Enabling NATO’s Collective Defense: Critical Infrastructure Security and Resiliency (NATO COE-DAT Handbook 1)

In 2014 NATO’s Center of Excellence-Defence Against Terrorism (COE-DAT) launched the inaugural course on “Critical Infrastructure Protection Against Terrorist Attacks.” As this course garnered increased attendance and interest, the core lecturer team felt the need to update the course in critical infrastructure (CI) taking into account the shift from an emphasis on “protection” of CI assets to “security and resiliency.” What was lacking in the fields of academe, emergency management, and the industry practitioner community was a handbook that leveraged the collective subject matter expertise of the core lecturer team, a handbook that could serve to educate government leaders, state and private-sector owners and operators of critical infrastructure, academicians, and policymakers in NATO and partner countries. Enabling NATO’s Collective Defense: Critical Infrastructure Security and Resiliency is the culmination of such an effort, the first major collaborative research project under a Memorandum of Understanding between the US Army War College Strategic Studies Institute (SSI), and NATO COE-DAT. The research project began in October 2020 with a series of four workshops hosted by SSI. The draft chapters for the book were completed in late January 2022. Little did the research team envision the Russian invasion of Ukraine in February this year. The Russian occupation of the Zaporizhzhya nuclear power plant, successive missile attacks against Ukraine’s electric generation and distribution facilities, rail transport, and cyberattacks against almost every sector of the country’s critical infrastructure have been on world display. Russian use of its gas supplies as a means of economic warfare against Europe—designed to undermine NATO unity and support for Ukraine—is another timely example of why adversaries, nation-states, and terrorists alike target critical infrastructure. Hence, the need for public-private sector partnerships to secure that infrastructure and build the resiliency to sustain it when attacked. Ukraine also highlights the need for NATO allies to understand where vulnerabilities exist in host nation infrastructure that will undermine collective defense and give more urgency to redressing and mitigating those fissures.https://press.armywarcollege.edu/monographs/1951/thumbnail.jp

2019: A Changing International Order? Implications for the Security Environment

KCIS2019 examined the implications of the changing international order for international security. It studied the hypercompetitive, multipolar environment in which we find ourselves, marked by a persistent struggle for influence and position within a “grey zone” of competition. This edited collection features contributions from academic and military experts who have examined the future of the liberal international order and what is at stake. These evidence-based examinations discuss the challenges to the order, and why it has been so difficult to articulate a compelling narrative to support the continuation of American leadership.https://press.armywarcollege.edu/monographs/1922/thumbnail.jp

Prevalence and Epidemiology of Non-O157 Escherichia coli Serogroups O26, O103, O111, and O145 and Shiga Toxin Gene Carriage in Scottish Cattle, 2014-2015

International audienceCattle are reservoirs for Shiga toxin Escherichia coli (STEC), bacteria shed in animal feces. Humans are infected through consumption of contaminated food or water and by direct contact, causing serious disease and kidney failure in the most vulnerable

What are emergency ambulance services doing to meet the needs of people who call frequently? A national survey of current practice in the United Kingdom

Background Emergency ambulance services are integral to providing a service for those with unplanned urgent and life-threatening health conditions. However, high use of the service by a small minority of patients is a concern. Our objectives were to describe: service-wide and local policies or pathways for people classified as Frequent Caller; call volume; and results of any audit or evaluation. Method We conducted a national survey of current practice in ambulance services in relation to the management of people who call the emergency ambulance service frequently using a structured questionnaire for completion by email and telephone interview. We analysed responses using a descriptive and thematic approach. Results Twelve of 13 UK ambulance services responded. Most services used nationally agreed definitions for ‘Frequent Caller’, with 600–900 people meeting this classification each month. Service-wide policies were in place, with local variations. Models of care varied from within-service care where calls are flagged in the call centre; contact made with callers; and their General Practitioner (GP) with an aim of discouraging further calls, to case management through cross-service, multi-disciplinary team meetings aiming to resolve callers’ needs. Although data were available related to volume of calls and number of callers meeting the threshold for definition as Frequent Caller, no formal audits or evaluations were reported. Conclusions Ambulance services are under pressure to meet challenging response times for high acuity patients. Tensions are apparent in the provision of care to patients who have complex needs and call frequently. Multi-disciplinary case management approaches may help to provide appropriate care, and reduce demand on emergency services. However, there is currently inadequate evidence to inform commissioning, policy or practice development

The Newcastle 85+ study: biological, clinical and psychosocial factors associated with healthy ageing: study protocol

<p>Abstract</p> <p>Background</p> <p>The UK, like other developed countries, is experiencing a marked change in the age structure of its population characterised by increasing life expectancy and continuing growth in the older fraction of the population. There is remarkably little up-to-date information about the health of the <it>oldest old </it>(over 85 years), demographically the fastest growing section of the population. There is a need, from both a policy and scientific perspective, to describe in detail the health status of this population and the factors that influence individual health trajectories. For a very large proportion of medical conditions, age is the single largest risk factor. Gaining new knowledge about why aged cells and tissues are more vulnerable to pathology is likely to catalyse radical new insights and opportunities to intervene. The aims of the Newcastle 85+ Study are to expose the spectrum of health within an inception cohort of 800 85 year-olds; to examine health trajectories and outcomes as the cohort ages and their associations with underlying biological, medical and social factors; and to advance understanding of the biological nature of ageing.</p> <p>Methods</p> <p>A cohort of 800 85 year olds from Newcastle and North Tyneside will be recruited at baseline and followed until the last participant has died. Eligible individuals will be <it>all </it>those who turn 85 during the year 2006 (i.e. born in 1921) and who are registered with a Newcastle or North Tyneside general practice. Participants will be visited in their current residence (own home or institution) by a research nurse at baseline, 18 months and 36 months. The assessment protocol entails a detailed multi-dimensional health assessment together with review of general practice medical records. Participants will be flagged with the NHS Central Register to provide details of the date and cause of death.</p> <p>Discussion</p> <p>The Newcastle 85+ Study will address key questions about health and health-maintenance in the 85+ population, with a particular focus on quantitative assessment of factors underlying variability in health, and on the relationships between health, nutrition and biological markers of the fundamental processes of ageing.</p