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

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

The number of houses damaged or destroyed after disasters is frequently large, and re-housing of homeless people is one of the most important tasks of reconstruction programmes. Reconstruction works often last long and during that time, it is essential to provide victims with the minimum conditions to live with dignity, privacy, and protection. This research intends to demonstrate the crucial role of temporary accommodation buildings to provide spaces where people can live and gradually resume their life until they have a permanent house. The study also aims to identify the main problems of temporary accommodation strategies and to discuss some principles and guidelines in order to reach better design solutions. It is found that temporary accommodation is an issue that goes beyond the simple provision of buildings, since the whole space for temporary settlement is important. Likewise, temporary accommodation is a process that should start before a disaster occurs, as a preventive pre-planning. In spite of being temporary constructions, these housing buildings are one of the most important elements to provide in emergency scenarios, contributing for better recovery and reconstruction actions.The first author gratefully acknowledges the financial support of Fundacao para a Ciencia e a Tecnologia, FCT, through grant SFRH/BD/73853/2010

The assessment of information technology maturity in emergency response organizations

[EN] In emergency response organizations, information technologies are not adequately explored. Sometimes, the mere adoption of new information technologies is not productive, as their efficient use depends on other interrelated technologies and the environment where they are installed. This work describes a model to help organizations understand their capability in respect to the adoption of these technologies. The model also helps the performing of the evaluation from different perspectives, making it suitable to collaborative evaluation. Using the proposed model, an organization can measure its maturity level in different aspects of the evaluation and guide the investment on its capabilities. Part of the model has been developed for emergency response organizations and the information technology dimension of the model has been applied to two fire department installations.Marcos R. S. Borges was partially supported by grants No. 560223/2010-2 and 480461/2009-0 from CNPq (Brazil). Work of José H. Canós is partially funded by the Spanish Ministerio. de Educación y Ciencia (MEC) under grant TIPEX (TIN2010–19859-C03-03). The cooperation between the Brazilian and the Spanish research groups was partially sponsored by the CAPES/MECD Cooperation Program, Project #169/ PHB2007-0064-PC.Santos, RS.; Borges, MRS.; Canos Cerda, JH.; Gomes, JO. (2011). The assessment of information technology maturity in emergency response organizations. Group Decision and Negotiation. 20(5):593-613. doi:10.1007/s10726-011-9232-zS593613205Bigley G, Roberts KH (2001) The incident command system: high reliability organizing for complex and volatile task environments. Acad Manag J 44(6): 1281–1299Chinowsky P, Molenaar K, Realph A (2007) Learning organizations in construction. J Manag Eng 23(1): 27–34Diniz VB, Borges MRS, Gomes JO, Canós JH (2008) Decision making support in emergency response. In: Encyclopedia of decision making, Information Science Reference (an imprint of IGI Global), New York, pp 184–191Dörner R, Grimm P, Seiler C (2001) ETOILE—an environment for team, organizational and individual learning. CG Top 13(3): 5–6Dykstra E (2003) Concept paper: toward an international system model in emergency management. In: Proceedings of toward an international system model in emergency management, Public Entity Risk InstituteFederal Emergency Management Agency (FEMA) (1998) Emergency management guide for business and industry: a step-by-step approach to emergency planning, response and recovery for companies of all sizesGu Q, Mendonça D (2005) Patterns of group information seeking in a simulated emergency response environment. In: Proceedings of the 2nd international ISCRAM conference, Brussels, BelgiumHale J (1997) A layered communication architecture for the support of crisis response. J Manag Inf Syst 14(1): 235–255King W, Teo T (1997) Integration between business planning and information systems planning: validating a stage hypothesis. Decis Sci 28(2): 279–307Lachner J, Hellwagner H (2008) Information and communication systems for mobile emergency response. Lecture notes in business information processing, vol 5. pp 213–224Lavoie D, Culbert A (1978) Stages in organization and development. Human Relat 31(5): 417–438Lindel MK, Prater C, Perry RW (2007) Emergency management. Wiley, New YorkLlavador M, Letelier P, Penadés MC, Borges MRS, Solís C (2006) Precise yet flexible specification of emergency resolution procedures. In: Proceedings of the information systems for crisis response and management (ISCRAM), pp 110–120Meissner A, Wang Z, Putz W, Grimmer J (2006) MIKoBOS: a mobile information and communication system for emergency response. In: Proceedings of the 3rd international ISCRAM conference, Newark, New JerseyNonaka I, Takeuchi H (1995) The knowledge creating company: how Japanese companies create the dynamics of innovation. Oxford University Press, OxfordOchoa S, Neyem A, Pino JA, Borges MRS (2007) Supporting group decision making and coordination in urban disasters relief efforts. J Decis Syst 16(2): 143–172Paton D, Flin R (1999) Disaster stress: an emergency management perspective. Disaster Prev Manag 8(4): 261–267Paulk MC, Weber C, Curtis B, Chrissis M (1995) The capability maturity model: guidelines for improving the software process. Addison-Wesley, ReadingQuarantelli EL (1997) Problematical aspects of the information/communication revolution for disaster planning and research: ten non-technical issues and questions. Disaster Prev Manag 6(2): 94–106Santos RS, Borges MRS, Gomes JO, Canós JH (2008) Maturity levels of information technologies in emergency response organizations. In: Proceedings of the international workshop on groupware, Omaha, Nebraska, USA. Groupware: design, implementation and use. Lecture notes in computer science, vol 5411. Springer, Berlin, pp 135–150Schoenharl T, Szabo G, Madey G, Barabasi AL (2006) WIPER: a multi-agent system for emergency response. In: Proceedings of the 3rd international ISCRAM conference, Newark, New JerseyTuroff M (2002) Past and future emergency response information systems. Commun ACM 45(4): 29–33Turoff M, Chumer M, Hiltz R, Clasher R, Alles M, Vasarhelyi M, Kogan A (2004a) Assuring homeland security: continuous monitoring, control and assurance of emergency preparedness. J Inf Technol Theor Appl (JITTA) 6(3): 1–24Turoff M, Chumer M, Vande Walle B, Yao X (2004b) The design of a dynamic emergency response management information system (DERMIS). J Inf Technol Theor Appl (JITTA) 5(4): 1–35Van der Lee MDE, Van Vugt M (2004) IMI—An information system for effective multidisciplinary incident management. In: Proceedings of the 1st international ISCRAM conference, Brussels, BelgiumYuan Y, Deltor B (2005) Intelligent mobile crisis response systems. Commun ACM 28(2): 95–98Zimmerman R, Restrepo CE (2006) Information technology (IT) and critical infrastructure interdependencies for emergency response. In: Proceedings of the 3rd international ISCRAM conference, Newark, New Jerse

Effect of aerobic exercise training and cognitive behavioural therapy on reduction of chronic fatigue in patients with facioscapulohumeral dystrophy: protocol of the FACTS-2-FSHD trial

<p>Abstract</p> <p>Background</p> <p>In facioscapulohumeral dystrophy (FSHD) muscle function is impaired and declines over time. Currently there is no effective treatment available to slow down this decline. We have previously reported that loss of muscle strength contributes to chronic fatigue through a decreased level of physical activity, while fatigue and physical inactivity both determine loss of societal participation. To decrease chronic fatigue, two distinctly different therapeutic approaches can be proposed: aerobic exercise training (AET) to improve physical capacity and cognitive behavioural therapy (CBT) to stimulate an active life-style yet avoiding excessive physical strain. The primary aim of the FACTS-2-FSHD (acronym for Fitness And Cognitive behavioural TherapieS/for Fatigue and ACTivitieS in FSHD) trial is to study the effect of AET and CBT on the reduction of chronic fatigue as assessed with the Checklist Individual Strength subscale fatigue (CIS-fatigue) in patients with FSHD. Additionally, possible working mechanisms and the effects on various secondary outcome measures at all levels of the International Classification of Functioning, Disability and Health (ICF) are evaluated.</p> <p>Methods/Design</p> <p>A multi-centre, assessor-blinded, randomized controlled trial is conducted. A sample of 75 FSHD patients with severe chronic fatigue (CIS-fatigue ≥ 35) will be recruited and randomized to one of three groups: (1) AET + usual care, (2) CBT + usual care or (3) usual care alone, which consists of no therapy at all or occasional (conventional) physical therapy. After an intervention period of 16 weeks and a follow-up of 3 months, the third (control) group will as yet be randomized to either AET or CBT (approximately 7 months after inclusion). Outcomes will be assessed at baseline, immediately post intervention and at 3 and 6 months follow up.</p> <p>Discussion</p> <p>The FACTS-2-FSHD study is the first theory-based randomized clinical trial which evaluates the effect and the maintenance of effects of AET and CBT on the reduction of chronic fatigue in patients with FSHD. The interventions are based on a theoretical model of chronic fatigue in patients with FSHD. The study will provide a unique set of data with which the relationships between outcome measures at all levels of the ICF could be assessed.</p> <p>Trial registration</p> <p>Dutch Trial Register, NTR1447.</p

Applying neighbourhood classification systems to natural hazards: a case study of Mt Vesuvius

The dynamic forces of urbanisation that characterised much of the 20th Century and still dominate population growth in developing countries have led to the increasing risk of natural hazards in cities around the world (Chester 2000, Pelling 2003). None of these physical dangers is more tangible than the threat volcanoes pose to the large populations living in close proximity. Vesuvius, a recognised decade volcano following the UN’s International Decade for Natural Disaster Reduction (IDNDR) has an estimated 550,000 people that live in areas susceptible to Pyroclastic Density Currents (PDC) (Barberi 2008) and a further 4 million at risk from ash fallout around the sprawling suburbs of Naples. Though quiescent since 1944, the prospect of a large eruption of Vesuvius presents a greater geophysical threat to the Campania region of Italy than perhaps ever before. With the Neopolitan region at risk from such an event, this paper proposes a new methodology for creating a Social Vulnerability Index (SoVi) using geodemographic classification systems. In this study, Experian’s MOSAIC Italy database is combined with geophysical risk boundaries to assess the overall vulnerability of the population around Vesuvius

An Automated System of Threat Propagation Using a Horizon of Events Model

International audienc