-depth, semistructured interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. The organization follows a standardized model across the states and union territories where they have contractual arrangements, including Karnataka. Processes for fleet maintenance, information systems/information technology and training, and deployment were well structured at the organizational level. The public-private partnership appears pro-poor in orientation; however, further demand-side research is required on the perspective of patients. Our study reveals a functional structure at the organizational level, which provides a key service at no cost to users. Detailed analyses of this nature can help inform global efforts for the development and strengthening of emergency medical services systems. Copyright © 2017 Elsevier Inc. All rights reserved.

Pre-shift fluid intake: effect on physiology, work and drinking during emergency wildfire fighting.

PubMed

Raines, Jenni; Snow, Rodney; Petersen, Aaron; Harvey, Jack; Nichols, David; Aisbett, Brad

2012-05-01

Wildfire fighters are known to report to work in a hypohydrated state, which may compromise their work performance and health. To evaluate whether ingesting a bolus of fluid before the shift had any effect on firefighters' fluid consumption, core temperature, or the time they spent in high heart rate and work activity zones when fighting emergency wildfires. Thirty-two firefighters were divided into non-bolus (AD) and pre-shift drinking bolus (PS, 500 ml water) groups. Firefighters began work hypohydrated as indicated by urine colour, specific gravity and plasma osmolality (P(osm)) results. Post-shift, firefighters were classified as euhydrated according to P(osm) and hypohydrated by urinary markers. No significant differences existed between the drinking groups in pre- or post-shift hydration status, total fluid intake, activity, heart rate or core temperature. Consuming a bolus of fluid, pre-shift provided no benefit over non-consumption as both groups had consumed equivalent ad libitum volumes of fluid, 2.5 h into the shift. No benefits of bolus consumption were observed in firefighter activity, heart rate response or core temperature response across the shift in the mild weather conditions experienced. Ad libitum drinking was adequate to facilitate rehydration in firefighters upon completion of their emergency firefighting work shift. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

The need for a systematic approach to disaster psychosocial response: a suggested competency framework.

PubMed

Cox, Robin S; Danford, Taryn

2014-04-01

Competency models attempt to define what makes expert performers "experts." Successful disaster psychosocial planning and the institutionalizing of psychosocial response within emergency management require clearly-defined skill sets. This necessitates anticipating both the short- and long-term psychosocial implications of a disaster or health emergency (ie, pandemic) by developing effective and sustained working relationships among psychosocial providers, programs, and other planning partners. The following article outlines recommended competencies for psychosocial responders to enable communities and organizations to prepare for and effectively manage a disaster response. Competency-based models are founded on observable performance or behavioral indicators, attitudes, traits, or personalities related to effective performance in a specific role or job. After analyzing the literature regarding competency-based frameworks, a proposed competency framework that details 13 competency domains is suggested. Each domain describes a series of competencies and suggests behavioral indicators for each competency and, where relevant, associated training expectations. These domains have been organized under three distinct categories or types of competencies: general competency domains; disaster psychosocial intervention competency domains; and disaster psychosocial program leadership and coordination competency domains. Competencies do not replace job descriptions nor should they be confused with performance assessments. What they can do is update and revise job descriptions; orient existing and new employees to their disaster/emergency roles and responsibilities; target training needs; provide the basis for ongoing self-assessment by agencies and individuals as they evaluate their readiness to respond; and provide a job- or role-relevant basis for performance appraisal dimensions or standards and review discussions. Using a modular approach to psychosocial planning, service providers can improve their response capacity by utilizing differences in levels of expertise and training. The competencies outlined in this paper can thus be used to standardize expectations about levels of psychosocial support interventions. In addition this approach provides an adaptable framework that can be adjusted for various contexts.

36 CFR 28.14 - Emergency action.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Emergency action. 28.14... Emergency action. If allowable by local law and if immediate action is essential to avoid or eliminate an... for undertaking the emergency action no longer exist, the agency or person shall cease an emergency...

Cortical Signal Analysis and Advances in Functional Near-Infrared Spectroscopy Signal: A Review.

PubMed

Kamran, Muhammad A; Mannan, Malik M Naeem; Jeong, Myung Yung

2016-01-01

Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging modality that measures the concentration changes of oxy-hemoglobin (HbO) and de-oxy hemoglobin (HbR) at the same time. It is an emerging cortical imaging modality with a good temporal resolution that is acceptable for brain-computer interface applications. Researchers have developed several methods in last two decades to extract the neuronal activation related waveform from the observed fNIRS time series. But still there is no standard method for analysis of fNIRS data. This article presents a brief review of existing methodologies to model and analyze the activation signal. The purpose of this review article is to give a general overview of variety of existing methodologies to extract useful information from measured fNIRS data including pre-processing steps, effects of differential path length factor (DPF), variations and attributes of hemodynamic response function (HRF), extraction of evoked response, removal of physiological noises, instrumentation, and environmental noises and resting/activation state functional connectivity. Finally, the challenges in the analysis of fNIRS signal are summarized.

Cortical Signal Analysis and Advances in Functional Near-Infrared Spectroscopy Signal: A Review

PubMed Central

Kamran, Muhammad A.; Mannan, Malik M. Naeem; Jeong, Myung Yung

2016-01-01

Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging modality that measures the concentration changes of oxy-hemoglobin (HbO) and de-oxy hemoglobin (HbR) at the same time. It is an emerging cortical imaging modality with a good temporal resolution that is acceptable for brain-computer interface applications. Researchers have developed several methods in last two decades to extract the neuronal activation related waveform from the observed fNIRS time series. But still there is no standard method for analysis of fNIRS data. This article presents a brief review of existing methodologies to model and analyze the activation signal. The purpose of this review article is to give a general overview of variety of existing methodologies to extract useful information from measured fNIRS data including pre-processing steps, effects of differential path length factor (DPF), variations and attributes of hemodynamic response function (HRF), extraction of evoked response, removal of physiological noises, instrumentation, and environmental noises and resting/activation state functional connectivity. Finally, the challenges in the analysis of fNIRS signal are summarized. PMID:27375458

The curiously suspicious: a role for Epstein-Barr virus in lupus.

PubMed

Harley, J B; Harley, I T W; Guthridge, J M; James, J A

2006-01-01

While the events initiating the development of autoantibodies in systemic lupus erythematosus (SLE) have not yet been convincingly established, newly developed tools for molecular investigation make such an undertaking increasingly practical. Applied to the earliest events in the sequence culminating in lupus autoimmunity, we present a critical potential role for Epstein-Barr virus (EBV) in the development and perhaps perpetuation of SLE. The expected properties for an environmental risk factor for SLE are found in this virus and the human host response against it. Existing data show the molecular progression to autoimmunity observed in SLE patient sera, the discovery of the first autoimmune epitopes in the Sm and Ro autoantigen systems, and the possible emergence of these autoantibodies from the heterologous antibodies against Epstein-Barr nuclear antigen-1 (EBNA-1). Further, existing data demonstrate association of SLE with EBV infection, even preceding the development of autoimmunity. Finally, the data are consistent with a proposed model of lupus pathogenesis that begins with antibodies to EBNA-1, predisposing to immune responses that develop crossreactive autoantibodies that culminate in the development of SLE autoimmunity.

Designing Mobile Applications for Emergency Response: Citizens Acting as Human Sensors

PubMed Central

Romano, Marco; Onorati, Teresa; Aedo, Ignacio; Diaz, Paloma

2016-01-01

When an emergency occurs, citizens can be a helpful support for the operation centers involved in the response activities. As witnesses to a crisis, they initially can share updated and detailed information about what is going on. Moreover, thanks to the current technological evolution people are able to quickly and easily gather rich information and transmit it through different communication channels. Indeed, modern mobile devices embed several sensors such as GPS receivers, Wi-Fi, accelerometers or cameras that can transform users into well-equipped human sensors. For these reasons, emergency organizations and small and medium enterprises have demonstrated a growing interest in developing smart applications for reporting any exceptional circumstances. In this paper, we present a practical study about this kind of applications for identifying both limitations and common features. Based on a study of relevant existent contributions in this area and our personal direct experience in developing and evaluating emergency management solutions, our aim is to propose several findings about how to design effective and efficient mobile emergency notification applications. For this purpose we have exploited the basic sensors of modern mobile devices and the users’ aptitude for using them. The evaluation consists of a practical and a theoretical part. In the practical part, we have simulated a traffic accident as closely as possible to a real scenario, with a victim lying on the ground near a car in the middle of a street. For the theoretical part, we have interviewed some emergency experts for collecting their opinions about the utility of the proposed solution. Results from this evaluation phase confirm the positive impact that EN application have for both operators’ and citizens’ perspective. Moreover, we collected several findings useful for future design challenges in the same area, as shown in the final redesign of the proposed application. PMID:27007375

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.

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...

Le Bon Samaritain: A Community-Based Care Model Supported by Technology.

PubMed

Gay, Valerie; Leijdekkers, Peter; Gill, Asif; Felix Navarro, Karla

2015-01-01

The effective care and well-being of a community is a challenging task especially in an emergency situation. Traditional technology-based silos between health and emergency services are challenged by the changing needs of the community that could benefit from integrated health and safety services. Low-cost smart-home automation solutions, wearable devices and Cloud technology make it feasible for communities to interact with each other, and with health and emergency services in a timely manner. This paper proposes a new community-based care model, supported by technology, that aims at reducing healthcare and emergency services costs while allowing community to become resilient in response to health and emergency situations. We looked at models of care in different industries and identified the type of technology that can support the suggested new model of care. Two prototypes were developed to validate the adequacy of the technology. The result is a new community-based model of care called 'Le Bon Samaritain'. It relies on a network of people called 'Bons Samaritains' willing to help and deal with the basic care and safety aspects of their community. Their role is to make sure that people in their community receive and understand the messages from emergency and health services. The new care model is integrated with existing emergency warning, community and health services. Le Bon Samaritain model is scalable, community-based and can help people feel safer, less isolated and more integrated in their community. It could be the key to reduce healthcare cost, increase resilience and drive the change for a more integrated emergency and care system.

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Federal role in the emergency response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING...

The impact of parenthood on Canadians' objectively measured physical activity: an examination of cross-sectional population-based data.

PubMed

Gaston, Anca; Edwards, Sarah A; Doelman, Amy; Tober, Jo Ann

2014-11-03

Parenthood has been associated with declines in leisure-time exercise and moderate-to-vigorous physical activity (MVPA), but less is known about its impact on sedentary time and light-intensity activity. Although the health benefits of MVPA are well established, a growing body of research has been showing that even after controlling for MVPA levels, a detrimental dose-response association exists between sedentary time and adverse health outcomes and a beneficial dose-response association exists for light-intensity activity. This study examined the impact of parenthood, the number of children in the home, and the age of the youngest child on objectively measured physical activity (i.e., accelerometer derived daily minutes of sedentary, light, and MVPA) among a nationally representative cross-sectional sample of 2234 men and women who participated in the 2009-2011 Canadian Health Measures Survey. After controlling for sociodemographic variables, ANCOVAs indicated that parents engaged in more light activity but less MVPA than non-parents and women whose youngest child was aged 12-15 years were more sedentary than women without children. Among both men and women, having a child <6 years of age in the home was associated with the greatest amount of light activity and lowest MVPA. Modest differences emerged between the physical activity level of parents and non-parents for both genders and across intensity levels. In general, parenthood was associated with less MVPA and more light-intensity activity, and more differences emerged among women compared to men. More research is needed before conclusions can be drawn regarding the health consequences of these differences.

Development of a digital clinical pathway for emergency medicine: Lessons from usability testing and implementation failure.

PubMed

Gutenstein, Marc; Pickering, John W; Than, Martin

2018-06-01

Clinical pathways are used to support the management of patients in emergency departments. An existing document-based clinical pathway was used as the foundation on which to design and build a digital clinical pathway for acute chest pain, with the aim of improving clinical calculations, clinician decision-making, documentation, and data collection. Established principles of decision support system design were used to build an application within the existing electronic health record, before testing with a multidisciplinary team of doctors using a think-aloud protocol. Technical authoring was successful, however, usability testing revealed that the user experience and the flexibility of workflow within the application were critical barriers to implementation. Emergency medicine and acute care decision support systems face particular challenges to existing models of linear workflow that should be deliberately addressed in digital pathway design. We make key recommendations regarding digital pathway design in emergency medicine.

Radiological emergency: Malaysian preparedness and response.

PubMed

Yusof, Mohd Abd Wahab; Ali, Hamrah Mohd

2011-07-01

Planning and preparation in advance for radiological emergencies can help to minimise potential public health and environmental threats if and when an actual emergency occurs. During the planning process, emergency response organisations think through how they would respond to each type of incident and the resources that will be needed. In Malaysia, planning, preparation for and response to radiological emergencies involve many parties. In the event of a radiological emergency and if it is considered a disaster, the National Security Council, the Atomic Energy Licensing Board and the Malaysian Nuclear Agency (Nuclear Malaysia) will work together with other federal agencies, state and local governments, first responders and international organisations to monitor the situation, contain the release, and clean up the contaminated site. Throughout the response, these agencies use their protective action guidelines. This paper discusses Malaysian preparedness for, and response to, any potential radiological emergency.

Emergency material allocation with time-varying supply-demand based on dynamic optimization method for river chemical spills.

PubMed

Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Wang, Peng

2018-04-13

Aiming to minimize the damage caused by river chemical spills, efficient emergency material allocation is critical for an actual emergency rescue decision-making in a quick response. In this study, an emergency material allocation framework based on time-varying supply-demand constraint is developed to allocate emergency material, minimize the emergency response time, and satisfy the dynamic emergency material requirements in post-accident phases dealing with river chemical spills. In this study, the theoretically critical emergency response time is firstly obtained for the emergency material allocation system to select a series of appropriate emergency material warehouses as potential supportive centers. Then, an enumeration method is applied to identify the practically critical emergency response time, the optimum emergency material allocation and replenishment scheme. Finally, the developed framework is applied to a computational experiment based on south-to-north water transfer project in China. The results illustrate that the proposed methodology is a simple and flexible tool for appropriately allocating emergency material to satisfy time-dynamic demands during emergency decision-making. Therefore, the decision-makers can identify an appropriate emergency material allocation scheme in a balance between time-effective and cost-effective objectives under the different emergency pollution conditions.

[Emergency response management near the tracks of the public railway network: special aspects of missions connected with the German national railway system].

PubMed

Krämer, P; Aul, A; Vock, B; Frank, C

2010-11-01

Emergency response management and rescue operations concerning the railway network in Germany need special attention and implementation in several ways. The emergency response concerning the German national railway network managed by Deutsche Bahn AG is subject to various rules and regulations which have to be followed precisely. Only by following these rules and procedures is the safety of all emergency staff at the scene ensured. The German national railway network (Deutsche Bahn AG) provides its own emergency response control center, which specializes in managing its response to emergencies and dispatches an emergency response manager to the scene. This person serves as the primary Deutsche Bahn AG representative at the scene and is the only person who is allowed to earth the railway electrical power lines. This article will discuss different emergency situations concerning railway accidents and the emergency medical response to them based on a near collision with a high speed train during a rescue mission close to the railway track. Injury to personnel could only be avoided by chance and luck. The dangers and risks for rescue staff are specified. Furthermore, the article details practical guidelines for rescue operations around the German national railway track system.

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.

The knowledge, attitude and behavior about public health emergencies and the response capacity of primary care medical staffs of Guangdong Province, China.

PubMed

Zhiheng, Zhou; Caixia, Wang; Jiaji, Wang; Huajie, Yang; Chao, Wang; Wannian, Liang

2012-09-25

Primary care medical staffs' knowledge, attitude and behavior about health emergency and the response capacity are directly related to the control and prevention of public health emergencies. Therefore, it is of great significance for improving primary care to gain in-depth knowledge about knowledge, attitude and behavior and the response capacity of primary care medical staffs. The main objective of this study is to explore knowledge, attitude and behavior, and the response capacity of primary care medical staffs of Guangdong Province, China. Stratified clustered sample method was used in the anonymous questionnaire investigation about knowledge, attitude and behavior, and the response capacity of 3410 primary care medical staffs in 15 cities of Guangdong Province, China from July, 2010 to October 2010. The emergency response capacity was evaluated by 33 questions. The highest score of the response capacity was 100 points (full score), score of 70 was a standard. 62.4% primary care medical staffs believed that public health emergencies would happen. Influenza (3.86 ± 0.88), food poisoning (3.35 ± 0.75), and environmental pollution events (3.23 ± 0.80) (the total score was 5) were considered most likely to occur. Among the 7 public health emergency skills, the highest self-assessment score is "public health emergency prevention skills" (2.90 ± 0.68), the lowest is "public health emergency risk management (the total score was 5)" (1.81 ± 0.40). Attitude evaluation showed 66.1% of the medical staffs believed that the community awareness of risk management were ordinary. Evaluation of response capacity of health emergency showed that the score of primary care medical staffs was 67.23 ± 10.61, and the response capacity of senior physicians, public health physicians and physicians with relatively long-term practice were significantly better (P <0.05). Multiple linear stepwise regression analysis showed gender, title, position, type of work, work experience and whether to participate relative training were the main factors affecting the health emergency response capacity. The knowledge, attitude and behavior about public health emergencies and the response capacity of primary care medical staffs of Guangdong Province (China) were poor. Health administrative departments should strengthen the training of health emergency knowledge and skills of the primary care medical staffs to enhance their health emergency response capabilities.

49 CFR 1.44 - Office of Intelligence, Security and Emergency Response.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 1 2013-10-01 2013-10-01 false Office of Intelligence, Security and Emergency... DELEGATION OF POWERS AND DUTIES Office of the Secretary Ost Officials § 1.44 Office of Intelligence, Security and Emergency Response. The Director of the Office of Intelligence, Security and Emergency Response is...

49 CFR 1.44 - Office of Intelligence, Security and Emergency Response.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false Office of Intelligence, Security and Emergency... DELEGATION OF POWERS AND DUTIES Office of the Secretary Ost Officials § 1.44 Office of Intelligence, Security and Emergency Response. The Director of the Office of Intelligence, Security and Emergency Response is...

49 CFR 1.44 - Office of Intelligence, Security and Emergency Response.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 1 2012-10-01 2012-10-01 false Office of Intelligence, Security and Emergency... DELEGATION OF POWERS AND DUTIES Office of the Secretary Ost Officials § 1.44 Office of Intelligence, Security and Emergency Response. The Director of the Office of Intelligence, Security and Emergency Response is...

CDC's Evolving Approach to Emergency Response.

PubMed

Redd, Stephen C; Frieden, Thomas R

The Centers for Disease Control and Prevention (CDC) transformed its approach to preparing for and responding to public health emergencies following the anthrax attacks of 2001. The Office of Public Health Preparedness and Response, an organizational home for emergency response at CDC, was established, and 4 programs were created or greatly expanded after the anthrax attacks: (1) an emergency management program, including an Emergency Operations Center; (2) increased support of state and local health department efforts to prepare for emergencies; (3) a greatly enlarged Strategic National Stockpile of medicines, vaccines, and medical equipment; and (4) a regulatory program to assure that work done on the most dangerous pathogens and toxins is done as safely and securely as possible. Following these changes, CDC led responses to 3 major public health emergencies: the 2009-10 H1N1 influenza pandemic, the 2014-16 Ebola epidemic in West Africa, and the ongoing Zika epidemic. This article reviews the programs of CDC's Office of Public Health Preparedness, the major responses, and how these responses have resulted in changes in CDC's approach to responding to public health emergencies.

75 FR 49508 - Recovery Policy, RP9525.7, Labor Costs-Emergency Work

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

...] Recovery Policy, RP9525.7, Labor Costs--Emergency Work AGENCY: Federal Emergency Management Agency, DHS... (FEMA) is accepting comments on RP9525.7, Labor Costs--Emergency Work. This is an existing policy that... who perform emergency work (Categories A and B). DATES: Comments must be received by September 13...

Adaptive remodeling of the biliary tree: the essence of liver progenitor cell expansion.

PubMed

Kok, Cindy Yuet-Yin; Miyajima, Atsushi; Itoh, Tohru

2015-07-01

The liver progenitor cell population has long been thought to exist within the liver. However, there are no standardized criteria for defining the liver progenitor cells, and there has been intense debate about the origin of these cells in the adult liver. The characteristics of such cells vary depending on the disease model used and also on the method of analysis. Visualization of three-dimensional biliary structures has revealed that the emergence of liver progenitor cells essentially reflects the adaptive remodeling of the hepatic biliary network in response to liver injury. We propose that the progenitor cell exists as a subpopulation in the biliary tree and show that the appearance of liver progenitor cells in injured parenchyma is reflective of extensive remodeling of the biliary structure. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Developing a new syndromic surveillance system for the London 2012 Olympic and Paralympic Games.

PubMed

Harcourt, S E; Fletcher, J; Loveridge, P; Bains, A; Morbey, R; Yeates, A; McCloskey, B; Smyth, B; Ibbotson, S; Smith, G E; Elliot, A J

2012-12-01

Syndromic surveillance is vital for monitoring public health during mass gatherings. The London 2012 Olympic and Paralympic Games represents a major challenge to health protection services and community surveillance. In response to this challenge the Health Protection Agency has developed a new syndromic surveillance system that monitors daily general practitioner out-of-hours and unscheduled care attendances. This new national system will fill a gap identified in the existing general practice-based syndromic surveillance systems by providing surveillance capability of general practice activity during evenings/nights, over weekends and public holidays. The system will complement and supplement the existing tele-health phone line, general practitioner and emergency department syndromic surveillance systems. This new national system will contribute to improving public health reassurance, especially to meet the challenges of the London 2012 Olympic and Paralympic Games.

Using existing health care systems to respond to the AIDS epidemic: research and recommendations for Chile.

PubMed

Aiken, L H; Smith, H L; Lake, E T

1997-01-01

Chile is a country with a relatively low prevalence of HIV infection, where successful prevention has the potential to change the future course of the epidemic. A controversial national prevention strategy based upon public education has emerged in response to characterizations of the epidemic as well-dispersed with a growing involvement of heterosexuals. This characterization is not consistent with the observed facts. There is a comparatively well-organized health care system in Santiago that is doing a good job of detecting HIV infection and already has in place the elements of a targeted intervention scheme. Chile should place priority on the use of the existing health care infrastructure for implementing both the traditional public health interventions for sexually transmitted diseases (contact tracing and partner notification) and the AIDS-necessitated strategy of focused counseling and education.

49 CFR 172.600 - Applicability and general requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MATERIALS TABLE, SPECIAL PROVISIONS, HAZARDOUS MATERIALS COMMUNICATIONS, EMERGENCY RESPONSE INFORMATION, TRAINING REQUIREMENTS, AND SECURITY PLANS Emergency Response Information § 172.600 Applicability and... prescribes requirements for providing and maintaining emergency response information during transportation...

49 CFR 172.600 - Applicability and general requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... MATERIALS TABLE, SPECIAL PROVISIONS, HAZARDOUS MATERIALS COMMUNICATIONS, EMERGENCY RESPONSE INFORMATION, TRAINING REQUIREMENTS, AND SECURITY PLANS Emergency Response Information § 172.600 Applicability and... prescribes requirements for providing and maintaining emergency response information during transportation...

The ASTER emergency scheduling system: A new project linking near-real-time satellite monitoring of disasters to the acquisition of high-resolution remote sensing data

NASA Astrophysics Data System (ADS)

Ramsey, M.; Dehn, J.; Wessels, R.; Byrnes, J.; Duda, K.; Maldonado, L.; Dwyer, J.

2004-12-01

Numerous government agencies and university partnerships are currently utilizing orbital instruments with high-temporal/low-spatial resolution (e.g. MODIS, AVHRR) to monitor hazards. These hazards are varied and include both natural (volcanic eruptions, severe weather, wildfires, earthquake damage) and anthropogenic (environmental damage, urban terrorism). Although monitoring a hazardous situation is critical, a key strategy of NASA's Earth science program is to develop a scientific understanding of the Earth system and its responses to changes, as well as to improve prediction of hazard onset. In order to develop a quantitative scientific basis from which to model transient geological and climatological hazards, much higher spatial/spectral resolution datasets are required. Such datasets are sparse, currently available from certain government (e.g. ASTER, Hyperion) and commercial (e.g. IKONOS, QuickBird) instruments. However, only ASTER has the capability to acquire high spatial resolution data from the visible to thermal infrared (TIR) wavelength region in conjunction with digital elevation models (DEM) generation. These capabilities are particularly useful for numerous aspects of volcanic remote sensing. For example, multispectral TIR data are critical for monitoring low temperature anomalies and mapping both chemical and textural variations on volcanic surfaces. Because ASTER data are scheduled in advance and the raw data are sent to Japan for calibration processing, rapid acquisition of hazards becomes problematic. However, a "rapid response" mode does exist for ASTER data scheduling and processing, but its availability is limited and requires significant human interaction. A newly-funded NASA ASTER science team project seeks to link this ASTER rapid response pathway to larger-scale monitoring alerts, which are already in-place and in-use by other organizations. By refining the initial event detection criteria and improving interfaces between these organizations and the ASTER project, we expect to minimize lag time and use existing monitoring tools as triggers for the emergency response of ASTER. The first phase of this project will be integrated into the Alaska Volcano Observatory's current near-real-time volcanic monitoring system, which relies on high temporal/low spatial resolution orbital data. This synergy will allow small-scale activity to be targeted for science and response, and a calibration baseline between each sensor to be established. If successful, this will be the first time that high spatial resolution, multispectral satellite data will be routinely scheduled, acquired, and analyzed in a "rapid response" mode within an existing hazard monitoring framework. Initial testing of this system is now underway using data from previous eruptions in the north Pacific region, and modifications to the rapid data flow procedure within the ASTER science and support structure has begun.

Five-year forward view: lessons from emergency care at the extremes of age.

PubMed

Minhas, J S; Minhas, D; Coats, T; Banerjee, J; Roland, D

2018-03-01

Objective The progressive rise in demand on NHS emergency care resources is partly attributable to increases in attendances of children and older people. A quality gap exists in the care provision for the old and the young. The Five Year Forward View suggested new models of care but that the "answer is not one-size-fits-all". This article discusses the urgent need for person-centred outcome measures to bridge the gap that exists between demand and provision. Design This review is based on evidence gathered from literature searching across several platforms using a variety of search terms to account for the obvious heterogeneity, drawing on key 'think-tank' evidence. Settings Qualitative and quantitative studies examining approaches to caring for individuals at the extremes of age. Participants Individuals at the extremes of age (infants and older people). Main Outcome Measures Understanding similarities and disparities in the care of individuals at the extremes of age in an emergency and non-emergency context. Results There exists several similarities and disparities in the care of individuals at the extremes of age. The increasing burden of health disease on the economy must acknowledge the challenges that exist in managing patients in emergency settings at the extremes of age and build systems to acknowledge the traits these individuals exhibit. Conclusion Commissioners of services must optimise the models of care delivery by appreciating the similarities and differences between care requirements in these two large groups seeking emergency care.

Innovation in Graduate Education for Health Professionals in Humanitarian Emergencies

PubMed Central

Evans, Dabney P.; Anderson, Mark; Shahpar, Cyrus; del Rio, Carlos; Curran, James W.

2017-01-01

The objective of this report was to show how the Center for Humanitarian Emergencies (the Center) at Emory University (Atlanta, Georgia USA) has trained graduate students to respond to complex humanitarian emergencies (CHEs) through innovative educational programs, with the goal of increasing the number of trained humanitarian workers. Natural disasters are on the rise with more than twice as many occurring from 2000–2009 as there were from 1980–1989. In 2012 alone, 144 million people were affected by a natural disaster or displaced by conflict worldwide. This has created an immense need for trained humanitarian workers to respond effectively to such disasters. The Center has developed a model for educational programming that targets learners along an educational continuum ranging from the undergraduate level through continuing professional education. These programs, based in the Rollins School of Public Health (RSPH) of Emory University, include: a competency-based graduate certificate program (the Certificate) in humanitarian emergencies; a fellowship program for mid-career professionals; and funded field practica. The competency-based Certificate program began in 2010 with a cohort of 14 students. Since then, 101 students have received the Certificate with 50 more due for completion in 2016 and 2017 combined. The fellowship program for mid-career professionals has hosted four fellows from conflict-affected or resource-poor countries, who have then gone on to assume leadership positions with humanitarian organizations. From 2009–2015, the field practicum program supported 34 students in international summer practicum experiences related to emergency response or preparedness. Students have participated in summer field experiences on every continent but Australia. Together the Certificate, funded field practicum opportunities, and the fellowship comprise current efforts in providing innovative education and training for graduate and post-graduate students of public health in humanitarian response. These modest efforts are just the beginning in terms of addressing the global shortage of skilled public health professionals that can coordinate humanitarian response. Evaluating existing programs will allow for refinement of current programs. Ultimately, these programs may influence the development of new programs and inform others interested in this area. PMID:27492749

Development of urban planning guidelines for improving emergency response capacities in seismic areas of Iran.

PubMed

Hosseini, Kambod Amini; Jafari, Mohammad Kazem; Hosseini, Maziar; Mansouri, Babak; Hosseinioon, Solmaz

2009-10-01

This paper presents the results of research carried out to improve emergency response activities in earthquake-prone areas of Iran. The research concentrated on emergency response operations, emergency medical care, emergency transportation, and evacuation-the most important issues after an earthquake with regard to saving the lives of victims. For each topic, some guidelines and criteria are presented for enhancing emergency response activities, based on evaluations of experience of strong earthquakes that have occurred over the past two decades in Iran, notably Manjil (1990), Bam (2003), Firouz Abad-Kojour (2004), Zarand (2005) and Broujerd (2006). These guidelines and criteria are applicable to other national contexts, especially countries with similar seismic and social conditions as Iran. The results of this study should be incorporated into comprehensive plans to ensure sustainable development or reconstruction of cities as well as to augment the efficiency of emergency response after an earthquake.

Ethical considerations in the translation of regenerative biofabrication technologies into clinic and society.

PubMed

Otto, I A; Breugem, C C; Malda, J; Bredenoord, A L

2016-10-07

Biofabrication technologies have the potential to improve healthcare by providing highly advanced and personalized biomedical products for research, treatment and prevention. As the combining of emerging techniques and integrating various biological and synthetic components becomes increasingly complex, it is important that relevant stakeholders anticipate the translation of biofabricated 3D tissue products into patients and society. Ethics is sometimes regarded as a brake on scientific progress, yet from our perspective, ethics in parallel with research anticipates societal impacts of emerging technologies and stimulates responsible innovation. For the ethical assessment, the biofabrication field benefits from similarities to regenerative medicine and an increasing ethical awareness in the development of tissue-engineered products. However, the novelty of the technology itself, the increase in attainable structural complexity, and the potential for automation and personalization are distinguishing facets of biofabrication that call for a specific exploration of the ethics of biofabrication. This review aims to highlight important points of existing ethical discussions, as well as to call attention to emerging issues specific to 3D biofabrication in bench and bedside research and the translation to society.

Hydrodynamic synchronization of flagella on the surface of the colonial alga Volvox carteri

NASA Astrophysics Data System (ADS)

Brumley, Douglas; Polin, Marco; Goldstein, Raymond; Pedley, Timothy

2012-11-01

Whether on the surface of unicellular ciliates or in the respiratory epithelium, groups of eukaryotic cilia and flagella are capable of coordinating their beating over large scales. The mechanism responsible for the emergence of these metachronal waves is still unclear, mostly because finding an experimental system in which the beating filaments can be followed individually is challenging. We propose the multicellular green alga Volvox carteri as an ideal model system to study metachronal coordination, and report the existence of robust metachronal waves on its surface. Inspired by flagellar tip trajectories of Volvox somatic cells, we model a flagellum using a sphere of radius a elastically bound to a circular orbit of radius r0, perpendicular to a no-slip plane. This elastohydrodynamic model of weakly-coupled self-sustained oscillators can be recast in terms of interacting phase oscillators, offering an intuitive understanding of the mechanism driving the emergence of coordination. Our results confirm that elasticity is fundamental to guarantee fast and robust synchronization, and that sufficiently compliant trajectories lead to the emergence of metachronal waves in a manner essentially independent of boundary conditions.

Lost in Translation: State Policies and Micro-politics of Water Governance in Namibia.

PubMed

Schnegg, Michael

Water governance in rural Namibia has profoundly changed since the early 1990s. After independence and in accordance with global environmental policies, it became a central theme of Namibia's environmental legislation to transfer the responsibility for managing natural resources to local user associations. In this article, I explore the emergence of new social forms at the intersection of existing cultural models and new rationalities for governance. Doing so combines an analysis of state legislation with the micro-politics of water governance in 60 pastoral communities. The ethnographic analysis reveals that different actors, including state bureaucrats as well as rich and poorer herd owners, have different understandings of how to share water. While the poorer often agree with the state policy that water is an economic good and should be paid for accordingly, only in about half of the communities do corresponding institutional regimes emerge. Using critical institutionalism as a theoretical guide, I offer a contribution to understanding how more than 20 years after Rio local institutions of resource governance emerge at the intersection of different, and often heterogeneous and intertwined, social fields.

Responsiveness of emergency obstetric care systems in low- and middle-income countries: a critical review of the "third delay".

PubMed

Cavallaro, Francesca L; Marchant, Tanya J

2013-05-01

We reviewed the evidence on the duration, causes and effects of delays in providing emergency obstetric care to women attending health facilities (the third delay) in low- and middle-income countries. We performed a critical literature review using terms related to obstetric care, birth outcome, delays and developing countries. A manual search of reference lists of key articles was also performed. 69 studies met the inclusion criteria. Most studies reported long delays in providing care, and the mean waiting time for women admitted with complications was as much as 24 h before treatment. The three most cited barriers to providing timely care were shortage of treatment materials, surgery facilities and qualified staff. Existing evidence is insufficient to estimate the effect of delays on birth outcomes. Delays in providing emergency obstetric care seem common in resource-constrained settings but further research is necessary to determine the effect of the third delay on birth outcomes. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Bedding down new words: Sleep promotes the emergence of lexical competition in visual word recognition.

PubMed

Wang, Hua-Chen; Savage, Greg; Gaskell, M Gareth; Paulin, Tamara; Robidoux, Serje; Castles, Anne

2017-08-01

Lexical competition processes are widely viewed as the hallmark of visual word recognition, but little is known about the factors that promote their emergence. This study examined for the first time whether sleep may play a role in inducing these effects. A group of 27 participants learned novel written words, such as banara, at 8 am and were tested on their learning at 8 pm the same day (AM group), while 29 participants learned the words at 8 pm and were tested at 8 am the following day (PM group). Both groups were retested after 24 hours. Using a semantic categorization task, we showed that lexical competition effects, as indexed by slowed responses to existing neighbor words such as banana, emerged 12 h later in the PM group who had slept after learning but not in the AM group. After 24 h the competition effects were evident in both groups. These findings have important implications for theories of orthographic learning and broader neurobiological models of memory consolidation.

Hypothesis: The Intratumoral Immune Response against a Cancer Progenitor Cell Impacts the Development of Well-Differentiated versus Dedifferentiated Disease in Liposarcoma

PubMed Central

Tseng, William W.; Chopra, Shefali; Engleman, Edgar G.; Pollock, Raphael E.

2016-01-01

Well-differentiated/dedifferentiated (WD/DD) liposarcoma is a rare malignancy of adipocyte origin (“fat cancer”). Tumors may be entirely WD, WD with a DD component, or rarely DD without a clear WD component. WD tumors are low grade and generally indolent, while tumors with a DD component are high grade and behave much more aggressively, with a modest potential for distant metastasis. The presence of cancer progenitor cells in WD/DD liposarcoma is suggested by clinical evidence and reported research findings. In addition, there are emerging data to support the existence of a naturally occurring, antigen-driven, and adaptive immune response within the tumor microenvironment. We hypothesize that the intratumoral immune response is directed against a cancer progenitor cell and that the outcome of this response impacts the development of WD versus DD disease. Further study will likely provide interesting insights into the disease biology of WD/DD liposarcoma that may be readily translated to other more common cancers. PMID:27376027

Lessons Learned from Emergency Response Vaccination Efforts for Cholera, Typhoid, Yellow Fever, and Ebola

PubMed Central

Date, Kashmira A.; Sreenivasan, Nandini; Harris, Jennifer B.; Hyde, Terri B.

2017-01-01

Countries must be prepared to respond to public health threats associated with emergencies, such as natural disasters, sociopolitical conflicts, or uncontrolled disease outbreaks. Rapid vaccination of populations vulnerable to epidemic-prone vaccine-preventable diseases is a major component of emergency response. Emergency vaccination planning presents challenges, including how to predict resource needs, expand vaccine availability during global shortages, and address regulatory barriers to deliver new products. The US Centers for Disease Control and Prevention supports countries to plan, implement, and evaluate emergency vaccination response. We describe work of the Centers for Disease Control and Prevention in collaboration with global partners to support emergency vaccination against cholera, typhoid, yellow fever, and Ebola, diseases for which a new vaccine or vaccine formulation has played a major role in response. Lessons learned will help countries prepare for future emergencies. Integration of vaccination with emergency response augments global health security through reducing disease burden, saving lives, and preventing spread across international borders. PMID:29155670

A Future of Satellite-Aided Search and Rescue

NASA Technical Reports Server (NTRS)

Wallace, Ronald

1998-01-01

Satellite technology has been an integral part of maritime search and rescue since the Cospas-Sarsat system began operation in 1984. This system, credited with more than eighty-six hundred lives saved, has recently been augmented to provide immediate response through geostationary satellites. The other satellite-based distress alerting system, INMARSAT, launched its emergency Standard C service in 1991 and Standard E in 1997. Current plans call for a continuation of service from both of these vital systems at least through the first decade of the next century. We are currently witnessing the construction of a number of new satellite systems that will have the potential for revolutionizing mobile communications. These systems will be capable of emergency communication, and must be given due consideration in any look at the future, This paper reviews existing systems using satellites for distress alerting, describes the plans in place for them, and discusses likely developments.

Blood pressure and pain sensitivity in children and adolescents.

PubMed

Drouin, Sammantha; McGrath, Jennifer J

2013-06-01

Elevated blood pressure is associated with diminished pain sensitivity. While this finding is well established in adults, it is less clear when the relation between blood pressure and pain sensitivity emerges across the life course. Evidence suggests this phenomenon may exist during childhood. Children (N = 309; 56% boys) aged 10-15 years and their parents participated. Blood pressure readings were taken during a resting baseline. Maximum pain intensity was rated using a visual analogue scale (rated 0-10) in response to a finger prick pain induction. Parent-measured resting blood pressure was inversely associated with boys' pain ratings only. Cross-sectionally, lower pain ratings were related to higher SBP, univariately. Longitudinally, pain ratings predicted higher DBP, even after controlling for covariates. Determining when and how the relation between blood pressure and pain sensitivity emerges may elucidate the pathophysiology of hypertension. Copyright © 2013 Society for Psychophysiological Research.

Race, Race-Based Discrimination, and Health Outcomes Among African Americans

PubMed Central

Mays, Vickie M.; Cochran, Susan D.; Barnes, Namdi W.

2014-01-01

Persistent and vexing health disadvantages accrue to African Americans despite decades of work to erase the effects of race discrimination in this country. Participating in these efforts, psychologists and other social scientists have hypothesized that African Americans’ continuing experiences with racism and discrimination may lie at the root of the many well-documented race-based physical health disparities that affect this population. With newly emerging methodologies in both measurement of contextual factors and functional neuroscience, an opportunity now exists to cleave together a comprehensive understanding of the ways in which discrimination has harmful effects on health. In this article, we review emerging work that locates the cause of race-based health disparities in the external effects of the contextual social space on the internal world of brain functioning and physiologic response. These approaches reflect the growing interdisciplinary nature of psychology in general, and the field of race relations in particular. PMID:16953796

Race, race-based discrimination, and health outcomes among African Americans.

PubMed

Mays, Vickie M; Cochran, Susan D; Barnes, Namdi W

2007-01-01

Persistent and vexing health disadvantages accrue to African Americans despite decades of work to erase the effects of race discrimination in this country. Participating in these efforts, psychologists and other social scientists have hypothesized that African Americans' continuing experiences with racism and discrimination may lie at the root of the many well-documented race-based physical health disparities that affect this population. With newly emerging methodologies in both measurement of contextual factors and functional neuroscience, an opportunity now exists to cleave together a comprehensive understanding of the ways in which discrimination has harmful effects on health. In this article, we review emerging work that locates the cause of race-based health disparities in the external effects of the contextual social space on the internal world of brain functioning and physiologic response. These approaches reflect the growing interdisciplinary nature of psychology in general, and the field of race relations in particular.

Emerging Interventions for PTSD: Future Directions for Clinical Care and Research

PubMed Central

Bomyea, Jessica; Lang, Ariel J.

2013-01-01

Efficacious therapeutic approaches for treating Posttraumatic Stress Disorder (PTSD) are needed given the significant psychosocial and physical impairment associated with the disorder (e.g., Hidalgo & Davidson, 2000; Jaycox & Foa, 1999; Stein, McQuaid, Pedrelli, Lenox & McCahill, 2000). Although variations of cognitive behavioral therapy (CBT) effectively treat PTSD, non-response rates and dropout rates remain relatively high (Bradley, Greene, Russ, Dutra, & Westen, 2005; Schottenbauer, Glass, Arnkoff, Tendick & Gray, 2008). Thus, treatment outcome research is needed to improve the effectiveness of existing protocols, particularly within specific populations, develop new approaches for treating individuals who cannot access or do not benefit from traditional treatments, and evaluate the types of treatment that may be effective for particular individuals. The present review provides an overview of emerging treatment approaches for PTSD that attempt to address these remaining issues in the treatment outcome literature. PMID:21664365

Deafness in the developing world: the place of cochlear implantation.

PubMed

Tarabichi, M B; Todd, C; Khan, Z; Yang, X; Shehzad, B; Tarabichi, M M

2008-09-01

This paper attempts to review changes in the lives of hearing-impaired patients within the developing world, brought about by globalisation and development. The paper also explores limitations to improved care and addresses the collective moral responsibility of developed nations. Analysis of literature. Within developing nations, large populations have emerged with a similar pattern of problems, access to information and aspirations as those living in developed nations. However, marked differences in income have persisted. These trends have resulted in a relative increase in the proportion of the hearing-impaired population in need of cochlear implantation, while at the same time restricting their access to such treatment. The emergence of global markets and media and a shared sense of destiny amongst the people of this planet should translate into a concerted, worldwide effort to assist the deaf in developing countries. Much more can be done within existing resources and frameworks to improve the quality of these peoples' lives.

On the molecular mechanisms driving pain perception and emergent collective behaviors

NASA Astrophysics Data System (ADS)

Di Patti, F.; Fanelli, D.

2010-05-01

A stochastic model to investigate the microscopic processes which trigger the sensation of pain is considered. The model, presented in Di Patti and Fanelli [Di Patti F, Fanelli D. Can a microscopic stochastic model explain the emergence of pain cycles in patients? J Stat Mech 2009. doi:10.1088/1742-5468/2009/01/P01004], accounts for the action of analgesic drug and introduces an effect of competition with the inactive species populating the bloodstream. Regular oscillations in the amount of bound receptors are detected, following a resonant amplification of the stochastic component intrinsic to the system. The condition for such oscillations to occur are here studied, resorting to combined numerical and analytical techniques. Extended and connected patches of the admissible parameters space are detected which do correspond to the oscillatory behaviors. These findings are discussed with reference to the existing literature on patients' response to the analgesic treatment.

American Association for Emergency Psychiatry Task Force on Medical Clearance of Adults Part I: Introduction, Review and Evidence-Based Guidelines

PubMed Central

Anderson, Eric L.; Nordstrom, Kimberly; Wilson, Michael P.; Peltzer-Jones, Jennifer M.; Zun, Leslie; Ng, Anthony; Allen, Michael H.

2017-01-01

Introduction In the United States, the number of patients presenting to the emergency department (ED) for a mental health concern is significant and expected to grow. The breadth of the medical evaluation of these patients is controversial. Attempts have been made to establish a standard evaluation for these patients, but to date no nationally accepted standards exist. A task force of the American Association of Emergency Psychiatry, consisting of physicians from emergency medicine and psychiatry, and a psychologist was convened to form consensus recommendations on the medical evaluation of psychiatric patients presenting to EDs. Methods The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED (Part I) and then combined this with expert consensus (Part II). Results In Part I, we discuss terminological issues and existing evidence on medical exams and laboratory studies of psychiatric patients in the ED. Conclusion Emergency physicians should work cooperatively with psychiatric receiving facilities to decrease unnecessary testing while increasing the quality of medical screening exams for psychiatric patients who present to EDs. PMID:28210358

School Emergency Preparedness in North Dakota Public School Districts

ERIC Educational Resources Information Center

Swiontek, Steven Wayne

2009-01-01

The basis for this study was to determine: (1) If school districts in North Dakota have an emergency response plan; (2) How comprehensive their emergency response plan is; (3) How well prepared school districts in North Dakota are for any type of disaster; and (4) The extent to which North Dakota LEAD Center school emergency response training and…

Establishment of CDC Global Rapid Response Team to Ensure Global Health Security.

PubMed

Stehling-Ariza, Tasha; Lefevre, Adrienne; Calles, Dinorah; Djawe, Kpandja; Garfield, Richard; Gerber, Michael; Ghiselli, Margherita; Giese, Coralie; Greiner, Ashley L; Hoffman, Adela; Miller, Leigh Ann; Moorhouse, Lisa; Navarro-Colorado, Carlos; Walsh, James; Bugli, Dante; Shahpar, Cyrus

2017-12-01

The 2014-2016 Ebola virus disease epidemic in West Africa highlighted challenges faced by the global response to a large public health emergency. Consequently, the US Centers for Disease Control and Prevention established the Global Rapid Response Team (GRRT) to strengthen emergency response capacity to global health threats, thereby ensuring global health security. Dedicated GRRT staff can be rapidly mobilized for extended missions, improving partner coordination and the continuity of response operations. A large, agencywide roster of surge staff enables rapid mobilization of qualified responders with wide-ranging experience and expertise. Team members are offered emergency response training, technical training, foreign language training, and responder readiness support. Recent response missions illustrate the breadth of support the team provides. GRRT serves as a model for other countries and is committed to strengthening emergency response capacity to respond to outbreaks and emergencies worldwide, thereby enhancing global health security.

30 CFR 254.23 - What information must I include in the “Emergency response action plan” section?

Code of Federal Regulations, 2013 CFR

2013-07-01

... LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response Plans for Outer Continental Shelf Facilities § 254.23 What information must I include in the “Emergency response action plan” section? The “Emergency response action plan” section is the core of the response plan. Put information in easy-to-use formats such...

30 CFR 254.23 - What information must I include in the “Emergency response action plan” section?

Code of Federal Regulations, 2011 CFR

2011-07-01

... FOR FACILITIES LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response Plans for Outer Continental Shelf Facilities § 254.23 What information must I include in the “Emergency response action plan” section? The “Emergency response action plan”section is the core of the response plan. Put information in easy-to-use...

30 CFR 254.23 - What information must I include in the “Emergency response action plan” section?

Code of Federal Regulations, 2014 CFR

2014-07-01

... LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response Plans for Outer Continental Shelf Facilities § 254.23 What information must I include in the “Emergency response action plan” section? The “Emergency response action plan” section is the core of the response plan. Put information in easy-to-use formats such...

30 CFR 254.23 - What information must I include in the “Emergency response action plan” section?

Code of Federal Regulations, 2012 CFR

2012-07-01

... LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response Plans for Outer Continental Shelf Facilities § 254.23 What information must I include in the “Emergency response action plan” section? The “Emergency response action plan” section is the core of the response plan. Put information in easy-to-use formats such...

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.

10 CFR 50.47 - Emergency plans.

Code of Federal Regulations, 2010 CFR

2010-01-01

... responsibilities for emergency response by the nuclear facility licensee and by State and local organizations... supporting organizations have been specifically established, and each principal response organization has... licensee's near-site Emergency Operations Facility have been made, and other organizations capable of...

40 CFR 300.4 - Abbreviations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Function FCO—Federal Coordinating Officer FRERP—Federal Radiological Emergency Response Plan FRP—Federal Response Plan FS—Feasibility Study HRS—Hazard Ranking System LEPC—Local Emergency Planning Committee NCP... Action RCP—Regional Contingency Plan RD—Remedial Design RERT—Radiological Emergency Response Team RI...

40 CFR 300.4 - Abbreviations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Function FCO—Federal Coordinating Officer FRERP—Federal Radiological Emergency Response Plan FRP—Federal Response Plan FS—Feasibility Study HRS—Hazard Ranking System LEPC—Local Emergency Planning Committee NCP... Action RCP—Regional Contingency Plan RD—Remedial Design RERT—Radiological Emergency Response Team RI...

40 CFR 300.4 - Abbreviations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Function FCO—Federal Coordinating Officer FRERP—Federal Radiological Emergency Response Plan FRP—Federal Response Plan FS—Feasibility Study HRS—Hazard Ranking System LEPC—Local Emergency Planning Committee NCP... Action RCP—Regional Contingency Plan RD—Remedial Design RERT—Radiological Emergency Response Team RI...

40 CFR 300.4 - Abbreviations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Function FCO—Federal Coordinating Officer FRERP—Federal Radiological Emergency Response Plan FRP—Federal Response Plan FS—Feasibility Study HRS—Hazard Ranking System LEPC—Local Emergency Planning Committee NCP... Action RCP—Regional Contingency Plan RD—Remedial Design RERT—Radiological Emergency Response Team RI...

Emergency Care Capabilities in North East Haiti: A Cross-sectional Observational Study.

PubMed

De Wulf, Annelies; Aluisio, Adam R; Muhlfelder, Dana; Bloem, Christina

2015-12-01

The North East Department is a resource-limited region of Haiti. Health care is provided by hospitals and community clinics, with no formal Emergency Medical System and undefined emergency services. As a paucity of information exists on available emergency services in the North East Department of Haiti, the objective of this study was to assess systematically the existing emergency care resources in the region. This cross-sectional observational study was carried out at all Ministry of Public Health and Population (MSPP)-affiliated hospitals in the North East Department and all clinics within the Fort Liberté district. A modified version of the World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care and Generic Essential Emergency Equipment Lists were completed for each facility. Three MSPP hospitals and five clinics were assessed. Among hospitals, all had a designated emergency ward with 24 hour staffing by a medical doctor. All hospitals had electricity with backup generators and access to running water; however, none had potable water. All hospitals had x-ray and ultrasound capabilities. No computed tomography scanners existed in the region. Invasive airway equipment and associated medications were not present consistently in the hospitals' emergency care areas, but they were available in the operating rooms. Pulse oximetry was unavailable uniformly. One hospital had intermittently functioning defibrillation equipment, and two hospitals had epinephrine. Basic supplies for managing obstetrical and traumatic emergencies were available at all hospitals. Surgical services were accessible at two hospitals. No critical care services were available in the region. Clinics varied widely in terms of equipment availability. They uniformly had limited emergency medical equipment. The clinics also had inconsistent access to basic assessment tools (sphygmomanometers 20% and stethoscopes 60%). A protocol for transferring patients requiring a higher level of care was present in most (80%) clinics and one of the hospitals. However, no facility had a written protocol for transferring patients to other facilities. One hospital reported intermittent access to an ambulance for transfers. Deficits in the supply of emergency equipment and limited protocols for inter-facility transfers exist in North East Department of Haiti. These essential areas represent appropriate targets for interventions aimed at improving access to emergency care within the North East region of Haiti.

The acute-phase response impairs host defence against Enterococcus faecium peritonitis

PubMed Central

Leendertse, Masja; Willems, Rob J L; Giebelen, Ida A J; van den Pangaart, Petra S; Bonten, Marc J M; van der Poll, Tom

2009-01-01

Enterococcus faecium is an emerging pathogen that causes infections in hospitalized patients with various co-morbid diseases. These underlying diseases are often associated with an acute-phase response that renders patients vulnerable to nosocomial infections. To study the influence of the acute-phase response induced by sterile tissue injury on host defence against E. faecium, mice were injected subcutaneously with either turpentine or casein 1 day before intraperitoneal infection with E. faecium. Control mice were subcutaneously injected with saline or sodium bicarbonate, respectively. Turpentine and casein induced an acute-phase response as reflected by increases in the plasma concentrations of interleukin-6, serum amyloid P and C3. A pre-existent acute-phase response in mice was associated with a strongly reduced capacity to clear E. faecium, resulting in prolonged bacteraemia for several days. The inflammatory response to E. faecium was impaired in mice with an acute-phase response, as shown by reduced capacity to mount a neutrophilic leucocytosis in peripheral blood and by decreased local cytokine concentrations. These data indicate that the acute-phase response impairs host defence against E. faecium, suggesting that this condition may contribute to the increased vulnerability of critically ill patients to enterococcal infections. PMID:19175794

10 CFR 50.103 - Suspension and operation in war or national emergency.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Suspension and operation in war or national emergency. 50..., Emergency Operations by the Commission § 50.103 Suspension and operation in war or national emergency. (a) Whenever Congress declares that a state of war or national emergency exists, the Commission, if it finds it...

Canadian Cytogenetic Emergency network (CEN) for biological dosimetry following radiological/nuclear accidents.

PubMed

Miller, Susan M; Ferrarotto, Catherine L; Vlahovich, Slavica; Wilkins, Ruth C; Boreham, Douglas R; Dolling, Jo-Anna

2007-07-01

To test the ability of the cytogenetic emergency network (CEN) of laboratories, currently under development across Canada, to provide rapid biological dosimetry using the dicentric assay for triage assessment, that could be implemented in the event of a large-scale radiation/nuclear emergency. A workshop was held in May 2004 in Toronto, Canada, to introduce the concept of CEN and recruit clinical cytogenetic laboratories at hospitals across the country. Slides were prepared for dicentric assay analysis following in vitro irradiation of blood to a range of gamma-ray doses. A minimum of 50 metaphases per slide were analyzed by 41 people at 22 different laboratories to estimate the exposure level. Dose estimates were calculated based on a dose response curve generated at Health Canada. There were a total of 104 dose estimates and 96 (92.3%) of them fell within the expected range using triage scoring criteria. Half of the laboratories analyzed 50 metaphases in

Secondary traumatic stress among emergency nurses: a cross-sectional study.

PubMed

Duffy, Emer; Avalos, Gloria; Dowling, Maura

2015-04-01

Emergency department nurses are required to deal with emotional trauma issues on a daily basis, which may result in them experiencing symptoms of secondary traumatic stress, a consequence of stress experienced when helping or wanting to help a person traumatised or suffering. This study measured emergency department nurses' self-reported levels of secondary traumatic stress. Registered nurses (n = 117) working at three emergency departments in the Western geographical region of Ireland were invited to complete the secondary traumatic stress scale (STSS). A response rate of 90% (n = 105) was achieved. Most participants (n = 67/64%) met the criteria for secondary traumatic stress. A statistically significant finding was that the highest proportion (82%) of secondary traumatic stress existed in the staff nurse group (p = 0.042). Moreover, for those nurses reporting secondary traumatic stress, statistical significance was found for the variables 'change of career considered' (p = 0.017) and 'finds alcohol helpful in alleviating work-related stress' (p = 0.004), when compared with nurses not reporting secondary traumatic stress. The findings suggest the need to examine current crisis management interventions and to introduce new systems to support nurses in Irish emergency departments. Moreover, because different types of traumatic events in the ED require different types of interventions, the prevention and management of STS among emergency department nurses must be tackled using a variety of approaches. Copyright © 2014 Elsevier Ltd. All rights reserved.

Innovation in Graduate Education for Health Professionals in Humanitarian Emergencies.

PubMed

Evans, Dabney P; Anderson, Mark; Shahpar, Cyrus; Del Rio, Carlos; Curran, James W

2016-10-01

The objective of this report was to show how the Center for Humanitarian Emergencies (the Center) at Emory University (Atlanta, Georgia USA) has trained graduate students to respond to complex humanitarian emergencies (CHEs) through innovative educational programs, with the goal of increasing the number of trained humanitarian workers. Natural disasters are on the rise with more than twice as many occurring from 2000-2009 as there were from 1980-1989. In 2012 alone, 144 million people were affected by a natural disaster or displaced by conflict worldwide. This has created an immense need for trained humanitarian workers to respond effectively to such disasters. The Center has developed a model for educational programming that targets learners along an educational continuum ranging from the undergraduate level through continuing professional education. These programs, based in the Rollins School of Public Health (RSPH) of Emory University, include: a competency-based graduate certificate program (the Certificate) in humanitarian emergencies; a fellowship program for mid-career professionals; and funded field practica. The competency-based Certificate program began in 2010 with a cohort of 14 students. Since then, 101 students have received the Certificate with 50 more due for completion in 2016 and 2017 combined. The fellowship program for mid-career professionals has hosted four fellows from conflict-affected or resource-poor countries, who have then gone on to assume leadership positions with humanitarian organizations. From 2009-2015, the field practicum program supported 34 students in international summer practicum experiences related to emergency response or preparedness. Students have participated in summer field experiences on every continent but Australia. Together the Certificate, funded field practicum opportunities, and the fellowship comprise current efforts in providing innovative education and training for graduate and post-graduate students of public health in humanitarian response. These modest efforts are just the beginning in terms of addressing the global shortage of skilled public health professionals that can coordinate humanitarian response. Evaluating existing programs will allow for refinement of current programs. Ultimately, these programs may influence the development of new programs and inform others interested in this area. Evans DP , Anderson M , Shahpar C , del Rio C , Curran JW . Innovation in graduate education for health professionals in humanitarian emergencies. Prehosp Disaster Med. 2016;31(5):532-538.

75 FR 15362 - Demand Response Compensation in Organized Wholesale Energy Markets

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission 18 CFR Part 35 [Docket No. RM10-17-000... FERC ] 61,213, PJM Interconnection, LLC, Docket No. EL09-68-000 Notice of Proposed Rulemaking Table of... Emergency Demand Response; NYISO's Emergency Demand Response Program; PJM's Emergency Load Response; and ISO...

A Building-Resolved Wind Field Library for Vancouver: Facilitating CBRN Emergency Response for the 2010 Winter Olympic Games

DTIC Science & Technology

2010-06-01

Vancouver. Facilitating CBRN Emergency Response for the 2010 Winter Olympic Games E. Vee Defence R&D Canada- Suffield F.-S. Lien University of...ana a A Building-Resolved Wind Field Library for Vancouver. Facilitating CBRN Emergency Response for the 2010 Winter Olympic Games E. Yee Defence...support of emergency response applications (requiring quick turn- around times) for the 2010 Winter Olympic Games . To this purpose, mean wind and

'Reverse triage' adds to surge capacity.

PubMed

2009-06-01

Providing adequate surge capacity during a disaster is one of the greatest challenges of emergency response. Now, researchers have proposed a new process called "reverse triage" to help create surge capacity that otherwise would not exist. Patients who have only a slight chance of experiencing an adverse event within four days of leaving the hospital may be discharged to free bed space. ED staff can provide a daily initial reverse triage score for patients being admitted, even if a disaster is not imminent. While general guidelines can have great value, take the interests of the patient and their family into account when making discharge decisions.

A pragmatic belief system in family meaning-making after death.

PubMed

Black, Helen K; Santanello, Holly R; Rubinstein, Robert L

2014-01-01

The authors explored a sample of families' beliefs concerning creation of meaning in the recent death of the elderly husband and father and his existence in an afterlife. Data were collected through qualitative inquiry. Family members from 34 families were asked about their reaction to their loved one's death. Three themes emerged from participants' responses (a) the significance of context in the father and husband's life and death; (b) family members' folk beliefs; and (c) recalling the after-death ritual. The themes interpenetrate at the point where family members, although doubtful, hoped their loved one continues in an afterlife.

Walk-through survey report: Control technology for integrated circuit fabrication, Xerox Corporation, El Segundo, California

NASA Astrophysics Data System (ADS)

Mihlan, G. J.; Ungers, L. J.; Smith, R. K.; Mitchell, R. I.; Jones, J. H.

1983-05-01

A preliminary control technology assessment survey was conducted at the facility which manufactures N-channel metal oxide semiconductor (NMOS) integrated circuits. The facility has industrial hygiene review procedures for evaluating all new and existing process equipment. Employees are trained in safety, use of personal protective equipment, and emergency response. Workers potentially exposed to arsenic are monitored for urinary arsenic levels. The facility should be considered a candidate for detailed study based on the diversity of process operations encountered and the use of state-of-the-art technology and process equipment.

[Emergency department as final destination: perception and reception of the palliative patient" concept as well as approach toward improving interdisciplinary collaboration - a survey of emergency personnel of a Swiss emergency department].

PubMed

Klenk, Laurence; Iucolano, Nicoletta M; Braun, Christian Tasso; Exadaktylos, Aristomenis K; Eychmüller, Steffen

2015-01-02

As the demand for palliative care (PC) in emergency wards continues to increase, emergency medicine is increasingly focusing on the care of extremely ill patients with incurable, chronic and/or advanced diseases. There is no consistent definition of the profile of PC or understanding of what PC involves. The mistake is often made of confusing PC with end-of-life or terminal care. The present study was intended to assess the situation at the Department of Emergency Medicine, Inselspital, Bern University Hospital (UNZ), which cares for about 32 400 patients annually. The plan was to find out how much staff members knew about PC and to survey their personal attitudes. The employees of the UNZ were surveyed with an online questionnaire by a special institution outside the hospital. This is based on an instrument [1] developed in a comparative study in an emergency ward in the USA and used for physicians. 60 of 154 staff members (physicians and nurses) completed the questionnaire, corresponding to a response rate of 39%. The definition of palliative care (n=60) was very mixed and could be classified into 6 areas. In response to questions about specific services, the staff members mentioned that their access to existing patient data should be facilitated. They also expressed the wish for a 24 h palliative consultation service and thought that, during normal working days, more time should be allotted to discussing issues related to palliative care. It has been confirmed that the definition of palliative care is not consistent. Within the UNZ, there is no clear procedure, but lack of time for detailed discussions with patients needing palliative care. Patient wishes or living wills with the DNR/DNI procedure do not contradict the personal ethics of most staff members. UNZ staff members would welcome the 24 h availability of a specialized PC team, as well as the development of guidelines and increased training in PC.

Characterization of post-disaster environmental management for Hazardous Materials Incidents: Lessons learnt from the Tianjin warehouse explosion, China.

PubMed

Zhang, Hui; Duan, Huabo; Zuo, Jian; Song, MingWei; Zhang, Yukui; Yang, Bo; Niu, Yongning

2017-09-01

Hazardous Materials Incidents (HMIs) have attracted a growing public concern worldwide. The health risks and environmental implications associated with HMIs are almost invariably severe, and underscore the urgency for sound management. Hazardous Materials Explosion incidents (HMEIs) belong to a category of extremely serious HMIs. Existing studies placed focuses predominately on the promptness and efficiency of emergency responses to HMIs and HMEIs. By contrast, post-disaster environmental management has been largely overlooked. Very few studies attempted to examine the post-disaster environmental management plan particularly its effectiveness and sufficiency. In the event of the Tianjin warehouse explosion (TWE), apart from the immediate emergency response, the post-disaster environmental management systems (P-EMSs) have been reported to be effective and sufficient in dealing with the environmental concerns. Therefore, this study aims to critically investigate the P-EMSs for the TWE, and consequently to propose a framework and procedures for P-EMSs in general for HMIs, particularly for HMEIs. These findings provide a useful reference to develop P-EMSs for HMIs in the future, not only in China but also other countries. Copyright © 2017. Published by Elsevier Ltd.

The Immune Landscape of Non-Small Cell Lung Cancer: Utility of Cytologic and Histologic Samples Obtained Through Minimally Invasive Pulmonary Procedures.

PubMed

Beattie, Jason; Yarmus, Lonny; Wahidi, Momen M; Rivera, M Patricia; Gilbert, Christopher; Maldonado, Fabien; Czarnecka, Kasia; Argento, Angela; Chen, Alexander; Herth, Felix; Sterman, Daniel H

2018-05-14

The success of immune checkpoint inhibitors and the discovery of useful biomarkers to predict response to these agents is shifting much of the focus of personalized care for non-small cell lung cancer towards harnessing the immune response. With further advancement, more effective immunotherapy options will emerge along with more useful biomarkers. Paradoxically, minimally invasive small biopsy and cytology specimens have become the primary method for diagnosis of patients with advanced disease, as well for initial diagnosis and staging in earlier stage disease. For the benefit of these patients, we will continue to learn how to do more with less. In this perspective, we review aspects of immunobiology that underlie the current state of the art of existing and emerging immunologic biomarkers that hold potential to enhance the care of patients with non-small cell lung cancer. We address practical considerations for acquiring patient samples that accurately reflect disease immune status. We also propose a paradigm shift wherein the most important sample types that need to be proven in pioneering basic science and translation work and subsequent clinical trials are the specimens most often obtained clinically.

Seeing double: visual physiology of double-retina eye ontogeny in stomatopod crustaceans.

PubMed

Feller, Kathryn D; Cohen, Jonathan H; Cronin, Thomas W

2015-03-01

Stomatopod eye development is unusual among crustaceans. Just prior to metamorphosis, an adult retina and associated neuro-processing structures emerge adjacent to the existing material in the larval compound eye. Depending on the species, the duration of this double-retina eye can range from a few hours to several days. Although this developmental process occurs in all stomatopod species observed to date, the retinal physiology and extent to which each retina contributes to the animal's visual sensitivity during this transition phase is unknown. We investigated the visual physiology of stomatopod double retinas using microspectrophotometry and electroretinogram recordings from different developmental stages of the Western Atlantic species Squilla empusa. Though microspectrophotometry data were inconclusive, we found robust ERG responses in both larval and adult retinas at all sampled time points indicating that the adult retina responds to light from the very onset of its emergence. We also found evidence of an increase in the response dynamics with ontogeny as well as an increase in sensitivity of retinal tissue during the double-retina phase relative to single retinas. These data provide an initial investigation into the ontogeny of vision during stomatopod double-retina eye development.

Management of patients infected with airborne-spread diseases: an algorithm for infection control professionals.

PubMed

Rebmann, Terri

2005-12-01

Many US hospitals lack the capacity to house safely a surge of potentially infectious patients, increasing the risk of secondary transmission. Respiratory protection and negative-pressure rooms are needed to prevent transmission of airborne-spread diseases, but US hospitals lack available and/or properly functioning negative-pressure rooms. Creating new rooms or retrofitting existing facilities is time-consuming and expensive. Safe methods of managing patients with airborne-spread diseases and establishing temporary negative-pressure and/or protective environments were determined by a literature review. Relevant data were analyzed and synthesized to generate a response algorithm. Ideal patient management and placement guidelines, including instructions for choosing respiratory protection and creating temporary negative-pressure or other protective environments, were delineated. Findings were summarized in a treatment algorithm. The threat of bioterrorism and emerging infections increases health care's need for negative-pressure and/or protective environments. The algorithm outlines appropriate response steps to decrease transmission risk until an ideal protective environment can be utilized. Using this algorithm will prepare infection control professionals to respond more effectively during a surge of potentially infectious patients following a bioterrorism attack or emerging infectious disease outbreak.

Addressing the gap between public health emergency planning and incident response

PubMed Central

Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

2013-01-01

Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods: This study was conducted using critical case study methodology consisting of document review and 18 key-informant interviews with individuals who played key roles in planning and response. Thematic analysis was used to analyze data. Results: Several broad elements emerged as key to ensuring effective and efficient public health response: 1) developing a plan for emergency response; 2) establishing the framework for an ICS; 3) creating the infrastructure to support response; 4) supporting a workforce trained on emergency response roles, responsibilities, and equipment; and 5) conducting regular preparedness exercises. Conclusions: This research demonstrates the value of investments made and that effective emergency preparedness requires sustained efforts to maintain personnel and material resources. By having the infrastructure and experience based on ICS and EOC, the public health system had the capability to surge-up: to expand its day-to-day operation in a systematic and prolonged manner. None of these critical actions are possible without sustained funding for the public health infrastructure. Ultimately, this case study illustrates the importance of public health as a key leader in emergency response. PMID:28228983

Intelligent transportation systems field operational test cross-cutting study : emergency notification and response.

DOT National Transportation Integrated Search

1998-09-01

Emergency Notification and Response report summarizes and interprets the results of two Field Operational Tests (FOTs) that included emergency notification and response system components. The tests included in this report are: Colorado Mayday and Pug...

47 CFR 0.192 - Emergency Response Interoperability Center.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Emergency Response Interoperability Center. 0.192 Section 0.192 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Public Safety and Homeland Security Bureau § 0.192 Emergency Response Interoperability Center. (a...

47 CFR 0.192 - Emergency Response Interoperability Center.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Emergency Response Interoperability Center. 0.192 Section 0.192 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Public Safety and Homeland Security Bureau § 0.192 Emergency Response Interoperability Center. (a...

47 CFR 0.192 - Emergency Response Interoperability Center.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Emergency Response Interoperability Center. 0.192 Section 0.192 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION Organization Public Safety and Homeland Security Bureau § 0.192 Emergency Response Interoperability Center. (a...

44 CFR 352.25 - Limitation on committing Federal facilities and resources for emergency preparedness.

Code of Federal Regulations, 2013 CFR

2013-10-01

... licensee offsite emergency response plan only to the extent necessary to compensate for the... response plan. ... Federal facilities and resources for emergency preparedness. 352.25 Section 352.25 Emergency Management...

44 CFR 352.25 - Limitation on committing Federal facilities and resources for emergency preparedness.

Code of Federal Regulations, 2014 CFR

2014-10-01

... licensee offsite emergency response plan only to the extent necessary to compensate for the... response plan. ... Federal facilities and resources for emergency preparedness. 352.25 Section 352.25 Emergency Management...

44 CFR 352.25 - Limitation on committing Federal facilities and resources for emergency preparedness.

Code of Federal Regulations, 2012 CFR

2012-10-01

... licensee offsite emergency response plan only to the extent necessary to compensate for the... response plan. ... Federal facilities and resources for emergency preparedness. 352.25 Section 352.25 Emergency Management...

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).

The Tanzanian trauma patients' prehospital experience: a qualitative interview-based study

PubMed Central

Kuzma, Kristin; Lim, Andrew George; Kepha, Bernard; Nalitolela, Neema Evelyne; Reynolds, Teri A

2015-01-01

Objectives We sought to characterise the prehospital experience of Tanzanian trauma patients, and identify barriers and facilitators to implement community-based emergency medical systems (EMS). Settings Our study was conducted in the emergency department of an urban national referral hospital in Tanzania. Participants A convenience sample of 34 adult trauma patients, or surrogate family members, presenting or referred to an urban referral emergency department in Tanzania for treatment of injury, participated in the study. Interventions Participation in semistructured, iteratively developed interviews until saturation of responses was reached. Outcomes A grounded theory-based approach to qualitative analysis was used to identify recurrent themes. Results We characterised numerous deficiencies within the existing clinic-to-hospital referral network, including missed/delayed diagnoses, limited management capabilities at pre-referral facilities and interfacility transfer delays. Potential barriers to EMS implementation include patient financial limitations and lack of insurance, limited public infrastructure and resources, and the credibility of potential first aid responders. Potential facilitators of EMS include communities’ tendency to pool resources, individuals’ trust of other community members to be first aid responders, and faith in community leaders to organise EMS response. Participants expressed a strong desire to learn first aid. Conclusions The composite themes generated by the data suggest that there are myriad structural, financial, institutional and cultural barriers to the implementation of a formal prehospital system. However, our analysis also revealed potential facilitators to a first-responder system that takes advantage of close-knit local communities and the trust of recognised leaders in society. The results suggest favourable acceptability for community-based response by trained lay people. There is significant opportunity for care improvements with short trainings and low-cost supply planning. Further research looking at the effects of delay on outcomes in this population is needed. PMID:25916487

The Rapid Disaster Evaluation System (RaDES): A Plan to Improve Global Disaster Response by Privatizing the Assessment Component.

PubMed

Iserson, Kenneth V

2017-09-01

Emergency medicine personnel frequently respond to major disasters. They expect to have an effective and efficient management system to elegantly allocate available resources. Despite claims to the contrary, experience demonstrates this rarely occurs. This article describes privatizing disaster assessment using a single-purposed, accountable, and well-trained organization. The goal is to achieve elegant disaster assessment, rather than repeatedly exhorting existing groups to do it. The Rapid Disaster Evaluation System (RaDES) would quickly and efficiently assess a postdisaster population's needs. It would use an accountable nongovernmental agency's teams with maximal training, mobility, and flexibility. Designed to augment the Inter-Agency Standing Committee's 2015 Emergency Response Preparedness Plan, RaDES would provide the initial information needed to avoid haphazard and overlapping disaster responses. Rapidly deployed teams would gather information from multiple sources and continually communicate those findings to their base, which would then disseminate them to disaster coordinators in a concise, coherent, and transparent way. The RaDES concept represents an elegant, minimally bureaucratic, and effective rapid response to major disasters. However, its implementation faces logistical, funding, and political obstacles. Developing and maintaining RaDES would require significant funding and political commitment to coordinate the numerous agencies that claim to be performing the same tasks. Although simulations can demonstrate efficacy and deficiencies, only field tests will demonstrate RaDES' power to improve interagency coordination and decrease the cost of major disaster response. At the least, the RaDES concept should serve as a model for discussing how to practicably improve our current chaotic disaster responses. Copyright © 2016 Elsevier Inc. All rights reserved.

The knowledge, attitude and behavior about public health emergencies and the response capacity of primary care medical staffs of Guangdong Province, China

PubMed Central

2012-01-01

Background Primary care medical staffs’ knowledge, attitude and behavior about health emergency and the response capacity are directly related to the control and prevention of public health emergencies. Therefore, it is of great significance for improving primary care to gain in-depth knowledge about knowledge, attitude and behavior and the response capacity of primary care medical staffs. The main objective of this study is to explore knowledge, attitude and behavior, and the response capacity of primary care medical staffs of Guangdong Province, China. Methods Stratified clustered sample method was used in the anonymous questionnaire investigation about knowledge, attitude and behavior, and the response capacity of 3410 primary care medical staffs in 15 cities of Guangdong Province, China from July, 2010 to October 2010. The emergency response capacity was evaluated by 33 questions. The highest score of the response capacity was 100 points (full score), score of 70 was a standard. Results 62.4% primary care medical staffs believed that public health emergencies would happen. Influenza (3.86 ± 0.88), food poisoning (3.35 ± 0.75), and environmental pollution events (3.23 ± 0.80) (the total score was 5) were considered most likely to occur. Among the 7 public health emergency skills, the highest self-assessment score is “public health emergency prevention skills” (2.90 ± 0.68), the lowest is “public health emergency risk management (the total score was 5)” (1.81 ± 0.40). Attitude evaluation showed 66.1% of the medical staffs believed that the community awareness of risk management were ordinary. Evaluation of response capacity of health emergency showed that the score of primary care medical staffs was 67.23 ± 10.61, and the response capacity of senior physicians, public health physicians and physicians with relatively long-term practice were significantly better (P <0.05). Multiple linear stepwise regression analysis showed gender, title, position, type of work, work experience and whether to participate relative training were the main factors affecting the health emergency response capacity. Conclusions The knowledge, attitude and behavior about public health emergencies and the response capacity of primary care medical staffs of Guangdong Province (China) were poor. Health administrative departments should strengthen the training of health emergency knowledge and skills of the primary care medical staffs to enhance their health emergency response capabilities. PMID:23009075

Trends and Issues in California's Low Carbon Fuel Standard - Learning from Response to Existing Climate Policy

NASA Astrophysics Data System (ADS)

Witcover, J.

2015-12-01

Debate over lower greenhouse gas (GHG) emissions from transportation has included heated discussion about appropriate policies and their cost and feasibility. One prominent policy mechanism, a carbon intensity standard, rates transport fuels based on analysis of lifecycle GHG emissions, and targets lower fuel pool carbon intensity through a market mechanism that uses a system of tradable, bankable credits and deficits. California instituted such a policy -- the Low Carbon Fuel Standard (LCFS) - in 2010, which targets a 10% carbon intensity (CI) reduction by 2020. The program rolled out amid concerns over slow development of new fuels expected to be very low carbon (such as cellulosic) and has faced court challenges that added considerable policy uncertainty. Since the program's start, state transport energy mix has shifted modestly but noticeably. Looking ahead, emerging issues for the program include amendments and re-adoption in response to a court ruling, potential interaction with California's multi-sector cap on carbon emissions (which started covering transport fuels in 2015), and impacts from similar CI standards in other jurisdictions. This study provides an analysis of fuel mix changes since the LCFS was implemented in 2011, and a discussion of emerging issues focusing on policy interaction. Descriptive statistics on alternative fuel use, available fuel pathways, and CI ratings are presented based on data from the California Air Resources Board (which runs the program). They document a shift towards more alternative fuels in a more diverse mix, with lower average CI ratings for most alternative fuel types. Financial incentives for various fuels are compared under the LCFS and the US federal Renewable Fuel Standard; disincentives from conceptually different carbon pricing schemes under the LCFS and the Cap-and-Trade are also outlined. The results provide important information on response to an existing market-based policy mechanism for addressing GHG emissions in transportation, as other jurisdictions weigh similar climate policies and debate mechanisms and costs and California announced an ambitious target of halving petroleum use by 2030.

A culture of tsunami preparedness and applying knowledge from recent tsunamis affecting California

NASA Astrophysics Data System (ADS)

Miller, K. M.; Wilson, R. I.

2012-12-01

It is the mission of the California Tsunami Program to ensure public safety by protecting lives and property before, during, and after a potentially destructive or damaging tsunami. In order to achieve this goal, the state has sought first to use finite funding resources to identify and quantify the tsunami hazard using the best available scientific expertise, modeling, data, mapping, and methods at its disposal. Secondly, it has been vital to accurately inform the emergency response community of the nature of the threat by defining inundation zones prior to a tsunami event and leveraging technical expertise during ongoing tsunami alert notifications (specifically incoming wave heights, arrival times, and the dangers of strong currents). State scientists and emergency managers have been able to learn and apply both scientific and emergency response lessons from recent, distant-source tsunamis affecting coastal California (from Samoa in 2009, Chile in 2010, and Japan in 2011). Emergency managers must understand and plan in advance for specific actions and protocols for each alert notification level provided by the NOAA/NWS West Coast/Alaska Tsunami Warning Center. Finally the state program has provided education and outreach information via a multitude of delivery methods, activities, and end products while keeping the message simple, consistent, and focused. The goal is a culture of preparedness and understanding of what to do in the face of a tsunami by residents, visitors, and responsible government officials. We provide an update of results and findings made by the state program with support of the National Tsunami Hazard Mitigation Program through important collaboration with other U.S. States, Territories and agencies. In 2009 the California Emergency Management Agency (CalEMA) and the California Geological Survey (CGS) completed tsunami inundation modeling and mapping for all low-lying, populated coastal areas of California to assist local jurisdictions on the coast in the identification of areas possible to be inundated in a tsunami. "Tsunami Inundation Maps for Emergency Planning" have provided the basis for some of the following preparedness, planning, and education activities in California: Improved evacuation and emergency response plans; Production of multi-language brochures: statewide, community, and boating; Development and support of tsunami scenario-driven exercises and drills; Development of workshops to educate both emergency managers and public; and Establishment of a comprehensive information website www.tsunami.ca.gov; and a preparedness website myhazards.calema.ca.gov. In addition, the California Tsunami Program has a number of initiatives underway through existing work plans to continue to apply scientifically vetted information toward comprehensive public understanding of the threat from future tsunamis to constituents on the coast. These include projects to: Complete tsunami land-use planning maps for California communities, Develop in-harbor tsunami hazard maps statewide, Complete modeling of offshore safety zones for the maritime community, Complete preliminary tsunami risk analysis for state utilizing new HAZUS tsunami module and probabilistic analysis results, and Develop a post-tsunami recovery and resiliency plan for the state.

Frustration-induced internal stresses are responsible for quasilocalized modes in structural glasses

NASA Astrophysics Data System (ADS)

Lerner, Edan; Bouchbinder, Eran

2018-03-01

It has been recently shown [E. Lerner, G. Düring, and E. Bouchbinder, Phys. Rev. Lett. 117, 035501 (2016), 10.1103/PhysRevLett.117.035501] that the nonphononic vibrational modes of structural glasses at low frequencies ω are quasilocalized and follow a universal density of states D (ω ) ˜ω4 . Here we show that the gapless nature of the observed density of states depends on the existence of internal stresses that generically emerge in glasses due to frustration, thus elucidating a basic element underlying this universal behavior. Similarly to jammed particulate packings, low-frequency modes in structural glasses emerge from a balance between a local elasticity term and an internal stress term in the dynamical matrix, where the difference between them is orders of magnitude smaller than their typical magnitude. By artificially reducing the magnitude of internal stresses in a computer glass former in three dimensions, we show that a gap is formed in the density of states below which no vibrational modes exist, thus demonstrating the crucial importance of internal stresses. Finally, we show that while better annealing the glass upon cooling from the liquid state significantly reduces its internal stresses, the self-organizational processes during cooling render the gapless D (ω ) ˜ω4 density of state unaffected.

Emerging pulmonary vasculature lacks fate specification.

PubMed

Schwarz, Margaret A; Caldwell, Lauren; Cafasso, Danielle; Zheng, Haihua

2009-01-01

Lung morphogenesis requires precise coordination between branching morphogenesis and vascularization to generate distal airways capable of supporting respiration at the cell-cell interface. The specific origins and types of blood vessels that initially form in the lung, however, remain obscure. Herein, we definitively show that during the early phases of lung development [i.e., embryonic day (E) 11.5], functional vessels, replete with blood flow, are restricted to the mesenchyme, distal to the epithelium. However, by day E14.5, and in response to epithelial-derived VEGF signals, functional vessels extend from the mesenchyme to the epithelial interface. Moreover, these vessels reside adjacent to multipotent mesenchymal stromal cells that likely play a regulatory role in this process. As well as and distinct from the systemic vasculature, immunostaining for EphrinB2 and EphB4 revealed that arterial and venous identity is not distinguishable in emergent pulmonary vasculature. Collectively, this study provides evidence that lung vascularization initially originates in the mesenchyme, distal to the epithelium, and that arterial-venous specification does not exist in the early lung. At a mechanistic level, we show that basilar epithelial VEGF prompts endothelial cells to move toward the epithelium where they undergo morphogenesis during the proliferative, canalicular stage. Thus our findings challenge existing notions of vascular origin and identity during development.

Contraceptive availability during an emergency response in the United States.

PubMed

Ellington, Sascha R; Kourtis, Athena P; Curtis, Kathryn M; Tepper, Naomi; Gorman, Susan; Jamieson, Denise J; Zotti, Marianne; Barfield, Wanda

2013-03-01

This article provides the evidence for contraceptive need to prevent unintended pregnancy during an emergency response, discusses the most appropriate types of contraceptives for disaster situations, and details the current provisions in place to provide contraceptives during an emergency response.

40 CFR 68.180 - Emergency response program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Emergency response program. 68.180 Section 68.180 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.180 Emergency response program...

Emergent intraverbal responses via tact and match-to-sample instruction.

PubMed

Grannan, Leigh; Rehfeldt, Ruth Anne

2012-01-01

The present investigation evaluated the effectiveness of category tact and match-to-sample instruction in facilitating the emergence of intraverbal responses (i.e., naming several items belonging to a specific category) for 2 children with autism. Results demonstrated the emergence of untaught responses, suggesting an effective instructional protocol for establishing intraverbal responses without direct instruction.

Integration of Palliative Care in the Context of Rapid Response

PubMed Central

Nelson, Judith E.; Mathews, Kusum S.; Weissman, David E.; Brasel, Karen J.; Campbell, Margaret; Curtis, J. Randall; Frontera, Jennifer A.; Gabriel, Michelle; Hays, Ross M.; Mosenthal, Anne C.; Mulkerin, Colleen; Puntillo, Kathleen A.; Ray, Daniel E.; Weiss, Stefanie P.; Bassett, Rick; Boss, Renee D.; Lustbader, Dana R.

2015-01-01

Rapid response teams (RRTs) can effectively foster discussions about appropriate goals of care and address other emergent palliative care needs of patients and families facing life-threatening illness on hospital wards. In this article, The Improving Palliative Care in the ICU (IPAL-ICU) Project brings together interdisciplinary expertise and existing data to address the following: special challenges for providing palliative care in the rapid response setting, knowledge and skills needed by RRTs for delivery of high-quality palliative care, and strategies for improving the integration of palliative care with rapid response critical care. We discuss key components of communication with patients, families, and primary clinicians to develop a goal-directed treatment approach during a rapid response event. We also highlight the need for RRT expertise to initiate symptom relief. Strategies including specific clinician training and system initiatives are then recommended for RRT care improvement. We conclude by suggesting that as evaluation of their impact on other outcomes continues, performance by RRTs in meeting palliative care needs of patients and families should also be measured and improved. PMID:25644909

Remotely Piloted Life-Saving Effort vehicles and emergency management: An analysis on revolutionizing humanitarian assistance in Pakistan.

PubMed

Nadeem, Ali Bin; Chandna, Ysa

The majority of the Pakistani public has known little of the unmanned aerial vehicles, also known for their onomatopoeically inspired name "drones," except the fact that it regularly rains Hellfire missiles in Pakistan, claiming the lives of many innocent Pakistanis settled in the western provinces. In actuality, in addition to their destructive capacities, these remotely piloted vehicles have been used since the turn of the century in a variety of live-saving and risk-reducing roles. This research article primarily addresses the third stage of Emergency management-response, with Pakistan being the primary region of research. This research article will first begin by diagnosing and accurately delineating the types of humanitarian crisis that grip Pakistan, devastating its land, exhausting its limited resources in its weak, and now almost archaic, disaster response strategy that results in the prolongation of its citizens' plight. Subsequently, this article will describe the history of the usage of unmanned vehicles, its multi-functional capacities, and its relevance in aiding humanitarian response efforts in disaster-stricken areas. Finally, this article will propose the introduction of Remotely Piloted Life-Saving Effort (RELIEF) vehicles in performing analysis and surveillance roles in Pakistan's disaster-prone and disaster-struck areas and its capacity to dramatically improve and expedite the existing relief supply delivery systems in place.

Review of disaster management implementation for the community safety in the vicinity of oil and gas field

NASA Astrophysics Data System (ADS)

Musa, R. Abdullah; Harjanto, Meddy; Heni, Siti

2015-04-01

Sukowati site which is operated by Production Sharing Contract (PSC) Joint Operating Body Pertamina Petrochina East Java (JOB P-PEJ) located at Bojonegoro regency East Java Province. This site is close to densely populated settlements with approximately 6,010 people within a radius less than 600 m. The fluid produced have a dangerous potential to the above mention community, due to accompanying of hydrogen sulphide gas (H2S) with a concentration about 0.6% - 2% from the total gas produced. In 2006, there was incident of gas leak from drilling development well of Sukowati # 5. The incident made the surrounding community panic due to lack of preparedness and awareness. Learning from the incident, the company together with the government and local communities initiated to make improvements through the disaster management system approach. The efforts are carried out in accordance with the 4 (four) periods in a continuous cycle consist of (1) mitigation; (2) preparation; (3) response and (4) recovery. Emergency response drills conducted regularly at least once a year, its main purpose is to find out the results of the implementation of the existing disaster management. The results of the drills showed an increase in public awareness and responsiveness to emergency situations caused by the operational failures of oil and gas exploration and production activities near their settlement.

Mutation as a Stress Response and the Regulation of Evolvability

PubMed Central

Galhardo, Rodrigo S.; Hastings, P. J.; Rosenberg, Susan M.

2010-01-01

Our concept of a stable genome is evolving to one in which genomes are plastic and responsive to environmental changes. Growing evidence shows that a variety of environmental stresses induce genomic instability in bacteria, yeast, and human cancer cells, generating occasional fitter mutants and potentially accelerating adaptive evolution. The emerging molecular mechanisms of stress-induced mutagenesis vary but share telling common components that underscore two common themes. The first is the regulation of mutagenesis in time by cellular stress responses, which promote random mutations specifically when cells are poorly adapted to their environments, i.e., when they are stressed. A second theme is the possible restriction of random mutagenesis in genomic space, achieved via coupling of mutation-generating machinery to local events such as DNA-break repair or transcription. Such localization may minimize accumulation of deleterious mutations in the genomes of rare fitter mutants, and promote local concerted evolution. Although mutagenesis induced by stresses other than direct damage to DNA was previously controversial, evidence for the existence of various stress-induced mutagenesis programs is now overwhelming and widespread. Such mechanisms probably fuel evolution of microbial pathogenesis and antibiotic-resistance, and tumor progression and chemotherapy resistance, all of which occur under stress, driven by mutations. The emerging commonalities in stress-induced-mutation mechanisms provide hope for new therapeutic interventions for all of these processes. PMID:17917874

Knowledge Management Framework for Emerging Infectious Diseases Preparedness and Response: Design and Development of Public Health Document Ontology

PubMed Central

Zhang, Zhizun; Gonzalez, Mila C; Morse, Stephen S

2017-01-01

Background There are increasing concerns about our preparedness and timely coordinated response across the globe to cope with emerging infectious diseases (EIDs). This poses practical challenges that require exploiting novel knowledge management approaches effectively. Objective This work aims to develop an ontology-driven knowledge management framework that addresses the existing challenges in sharing and reusing public health knowledge. Methods We propose a systems engineering-inspired ontology-driven knowledge management approach. It decomposes public health knowledge into concepts and relations and organizes the elements of knowledge based on the teleological functions. Both knowledge and semantic rules are stored in an ontology and retrieved to answer queries regarding EID preparedness and response. Results A hybrid concept extraction was implemented in this work. The quality of the ontology was evaluated using the formal evaluation method Ontology Quality Evaluation Framework. Conclusions Our approach is a potentially effective methodology for managing public health knowledge. Accuracy and comprehensiveness of the ontology can be improved as more knowledge is stored. In the future, a survey will be conducted to collect queries from public health practitioners. The reasoning capacity of the ontology will be evaluated using the queries and hypothetical outbreaks. We suggest the importance of developing a knowledge sharing standard like the Gene Ontology for the public health domain. PMID:29021130

Prehospital Emergencies in Illegal Gold Mining Sites in French Guiana.

PubMed

Egmann, Gérald; Tattevin, Pierre; Palancade, Renaud; Nacher, Matthieu

2018-03-01

Illegal gold mining is flourishing in French Guiana, existing outside the law due to both the high cost of gold mining permits and the challenges of law enforcement within the Amazon forest. We report the characteristics of, and the medical responses to, medical emergencies in illegal gold mining sites. We performed a retrospective study of all medical emergencies reported from illegal gold mining sites to the centralized call office of SAMU 973 from 1998 through 2000 and from 2008 through 2010. According to the national health care system, any medical emergency within the territory is handled by the prehospital emergency medical service (SAMU 973), irrespective of the patients' legal status. Data were extracted from the SAMU 973 notebook registry (1998-2000) or the SAMU 973 computerized database (2008-2010) and werre collected using a standardized questionnaire. Of 71,932 calls for medical emergencies in French Guiana during the study periods, 340 (0.5%) originated from illegal gold mining sites. Of these, 196 (58%) led to medical evacuation by helicopter, whereas the overall rate of evacuation by helicopter after placing a call to SAMU 973 was only 4% (3020/71,932; P<0.0001 for comparison with illegal gold mining sites). Medical emergencies were classified as illness (48%, mostly infectious), trauma (44%, mostly weapon wounds), and miscellaneous (8%). Medical emergencies at illegal gold mining sites in the Amazon forest mostly include infectious diseases, followed by trauma, and often require medical evacuation by helicopter. Our study suggests that implementation of preventive medicine within gold mining sites, irrespective of their legal status, could be cost-effective and reduce morbidity. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Exploratory analysis of real personal emergency response call conversations: considerations for personal emergency response spoken dialogue systems.

PubMed

Young, Victoria; Rochon, Elizabeth; Mihailidis, Alex

2016-11-14

The purpose of this study was to derive data from real, recorded, personal emergency response call conversations to help improve the artificial intelligence and decision making capability of a spoken dialogue system in a smart personal emergency response system. The main study objectives were to: develop a model of personal emergency response; determine categories for the model's features; identify and calculate measures from call conversations (verbal ability, conversational structure, timing); and examine conversational patterns and relationships between measures and model features applicable for improving the system's ability to automatically identify call model categories and predict a target response. This study was exploratory and used mixed methods. Personal emergency response calls were pre-classified according to call model categories identified qualitatively from response call transcripts. The relationships between six verbal ability measures, three conversational structure measures, two timing measures and three independent factors: caller type, risk level, and speaker type, were examined statistically. Emergency medical response services were the preferred response for the majority of medium and high risk calls for both caller types. Older adult callers mainly requested non-emergency medical service responders during medium risk situations. By measuring the number of spoken words-per-minute and turn-length-in-words for the first spoken utterance of a call, older adult and care provider callers could be identified with moderate accuracy. Average call taker response time was calculated using the number-of-speaker-turns and time-in-seconds measures. Care providers and older adults used different conversational strategies when responding to call takers. The words 'ambulance' and 'paramedic' may hold different latent connotations for different callers. The data derived from the real personal emergency response recordings may help a spoken dialogue system classify incoming calls by caller type with moderate probability shortly after the initial caller utterance. Knowing the caller type, the target response for the call may be predicted with some degree of probability and the output dialogue could be tailored to this caller type. The average call taker response time measured from real calls may be used to limit the conversation length in a spoken dialogue system before defaulting to a live call taker.

A national survey on health department capacity for community engagement in emergency preparedness.

PubMed

Schoch-Spana, Monica; Selck, Frederic W; Goldberg, Lisa A

2015-01-01

Limited systematic knowledge exists about how public health practitioners and policy makers can best strengthen community engagement in public health emergency preparedness ("CE-PHEP"), a top priority for US national health security. To investigate local health department (LHD) adoption of federally recommended participatory approaches to PHEP and to identify LHD organizational characteristics associated with more intense CE-PHEP. National survey in 2012 of LHDs using a self-administered Web-based questionnaire regarding LHD practices and resources for CE-PHEP ("The Community Engagement for Public Health Emergency Preparedness Survey"). Differences in survey responses were examined, and a multivariate analysis was used to test whether LHD organizational characteristics were associated with differences in CE-PHEP intensity. A randomized sample of 754 LHDs drawn from the 2565 LHDs that had been invited to participate in the 2010 National Profile of LHDs. Sample selection was stratified by the size of population served and geographic location. Emergency preparedness coordinators reporting on their respective LHDs. CE-PHEP intensity as measured with a scoring system that rated specific CE-PHEP practices by LHD according to the relative degrees of public participation and community capacity they represented. Survey response rate was 61%. The most common reported CE-PHEP activity was disseminating personal preparedness materials (90%); the least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE-PHEP were having a formal CE-PHEP policy, allocating funds for CE-PHEP, having strong support from community-based organizations, and employing a coordinator with prior CE experience. Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and aligning budgets with the value of CE-PHEP to US national health security.

Emergency Response Virtual Environment for Safe Schools

NASA Technical Reports Server (NTRS)

Wasfy, Ayman; Walker, Teresa

2008-01-01

An intelligent emergency response virtual environment (ERVE) that provides emergency first responders, response planners, and managers with situational awareness as well as training and support for safe schools is presented. ERVE incorporates an intelligent agent facility for guiding and assisting the user in the context of the emergency response operations. Response information folders capture key information about the school. The system enables interactive 3D visualization of schools and academic campuses, including the terrain and the buildings' exteriors and interiors in an easy to use Web..based interface. ERVE incorporates live camera and sensors feeds and can be integrated with other simulations such as chemical plume simulation. The system is integrated with a Geographical Information System (GIS) to enable situational awareness of emergency events and assessment of their effect on schools in a geographic area. ERVE can also be integrated with emergency text messaging notification systems. Using ERVE, it is now possible to address safe schools' emergency management needs with a scaleable, seamlessly integrated and fully interactive intelligent and visually compelling solution.

Expanding CERC beyond public health: sharing best practices with healthcare managers via virtual learning.

PubMed

Hewitt, Anne M; Spencer, Susan S; Ramloll, Rameshsharma; Trotta, Heidi

2008-10-01

Developed by the Center for Disease Control and Prevention in 2002, the Crisis Emergency and Risk Communication (CERC) training module is a nationally and internationally recognized communication model. With the looming threat of a pandemic and the potential for a protracted ongoing siege, a valuable opportunity exists to introduce crisis and emergency preparedness communication best practices to a new population--health care managers and administrators. The CERC toolkit and resources, provide an easy, turn-key solution and a validated template for educators who are not directly involved in public health education but desire to share this content. In this example, graduate students enrolled in an Master of Health Administration program, used a Play2Train scenario, located in the virtual learning environment of SecondLife (2007), to incorporate concepts from the CERC model. By applying the CERC best practices in a real-time virtual learning scenario, students learned collaboration and the leadership competencies necessary to help implement Joint Commission on Accreditation of Health Organizations emergency communication protocols and community collaboration requirements. By expanding the impact of the CERC model and developing unified risk communication responses and information sharing, all health professionals can enhance the effectiveness of their emergency preparedness plans so that the public can be better served.

Prince William Sound disabled tanker towing study. Part 1. Evaluation of existing equipment, personnel and procedures

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

Not Available

1993-08-01

The study has been undertaken by the Glosten Associates, Inc., to evaluate the existing capability for emergency towing at Prince William Sound and to examine alternatives that could enhance the escort and assist capabilities for disabled tankers within the waterway from the Alyeska Oil Terminal at the Port of Valdez to the Gulf of Alaska outside Hinchinbrook Entrance. Part 1, reported herein, is an objective evaluation by an experienced salvage towing master of the existing tugs, emergency towing equipment, towing practices, and discussion of alternative tug types.

Contraceptive Availability During an Emergency Response in the United States

PubMed Central

Ellington, Sascha R; Kourtis, Athena P; Curtis, Kathryn M; Tepper, Naomi; Gorman, Susan; Jamieson, Denise J; Zotti, Marianne; Barfield, Wanda

2015-01-01

This article provides the evidence for contraceptive need to prevent unintended pregnancy during an emergency response, discusses the most appropriate types of contraceptives for disaster situations, and details the current provisions in place to provide contraceptives during an emergency response. PMID:23421580

44 CFR 334.6 - Department and agency responsibilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Department and agency responsibilities. 334.6 Section 334.6 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS GRADUATED MOBILIZATION RESPONSE § 334.6 Department and agency...

44 CFR 334.6 - Department and agency responsibilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Department and agency responsibilities. 334.6 Section 334.6 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS GRADUATED MOBILIZATION RESPONSE § 334.6 Department and agency...

44 CFR 334.6 - Department and agency responsibilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Department and agency responsibilities. 334.6 Section 334.6 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS GRADUATED MOBILIZATION RESPONSE § 334.6 Department and agency...

44 CFR 206.42 - Responsibilities of coordinating officers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Responsibilities of coordinating officers. 206.42 Section 206.42 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... Process § 206.42 Responsibilities of coordinating officers. (a) Following a declaration of a major...

44 CFR 206.42 - Responsibilities of coordinating officers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Responsibilities of coordinating officers. 206.42 Section 206.42 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... Process § 206.42 Responsibilities of coordinating officers. (a) Following a declaration of a major...

44 CFR 206.42 - Responsibilities of coordinating officers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Responsibilities of coordinating officers. 206.42 Section 206.42 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... Process § 206.42 Responsibilities of coordinating officers. (a) Following a declaration of a major...

44 CFR 206.42 - Responsibilities of coordinating officers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Responsibilities of coordinating officers. 206.42 Section 206.42 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... Process § 206.42 Responsibilities of coordinating officers. (a) Following a declaration of a major...

Developing a Decision Support System for Flood Response: NIMS/ICS Fundamentals

NASA Astrophysics Data System (ADS)

Gutenson, J. L.; Zhang, X.; Ernest, A. N. S.; Oubeidillah, A.; Zhu, L.

2015-12-01

Effective response to regional disasters such as floods requires a multipronged, non-linear approach to reduce loss of life, property and harm to the environment. These coordinated response actions are typically undertaken by multiple jurisdictions, levels of government, functional agencies and other responsible entities. A successful response is highly dependent on the effectiveness and efficiency of each coordinated response action undertaken across a broad spectrum of organizations and activities. In order to provide a unified framework for those responding to incidents or planned events, FEMA provides a common and flexible approach for managing incidents, regardless of cause, size, location or complexity, referred to as the National Incident Management System (NIMS). Integral to NIMS is the Incident Command System (ICS), which establishes a common, pre-defined organizational structure to ensure coordination and management of procedures, resources and communications, for efficient incident management. While being both efficient and rigorous, NIMS, and ICS to a lesser extent, is an inherently complex framework that requires significant amount of training for planners, responders and managers to master, especially considering the wide array of incident types that Local Emergency Planning Committees (LEPCs) must be prepared to respond to. The existing Water-Wizard Decision Support System (DSS), developed to support water distribution system recovery operations for Decontamination (Decon), Operational Optimization (WDS), and Economic Consequence Assessment (Econ), is being evolved to integrate incident response functions. Water-Wizard runs on both mobile and desktop devices, and is being extended to utilize smartphone and mobile device specific data streams (e.g GPS location) to augment its fact-base in real-time for situational-aware DSS recommendations. In addition, the structured NIMS and ICS frameworks for incident management and response are being incorporated into the Water-Wizard knowledgebase, with a mid-term goal of integrating flood-specific emergency response domain knowledge to provide a real-time flood responder decision support.

Boundaries as Mechanisms for Learning in Emergency Exercises with Students from Emergency Service Organisations

ERIC Educational Resources Information Center

Andersson, Annika

2016-01-01

To prepare emergency response organisations for collaborative work in unpredictable and dynamic situations, various types of exercises are widely used. Still, our knowledge of collaboration exercises with emergency response students is limited. This study aimed to contribute to this field by exploring boundaries that emerged between collaborating…

Preparing nurses internationally for emergency planning and response.

PubMed

Weiner, Elizabeth

2006-09-30

Competency-based education provides an international infrastructure for nurses to learn about emergency preparedness and response. The International Nursing Coalition for Mass Casualty Education (INCMCE) has developed competencies for all nurses, as well as online modules for meeting those competencies. In addition, other curriculum resources are available that range from face-to-face classes, web-based modules, and electronic journals, to complete pre-packaged materials. The author of this article describes competencies needed for emergency preparedness identified by Columbia University, Vanderbilt University, and the International Nursing Coalition for Mass Casualty Education, as well as various curriculum resources for emergency planning and response and also processes to prepare nurses for emergency responses. Examples of international "Best Practices" feature programs that provide examples of innovative educational strategies for preparing nurses for emergency response are presented. The author concludes that while curriculum resources are widely available, a better centralized clearinghouse could be made available for both faculty and students.

Introduction of an Emergency Response Plan for flood loading of Sultan Abu Bakar Dam in Malaysia

NASA Astrophysics Data System (ADS)

Said, N. F. Md; Sidek, L. M.; Basri, H.; Muda, R. S.; Razad, A. Z. Abdul

2016-03-01

Sultan Abu Bakar Dam Emergency Response Plan (ERP) is designed to assist employees for identifying, monitoring, responding and mitigation dam safety emergencies. This paper is outlined to identification of an organization chart, responsibility for emergency management team and triggering level in Sultan Abu Bakar Dam ERP. ERP is a plan that guides responsibilities for proper operation of Sultan Abu Bakar Dam in respond to emergency incidents affecting the dam. Based on this study four major responsibilities are needed for Abu Bakar Dam owing to protect any probable risk for downstream which they can be Incident Commander, Deputy Incident Commander, On-Scene Commander, Civil Engineer. In conclusion, having organization charts based on ERP studies can be helpful for decreasing the probable risks in any projects such as Abu Bakar Dam and it is a way to identify and suspected and actual dam safety emergencies.

California Earthquake Clearinghouse Crisis Information-Sharing Strategy in Support of Situational Awareness, Understanding Interdependencies of Critical Infrastructure, Regional Resilience, Preparedness, Risk Assessment/mitigation, Decision-Making and Everyday Operational Needs

NASA Astrophysics Data System (ADS)

Rosinski, A.; Morentz, J.; Beilin, P.

2017-12-01

The principal function of the California Earthquake Clearinghouse is to provide State and Federal disaster response managers, and the scientific and engineering communities, with prompt information on ground failure, structural damage, and other consequences from significant seismic events such as earthquakes and tsunamis. The overarching problem highlighted in discussions with Clearinghouse partners is the confusion and frustration of many of the Operational Area representatives, and some regional utilities throughout the state on what software applications they should be using and maintaining to meet State, Federal, and Local, requirements, and for what purposes, and how to deal with the limitations of these applications. This problem is getting in the way of making meaningful progress on developing multi-application interoperability and the necessary supporting cross-sector information-sharing procedures and dialogue on essential common operational information that entities need to share for different all hazards missions and related operational activities associated with continuity, security, and resilience. The XchangeCore based system the Clearinghouse is evolving helps deal with this problem, and does not compound it by introducing yet another end-user application; there is no end-user interface with which one views XchangeCore, all viewing of data provided through XchangeCore occurs in and on existing, third-party operational applications. The Clearinghouse efforts with XchangeCore are compatible with FEMA, which is currently using XchangeCore-provided data for regional and National Business Emergency Operations Center (source of business information sharing during emergencies) response. Also important, and should be emphasized, is that information-sharing is not just for response, but for preparedness, risk assessment/mitigation decision-making, and everyday operational needs for situational awareness. In other words, the benefits of the Clearinghouse information sharing efforts transcend emergency response. The Clearinghouse is in the process of developing an Information-Sharing System Guide and CONOPS/ templates, that should be aimed a multi-stakeholder, non-technical audience.

Locating helicopter emergency medical service bases to optimise population coverage versus average response time.

PubMed

Garner, Alan A; van den Berg, Pieter L

2017-10-16

New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along the eastern seaboard. The aim of this study was to estimate optimal HEMS base locations within NSW using advanced mathematical modelling techniques. We used high resolution census population data for NSW from 2011 which divides the state into areas containing 200-800 people. Optimal HEMS base locations were estimated using the maximal covering location problem facility location optimization model and the average response time model, exploring the number of bases needed to cover various fractions of the population for a 45 min response time threshold or minimizing the overall average response time to all persons, both in green field scenarios and conditioning on the current base structure. We also developed a hybrid mathematical model where average response time was optimised based on minimum population coverage thresholds. Seven bases could cover 98% of the population within 45mins when optimised for coverage or reach the entire population of the state within an average of 21mins if optimised for response time. Given the existing bases, adding two bases could either increase the 45 min coverage from 91% to 97% or decrease the average response time from 21mins to 19mins. Adding a single specialist prehospital rapid response HEMS to the area of greatest population concentration decreased the average state wide response time by 4mins. The optimum seven base hybrid model that was able to cover 97.75% of the population within 45mins, and all of the population in an average response time of 18 mins included the rapid response HEMS model. HEMS base locations can be optimised based on either percentage of the population covered, or average response time to the entire population. We have also demonstrated a hybrid technique that optimizes response time for a given number of bases and minimum defined threshold of population coverage. Addition of specialized rapid response HEMS services to a system of multirole retrieval HEMS may reduce overall average response times by improving access in large urban areas.

10 CFR 70.82 - Suspension and operation in war or national emergency.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Suspension and operation in war or national emergency. 70... NUCLEAR MATERIAL Modification and Revocation of Licenses § 70.82 Suspension and operation in war or national emergency. Whenever Congress declares that a state of war or national emergency exists, the...

78 FR 33467 - Second Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-04

... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Second Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy: Response, Recovery & Resiliency; Correction... allocation of $3.7 billion under the Public Transportation Emergency Relief Program to the four FTA...

40 CFR 68.95 - Emergency response program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... emergency response plan, which shall be maintained at the stationary source and contain at least the...; and (4) Procedures to review and update, as appropriate, the emergency response plan to reflect... that complies with other Federal contingency plan regulations or is consistent with the approach in the...

40 CFR 68.95 - Emergency response program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... emergency response plan, which shall be maintained at the stationary source and contain at least the...; and (4) Procedures to review and update, as appropriate, the emergency response plan to reflect... that complies with other Federal contingency plan regulations or is consistent with the approach in the...

40 CFR 68.95 - Emergency response program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... emergency response plan, which shall be maintained at the stationary source and contain at least the...; and (4) Procedures to review and update, as appropriate, the emergency response plan to reflect... that complies with other Federal contingency plan regulations or is consistent with the approach in the...

40 CFR 68.95 - Emergency response program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... emergency response plan, which shall be maintained at the stationary source and contain at least the...; and (4) Procedures to review and update, as appropriate, the emergency response plan to reflect... that complies with other Federal contingency plan regulations or is consistent with the approach in the...

40 CFR 68.95 - Emergency response program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... emergency response plan, which shall be maintained at the stationary source and contain at least the...; and (4) Procedures to review and update, as appropriate, the emergency response plan to reflect... that complies with other Federal contingency plan regulations or is consistent with the approach in the...

77 FR 35962 - Utilizing Rapidly Deployable Aerial Communications Architecture in Response to an Emergency

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... Aerial Communications Architecture in Response to an Emergency AGENCY: Federal Communications Commission... deployable aerial communications architecture (DACA) in facilitating emergency response by rapidly restoring... copying during normal business hours in the FCC Reference Information Center, Portals II, 445 12th Street...

Local field in finite-size metamaterials: Application to composites of dielectrics and metal nanoparticles

NASA Astrophysics Data System (ADS)

Bordo, V. G.

2018-03-01

The theory of the optical response of a metamaterial slab which is represented by metal nanoparticles embedded in a dielectric matrix is developed. It is demonstrated that the account of the reflections from the slab boundaries essentially modifies the local field in the slab and leads to the anisotropy and spatial dispersion of its dielectric function as well as to the emergence of modes which do not exist in an infinite metamaterial. It is shown that these features introduce the existence of self-excited normal waves (polaritons) and mechanical excitons (polarization waves). These findings reveal that the metamaterial slab can be regarded as an active device ("plasmonic oscillator") which generates sustained polaritons in the presence of dissipation. A relation of this effect with the phenomenon of a plasmonic blackbody or perfect absorber, observed in such structures, is discussed and a possible mechanism of this phenomenon is proposed.

Population biological principles of drug-resistance evolution in infectious diseases.

PubMed

zur Wiesch, Pia Abel; Kouyos, Roger; Engelstädter, Jan; Regoes, Roland R; Bonhoeffer, Sebastian

2011-03-01

The emergence of resistant pathogens in response to selection pressure by drugs and their possible disappearance when drug use is discontinued are evolutionary processes common to many pathogens. Population biological models have been used to study the dynamics of resistance in viruses, bacteria, and eukaryotic microparasites both at the level of the individual treated host and of the treated host population. Despite the existence of generic features that underlie such evolutionary dynamics, different conclusions have been reached about the key factors affecting the rate of resistance evolution and how to best use drugs to minimise the risk of generating high levels of resistance. Improved understanding of generic versus specific population biological aspects will help to translate results between different studies, and allow development of a more rational basis for sustainable drug use than exists at present. Copyright © 2011 Elsevier Ltd. All rights reserved.

Harms to “Others” and the Selection Against Disability View

PubMed Central

2017-01-01

Abstract In recent years, the question of whether prospective parents might have a moral obligation to select against disability in their offspring has piqued the attention of many prominent philosophers and bioethicists, and a large literature has emerged surrounding this question. Rather than looking to the most common arguments given in support of a positive response to the abovementioned question, such as those focusing on the harms disability may impose on the child created, duties and role-specific obligations, and impersonal ‘harms’, a less commonly made set of arguments is focused upon which looks to the harms that a decision not to select against disability may impose on others. Three different possible arguments supporting a limited duty of disability avoidance are thus identified and subsequently explored: harms to parents themselves, harms to existing family members, and harms to other existing members of society. PMID:28180274

Emergency Preparedness and Response in the School Setting--The Role of the School Nurse. Position Statement

ERIC Educational Resources Information Center

Tuck, Christine M.; Haynie, Kathey; Davis, Catherine

2014-01-01

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) provides leadership in all phases of emergency preparedness and response. School nurses are a vital part of the school team responsible for developing emergency response procedures for the…

Recommended emergency preparedness guidelines for elderly and disabled rail-transit passengers. Final report, November 1987-March 1989

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

Hathaway, W.T.; Markos, S.H.; Balog, J.N.

1989-08-01

Rail transit has become an important source of transportation for many elderly and disabled persons. The principal reasons for the increased use are improved accessibility, low cost, and expanded areas of service. For the purposes of the report, 'elderly' is defined as any member of the population who is 60 years of age or older, and 'disabled' is defined as any person who has some type of disability. The Urban Mass Transportation Administration (UMTA) has recognized the need to consider the unique characteristics of elderly and disabled passengers in rail-transit emergency response planning. The needs of these passengers can bemore » addressed through carefully planned emergency response procedures, proper training of transit and emergency-response personnel, and effective use of equipment. The recommendations contained herein are therefore intended to assist rail-transit and emergency response organization personnel in evaluating their emergency response plans in terms of the needs of elderly and disabled passengers and, if necessary, to modify or supplement those plans accordingly. The report is intended to supplement the UMTA publication Recommended Emergency Preparedness Guidelines for Rail Transit Systems. That report contains general guidelines designed to assist rail-transit systems in assessing, developing, documenting, and improving their capabilities for responding to emergencies and in coordinating those efforts with emergency response organizations.« less

10 CFR 850.33 - Beryllium emergencies.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Beryllium emergencies. (a) The responsible employer must comply with 29 CFR 1910.120(l) for handling beryllium emergencies related to decontamination and decommissioning operations. (b) The responsible employer must comply with 29 CFR 1910.120(q) for handling beryllium emergencies related to all other...

10 CFR 76.91 - Emergency planning.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... The Corporation shall establish, maintain, and be prepared to follow a written emergency plan. The emergency plan submitted under § 76.35(f) must include the following information: (a) Plant description. A... responsibilities of all individuals supporting emergency response should an accident occur, including...

10 CFR 76.91 - Emergency planning.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... The Corporation shall establish, maintain, and be prepared to follow a written emergency plan. The emergency plan submitted under § 76.35(f) must include the following information: (a) Plant description. A... responsibilities of all individuals supporting emergency response should an accident occur, including...

Smart Growth Streets and Emergency Response

EPA Pesticide Factsheets

This page describes how street networks and street design affect emergency response and links to resources for designing streets that work for emergency responders and communities' smart growth goals.

Development Of New Databases For Tsunami Hazard Analysis In California

NASA Astrophysics Data System (ADS)

Wilson, R. I.; Barberopoulou, A.; Borrero, J. C.; Bryant, W. A.; Dengler, L. A.; Goltz, J. D.; Legg, M.; McGuire, T.; Miller, K. M.; Real, C. R.; Synolakis, C.; Uslu, B.

2009-12-01

The California Geological Survey (CGS) has partnered with other tsunami specialists to produce two statewide databases to facilitate the evaluation of tsunami hazard products for both emergency response and land-use planning and development. A robust, State-run tsunami deposit database is being developed that compliments and expands on existing databases from the National Geophysical Data Center (global) and the USGS (Cascadia). Whereas these existing databases focus on references or individual tsunami layers, the new State-maintained database concentrates on the location and contents of individual borings/trenches that sample tsunami deposits. These data provide an important observational benchmark for evaluating the results of tsunami inundation modeling. CGS is collaborating with and sharing the database entry form with other states to encourage its continued development beyond California’s coastline so that historic tsunami deposits can be evaluated on a regional basis. CGS is also developing an internet-based, tsunami source scenario database and forum where tsunami source experts and hydrodynamic modelers can discuss the validity of tsunami sources and their contribution to hazard assessments for California and other coastal areas bordering the Pacific Ocean. The database includes all distant and local tsunami sources relevant to California starting with the forty scenarios evaluated during the creation of the recently completed statewide series of tsunami inundation maps for emergency response planning. Factors germane to probabilistic tsunami hazard analyses (PTHA), such as event histories and recurrence intervals, are also addressed in the database and discussed in the forum. Discussions with other tsunami source experts will help CGS determine what additional scenarios should be considered in PTHA for assessing the feasibility of generating products of value to local land-use planning and development.

40 CFR 266.204 - Standards applicable to emergency responses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... HAZARDOUS WASTE MANAGEMENT FACILITIES Military Munitions § 266.204 Standards applicable to emergency responses. Explosives and munitions emergencies involving military munitions or explosives are subject to 40...

40 CFR 266.204 - Standards applicable to emergency responses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... HAZARDOUS WASTE MANAGEMENT FACILITIES Military Munitions § 266.204 Standards applicable to emergency responses. Explosives and munitions emergencies involving military munitions or explosives are subject to 40...

49 CFR 1.69 - Delegations to the Director of Intelligence, Security, and Emergency Response.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Delegations to the Director of Intelligence... Intelligence, Security, and Emergency Response. The Director of Intelligence, Security, and Emergency Response is delegated authority for the following: (a) Intelligence and Security. Carry out the functions...

49 CFR 1.69 - Delegations to the Director of Intelligence, Security, and Emergency Response.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Delegations to the Director of Intelligence... Intelligence, Security, and Emergency Response. The Director of Intelligence, Security, and Emergency Response is delegated authority for the following: (a) Intelligence and Security. Carry out the functions...

44 CFR 72.4 - Submittal/payment procedures and FEMA response.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Submittal/payment procedures and FEMA response. 72.4 Section 72.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... PROCEDURES AND FEES FOR PROCESSING MAP CHANGES § 72.4 Submittal/payment procedures and FEMA response. (a) The...

30 CFR 75.1507 - Emergency Response Plan; refuge alternatives.

Code of Federal Regulations, 2011 CFR

2011-07-01

....1507 Emergency Response Plan; refuge alternatives. (a) The Emergency Response Plan (ERP) shall include... request and the District Manager may approve an alternative location in the ERP if mining involves two... constructed prior to an event in a secure space and an isolated atmosphere, the ERP shall specify that— (1...

44 CFR 72.4 - Submittal/payment procedures and FEMA response.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Submittal/payment procedures and FEMA response. 72.4 Section 72.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... PROCEDURES AND FEES FOR PROCESSING MAP CHANGES § 72.4 Submittal/payment procedures and FEMA response. (a) The...

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

Not Available

The Drawdown and Distribution Management Manual (DDMM) provides a comprehensive guide to the planning, preparation, and operational processes associated with an SPR system response to an energy emergency. Although parts of the process may be unique to a particular situation, the manual describes the end-to-end continuity of the response by including those activities that would be common to most situations. This manual follows DOE policy contained in DOE Office of Energy Emergencies (OEE) documents that define comprehensive DOE energy emergency response procedures, currently known as the Energy Emergency Response Management System (EERMS). 6 refs.

Report on the 2010 Chilean earthquake and tsunami response

USGS Publications Warehouse

,

2011-01-01

In July 2010, in an effort to reduce future catastrophic natural disaster losses for California, the American Red Cross coordinated and sent a delegation of 20 multidisciplinary experts on earthquake response and recovery to Chile. The primary goal was to understand how the Chilean society and relevant organizations responded to the magnitude 8.8 Maule earthquake that struck the region on February 27, 2010, as well as how an application of these lessons could better prepare California communities, response partners and state emergency partners for a comparable situation. Similarities in building codes, socioeconomic conditions, and broad extent of the strong shaking make the Chilean earthquake a very close analog to the impact of future great earthquakes on California. To withstand and recover from natural and human-caused disasters, it is essential for citizens and communities to work together to anticipate threats, limit effects, and rapidly restore functionality after a crisis. The delegation was hosted by the Chilean Red Cross and received extensive briefings from both national and local Red Cross officials. During nine days in Chile, the delegation also met with officials at the national, regional, and local government levels. Technical briefings were received from the President’s Emergency Committee, emergency managers from ONEMI (comparable to FEMA), structural engineers, a seismologist, hospital administrators, firefighters, and the United Nations team in Chile. Cities visited include Santiago, Talca, Constitución, Concepción, Talcahuano, Tumbes, and Cauquenes. The American Red Cross Multidisciplinary Team consisted of subject matter experts, who carried out special investigations in five Teams on the (1) science and engineering findings, (2) medical services, (3) emergency services, (4) volunteer management, and (5) executive and management issues (see appendix A for a full list of participants and their titles and teams). While developing this delegation, it was clear that a multidisciplinary approach was required to properly analyze the emergency response, technical, and social components of this disaster. A diverse and knowledgeable delegation was necessary to analyze the Chilean response in a way that would be beneficial to preparedness in California, as well as improve mitigation efforts around the United States. By most standards, the Maule earthquake was a catastrophe for Chile. The economic losses totaled $30 billion USD or 17% of the GDP of the country. Twelve million people, or ¾ of the population of the country, were in areas that felt strong shaking. Yet only 521 fatalities have been confirmed, with 56 people still missing and presumed dead in the tsunami. The Science and Technology Team evaluated the impacts of the earthquake on built environment with implications for the United States. The fires following the earthquake were minimal in part because of the shutdown of the national electrical grid early in the shaking. Only five engineer-designed buildings were destroyed during the earthquake; however, over 350,000 housing units were destroyed. Chile has a law that holds building owners liable for the first 10 years of a building’s existence for any losses resulting from inadequate application of the building code during construction. This law was cited by many our team met with as a prime reason for the strong performance of the built environment. Overall, this earthquake demonstrated that strict building codes and standards could greatly reduce losses in even the largest earthquakes. In the immediate response to the earthquake and tsunami, first responders, emergency personnel, and search and rescue teams handled many challenges. Loss of communications was significant; many lives were lost and effective coordination to support life-sustaining efforts was gravely impacted due to a lack of inter- and intra-agency coordination. The Health and Medical Services Team sought to understand the medical disaster response strategies and operations of Chilean agencies, including perceived or actual failures in disaster preparation that impacted the medical disaster response; post-disaster health and medical interventions to save lives and limit suffering; and the lessons learned by public health and medical personnel as a result of their experiences. Despite devastating damage to the health care and civic infrastructure, the health care response to the Chilean earthquake appeared highly successful due to several factors. Like other first responders, the medical community had the ability and resourcefulness to respond without centralized control in the early response phase. The health care community maintained patient care under austere conditions, despite many obstacles that could have prevented such care. National and international resources were rapidly mobilized to support the medical response. The Emergency Services Team sought to collect information on all phases of emergency management (preparedness, mitigation, response, and recovery) and determine what worked well and what could be improved upon. The Chileans reported being surprised that they were not as ready for this event as they thought they were. The use of mass care sheltering was limited, given the scope of the disaster, because of the resiliency of the population. The impacts of the earthquake and the tsunami were quite different, as were the needs of urban and rural dwellers, necessitating different response activities. The Volunteer Services Team examined the challenges faced in mobilizing a large number of volunteers to assist in the aftermath of a disaster of this scale. One of the greatest challenges expressed was difficulty in communication; the need for redundancy in communication mechanisms was cited. The flexibility and ability to work autonomously by the frontline volunteers was a significant factor in effective response. It was also important for volunteer leadership to know the emergency plans. These plans need to be flexible, include alternative options, and be completed in conjunction with local officials and other volunteers. The Executive/Red Cross Management Team took a broad look at the impacts of the earthquake and the implications for California. Some of the most important preparation for the disaster came from relationships formed before the event. The communities with strong connections between different government services generally fared well. The initial response and resilience of individuals and communities was another important component. Communication system failures limited the ability of a central government to assist impacted communities, or to issue tsunami warnings. It also delayed the response since the government did not know (in some case for several days) the impact and needs of local governments. In general, plans for congregate care shelters existed but were little used as most people chose to stay at damaged homes or with relatives. Looting was a surprise to response officials as well as social scientists, but both public and private sector organizations, including NGOs (Non-Governmental Organizations), must consider security for damaged businesses as a priority in California’s multihazard planning. Class and ethnic divisions that become heightened during some cases of actual or perceived injustice may also emerge in natural disasters in California. Several factors contributed overall to the low casualty rate and rapid recovery. A major factor is the strong building code in Chile and its comprehensive enforcement. In particular, Chile has a law that holds building owners accountable for losses in a building they build for 10 years. A second factor was the limited number of fires after the earthquake. In the last few California earthquakes, 60% of the fires were started by electrical problems, so the rarity of fires may have been affected by the shut down of the electricity grid early in the earthquake. Third, in many areas, the local emergency response was very effective. The most effective regions had close coordination between emergency management, fire, and police and were empowered to respond without communication with the capital. The fourth factor was the overall high level of knowledge about earthquakes and tsunamis by much of the population that helped them respond more appropriately after the event.

Educating First Responders to Provide Emergency Services to Individuals with Disabilities

PubMed Central

Wolf-Fordham, Susan B.; Twyman, Janet S.; Hamad, Charles D.

2015-01-01

Objective Individuals with disabilities experience more negative outcomes due to natural and manmade disasters and emergencies than do people without disabilities. This vulnerability appears due in part to knowledge gaps among public health and safety emergency planning and response personnel (responders). The research assessed the effectiveness of an online program to increase emergency responder knowledge about emergency planning and response for individuals with disabilities. Method Researchers developed an online course designed to teach public health, emergency planning/management and other first response personnel about appropriate, efficient and equitable emergency planning, response, interaction and communication with children and adults with disabilities before, during and after disasters or emergencies. Course features include an ongoing storyline, exercises embedded in the form of “real life” scenarios, and game-like features such as points and timed segments. Results Evaluation measures indicated significant pre- to post-test gains in learner knowledge and simulated applied skills. Conclusion An online program using scenarios and simulations is an effective means to make disability-related training available to a wide variety of emergency responders across geographically disparate areas. PMID:25859692

Detecting and Responding to a Dengue Outbreak: Evaluation of Existing Strategies in Country Outbreak Response Planning

PubMed Central

Kroeger, Axel; Runge-Ranzinger, Silvia; O'Dempsey, Tim

2013-01-01

Background. Dengue outbreaks are occurring with increasing frequency and intensity. Evidence-based epidemic preparedness and effective response are now a matter of urgency. Therefore, we have analysed national and municipal dengue outbreak response plans. Methods. Thirteen country plans from Asia, Latin America and Australia, and one international plan were obtained from the World Health Organization. The information was transferred to a data analysis matrix where information was extracted according to predefined and emerging themes and analysed for scope, inconsistencies, omissions, and usefulness. Findings. Outbreak response planning currently has a considerable number of flaws. Outbreak governance was weak with a lack of clarity of stakeholder roles. Late timing of responses due to poor surveillance, a lack of combining routine data with additional alerts, and lack of triggers for initiating the response weakened the functionality of plans. Frequently an outbreak was not defined, and early response mechanisms based on alert signals were neglected. There was a distinct lack of consideration of contextual influences which can affect how an outbreak detection and response is managed. Conclusion. A model contingency plan for dengue outbreak prediction, detection, and response may help national disease control authorities to develop their own more detailed and functional context specific plans. PMID:24222774

Increase in disaster-related deaths: risks and social impacts of evacuation.

PubMed

Hayakawa, M

2016-12-01

In Fukushima Prefecture, disaster-related death is a social problem for individuals who were forced to leave their hometowns as a result of the Great East Japan Earthquake and the accident at Fukushima Daiichi nuclear power plant. Disaster-related death is caused by stress, exhaustion, and worsening of pre-existing illnesses due to evacuation. The number of disaster-related deaths has reached almost 2000, and continues to rise. Prolonged uncertainty and deteriorating living conditions suggest no end to such deaths, although response measures have been taken to improve the situation. It is said that insufficient response measures were taken, in particular, during the transitional period between the emergency phase and the reconstruction phase. There is a need to apply the lessons learned in planning for evacuation after a nuclear hazard, considering radiological protection as well as risks associated with evacuation.

Assessing Emergency Preparedness and Response Capacity Using Community Assessment for Public Health Emergency Response Methodology: Portsmouth, Virginia, 2013.

PubMed

Kurkjian, Katie M; Winz, Michelle; Yang, Jun; Corvese, Kate; Colón, Ana; Levine, Seth J; Mullen, Jessica; Ruth, Donna; Anson-Dwamena, Rexford; Bayleyegn, Tesfaye; Chang, David S

2016-04-01

For the past decade, emergency preparedness campaigns have encouraged households to meet preparedness metrics, such as having a household evacuation plan and emergency supplies of food, water, and medication. To estimate current household preparedness levels and to enhance disaster response planning, the Virginia Department of Health with remote technical assistance from the Centers for Disease Control and Prevention conducted a community health assessment in 2013 in Portsmouth, Virginia. Using the Community Assessment for Public Health Emergency Response (CASPER) methodology with 2-stage cluster sampling, we randomly selected 210 households for in-person interviews. Households were questioned about emergency planning and supplies, information sources during emergencies, and chronic health conditions. Interview teams completed 180 interviews (86%). Interviews revealed that 70% of households had an emergency evacuation plan, 67% had a 3-day supply of water for each member, and 77% had a first aid kit. Most households (65%) reported that the television was the primary source of information during an emergency. Heart disease (54%) and obesity (40%) were the most frequently reported chronic conditions. The Virginia Department of Health identified important gaps in local household preparedness. Data from the assessment have been used to inform community health partners, enhance disaster response planning, set community health priorities, and influence Portsmouth's Community Health Improvement Plan.

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

Code of Federal Regulations, 2010 CFR

2010-10-01

... Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING Federal Participation § 352.26 Arrangements for... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Arrangements for Federal...

Evaluating the Effects that Existing Instruction on Responsible Conduct of Research Has on Ethical Decision Making

PubMed Central

Antes, Alison L.; Wang, Xiaoqian; Mumford, Michael D.; Brown, Ryan P.; Connelly, Shane; Devenport, Lynn D.

2015-01-01

Purpose To examine the effects that existing courses on the responsible conduct of research (RCR) have on ethical decision making by assessing the ethicality of decisions made in response to ethical problems and the underlying processes involved in ethical decision making. These processes included how an individual thinks through ethical problems (i.e., meta-cognitive reasoning strategies) and the emphasis placed on social dimensions of ethical problems (i.e., social–behavioral responses). Method In 2005–2007, recruitment announcements were made, stating that a nationwide, online study was being conducted to examine the impact of RCR instruction on the ethical decision making of scientists. Recruitment yielded contacts with over 200 RCR faculty at 21 research universities and medical schools; 40 (20%) RCR instructors enrolled their courses in the current study. From those courses, 173 participants completed an ethical decision-making measure. Results A mixed pattern of effects emerged. The ethicality of decisions did not improve as a result of RCR instruction and even decreased for decisions pertaining to business aspects of research, such as contract bidding. Course participants improved on some meta-cognitive reasoning strategies, such as awareness of the situation and consideration of personal motivations, but declined for seeking help and considering others’ perspectives. Participants also increased in their endorsement of detrimental social–behavioral responses, such as deception, retaliation, and avoidance of personal responsibility. Conclusions These findings indicated that RCR instruction may not be as effective as intended, and in fact, may even be harmful. Harmful effects might result if instruction leads students to overstress avoidance of ethical problems, be overconfident in their ability to handle ethical problems, or overemphasize their ethical nature. Future research must examine these and other possible obstacles to effective RCR instruction. PMID:20182131

Evaluating the effects that existing instruction on responsible conduct of research has on ethical decision making.

PubMed

Antes, Alison L; Wang, Xiaoqian; Mumford, Michael D; Brown, Ryan P; Connelly, Shane; Devenport, Lynn D

2010-03-01

To examine the effects that existing courses on the responsible conduct of research (RCR) have on ethical decision making by assessing the ethicality of decisions made in response to ethical problems and the underlying processes involved in ethical decision making. These processes included how an individual thinks through ethical problems (i.e., meta-cognitive reasoning strategies) and the emphasis placed on social dimensions of ethical problems (i.e., social-behavioral responses). In 2005-2007, recruitment announcements were made, stating that a nationwide, online study was being conducted to examine the impact of RCR instruction on the ethical decision making of scientists. Recruitment yielded contacts with over 200 RCR faculty at 21 research universities and medical schools; 40 (20%) RCR instructors enrolled their courses in the current study. From those courses, 173 participants completed an ethical decision-making measure. A mixed pattern of effects emerged. The ethicality of decisions did not improve as a result of RCR instruction and even decreased for decisions pertaining to business aspects of research, such as contract bidding. Course participants improved on some meta-cognitive reasoning strategies, such as awareness of the situation and consideration of personal motivations, but declined for seeking help and considering others' perspectives. Participants also increased their endorsement of detrimental social-behavioral responses, such as deception, retaliation, and avoidance of personal responsibility. These findings indicated that RCR instruction may not be as effective as intended and, in fact, may even be harmful. Harmful effects might result if instruction leads students to overstress avoidance of ethical problems, be overconfident in their ability to handle ethical problems, or overemphasize their ethical nature. Future research must examine these and other possible obstacles to effective RCR instruction.

Emergent Literacy Activities in the Final Preschool Year in the German Federal States of Bavaria and Hesse

ERIC Educational Resources Information Center

Smidt, Wilfried K.; Lehrl, Simone; Anders, Yvonne; Pohlmann-Rother, Sanna; Kluczniok, Katharina

2012-01-01

Emergent literacy activities are considered to be important for promoting children's emergent literacy skills. However, little research exists, especially in Germany, regarding how often such activities occur and in what context. The purpose of this study was to determine the extent of emergent literacy activities occurring in the final preschool…

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.

Electronic Reporting and Signature under EPCRA Section 312

EPA Pesticide Factsheets

This memorandum provides guidance for State Emergency Response Commissions, Tribal Emergency Response Commissions, and local governments regarding electronic reporting and signature under the Emergency Planning and Community Right-to-Know Act.

Public health emergencies and responses: what are they, how long do they last, and how many staff does your agency need?

PubMed

Posid, Joseph M; Bruce, Sherrie M; Guarnizo, Julie T; O'Connor, Ralph C; Papagiotas, Stephen S; Taylor, Melissa L

2013-12-01

Responding to outbreaks is one of the most routine yet most important functions of a public health agency. However, some outbreaks are bigger, more visible, or more complex than others, prompting discussion about when an "outbreak" becomes a "public health emergency." When a public health emergency is identified, resources (eg, funding, staff, space) may need to be redirected from core public health programs to contribute to the public health emergency response. The need to sustain critical public health functions while preparing for public health emergency responses raises a series of operational and resource management questions, including when a public health emergency begins and ends, why additional resources are needed, how long an organization should expect staff to be redirected, and how many staff (or what proportion of the agency's staff ) an organization should anticipate will be needed to conduct a public health emergency response. This article addresses these questions from a national perspective by reviewing events for which the Centers for Disease Control and Prevention redirected staff from core public health functions to respond to a series of public health emergencies. We defined "public health emergency" in both operational and public health terms and found that on average each emergency response lasted approximately 4 months and used approximately 9.5% of our workforce. We also provide reasons why public health agencies should consider the impact of redirecting resources when preparing for public health emergencies.

Constructing a Community Response Grid (CRG): The Dublin, Ohio Case Study

ERIC Educational Resources Information Center

Freund, John F., III.

2012-01-01

During an emergency, information availability is critical to preserving life and minimizing damages. During the emergency response, however, information may not be available to those who need it. A community response grid (CRG) can help ameliorate this lack of availability by allowing people to document and distribute emergency information to…

44 CFR 350.5 - Criteria for review and approval of State and local radiological emergency plans and preparedness.

Code of Federal Regulations, 2010 CFR

2010-10-01

... response by the nuclear facility licensee, and by State and local organizations within the Emergency Planning Zones have been assigned, the emergency responsibilities of the various supporting organizations have been specifically established and each principal response organization has staff to respond to and...

44 CFR 350.5 - Criteria for review and approval of State and local radiological emergency plans and preparedness.

Code of Federal Regulations, 2011 CFR

2011-10-01

... response by the nuclear facility licensee, and by State and local organizations within the Emergency Planning Zones have been assigned, the emergency responsibilities of the various supporting organizations have been specifically established and each principal response organization has staff to respond to and...

Very serious and non-ignorable problem: Crisis in emergency medical response in catastrophic event.

PubMed

Shen, Weifeng; Jiang, Libing; Zhang, Mao; Ma, Yuefeng; Jiang, Guanyu; He, Xiaojun

2015-12-01

The crisis of medical response caused by catastrophic events might significantly affect emergency response, and might even initiate more serious social crisis. Therefore, early identification and timely blocking the formation of crisis in the early phase after a major disaster will improve the efficiency of medical response in a major disaster and avoid serious consequences. In the present paper, we described the emergency strategy to crisis management of medical response after a major disaster. Major catastrophic events often lead to various crises, including excess demand, the crisis of response in barrier and the structural crisis in response. The corresponding emergency response strategies include: (i) shunt of catastrophic medical surge; (ii) scalability of medical surge capacity; (iii) matching of the structural elements of response; (iv) maintaining the functions of support system for medical response and maximising the operation of the integrated response system; and (v) selection of appropriate care 'standard' in extreme situations of overload of disaster medical surge. In conclusion, under the impact of a major catastrophic event, medical response is often complex and the medical surge beyond the conventional response capacity and it is easy to be in crisis. In addition to the current consensus of disaster response, three additional aspects should be considered. First, all relevant society forces led by the government and military should be linkages. Second, a powerful medical response system must be based on a strong support system. Third, countermeasures of medical surge should be applied flexibly to the special and specific disaster environment, to promote the effective medical response force. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

The German approach to emergency/disaster management.

PubMed

Domres, B; Schauwecker, H H; Rohrmann, K; Roller, G; Maier, G W; Manger, A

2000-01-01

Disaster control and disaster relief in Germany are public tasks. But the government has shifted the responsibility of the administration of these tasks to the 16 states, the so called "Lander", because the EFG is a federal republic. The same is valid for the civil defense and the civil protection in the case of military or international risks. The 16 states are also responsible for the legislation of rescue service, fire fighting service and disaster control (natural and technical disasters). Counties and district-free cities are responsible for the organisation of these services. The German system is based on the principle of subsidiary between official and private institutions. A lot of official and private relief organisations are responsible for the execution of disaster relief tasks. In Germany the following organisations exist: Official (GO): Technisches Hilfswerk (THW/Federal Technical Support Service), Feuerwehren (Fire Brigades/professionals and volunteers) Academie of Emergency Planning and Civil Defense Private (NGO): Arbeiter-Samariter-Bund Deutschland (ASB/Workers' Samaritan Association Germany), Deutsche Gesellschaft zur Rettung Schiffbruchiger (DGzRS, German Lifesaving Association), Deutsches Rotes Kreuz (DRK/German Red Cross), Johanniter-Unfall-Hilfe (JUH/St. John's Ambulance), Malteser Hilfsdienst (MEID/Maltese-Relief-Organisation). ASB, DRK, JUH and MHD are specialised in the field of rescue, medical and welfare services and medical disaster relief. 80% of the German rescue service and 95% of the German disaster medical relief are realised by these NGO's. NGO's and GO's employ more than 1.2 million volunteers and appr. 100,000 professionals. Rescue service is carried out by professionals, disaster relief by volunteers. The German constitution allows to call the federal army in case of disaster, to support the disaster relief organisations (for example: flood Oder River 1997, train-crash "ICE" 1998). In all counties and district free cities disaster control staffs are set up by the administration. During disaster relief operations a operational command is on site. Most of the counties and district free cities, medical executives, rescue staff executives along with fire executive officers are responsible for the medical rescue organisation. All emergency physicians and medical executives have attended special training or a 520 hours-training-course (Paramedics). All volunteers of the medical service in the disaster relief organisations are trained in separate special courses (90 hours). Over the last years, civil protection, disaster relief and rescue services in the FRG have been reorganised. In 1997, the civil protection was reformed by a new federal act. Disaster relief of the "Lander" is supported by Federal Government with about 9000 vehicles and a budget for training. Emergency physicians have to take part in a (80) eighty hours lasting course on emergency medicine from an interdisciplinary point of view; they are only allowed to do rescue missions after having proved basic experience in emergency medicine as well as having completed a (18) eighteen-months-postgraduate training period at least. Senior emergency physicians receive and additional (40) forty-hours-lasting theoretical and practical training-after three years practice in rescue services as a minimum. There are special training courses offered for Medical and Non-Medical Personal to cope with disaster situation by different institutions and organisations.

Occupational Safety and Health System for Workers Engaged in Emergency Response Operations in the USA.

PubMed

Toyoda, Hiroyuki; Kubo, Tatsuhiko; Mori, Koji

2016-12-03

To study the occupational safety and health systems used for emergency response workers in the USA, we performed interviews with related federal agencies and conducted research on related studies. We visited the Federal Emergency Management Agency (FEMA) and National Institute for Occupational Safety and Health (NIOSH) in the USA and performed interviews with their managers on the agencies' roles in the national emergency response system. We also obtained information prepared for our visit from the USA's Occupational Safety and Health Administration (OSHA). In addition, we conducted research on related studies and information on the website of the agencies. We found that the USA had an established emergency response system based on their National Incident Management System (NIMS). This enabled several organizations to respond to emergencies cooperatively using a National Response Framework (NRF) that clarifies the roles and cooperative functions of each federal agency. The core system in NIMS was the Incident Command System (ICS), within which a Safety Officer was positioned as one of the command staff supporting the commander. All ICS staff were required to complete a training program specific to their position; in addition, the Safety Officer was required to have experience. The All-Hazards model was commonly used in the emergency response system. We found that FEMA coordinated support functions, and OSHA and NIOSH, which had specific functions to protect workers, worked cooperatively under NRF. These agencies employed certified industrial hygienists that play a professional role in safety and health. NIOSH recently executed support activities during disasters and other emergencies. The USA's emergency response system is characterized by functions that protect the lives and health of emergency response workers. Trained and experienced human resources support system effectiveness. The findings provided valuable information that could be used to improve the occupational safety and health function in the Japanese system.

76 FR 39843 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

...: National Institute of Standards and Technology (NIST). Title: Usage of Elevators for Occupant Evacuation...- story buildings in the United States during fire emergencies. This research aims to summarize emergency... emergency procedures for multi-story buildings) from existing buildings in the United States, including...

Old and New Insurgency Forms

DTIC Science & Technology

2016-03-01

undertaken to analyze and synthesize the post -Cold War insurgency form writings that have emerged over the last 2 de- cades. It is apropos that these...implosion of the Soviet Union, post -Cold War insurgency typologies began to emerge because a need existed to understand where this component of the...provide a literature review of the post -Cold War in- surgency typologies that exist, create a proposed in- surgency typology divided into legacy

Potential for Integrating Diffusion of Innovation Principles into Life Cycle Assessment of Emerging Technologies.

PubMed

Sharp, Benjamin E; Miller, Shelie A

2016-03-15

Life cycle assessment (LCA) measures cradle-to-grave environmental impacts of a product. To assess impacts of an emerging technology, LCA should be coupled with additional methods that estimate how that technology might be deployed. The extent and manner that an emerging technology diffuses throughout a region shapes the magnitude and type of environmental impacts. Diffusion of innovation is an established field of research that analyzes the adoption of new innovations, and its principles can be used to construct scenario models that enhance LCA of emerging technologies. Integrating diffusion modeling techniques with an LCA of emerging technology can provide estimates for the extent of market penetration, the displacement of existing systems, and the rate of adoption. Two general perspectives of application are macro-level diffusion models that use a function of time to represent adoption, and microlevel diffusion models that simulate adoption through interactions of individuals. Incorporating diffusion of innovation concepts complement existing methods within LCA to inform proactive environmental management of emerging technologies.

Geospatial Information Response Team

USGS Publications Warehouse

Witt, Emitt C.

2010-01-01

Extreme emergency events of national significance that include manmade and natural disasters seem to have become more frequent during the past two decades. The Nation is becoming more resilient to these emergencies through better preparedness, reduced duplication, and establishing better communications so every response and recovery effort saves lives and mitigates the long-term social and economic impacts on the Nation. The National Response Framework (NRF) (http://www.fema.gov/NRF) was developed to provide the guiding principles that enable all response partners to prepare for and provide a unified national response to disasters and emergencies. The NRF provides five key principles for better preparation, coordination, and response: 1) engaged partnerships, 2) a tiered response, 3) scalable, flexible, and adaptable operations, 4) unity of effort, and 5) readiness to act. The NRF also describes how communities, tribes, States, Federal Government, privatesector, and non-governmental partners apply these principles for a coordinated, effective national response. The U.S. Geological Survey (USGS) has adopted the NRF doctrine by establishing several earth-sciences, discipline-level teams to ensure that USGS science, data, and individual expertise are readily available during emergencies. The Geospatial Information Response Team (GIRT) is one of these teams. The USGS established the GIRT to facilitate the effective collection, storage, and dissemination of geospatial data information and products during an emergency. The GIRT ensures that timely geospatial data are available for use by emergency responders, land and resource managers, and for scientific analysis. In an emergency and response capacity, the GIRT is responsible for establishing procedures for geospatial data acquisition, processing, and archiving; discovery, access, and delivery of data; anticipating geospatial needs; and providing coordinated products and services utilizing the USGS' exceptional pool of geospatial experts and equipment.

'Biologic memory' in response to acute kidney injury: cytoresistance, toll-like receptor hyper-responsiveness and the onset of progressive renal disease.

PubMed

Zager, Richard A

2013-08-01

Following the induction of ischemic or toxin-mediated acute kidney injury (AKI), cellular adaptations occur that 're-program' how the kidney responds to future superimposed insults. This re-programming is not simply a short-lived phenomenon; rather it can persist for many weeks, implying that a state of 'biologic memory' has emerged. These changes can be both adaptive and maladaptive in nature and they can co-exist in time. A beneficial adaptation is the emergence of acquired cytoresistance, whereby a number of physiologic responses develop that serve to protect the kidney against further ischemic or nephrotoxic attack. Conversely, some changes are maladaptive, such as a predisposition to Gram-negative or Gram-positive bacteremia due to a renal tubular up-regulation of toll-like receptor responses. This latter change culminates in exaggerated cytokine production, and with efflux into the systemic circulation, extra-renal tissue injury can result (so-called 'organ cross talk'). Another maladaptive response is a persistent up-regulation of pro-inflammatory, pro-fibrotic and vasoconstrictive genes, culminating in progressive renal injury and ultimately end-stage renal failure. The mechanisms by which this biologic re-programming, or biologic memory, is imparted remain subjects for considerable debate. However, injury-induced, and stable, epigenetic remodeling at pro-inflammatory/pro-fibrotic genes seems likely to be involved. The goal of this editorial is to highlight that the so-called 'maintenance phase' of acute renal failure is not a static one, somewhere between injury induction and the onset of repair. Rather, this period is one in which the induction of 'biologic memory' can ultimately impact renal functional recovery, extra-renal injury and the possible transition of AKI into chronic, progressive renal disease.

Predicting Response to Reassurances and Uncertainties in Bioterrorism Communications for Urban Populations in New York and California

PubMed Central

Vaughan, Elaine; Tinker, Tim L.; Truman, Benedict I.; Edelson, Paul; Morse, Stephen S.

2015-01-01

Recent national plans for recovery from bioterrorism acts perpetrated in densely populated urban areas acknowledge the formidable technical and social challenges of consequence management. Effective risk and crisis communication is one priority to strengthen the U.S.’s response and resilience. However, several notable risk events since September 11, 2001, have revealed vulnerabilities in risk/crisis communication strategies and infrastructure of agencies responsible for protecting civilian populations. During recovery from a significant biocontamination event, 2 goals are essential: (1) effective communication of changing risk circumstances and uncertainties related to cleanup, restoration, and reoccupancy; and (2) adequate responsiveness to emerging information needs and priorities of diverse populations in high-threat, vulnerable locations. This telephone survey study explored predictors of public reactions to uncertainty communications and reassurances from leaders related to the remediation stage of an urban-based bioterrorism incident. African American and Hispanic adults (N = 320) were randomly sampled from 2 ethnically and socioeconomically diverse geographic areas in New York and California assessed as high threat, high vulnerability for terrorism and other public health emergencies. Results suggest that considerable heterogeneity exists in risk perspectives and information needs within certain sociodemographic groups; that success of risk/crisis communication during recovery is likely to be uneven; that common assumptions about public responsiveness to particular risk communications need further consideration; and that communication effectiveness depends partly on preexisting values and risk perceptions and prior trust in leaders. Needed improvements in communication strategies are possible with recognition of where individuals start as a reference point for reasoning about risk information, and comprehension of how this influences subsequent interpretation of agencies’ actions and communications. PMID:22582813

Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak.

PubMed

Schemann, K; Gillespie, J A; Toribio, J-A L M L; Ward, M P; Dhand, N K

2014-10-01

Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy issues regarding policy modifications or differing interpretations by different state agencies. Data on factors influencing the decision-making process for these six issues and on stakeholder interaction were collected using a pre-tested, semi-structured questionnaire. Face-to-face interviews were conducted with 24 individuals representing 12 industry and government organizations. Quantitative data were analysed using social network analysis. Qualitative data were coded and patterns matched to test a pre-determined general theory using a method called theory-oriented process-tracing. Results revealed that technical policy decisions were framed by social, political, financial, strategic and operational considerations. Industry stakeholders had influence through formal pre-existing channels, yet specific gaps in stakeholder interaction were overcome by reactive alliances formed during the outbreak response but outside the established system. Overall, the crisis management system and response were seen as positive, and 75-100% of individuals interviewed were supportive of, had interest in and considered the outcome as good for the majority of policy decisions, yet only 46-75% of those interviewed considered that they had influence on these decisions. Training to increase awareness and knowledge of emergency animal diseases (EADs) and response systems will improve stakeholder participation in emergency disease management and preparedness for future EAD incursions. © 2012 Blackwell Verlag GmbH.

Predicting response to reassurances and uncertainties in bioterrorism communications for urban populations in New York and California.

PubMed

Vaughan, Elaine; Tinker, Tim L; Truman, Benedict I; Edelson, Paul; Morse, Stephen S

2012-06-01

Recent national plans for recovery from bioterrorism acts perpetrated in densely populated urban areas acknowledge the formidable technical and social challenges of consequence management. Effective risk and crisis communication is one priority to strengthen the U.S.'s response and resilience. However, several notable risk events since September 11, 2001, have revealed vulnerabilities in risk/crisis communication strategies and infrastructure of agencies responsible for protecting civilian populations. During recovery from a significant biocontamination event, 2 goals are essential: (1) effective communication of changing risk circumstances and uncertainties related to cleanup, restoration, and reoccupancy; and (2) adequate responsiveness to emerging information needs and priorities of diverse populations in high-threat, vulnerable locations. This telephone survey study explored predictors of public reactions to uncertainty communications and reassurances from leaders related to the remediation stage of an urban-based bioterrorism incident. African American and Hispanic adults (N=320) were randomly sampled from 2 ethnically and socioeconomically diverse geographic areas in New York and California assessed as high threat, high vulnerability for terrorism and other public health emergencies. Results suggest that considerable heterogeneity exists in risk perspectives and information needs within certain sociodemographic groups; that success of risk/crisis communication during recovery is likely to be uneven; that common assumptions about public responsiveness to particular risk communications need further consideration; and that communication effectiveness depends partly on preexisting values and risk perceptions and prior trust in leaders. Needed improvements in communication strategies are possible with recognition of where individuals start as a reference point for reasoning about risk information, and comprehension of how this influences subsequent interpretation of agencies' actions and communications.

A collaborative user-producer assessment of earthquake-response products

USGS Publications Warehouse

Gomberg, Joan; Jakobitz, Allen

2013-01-01

The U.S. Geological Survey (USGS) and the Washington State Emergency Management Division assessed how well USGS earthquake-response products met the needs of emergency managers at county and local levels. Focus-group responses guided development of new products for testing in a regional-scale earthquake exercise. The assessment showed that (1) emergency responders consider most USGS products unnecessary after the first few postearthquake hours because the products are predictors, and responders are quickly immersed in reality; (2) during crises a significant fraction of personnel engaged in emergency response are drawn from many sectors, increasing the breadth of education well beyond emergency management agencies; (3) many emergency personnel do not use maps; and (4) information exchange, archiving, and analyses involve mechanisms and technical capabilities that vary among agencies, so widely used products must be technically versatile and easy to use.

Funding global emergency medicine research-from seed grants to NIH support.

PubMed

Hansoti, Bhakti; Levine, Adam; Ganti, Latha; Oteng, Rockefeller; DesRosiers, Taylor; Modi, Payal; Brown, Jeremy

2016-12-01

Funding for global health has grown significantly over the past two decades. Numerous funding opportunities for international development and research work exist; however, they can be difficult to navigate. The 2013 Academic Emergency Medicine consensus conference on global health and emergency care identified the need to strengthen global emergency care research funding, solidify existing funding streams, and expand funding sources. This piece focuses on the various federal funding opportunities available to support emergency physicians conducting international research from seed funding to large institutional grants. In particular, we focus on the application and review processes for the Fulbright and Fogarty programs, National Institutes of Health (NIH) Career development awards, and the Medical Education Partnership Initiative (MEPI), including tips and pathways through each application process. Lastly, the paper provides an index that may be used as a guide in determining whether the amount of funding provided by a grant is worth the effort in applying.

Emergency Management and Tourism Stakeholder Responses to Crises: A Global Survey.

PubMed

Morakabati, Yeganeh; Page, Stephen J; Fletcher, John

2017-03-01

This article examines the contested area of the responsibility for destinations and tourists, within emergency settings. It incorporates a Delphi-Scenario technique to facilitate a structured discussion of emergency management for different destination stakeholders. The Delphi exercise engaged 123 senior international stakeholders, from 9 different industry sectors, across 34 countries to provide a global perspective. The study's principal focus is on the notion of emergency management, to identify the challenges that stakeholders would face within a disaster scenario. The exercise asked stakeholders to identify with whom the responsibility rests for 18 distinct disaster-related activities. The study proposes a responsibility allocation building-block framework that could help speed up the emergency management responses by "knowing who is going to do what" with a particular focus on dealing with international tourists as a community in a disaster zone.

Emergency Management and Tourism Stakeholder Responses to Crises

PubMed Central

Morakabati, Yeganeh; Page, Stephen J.; Fletcher, John

2016-01-01

This article examines the contested area of the responsibility for destinations and tourists, within emergency settings. It incorporates a Delphi-Scenario technique to facilitate a structured discussion of emergency management for different destination stakeholders. The Delphi exercise engaged 123 senior international stakeholders, from 9 different industry sectors, across 34 countries to provide a global perspective. The study’s principal focus is on the notion of emergency management, to identify the challenges that stakeholders would face within a disaster scenario. The exercise asked stakeholders to identify with whom the responsibility rests for 18 distinct disaster-related activities. The study proposes a responsibility allocation building-block framework that could help speed up the emergency management responses by “knowing who is going to do what” with a particular focus on dealing with international tourists as a community in a disaster zone. PMID:29708106

The emergency first aid responder system model: using community members to assist life-threatening emergencies in violent, developing areas of need.

PubMed

Sun, Jared H; Wallis, Lee A

2012-08-01

As many as 90% of all trauma-related deaths occur in developing nations, and this is expected to get worse with modernisation. The current method of creating an emergency care system by modelling after that of a Western nation is too resource-heavy for most developing countries to handle. A cheaper, more community-based model is needed to establish new emergency care systems and to support them to full maturity. A needs assessment was undertaken in Manenberg, a township in Cape Town with high violence and injury rates. Community leaders and successfully established local services were consulted for the design of a first responder care delivery model. The resultant community-based emergency first aid responder (EFAR) system was implemented, and EFARs were tracked over time to determine skill retention and usage. The EFAR system model and training curriculum. Basic EFARs are spread throughout the community with the option of becoming stationed advanced EFARs. All EFARs are overseen by a local organisation and a professional body, and are integrated with the local ambulance response if one exists. On competency examinations, all EFARs tested averaged 28.2% before training, 77.8% after training, 71.3% 4 months after training and 71.0% 6 months after training. EFARs reported using virtually every skill taught them, and further review showed that they had done so adequately. The EFAR system is a low-cost, versatile model that can be used in a developing region both to lay the foundation for an emergency care system or support a new one to maturity.