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Rimstad R.,Development | Rimstad R.,University of Stavanger | Rimstad R.,University of Oslo | Braut G.S.,University of Stavanger | Braut G.S.,Stord/Haugesund University College
Prehospital and Disaster Medicine | Year: 2015

Introduction It is not known what constitutes the optimal emergency management system, nor is there a consensus on how effectiveness and efficiency in emergency response should be measured or evaluated. Literature on the role and tasks of commanders in the prehospital emergency services in the setting of mass-casualty incidents has not been summarized and published. Problem This comprehensive literature review addresses some of the needs for future research in emergency management through three research questions: (1) What are the basic assumptions underlying incident command systems (ICSs)? (2) What are the tasks of ambulance and medical commanders in the field? And (3) How can field commanders' performances be measured and assessed? Methods A systematic literature search in MEDLINE, PubMed, PsycINFO, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library, ISI Web of Science, Scopus, International Security & Counter Terrorism Reference Center, Current Controlled Trials, and PROSPERO covering January 1, 1990 through March 1, 2014 was conducted. Reference lists of included literature were hand searched. Included papers were analyzed using Framework synthesis. Results The literature search identified 6,049 unique records, of which, 76 articles and books where included in qualitative synthesis. Most ICSs are described commonly as hierarchical, bureaucratic, and based on military principles. These assumptions are contested strongly, as is the applicability of such systems. Linking of the chains of command in cooperating agencies is a basic difficulty. Incident command systems are flexible in the sense that the organization may be expanded as needed. Commanders may command by direction, by planning, or by influence. Commanders' tasks may be summarized as: conducting scene assessment, developing an action plan, distributing resources, monitoring operations, and making decisions. There is considerable variation between authors in nomenclature and what tasks are included or highlighted. There are no widely acknowledged measurement tools of commanders' performances, though several performance indicators have been suggested. Conclusion The competence and experience of the commanders, upon which an efficient ICS has to rely, cannot be compensated significantly by plans and procedures, or even by guidance from superior organizational elements such as coordination centers. This study finds that neither a certain system or structure, or a specific set of plans, are better than others, nor can it conclude what system prerequisites are necessary or sufficient for efficient incident management. Commanders need to be sure about their authority, responsibility, and the functional demands posed upon them. Rimstad R, Braut GS. Copyright © World Association for Disaster and Emergency Medicine 2015.


Roby H.,Development
Journal of Transport Geography | Year: 2010

Transport policy in the UK now emphasises managing travel demand, with the generators of travel expected to play a role. Workplace travel plans are part of this, with a cohort running within organisations since the early 2000s. Concentrating on the private sector, this article presents the results of an employer survey of 25 organisations, showing how the motivations for travel plans have changed over time, and what they are anticipated to be in the future. An important finding has been to identify factors that have led to a travel plan progressing from a reactive (e.g. a planning consent), to a proactive state, whereby the travel plan starts to deliver business objectives, becoming organisationally embedded. © 2008 Elsevier Ltd. All rights reserved.


Purvis S.,University of Wisconsin - Madison | Gion T.,Quality and Safety | Kennedy G.,University of Wisconsin - Madison | Rees S.,Development | And 4 more authors.
Journal of Nursing Care Quality | Year: 2014

An interdisciplinary clinical improvement workgroup was formed at this academic medical center with the goal of reducing catheter-associated urinary tract infections (CAUTIs). In 2011, the CAUTI rate was noted to be 4.7 CAUTIs per 1000 catheter days. Rounding by 2 lead clinical nurse specialists revealed deficiencies in current practice, which were addressed with multifaceted strategies, including evidence-based indwelling urinary catheter and bladder management protocols, education of staff, reporting of data, and utilization of an icon in the electronic health record (EHR). After the implementation of these strategies, the CAUTI rate decreased and was noted to be 2.4 in February 2013. In addition to this, there was a downward trend line for catheter days. © 2014 Wolters Kluwer Health | Lippincott Williams &Wilkins.


Esfandiary R.,MedImmune | Parupudi A.,MedImmune | Casas-Finet J.,Development | Gadre D.,MedImmune | Sathish H.,MedImmune
Journal of Pharmaceutical Sciences | Year: 2015

Reversible self-association of protein therapeutics, the phenomenon of formation of native reversible oligomeric species as a result of noncovalent intermolecular interactions, can add additional manufacturing, stability, delivery, and safety complexities in biopharmaceutical development. Its early detection, characterization, and mitigation can therefore contribute to the success of drug development. A variety of structural and environmental factors can contribute to the modulation of self-association with mechanisms still elusive in some cases due to the inherent structural complexity of proteins. By combining the capabilities of dynamic and static light scattering techniques, the modulatory effects of a variety of solution conditions on a model IgG1's (mAbA) intermolecular interactions have been utilized to derive mechanism of its self-association at relatively low-protein concentration. The analysis of the effect of pH, buffer type, Hofmeister salts, and aromatic amino acids utilizing light scattering supported a combined role of hydrophobic and electrostatic interactions in mAbA self-association. Fitting of the data into the equilibrium models obtained from the multiangle static light scattering provided the enthalpic and entropic contributions of self-association, highlighting the more dominant effect of electrostatic interactions. In addition, studies of the Fab and Fc fragments of mAbA suggested the key role of the former in observed self-association. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.


Jung Y.J.,Agency for Defense Development | Jeong S.-P.,BNU HKBU United International College | Shin M.S.,Konkuk University | Choi H.,Development
International Journal of Control and Automation | Year: 2014

An environmental monitoring application is designed to monitor and track various kinds of environmental phenomena such as water pollution and global warming. By collecting detected sensor data from the sensors installed at a target place, a monitoring system analyzes and predicts an environmental change. For smoothly answering a user query, a data abstraction model is designed to rapidly process an amount of sensor data by employing data filtering, data aggregation, and data summarization. In order to dynamically represent the different layer of sensor data in a region, we design FLSA (Flexible Layered Sensor Data Abstraction), which supports a flexible layer of SGSA (Slope Grid for Sensor Data Abstraction). When the sensor data is transmitted to a server, FLSA make some clusters to shows several layer of sensor data depending on sensor data gradient. Each cell of FLSA hasa set of SGSA to represent each sensor data layer in the cell. This layered SGSA of FLSA is useful to represent a distributed sensor data in a cell. When an abstraction model is used to environmental monitoring, there is a trade-off between faster data processing anddata representation. FLSA focuses on data representation to show detailed condition of a target place. © 2014 SERSC.

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