Risk-Based Decision Making During Public Health Emergencies Involving Environmental Contamination

When major contamination emergencies involving chemical, biological, and radiological hazards occur, decisions about actions to protect public health are often needed very quickly. However, there is very little guidance for leaders about how to make these decisions, which may be very consequential. The goal of this research is to learn from disparate disciplines that deal with crisis decision making and risk-based decision making in order to understand the elements that are important for successful decision making in contamination emergencies, and translate those findings into a framework that can help guide risk assessors and decision makers through the process in future contamination emergencies. This research was conducted in three parts. First, a case study on biological threat characterization was conducted using a modified Delphi approach to gather subject-matter expert opinion on the process of characterizing contaminants and conducting human-health risk assessment prior to an emergency. Second, an integrative literature review was conducted to bring together relevant findings from different types of literature from the fields of risk-based and crisis decision making. Finally, building on the findings of the literature review, semi-structured interviews with subject matter experts were held to discuss the important elements, information needs, and processes that can support a political-level decision maker such as a mayor or governor, who may be in the position of making these difficult decisions. Findings from the Delphi case study revealed the importance of characterizing potential hazards before an emergency occurs, so that data about a contaminant and information about risk to human health can be used to make more-accurate decisions to protect the public’s health. The literature review uncovered a number of key findings regarding cognitive factors affecting decisions, key sources and topics to incorporate into decisions, and decision-making processes and supporting structures that can improve the quality of decision making in a time-pressured and uncertain environment. Interviews with subject matter experts helped to further explore and validate the themes derived from the literature review, which were then condensed into a decision-making framework. This framework is intended to inform future development of guidance for mayors and governors

Security and defence research in the European Union: a landscape review

This landscape report describes the state of play of the European Union’s policies and activities in security and defence and the EU-funded research aimed at supporting them, with an exclusive focus on intentional harm. It is organised around several thematic building blocks under the umbrella of the three core priorities defined in the European agenda on security. The report reviews the current main risks and threats but also those that may emerge within the next 5 years, the policy and operational means developed to combat them, the main active stakeholders and the EU legislation in force. In this context, a short history of EU research on security and defence is presented, followed by an inventory of relevant research and development projects funded under the Horizon 2020 framework programme during the period 2014-2018. The specific contributions of the Joint Research Centre to security research are also highlighted. Finally, future avenues for security and defence research and development are discussed. Please note that the executive summary of this landscape report has been published simultaneously as a companion document.JRC.E.7-Knowledge for Security and Migratio

DRONE DELIVERY OF CBNRECy – DEW WEAPONS Emerging Threats of Mini-Weapons of Mass Destruction and Disruption (WMDD)

Drone Delivery of CBNRECy – DEW Weapons: Emerging Threats of Mini-Weapons of Mass Destruction and Disruption (WMDD) is our sixth textbook in a series covering the world of UASs and UUVs. Our textbook takes on a whole new purview for UAS / CUAS/ UUV (drones) – how they can be used to deploy Weapons of Mass Destruction and Deception against CBRNE and civilian targets of opportunity. We are concerned with the future use of these inexpensive devices and their availability to maleficent actors. Our work suggests that UASs in air and underwater UUVs will be the future of military and civilian terrorist operations. UAS / UUVs can deliver a huge punch for a low investment and minimize human casualties.https://newprairiepress.org/ebooks/1046/thumbnail.jp

How to Improve Assessment of Tetanus Immunity in the Emergency Room: A Prospective Cost-Effectiveness, Double Blind Study

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Maneuver Enhancement Brigade

Maneuver Enhancement Brigade, United States Army Field Manual FM 3-8

A Survey of the European Security Market

This document synthesizes the results of the research made on the European security market. It deals with questions of interest regarding the provision of security goods and services for protecting society from terrorism and organised crime. It explores issues such as market revenues, demand and supply, industrial capabilities, technology, research and development, innovation, business strategies, competition as well as market structure, agents' conduct and economic performance. The research has been based upon desk analysis of open source information related to the security market. Economic theory and critical analysis has been applied to understand the gathered information, derive knowledge, point out key issues and assess trends and drivers that will likely shape the sector's future. The study is the outcome of the working package number 5 included in the research project A new Agenda for European Security Economics (EUSECON). This project with code number 218195 has been financed by the European Commission within the 7th European Research Framework Programme. The task has been performed by the company ISDEFE according to the scope and work plan described in the EUSECON proposal. The author wishes to express his appreciation to all the individuals that have provided input and valuable comments to this study, including anonymous referees. Any flaws or omissions contained in this document are solely the responsibility of the author.

Developing evidence-based practice in emergency planning and management

BACKGROUND Emergency planning is essential to mitigate disasters and ensure appropriate emergency responses. However, it is imperfect and rarely ‘evidence-based’. The extent of the evidence-base and how it is utilised is also unclear. This thesis scopes the evidence-base from a health perspective, and explores the determinants of evidence-based practice in this field. METHODS Three scoping reviews of published literature including British grey literature were conducted to map the evidence-base. Two further studies involving key informant interviews in the UK and Nepal were then conducted to understand how evidence was used and identify determinants of evidence-based practice in this field. A thematic approach was then applied during data analysis for key themes. FINDINGS Many publications originate from high income countries, especially North America. Most were observational and unsystematically reported commentaries and event reports. Whilst many addressed emergency planning and response issues, few covered disaster mitigation or recovery. More disaster research especially from LMIC settings is required. The UK interviews revealed greater practitioner focus on operational aspects. Knowledge gaps included individual and organisational behaviour in emergencies, public engagement and community disaster resilience. There were issues with knowledge acquisition, dissemination and utilisation, and ascertaining the optimal system configuration. Interviews in Nepal uncovered further barriers to evidence-based practice such as contextual factors (e.g. poverty), local custom and culture, weak legislative infrastructure, and limited demand and accessibility of the evidence-base. CONCLUSIONS The validity and generalisability of existing disaster literature is unclear and little evidence synthesis has been performed to inform policy and practice. What constitutes “evidence” is also contested. Various knowledge management issues exist. Current knowledge gaps are diverse, including socio-behavioural aspects, operational processes and organisational configuration issues. Barriers to evidence-based practice include political factors especially in settings where governance, legislation and leadership are weaker. Promoting evidence-based practice will require individual, organisational and system culture change

Bioterrorism Hardening: An Exploratory Study of EMTs Preparedness and Practices

The 2001 anthrax attacks heightened awareness of the possibility of weaponizing biological agents such as Ebola, anthrax, and smallpox and hence, the Bioterrorism Act of 2002 to prevent biological attacks and reduce bioterrorism threats and vulnerabilities. However, the 2014 Ebola epidemic raised concerns about unpreparedness for bioterrorism within the healthcare community and about secondary infections from healthcare workers. Using Kingdon\u27s conceptualization of multiple streams as the foundation, the purpose of this case study was to explore the nature of bioterrorism threats and the level of preparedness of Emergency Medical Technicians (EMTs) who were involved in the 2014 Ebola epidemic in a New Jersey County for biological attacks and avoidance or reduction of secondary infections. Data were collected from 18 individuals through interviews and from emergency response documents. The data were inductively coded and subjected to thematic analysis. The emergent themes indicated that although there was an abundance of bioterrorism preparedness policies and programs dating back to the 2001 anthrax attacks, the response to the 2014 Ebola epidemic revealed inadequate bioterrorism preparedness practices. The study participants identified insufficient knowledge of bioagents and lack of regular training as factors that prevented enhanced preparedness practices. Participants suggested that improved training opportunities, interagency collaborations, and better funding would improve bioterrorism preparedness practices. The social change implications of this study include increased funding for bioterrorism preparedness to harden EMTs and the creation of public awareness of bioagents for improved 911 calls and emergency response practices