Road traffic crashes and risk groups in India: Analysis, interpretations, and prevention strategies

Directory of Open Access Journals (Sweden)

Raj V. Ponnaluri

2012-03-01

Recommended prevention strategies include: developing a road accident recording system and an access management policy; integrating safety into corridor design and road construction; undertaking capacity-building efforts; and expanding emergency response services.

Emergence of Mobility Services in Urban China

Institute of Scientific and Technical Information of China (English)

Jean-Francois Doulet

2010-01-01

This article points out the limits of top-down strategies in China rooted in the construction of large-scale transportation facilities, primarily road networks. It helps to identify emerging trends that show a shift from a "hardware" approach, which focuses mainly on heavy in- frastructure investments, to a "software" approach, which rather relies on improving travel conditions. Based on the description of three existing mobility services that won awards in the 2010 "Better Mobility, Better Life" Prize for Innovative Urban Mobility Solutions, this article assesses these bottom-up, multi-participation strategies, and the effects of these "soft strategies" on improving travel conditions, reducing car dependency, building communities, etc. Finally, it concludes that these soft measures can contribute to the building of a harmonious society and low-carbon cities, and should receive more attention and support.

A Road Map for Empowering Undergraduates to Practice Service Leadership through Service-Learning in Teams

Science.gov (United States)

Snell, Robin Stanley; Chan, Maureen Yin Lee; Ma, Carol Hok Ka; Chan, Carman Ka Man

2015-01-01

We present a road map for providing course-embedded service-learning team projects as opportunities for undergraduates to practice as service leaders in Asia and beyond. Basic foundations are that projects address authentic problems or needs, partner organization representatives (PORs) indicate availability for ongoing consultation, students…

Risk management of emergency service vehicle crashes in the United States fire service: process, outputs, and recommendations.

Science.gov (United States)

Bui, David P; Pollack Porter, Keshia; Griffin, Stephanie; French, Dustin D; Jung, Alesia M; Crothers, Stephen; Burgess, Jefferey L

2017-11-17

Emergency service vehicle crashes (ESVCs) are a leading cause of death in the United States fire service. Risk management (RM) is a proactive process for identifying occupational risks and reducing hazards and unwanted events through an iterative process of scoping hazards, risk assessment, and implementing controls. We describe the process, outputs, and lessons learned from the application of a proactive RM process to reduce ESVCs in US fire departments. Three fire departments representative of urban, suburban, and rural geographies, participated in a facilitated RM process delivered through focus groups and stakeholder discussion. Crash reports from department databases were reviewed to characterize the context, circumstances, hazards and risks of ESVCs. Identified risks were ranked using a risk matrix that considered risk likelihood and severity. Department-specific control measures were selected based on group consensus. Interviews, and focus groups were used to assess acceptability and utility of the RM process and perceived facilitators and barriers of implementation. Three to six RM meetings were conducted at each fire department. There were 7.4 crashes per 100 personnel in the urban department and 10.5 per 100 personnel in the suburban department; the rural department experienced zero crashes. All departments identified emergency response, backing, on scene struck by, driver distraction, vehicle/road visibility, and driver training as high or medium concerns. Additional high priority risks varied by department; the urban department prioritized turning and rear ending crashes; the suburban firefighters prioritized inclement weather/road environment and low visibility related crashes; and the rural volunteer fire department prioritized exiting station, vehicle failure, and inclement weather/road environment related incidents. Selected controls included new policies and standard operating procedures to reduce emergency response, cameras to enhance driver

Application of IC Card License for Road Transportation in Commercial Vehicles Supervision and Service

Directory of Open Access Journals (Sweden)

Li Weiwei

2016-01-01

Full Text Available IC card electronic license for road transport includes the IC card commercial vehicle’s certificate and IC card practitioner’s qualification certificate. In China, the IC card electronic license for road transport is the electronic ID card which must be carried by each commercial vehicles and practitioners. This paper briefly introduces the basic situation, data format and security keys architecture of IC card electronic license for road transportation of China. In order to strengthen the supervision and service of commercial vehicles, this paper puts forward the overall application framework of IC card electronic license for road transport. The application examples of IC card license in the supervision of passenger station, dangerous goods transport management, governance overload and logistics park and port area management are discussed. The practical application results show that the application of IC card electronic license for road transport is an important technical means to improve the supervision ability and service quality of the road transportation industry.

Satellites vs. fiber optics based networks and services - Road map to strategic planning

Science.gov (United States)

Marandi, James H. R.

An overview of a generic telecommunications network and its components is presented, and the current developments in satellite and fiber optics technologies are discussed with an eye on the trends in industry. A baseline model is proposed, and a cost comparison of fiber- vs satellite-based networks is made. A step-by-step 'road map' to the successful strategic planning of telecommunications services and facilities is presented. This road map provides for optimization of the current and future networks and services through effective utilization of both satellites and fiber optics. The road map is then applied to different segments of the telecommunications industry and market place, to show its effectiveness for the strategic planning of executives of three types: (1) those heading telecommunications manufacturing concerns, (2) those leading communication service companies, and (3) managers of telecommunication/MIS departments of major corporations. Future networking issues, such as developments in integrated-services digital network standards and technologies, are addressed.

Pre-Hospital Emergency Medical Services: An Epidemiological Survey in Mashhad, Iran

Directory of Open Access Journals (Sweden)

Mohsen Seyyednozadi

2017-07-01

Full Text Available Introduction: Providing appropriate care, in the right place and at the right time, is the main goal of emergency medical services (EMS to save lives. The present study aimed to assess the pre-hospital EMS in Mashhad, the second largest metropolis in Iran. Materials and Methods: In this research, data were extracted from the pre-hospital emergency mission forms, which were collected from the EMS stations in Mashhad and suburbs through systematic random sampling. In addition, supplementary information was obtained from the ambulance dispatch cards and emergency communication center forms. Results:Automobile accidents (33.7% and cardiovascular events (17.8% were the most common causes of contacts to the EMS. In the city and road stations, the mean response time was 2.6 and 1.6 minutes, while the mean time of arrival at the scene was 13.2 and 11.4 minutes, and the mean evacuation time was 13.2 and 11.4 minutes, respectively. Individuals aged 20-29 (25.2% and more than 60 years (23.9% constituted the majority of the cases receiving EMS. Conclusion: According to the results, the ‘golden time’ for emergency care was of great importance in the patients injured in car accidents or affected by cardiovascular events. Furthermore, a significant difference was observed in the time indices of EMS in Mashhad city with the EMS standards due to the lack of human resources or EMS facilities. Some contacts to the EMS were unnecessary, and no expert team aid was needed in some cases. It is recommended that citizens be trained on solving the problems associated with road traffic by implementing mobile emergency, while transfer units must be established for the better provision of emergency care by the EMS in Mashhad.

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

Science.gov (United States)

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.

Road Accident Prevention with Instant Emergency Warning Message Dissemination in Vehicular Ad-Hoc Network.

Directory of Open Access Journals (Sweden)

P Gokulakrishnan

Full Text Available A Road Accident Prevention (RAP scheme based on Vehicular Backbone Network (VBN structure is proposed in this paper for Vehicular Ad-hoc Network (VANET. The RAP scheme attempts to prevent vehicles from highway road traffic accidents and thereby reduces death and injury rates. Once the possibility of an emergency situation (i.e. an accident is predicted in advance, instantly RAP initiates a highway road traffic accident prevention scheme. The RAP scheme constitutes the following activities: (i the Road Side Unit (RSU constructs a Prediction Report (PR based on the status of the vehicles and traffic in the highway roads, (ii the RSU generates an Emergency Warning Message (EWM based on an abnormal PR, (iii the RSU forms a VBN structure and (iv the RSU disseminates the EWM to the vehicles that holds the high Risk Factor (RF and travels in High Risk Zone (HRZ. These vehicles might reside either within the RSU's coverage area or outside RSU's coverage area (reached using VBN structure. The RAP scheme improves the performance of EWM dissemination in terms of increase in notification and decrease in end-to-end delay. The RAP scheme also reduces infrastructure cost (number of RSUs by formulating and deploying the VBN structure. The RAP scheme with VBN structure improves notification by 19 percent and end-to-end delay by 14.38 percent for a vehicle density of 160 vehicles. It is also proved from the simulation experiment that the performance of RAP scheme is promising in 4-lane highway roads.

Road Accident Prevention with Instant Emergency Warning Message Dissemination in Vehicular Ad-Hoc Network.

Science.gov (United States)

Gokulakrishnan, P; Ganeshkumar, P

2015-01-01

A Road Accident Prevention (RAP) scheme based on Vehicular Backbone Network (VBN) structure is proposed in this paper for Vehicular Ad-hoc Network (VANET). The RAP scheme attempts to prevent vehicles from highway road traffic accidents and thereby reduces death and injury rates. Once the possibility of an emergency situation (i.e. an accident) is predicted in advance, instantly RAP initiates a highway road traffic accident prevention scheme. The RAP scheme constitutes the following activities: (i) the Road Side Unit (RSU) constructs a Prediction Report (PR) based on the status of the vehicles and traffic in the highway roads, (ii) the RSU generates an Emergency Warning Message (EWM) based on an abnormal PR, (iii) the RSU forms a VBN structure and (iv) the RSU disseminates the EWM to the vehicles that holds the high Risk Factor (RF) and travels in High Risk Zone (HRZ). These vehicles might reside either within the RSU's coverage area or outside RSU's coverage area (reached using VBN structure). The RAP scheme improves the performance of EWM dissemination in terms of increase in notification and decrease in end-to-end delay. The RAP scheme also reduces infrastructure cost (number of RSUs) by formulating and deploying the VBN structure. The RAP scheme with VBN structure improves notification by 19 percent and end-to-end delay by 14.38 percent for a vehicle density of 160 vehicles. It is also proved from the simulation experiment that the performance of RAP scheme is promising in 4-lane highway roads.

In–Service Road Safety Audits

Directory of Open Access Journals (Sweden)

A. Mendoza–Díaz

2009-04-01

Full Text Available A road safety audit is a formal analysis that seeks to guarantee that an existing or future road fulfills optimal safety criteria, conducted by a team of experts who se members are independent of the road project. It can be carried out in one, several or all of the stages of the project (planning, design, construction, before opening the road to traffic, and operation. The development and implementation of a road safety audit process is one of the strategies that have been applied in Mexico in recent years to reduce road accidents and their associated consequences. The objective of this work is to present the procedures that have been developed and applied in Mexico, as well as the benefits and problems that have been encountered. The application of those procedures to a specific case is also shown. Emphasis is made in the audit of high ways in the operation stage, which is the type that greater application and development has had in Mexico.

Modeling Road Traffic Using Service Center

Directory of Open Access Journals (Sweden)

HARAGOS, I.-M.

2012-05-01

Full Text Available Transport systems have an essential role in modern society because they facilitate access to natural resources and they stimulate trade. Current studies aimed at improving transport networks by developing new methods for optimization. Because of the increase in the global number of cars, one of the most common problems facing the transport network is congestion. By creating traffic models and simulate them, we can avoid this problem and find appropriate solutions. In this paper we propose a new method for modeling traffic. This method considers road intersections as being service centers. A service center represents a set consisting of a queue followed by one or multiple servers. This model was used to simulate real situations in an urban traffic area. Based on this simulation, we have successfully determined the optimal functioning and we have computed the performance measures.

A Bayesian analysis of the impact of post-crash care on road mortality in Sub-Saharan African countries

Directory of Open Access Journals (Sweden)

Wonmongo Lacina Soro

2017-10-01

Full Text Available Sub-Saharan Africa is undergoing a disproportionate road tragedy compared to its motorization rate and road network density. Most of the road traffic deaths occur in the pre-hospital phase. Yet, more than half of the African countries do not possess formal pre-hospital care system. This study assesses the potential impact of post-crash care on road mortality in 23 Sub-Saharan African countries. A panel Bayesian normal linear regression with normally distributed non-informative priors is used to fit the data set covering the time period 2001–2010. The post-crash care system is proxied by the estimated share of seriously injured transported by ambulance, and three binary variables indicating the existence of emergency access telephone services and emergency training for doctors and nurses. The findings suggest a negative correlation between the road mortality rate and the estimated share of seriously injured transported by ambulance, the emergency access telephone services and the emergency training for doctors. A positive relation is unexpectedly observed for the emergency training for nurses. Other regressors such as the Gross Domestic Product per capita and populations in the age range 15–64 years are related to higher fatality rates while the length of the road network and life expectancy are linked to decreasing fatality rates.

Vehicular Networks and Road Safety: an Application for Emergency/Danger Situations Management Using the WAVE/802.11p Standard

Directory of Open Access Journals (Sweden)

Peppino Fazio

2013-01-01

Full Text Available Car-to-car communication makes possible offering many services for vehicular environment, mainly to improve the safety. The decentralized kind of these networks requires new protocols to distribute information. The advantages that it offers depend on the penetration rate, that will be enough only after years since the introduction, due to the longevity of the current cars. The V2X communication requires On-Board Units (OBUs in the vehicles, and Road-Side Units (RSUs on the roads. The proposed application uses the peculiarities of the VANETs to advise danger or emergency situations with V2V and V2I message exchange. IEEE 802.11p is standard on which the communication is based, that provides the physical and the MAC layers. The WAVE protocol uses this standard, implementing other protocols defined by the family of standards IEEE P1609 in the upper layers. They define security services, resource management, multichannel operations and the message exchange protocol in WAVE. The performance of the application will be evaluated through many simulations executed in different scenarios, to provide general data independent from them.

49 CFR 37.169 - Interim requirements for over-the-road bus service operated by private entities.

Science.gov (United States)

2010-10-01

... of such devices, shall be permitted in the passenger compartment. When the bus is at rest at a stop... 49 Transportation 1 2010-10-01 2010-10-01 false Interim requirements for over-the-road bus service... Interim requirements for over-the-road bus service operated by private entities. (a) Private entities...

49 CFR 231.15 - Steam locomotives used in road service.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Steam locomotives used in road service. 231.15 Section 231.15 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD SAFETY APPLIANCE STANDARDS § 231.15 Steam locomotives used...

Ground and Helicopter Emergency Medical Services Time Tradeoffs Assessed with Geographic Information.

Science.gov (United States)

Widener, Michael J; Ginsberg, Zac; Schleith, Daniel; Floccare, Douglas J; Hirshon, Jon Mark; Galvagno, Samuel

2015-07-01

We describe how geographic information systems (GIS) can be used to assess and compare estimated transport time for helicopter and ground emergency medical services. Recent research shows that while the odds of a trauma patient's survival increase with helicopter emergency medical services (HEMS), they may not increase to the extent necessary to make HEMS cost effective. This study offers an analytic tool to objectively quantify the patient travel time advantage that HEMS offers compared to ground emergency medical services (GEMS). Using helicopter dispatch data from the Maryland State Police from 2000-2011, we computed transport time estimates for HEMS and GEMS, compare these results to a reference transport time of 60 min, and use geospatial interpolation to extrapolate the total response times for each mode across the study region. Mapping the region's trauma incidents and modeling response times, our findings indicate the GIS framework for calculating transportation time tradeoffs is useful in identifying which areas can be better served by HEMS or GEMS. The use of GIS and the analytical methodology described in this study present a method to compare transportation by air and ground in the prehospital setting that accounts for how mode, distance, and road infrastructure impact total transport time. Whether used to generate regional maps in advance or applied real-time, the presented framework provides a tool to identify earlier incident locations that favor HEMS over GEMS transport modes.

Radiological emergency: road map for radiation accident victim transport

International Nuclear Information System (INIS)

Costa, V.S.G.; Alcantara, Y.P.; Lima, C.M.A.; Silva, F. C. A. da

2017-01-01

During a radiological or nuclear emergency, a number of necessary actions are taken, both within the radiation protection of individuals and the environment, involving many institutions and highly specialized personnel. Among them it is possible to emphasize the air transportation of radiation accident victims.The procedures and measures for the safe transport of these radiation accident victims are generally the responsibility of the armed forces, specifically the Aeronautics, with the action denominated 'Aeromedical Military Evacuation of Radiation Accident Victims'. The experience with the Radiological Accident of Goiânia demonstrated the importance of adequate preparation and response during a radiological emergency and the need for procedures and measures with regard to the transport of radiation victims are clearly defined and clearly presented for the effectiveness of the actions. This work presents the necessary actions for the transport of radiation accident victim during a radiological emergency, through the road map technique, which has been widely used in scientific technical area to facilitate understanding and show the way to be followed to reach the proposed objectives

Conceptions of mobile emergency service health professionals concerning psychiatric emergency

Directory of Open Access Journals (Sweden)

Diego Bonfada

2012-06-01

Full Text Available Under the Brazilian Psychiatric Reformation, assistance to psychological seizures represents a challenge for the emergency services. Therefore, the objective of this paper is the analysis of the conceptions of health professionals who work at the Mobile Emergency Service in Natal on psychiatric emergency care. This paper is, then, a qualitative study that used interviews as tools for collecting information. By using thematic analysis, the speeches were grouped into three categories: the stigma on patients and the professionals' fear of services interventions in psychiatric emergencies; having psychiatric emergencies regarded as harmful to patients and others' security; psychiatric emergencies being taken as patients' aggressiveness or severe depression. The data collected indicate that the interviewed professionals' ideas are supported by elements associated with the ideology that insanity implies social segregation and dangerousness. Thus, the survey prompted reflection on relevant issues to the process of psychiatric reformation implementation.

Kilburn High Road Revisited

Directory of Open Access Journals (Sweden)

Cristina Capineri

2016-07-01

Full Text Available Drawing on John Agnew’s (1987 theoretical framework for the analysis of place (location, locale and sense of place and on Doreen Massey’s (1991 interpretation of Kilburn High Road (London, the contribution develops an analysis of the notion of place in the case study of Kilburn High Road by comparing the semantics emerging from Doreen Massey’s interpretation of Kilburn High Road in the late Nineties with those from a selection of noisy and unstructured volunteered geographic information collected from Flickr photos and Tweets harvested in 2014–2015. The comparison shows how sense of place is dynamic and changing over time and explores Kilburn High Road through the categories of location, locale and sense of place derived from the qualitative analysis of VGI content and annotations. The contribution shows how VGI can contribute to discovering the unique relationship between people and place which takes the form given by Doreen Massey to Kilburn High Road and then moves on to the many forms given by people experiencing Kilburn High Road through a photo, a Tweet or a simple narrative. Finally, the paper suggests that the analysis of VGI content can contribute to detect the relevant features of street life, from infrastructure to citizens’ perceptions, which should be taken into account for a more human-centered approach in planning or service management.

Road Service Performance Based On Integrated Road Design Consistency (IC) Along Federal Road F0023

OpenAIRE

Zainal Zaffan Farhana; Prasetijo Joewono; Musa Wan Zahidah

2017-01-01

Road accidents are one of the world’s largest public health and injury prevention problems. In Malaysia, the west coast area of Malaysia been stated as the highest motorcycle fatalities and road accidents are one of the factors that cause of death and injuries in this country. The most common fatal accident is between a motorcycle and passenger car. The most of the fatal accidents happened on Federal roads with 44 fatal accidents reported, which is equal to 29%. Lacks of road geometric design...

Road Service Performance Based On Integrated Road Design Consistency (IC Along Federal Road F0023

Directory of Open Access Journals (Sweden)

Zainal Zaffan Farhana

2017-01-01

Full Text Available Road accidents are one of the world’s largest public health and injury prevention problems. In Malaysia, the west coast area of Malaysia been stated as the highest motorcycle fatalities and road accidents are one of the factors that cause of death and injuries in this country. The most common fatal accident is between a motorcycle and passenger car. The most of the fatal accidents happened on Federal roads with 44 fatal accidents reported, which is equal to 29%. Lacks of road geometric designs consistency where the drivers make mistakes errors due to the road geometric features causes the accident kept rising in Malaysia. Hence, models are based on operating speed to calculate design consistency of road. The profiles were obtained by continuous speed profile using GPS data. The continuous operating speed profile models were plotted based on operating speed model (85th percentile. The study was conduct at F0023 from km 16 until km 20. The purpose of design consistency is to know the relationship between the operating speed and elements of geometric design on the road. As a result, the integrated design consistency motorcycle and cars along a segment at F0023, the threshold shows poor design quality for motorcycles and cars.

Evaluation of emergency department nursing services and patient satisfaction of services.

Science.gov (United States)

Mollaoğlu, Mukadder; Çelik, Pelin

2016-10-01

To identify nursing services and assess patient satisfaction in patients who present to the emergency department. Emergency nursing care is a significant determinant of patient satisfaction. Patient satisfaction is often regarded as a reliable indicator of the quality of services provided in the emergency department. This is a descriptive study. Eighty-four patients who presented to the university emergency department were included in the study. The study data were collected by the Patient Information Form and the Satisfaction Level Form. Emergency nursing services, including history taking, assessing vital signs, preparing the patient for an emergency intervention, oxygen therapy, drug delivery and blood-serum infusion were shown to be more commonly provided compared with other services such as counselling the patients and the relatives about their care or delivering educational and psychosocial services. However, 78·6% of the patients were satisfied with their nursing services. The highest satisfaction rates were observed in the following sub-dimensions of the Satisfaction Level Form: availability of the nurse (82·1%), behaviour of the nurse towards the patient (78·6%) and the frequency of nursing rounds (77·4%). The most common practices performed by nurses in the emergency department were physical nursing services. Patient satisfaction was mostly associated with the availability of nurses when they were needed. Our results suggest that in addition to the physical care, patients should also receive education and psychosocial care in the emergency department. We believe that this study will contribute to the awareness and understanding of principles and concepts of emergency nursing, extend the limits of nursing knowledge and abilities, and improve and maintain the quality of clinical nursing education and practice to train specialist nurses with high levels of understanding in ethical, intellectual, administrative, investigative and professional issues. �

A Review of Roads Data Development Methodologies

Directory of Open Access Journals (Sweden)

Taro Ubukawa

2014-05-01

Full Text Available There is a clear need for a public domain data set of road networks with high special accuracy and global coverage for a range of applications. The Global Roads Open Access Data Set (gROADS, version 1, is a first step in that direction. gROADS relies on data from a wide range of sources and was developed using a range of methods. Traditionally, map development was highly centralized and controlled by government agencies due to the high cost or required expertise and technology. In the past decade, however, high resolution satellite imagery and global positioning system (GPS technologies have come into wide use, and there has been significant innovation in web services, such that a number of new methods to develop geospatial information have emerged, including automated and semi-automated road extraction from satellite/aerial imagery and crowdsourcing. In this paper we review the data sources, methods, and pros and cons of a range of road data development methods: heads-up digitizing, automated/semi-automated extraction from remote sensing imagery, GPS technology, crowdsourcing, and compiling existing data sets. We also consider the implications for each method in the production of open data.

Nursing service innovation: A case study examining emergency nurse practitioner service sustainability.

Science.gov (United States)

Fox, Amanda; Gardner, Glenn; Osborne, Sonya

2018-02-01

This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, ). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. © 2017 John Wiley & Sons Ltd.

The crisis in United States hospital emergency services.

Science.gov (United States)

Harrison, Jeffrey P; Ferguson, Emily D

2011-01-01

Emergency services are critical for high-quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (U.S.) acute care hospital staffs ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers. Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities. U.S. acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, U.S. emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staffs ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state-of-the-art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement. This research uses the AHA annual surveys,which represent self-reported data by individual hospital staff. However, the AHA expendssignificant resources to validate reported information and the annual survey data are widely used for hospital research. The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure. This article has important information on US emergency service availability in the hospital industry.

Eight months of emergency services by ambulance (with doctor on board) of the Emergency Department of Prato, Italy.

Science.gov (United States)

Olia, P M; Mollica, T V; Querci, A

2002-11-01

The aim of the present study was to analyse the types of calls attended by the authors in their ambulance, assigned to one sector of the urban area of Prato. We analysed 1060 consecutive calls carried out by our ambulance; 33 calls (3.1%), cancelled for various reasons, were excluded from statistical analysis. The calls regarded 1027 patients, 549 (53.5%) males and 478 (46.5%) females. 46% of calls concerned non trauma cases, 17% trauma cases and 7.2% transfers between hospitals. Calls in the non trauma group were for dyspnea (16.7%), unconsciousness (16.6%), chest pain (11.8%), cerebrovascular pathology (7.7%), mental disorders (7.1%), abdominal pain (5.1%), use of psychotropic substances (4%) and convulsions (3.2%). Support to patients with terminal cancer accounted for 2.3% of cases, metabolic disorders 2.2%, hypertensive events 2.1%, tachycardia 1.9%, vertigo 1.9%, allergies 1%, obstetric pathology 0.5% and cardiorespiratory resuscitation 2,2%. Thirteen point seven percent were miscellaneous, including poisonings, migraines, haemorrhages and flu syndromes. Trauma cases included road accidents (62.6%), falls (27%), aggression (6.9%), work-related accidents (3.5%). The percentage of trauma cases (17%) was similar to that reported for a Swedish urban area (20%). Cases of cardiorespiratory resuscitation were 1.65% of our calls, compared to 1.73% and 1.8% reported in Northeastern Germany and Taiwan. Although prehospital emergency medical services are organised differently in different countries, our data suggest that emergency medical services in our area have a percentage distribution of case types similar to services in other countries.

Autonomous emergency braking systems adapted to snowy road conditions improve drivers' perceived safety and trust.

Science.gov (United States)

Koglbauer, Ioana; Holzinger, Jürgen; Eichberger, Arno; Lex, Cornelia

2018-04-03

This study investigated drivers' evaluation of a conventional autonomous emergency braking (AEB) system on high and reduced tire-road friction and compared these results to those of an AEB system adaptive to the reduced tire-road friction by earlier braking. Current automated systems such as the AEB do not adapt the vehicle control strategy to the road friction; for example, on snowy roads. Because winter precipitation is associated with a 19% increase in traffic crashes and a 13% increase in injuries compared to dry conditions, the potential of conventional AEB to prevent collisions could be significantly improved by including friction in the control algorithm. Whereas adaption is not legally required for a conventional AEB system, higher automated functions will have to adapt to the current tire-road friction because human drivers will not be required to monitor the driving environment at all times. For automated driving functions to be used, high levels of perceived safety and trust of occupants have to be reached with new systems. The application case of an AEB is used to investigate drivers' evaluation depending on the road condition in order to gain knowledge for the design of future driving functions. In a driving simulator, the conventional, nonadaptive AEB was evaluated on dry roads with high friction (μ = 1) and on snowy roads with reduced friction (μ = 0.3). In addition, an AEB system adapted to road friction was designed for this study and compared with the conventional AEB on snowy roads with reduced friction. Ninety-six drivers (48 males, 48 females) assigned to 5 age groups (20-29, 30-39, 40-49, 50-59, and 60-75 years) drove with AEB in the simulator. The drivers observed and evaluated the AEB's braking actions in response to an imminent rear-end collision at an intersection. The results show that drivers' safety and trust in the conventional AEB were significantly lower on snowy roads, and the nonadaptive autonomous braking strategy was

Safer Roads: Comparisons Between Road Assessment Program and Composite Road Safety Index Method

Directory of Open Access Journals (Sweden)

Mohd Razelan Intan Suhana

2017-01-01

Full Text Available In most countries, crash statistics have becoming very crucial in evaluating road’s safety level. In Malaysia, these data are very important in deciding crash-prone areas known as black spot where specific road improvements plan will be proposed. However due to the unavailability of reliable crash data in many developing countries, appropriate road maintenance measures are facing great troubles. In light of that, several proactive methods in defining road’s safety level such as Road Assessment Program (RAP have emerged. This research aim to compare two proactive methods that have been tested in Malaysian roads ; road assessment program and road environment risk index which was developed based on composite index theory in defining road’s safety level. Composite road environment risk index was combining several crucial environment indicators, assigning weight and aggregating the individual index together to form a single value representing the road’s safety level. Based on the results, it can be concluded that both road assessment program and composite road environment risk index are contradicted in six different ways such as type of speed used, type of analysis used and their final outcomes. However, with an aim to promote safer roads, these two methods can be used concurrently as the outcomes in both methods seems to fulfil each other’s gap very well.

The single-track road running parallel to the D884 dual carriageway in the Pays de Gex is now closed to motor vehicles

CERN Multimedia

DSU Department

2008-01-01

The French authorities have informed CERN that, once the corresponding road signs have been installed, the single-track road running parallel to the dual carriageway culminating at Gate E will be closed to all motorised vehicle traffic, with the exception of agricultural plant, motorcycles, and service, emergency and police vehicles. Relations with the Host States Service Tel.: 72848 mailto:relations.secretariat@cern.chhttp://www.cern.ch/relations

Excellency in banking services - A new road map for banks in the emerging new competition

Directory of Open Access Journals (Sweden)

R. K. Uppal

2011-01-01

Full Text Available The widening gap between desirability and availability is becoming a major cause of dissatisfaction in the banking industry. The bridging of this gap is one of the solutions to make the customers delight. The present study analyzes the widening gap between desirability and availabilityregarding reliability, accuracy, confidentiality, flexibility, e-channels, high attention to customers, low service charges and overall satisfaction of customers in three bank groups i.e. public sector banks, Indian private sector banks and foreign banks. The survey was conducted in Chandigarh in the month of October, 2008. Three banks have been selected one each from three bank groups; PNB from public sector banks, HDFC bank from Indian Private Sector banks and Amro bank from foreign banks have been taken for consideration. On the basis of five point Likert type scale, survey concludes that desirability regarding all the parameters is very high as compared to availability of banking servicesand on the basis of this empirical survey, study recommends some measures to bridge this gap between the D/A of service quality parameters in the banking sector in the emerging competition.

Determinants of injuries and Road Traffic Accidents amongst service personnel in a large Defence station.

Science.gov (United States)

Neelakantan, Anand; Kotwal, Brig Atul; Ilankumaran, Mookkiah

2017-07-01

Injuries are assuming epidemic proportions globally; and in India. Also, previous decade witnessed carnage on Indian roads, with nearly 12 lakh people killed and 55 lakhs disabled in road crashes. The trend in Armed Forces is reflective of the aforesaid patterns. Behaviour and socio-demographic background of the victims are significant determinants of injuries and road accidents. Community-based epidemiological information on these aspects is envisaged to contribute in their preventive strategy. Towards this direction, the present study was conducted with aim to generate socio-behavioural profile of injuries and Road Traffic Accidents (RTAs) amongst service personnel in a large defence station; and to evaluate their determinants. A cross sectional descriptive study was carried out among 796 Naval personnel onboard warships in large Naval station. Data on socio-behavioural aspects and determinants of injuries and road accidents was collected using a pre-validated questionnaire; and by scrutiny of relevant records. Data was analysed using MSExcel, Epi-info and SPSS 17. Young and middle-aged persons were predominantly involved in injuries and road accidents. Two-wheeler users sustained maximum road accidents. Human factor was a significant determinant in RTAs and injuries. A majority of victims admitted that human factors were the predominant cause of road accidents; and opined that the events were preventable. Age-specific Behavioural Change Communication strategies aimed at refining user outlook are imperative; tailored to sociodemographic milieu of user/victim. Incorporation of a dynamic feedback/reporting mechanism, creation of 'armed forces-specific road safety and injury prevention policy' and safety audits on injuries and road crashes are measures in this direction.

In Case of Emergency Card - support of the emergency services and victims on accident site as a part of the campaigns to improve road safety

Directory of Open Access Journals (Sweden)

Witold Pawłowski

2017-07-01

Full Text Available Emergency medical services, police, firefighters and all others who provide first aid on-site emergency many times have hardness when they have to inform family or people related with victims. Some years ago italian medical rescuers suggest to mark some number in mobile phone in a special way to make contact with family easier. In the opinions of the Italian rescuers the best way to mark this number is to name it I.C.E. (In Case of Emergency. This kind of mark would make job of medical rescuers easier. More than one number in mobile phone should be called ICE1, ICE2, ICE3, etc. ICE begin in 2005 along the world. Its common in England, Italy, German. In Poland is popular from this year. I.C.E. is promoted by Polish Red Cross.

Consultant-based otolaryngology emergency service: a five-year experience.

Science.gov (United States)

Barnes, M L; Hussain, S S M

2011-12-01

To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

Health Services Utilization Patterns Associated with Emergency Department Closure

DEFF Research Database (Denmark)

Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders

2011-01-01

, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...... = -0.12, P = 0.022) during the period when emergeny services were only available in the daytime. CONCLUSIONS: Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care...

Incidence of Road Traffic Injury and Associated Factors among Patients Visiting the Emergency Department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia

Directory of Open Access Journals (Sweden)

Bewket Tadesse Tiruneh

2014-01-01

Full Text Available Background. Road traffic injuries are a major public health issue. The problem is increasing in Africa. Objective. To assess the incidence of road traffic injury and associated factors among patients visiting the emergency department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Methods. Institutional based cross-sectional study design was conducted. A total of 356 systematically selected study subjects were included in the study. Bivariate and multivariate logistic regressions were performed to identify associated factors with road traffic injury. Odds ratios with 95% confidence interval were computed to determine the level of significance. Results. The incidence of road traffic injury in the emergency department of Tikur Anbessa Specialized Teaching Hospital was 36.8%. Being a farmer (AOR = 3.3; 95% CI = 1.06–10.13, conflict with family members (AOR = 7.7; 95% CI = 3.49–8.84, financial problem (AOR = 9.91; 95% CI = 4.79–6.48, psychological problem (AOR = 17.58; 95% CI = 7.70–12.14, and alcohol use (AOR = 2.98; 95% CI = 1.61–5.27 were independently associated with road traffic injury. Conclusion and Recommendation. In this study the incidence of road traffic injury was high. Alcohol is one of the most significant factors associated with Road Traffic Injury. Thus urgent education on the effect of alcohol is recommended.

Techniques for Efficient Tracking of Road-Network-Based Moving Objects

DEFF Research Database (Denmark)

Civilis, Alminas; Jensen, Christian Søndergaard; Saltenis, Simonas

With the continued advances in wireless communications, geo-positioning, and consumer electronics, an infrastructure is emerging that enables location-based services that rely on the tracking of the continuously changing positions of entire populations of service users, termed moving objects....... The main issue considered is how to represent the location of a moving object in a database so that tracking can be done with as few updates as possible. The paper proposes to use the road network within which the objects are assumed to move for predicting their future positions. The paper presents...... algorithms that modify an initial road-network representation, so that it works better as a basis for predicting an object's position; it proposes to use known movement patterns of the object, in the form of routes; and it proposes to use acceleration profiles together with the routes. Using real GPS...

Techniques for efficient road-network-based tracking of moving objects

DEFF Research Database (Denmark)

Civilis, A.; Jensen, Christian Søndergaard; Pakalnis, Stardas

2005-01-01

With the continued advances in wireless communications, geo-positioning, and consumer electronics, an infrastructure is emerging that enables location-based services that rely on the tracking of the continuously changing positions of entire populations of service users, termed moving objects....... The main issue considered is how to represent the location of a moving object in a database so that tracking can be done with as few updates as possible. The paper proposes to use the road network within which the objects are assumed to move for predicting their future positions. The paper presents...... algorithms that modify an initial road-network representation, so that it works better as a basis for predicting an object's position; it proposes to use known movement patterns of the object, in the form of routes; and it proposes to use acceleration profiles together with the routes. Using real GPS...

Identifying barriers to emergency care services.

Science.gov (United States)

Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

2012-01-01

This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

Traffic condition with road upgrading during construction and operation stages based on level-of-service (LOS)

Science.gov (United States)

Tay, A. C.; Lee, H. H.

2018-04-01

In this study, traffic survey was done at signalized intersection of both ends of an upgrading road during morning and afternoon peak hours throughout construction period. The intersections of Tudan Road located at Miri City in Sarawak State, Malaysia were chosen as study sites. The aim of this research was to investigate the traffic condition for the signalized intersections of a R3 secondary road that being upgrading to standard U5 dual carriageway during peak hours for construction and operation stages. Data collected from these sites were analyzed according to Highway Capacity Manual (HCM) 2010. From the results, the level-of-services (LOS) of Kuala Baram By Pass Road intersection improved from Level F to Level E at operation stage for weekday during peak hours in the morning. LOS of Lutong-Kuala Baram Road intersection at construction stage were Level C during peak hours in the morning and Level D during peak hours in the afternoon for weekends. However, the LOS during both peak hours for weekends were projected to improve to Level B at the operation stage. It proved that the road construction has affected LOS, and this temporary issue can be solved after the upgraded road is in operation.

Medical Emergencies in Goa

Science.gov (United States)

Saddichha, Sahoo; Saxena, Mukul Kumar

2010-01-01

Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa's roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs) were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%), which were mainly of the nature of accidents or assaults (17%) and fever related (17%). Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa. PMID:20606921

The appropriateness of emergency medical service responses in the ...

African Journals Online (AJOL)

The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa. PR Newton, R Naidoo, P Brysiewicz. Abstract. Introduction. Emergency medical services (EMS) are sometimes required to respond to cases that are later found not to be emergencies, resulting in high ...

Problematics of Reliability of Road Rollers

Science.gov (United States)

Stawowiak, Michał; Kuczaj, Mariusz

2018-06-01

This article refers to the reliability of road rollers used in a selected roadworks company. Information on the method of road rollers service and how the service affects the reliability of these rollers is presented. Attention was paid to the process of the implemented maintenance plan with regard to the machine's operational time. The reliability of road rollers was analyzed by determining and interpreting readiness coefficients.

Emergency Medical Service (EMS): Rotorcraft Technology Workshop

Science.gov (United States)

Bauchspies, J. S.; Adams, R. J.

1981-01-01

A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

42 CFR 485.618 - Condition of participation: Emergency services.

Science.gov (United States)

2010-10-01

... Boards of Medicine and Nursing about issues related to access to and the quality of emergency services in... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Emergency services. 485.618 Section 485.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

Emergency Medical Service (EMS) Stations

Data.gov (United States)

Kansas Data Access and Support Center — EMS Locations in Kansas The EMS stations dataset consists of any location where emergency medical services (EMS) personnel are stationed or based out of, or where...

Disaster Monitoring and Emergency Response Services in China

Science.gov (United States)

Wu, J.; Han, X.; Zhou, Y.; Yue, P.; Wang, X.; Lu, J.; Jiang, W.; Li, J.; Tang, H.; Wang, F.; Li, X.; Fan, J.

2018-04-01

The Disaster Monitoring and Emergency Response Service(DIMERS) project was kicked off in 2017 in China, with the purpose to improve timely responsive service of the institutions involved in the management of natural disasters and man-made emergency situations with the timely and high-quality products derived from Space-based, Air-based and the in-situ Earth observation. The project team brought together a group of top universities and research institutions in the field of Earth observations as well as the operational institute in typical disaster services at national level. The project will bridge the scientific research and the response services of massive catastrophe in order to improve the emergency response capability of China and provide scientific and technological support for the implementation of the national emergency response strategy. In response to the call for proposal of "Earth Observation and Navigation" of 2017 National Key R&D Program of China, Professor Wu Jianjun, the deputy chairman of Faculty of Geographical Science of Beijing Normal University, submitted the Disaster Monitoring and Emergency Response Service (DIMERS) project, jointly with the experts and scholars from Institute of Remote Sensing and Digital Earth, Chinese Academy of Sciences, Wuhan University, China Institute of Earthquake Forecasting of China Earthquake Administration and China Institute of Water Resources and Hydropower Science. After two round evaluations, the proposal was funded by Ministry of Science and Technology of China.

Servant Leadership Theory and the Emergency Services Student

Science.gov (United States)

Russell, Eric James

2014-01-01

This present case study explores the influence a servant leadership class had on a group of emergency service students' understanding of the roles and characteristics of a leader. The setting for the study was a state university in the Western United States. The six participants were undergraduate emergency services majors that underwent a 15-week…

Crash Injury Management: Emergency Medical Services for Traffic Law Enforcement Officers. Instructor's Lesson Plans.

Science.gov (United States)

National Highway Traffic Safety Administration (DOT), Washington, DC.

To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this instructor's guide provides a standardized approach for providing training in emergency medical care for first responders to traffic accidents. The objective of the course is to provide training in all aspects of emergency medical…

Evaluating public ambulance service levels by applying a GIS based ...

African Journals Online (AJOL)

Ambulance vehicles are required to respond rapidly to medical emergencies. A number of factors may affect response times, most importantly the location of emergency services stations, the number of ambulance vehicles available at each station, road conditions and traffic volumes. To support spatial planning and provide ...

Internet protocol-based emergency services

CERN Document Server

Schulzrinne, Henning

2013-01-01

Written by international experts in the field, this book covers the standards, architecture and deployment issues related to IP-based emergency services This book brings together contributions from experts on technical and operational aspects within the international standardisation and regulatory processes relating to routing and handling of IP-based emergency calls.  Readers will learn how these standards work, how various standardization organizations contributed to them and about pilot projects, early deployment and current regulatory situation. Key Featur

Crash Injury Management: Emergency Medical Services for Traffic Law Enforcement Officers. Student Study Guide.

Science.gov (United States)

National Highway Traffic Safety Administration (DOT), Washington, DC.

To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this student guide provides a standardized approach for first responders to traffic accidents to learn emergency medical care. Training is provided in all aspects of emergency medical care required at the scene of a traffic accident.…

VT Data - E911 Road Centerlines

Data.gov (United States)

Vermont Center for Geographic Information — (Link to Metadata) EmergencyE911_RDS was originally derived from RDSnn (now called TransRoad_RDS). "Zero-length ranges" in the ROADS layer pertain to grand-fathered...

Multimedia Messaging Service teleradiology in the provision of emergency neurosurgery services.

Science.gov (United States)

Ng, Wai Hoe; Wang, Ernest; Ng, Ivan

2007-04-01

Neurosurgical emergencies constitute a significant proportion of workload of a tertiary neurosurgical service. Prompt diagnosis and emergent institution of definitive treatment are critical to reduce neurological mortality and morbidity. Diagnosis is highly dependent on accurate interpretation of scans by experienced clinicians. This expertise may not be readily available especially after office hours because many neurosurgical units are manned by middle-level neurosurgical staff with varying levels of experience in scan interpretation. Multimedia Messaging Service mobile phone technology offers a simple, cheap, quick, and effective solution to the problem of scan interpretation. An MMS takes only a few minutes to send and receive and allows senior doctors to view important images and make important clinical decisions to enhance patient management in an emergency situation. A mobile phone (with VGA camera and MMS capabilities) was provided to the neurosurgery registrar on call. The on-call mobile phone is passed on to the corresponding registrar on-call the next day. All consultants had personal mobile phones that are MMS-enabled. Relevant representative CT/MRI images can be taken directly from the mobile phone from the PACS off the computer screen. When only hard copies are available, the images can be taken off the light box. After a 12-month trial period, a questionnaire was given to all staff involved in the project to ascertain the usefulness of the MMS teleradiology service. The survey on the use of the MMS service in a tertiary neurosurgical service demonstrated that the technology significantly improved the level of confidence of the senior-level staff in emergent clinical decision making. Significantly, the MMS images were of sufficient quality and resolution to obviate the need to view the actual scans. The impact of MMS is less pronounced in the middle-level staff, but there was a trend that most of the junior staff found the service more useful. The MMS

Evaluating public ambulance service levels by applying a GIS based accessibility analysis approach

CSIR Research Space (South Africa)

Baloyi, Ethel

2017-08-01

Full Text Available Ambulance vehicles are required to respond rapidly to medical emergencies. A number of factors may affect response times, most importantly the location of emergency services stations, the number of ambulance vehicles available at each station, road...

Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services

DEFF Research Database (Denmark)

Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C

2017-01-01

BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS)....... initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.......BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS......). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed...

Design and Research of Service Platform for Protection and Dissemination of Cultural Heritage Resources of The Silk Road in the Territory of China

Science.gov (United States)

Zhang, L.; Zhang, W.; Zeng, S. J.; Na, W.; Yang, H.; Huang, J.; Tan, X. D.; Sun, Z. J.

2015-08-01

The Silk Road, a major traffic route across the Eurasia continent, has been a convergence for the exchange, communication and dissemination of various cultures such as nations, materials, religions and arts for more than two thousand years. And the cultural heritage along the long and complicate route has been also attractive. In recent years, the Silk Road - the Road Network along the Chang'an-Tianshan Mountain has been listed in the Directory of World Cultural Heritage. The rare and rich cultural resources along the Silk Road, especially those in the territory of China, have attracted attentions of the world. This article describes the research ideas, methods, processes and results of the planning design on the internet-based dissemination services platform system for cultural heritage resources. First of all, it has defined the targeting for dissemination services and the research methods applied for the Silk Road heritage resources, based on scientific and objective spatial measurement and research on history and geography, to carry on the excavation of values of cultural resource for the target users. Then, with the front-end art exhibit by means of innovative IT, time and space maps of cultural heritage resources, interactive graphics display, panoramic three-dimensional virtual tour, and the Silk Road topics as the main features, a comprehensive and multi-angle cultural resources dissemination services platform is built. The research core of the platform is a demand-oriented system design on the basis of cultural resources and features as the fundamental, the value of contemporary manifestation as the foundation, and cultural dissemination and service as a starting point. This platform has achieved, temporal context generalization, interest profiles extension, online and offline adaptation, and other prominent innovations. On the basis of routes heritage resource protection and dissemination services with complex relationship between time and space, and the

Determinants of Demand in the Public Dental Emergency Service.

Science.gov (United States)

Matsumoto, Maria Sa; Gatti, Marcia An; de Conti, Marta Hs; de Ap Simeão, Sandra F; de Oliveira Braga Franzolin, Solange; Marta, Sara N

2017-02-01

Although dental emergencies are primarily aimed at pain relief, in practice, dental emergency services have been overwhelmed by the massive inflow of patients with less complex cases, which could be resolved at basic levels of health care. They frequently become the main gateway to the system. We investigated the determinant factors of demand at the Central Dental Emergency Unit in Bauru, São Paulo, Brazil. The questionnaire was applied to 521 users to evaluate sociodemographic profile; factors that led users to seek the service at the central dental emergency; perception of service offered. About 80.4% of users went directly to the central dental emergency, even before seeking basic health units. The reasons were difficulty to be attended (34.6%) and incompatible time (9.8%). To the perception of the necessity of the service, responses were problem as urgent (78.3%) and pain was the main complaint (69.1%). The profile we found was unmarried (41.5%), male (52.2%), white (62.8%), aged 30 to 59 (52.2%), incomplete basic education (41.6%), family income up to 2 minimum wages (47.4%), and no medical/dental plan (88.9%). It was concluded that the users of central dental emergency come from all sectors of the city, due to difficult access to basic health units; they consider their complaint urgent; and they are satisfied with the service offered. To meet the profile of the user urgency's service so that it is not overloaded with demand that can be fulfilled in basic health units.

Determining optimum flash patterns for emergency service vehicles: an experimental investigation using high definition film.

Science.gov (United States)

Turner, Sally; Wylde, Julie; Langham, Martin; Morrow, Andrew

2014-09-01

An investigation of how emergency vehicle lighting (EVL) can be improved is reported with reference to an analysis of police vehicle road traffic accidents (Study 1). In Study 2, 37 regular drivers were shown film clips of a marked police vehicle, in which flash rate (1 Hz, 4 Hz) and pattern (single, triple pulse) were varied on the blue Light Emitting Diode (LED) roofbar. Results indicate a 4 Hz flash rate conveys greater urgency than a 1 Hz rate, while a 1 Hz, single flash combination was ranked the least urgent of all combinations. Participants claimed they would leave significantly more space before pulling out in front of an approaching police car (gap acceptance) in the 4 Hz single pulse condition in comparison to other EVL combinations. The preliminary implications for which flash characteristics could prove most optimal for emergency service use are discussed with regard to effects on driver perception and expected driving behaviour. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Financial Services and Emerging Markets

NARCIS (Netherlands)

B. Karreman (Bas)

2011-01-01

textabstractThis study addresses the organization and strategy of firms in emerging markets with an explicit application to financial services. Given the relevance of a well-functioning financial system for economic growth, understanding the organization and strategy of firms contributing to the

Adolescents and Dual Diagnosis in a Psychiatric Emergency Service.

Science.gov (United States)

Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis

2016-03-02

In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.

Radioactive material (road transport) bill. [Third reading

International Nuclear Information System (INIS)

Fishburn, D.; Walley, J.; Currie, E.

1991-01-01

This is a private members Bill which will enable new rules to be set out that will govern the way in the which nearly 500,000 shipments of radioactive and nuclear material go by road in the United Kingdom every year. It would give the Department of Transport, which would become the enforcing authority, the powers of entry and inspection and allows penalties to be exacted from those breaking the rules. The present regulations for transport by road are those set out in 1947 and these need to be updated to comply with International Atomic Energy Authority Standards. The debate which lasted over one and a half hours is reported verbatim. The main points raised were about which emergency services if any should be notified on the transport of nuclear materials, with particular reference to Derbyshire. Nuclear power in general was also discussed. (UK)

Radiological emergency: road map for radiation accident victim transport; Emergência radiológica: roadmap para o transporte de radioacidentado

Energy Technology Data Exchange (ETDEWEB)

Costa, V.S.G.; Alcantara, Y.P. [Faculdade Casa Branca, SP (Brazil); Lima, C.M.A. [MAXIM Cursos, Rio de Janeiro, RJ (Brazil); Silva, F. C. A. da, E-mail: franciscodasilva13uk@gmail.com [Instituto de Radioproteção e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

2017-07-01

During a radiological or nuclear emergency, a number of necessary actions are taken, both within the radiation protection of individuals and the environment, involving many institutions and highly specialized personnel. Among them it is possible to emphasize the air transportation of radiation accident victims.The procedures and measures for the safe transport of these radiation accident victims are generally the responsibility of the armed forces, specifically the Aeronautics, with the action denominated 'Aeromedical Military Evacuation of Radiation Accident Victims'. The experience with the Radiological Accident of Goiânia demonstrated the importance of adequate preparation and response during a radiological emergency and the need for procedures and measures with regard to the transport of radiation victims are clearly defined and clearly presented for the effectiveness of the actions. This work presents the necessary actions for the transport of radiation accident victim during a radiological emergency, through the road map technique, which has been widely used in scientific technical area to facilitate understanding and show the way to be followed to reach the proposed objectives.

Inovasi Manajemen Pelayanan Publik Tim Emergency Service Kabupaten Bantaeng

OpenAIRE

Tamimi, Zindar

2015-01-01

Bantaeng an area that small territory, small population, small local revenues, frequent natural disasters, and frequent cases of fatal such as maternal mortality. To overcome this situation Local Government made Emergency Service Team. Emergency Service Teams provide services in new ways, namely by finding and serving the community in a proactive and integrated. This study uses exploratif qualitative method. Data collection techniques in research using interviews, observation, and documentati...

Emerging research methods and their application to road safety.

Science.gov (United States)

Tarko, Andrew; Boyle, Linda Ng; Montella, Alfonso

2013-12-01

The study of road safety has seen great strides over the past few decades with advances in analytical methods and research tools that allow researchers to provide insights into the complex interactions of the driver, vehicle, and roadway. Data collection methods range from traditional traffic and roadway sensors to instrumented vehicles and driving simulators, capable of providing detailed data on both the normal driving conditions and the circumstances surrounding a safety critical event. In September 2011, the Third International Conference on Road Safety and Simulation was held in Indianapolis, Indiana, USA, which was hosted by the Purdue University Center for Road Safety and sponsored by the Transportation Research Board and its three committees: ANB20 Safety Data, Analysis and Evaluation, AND30 Simulation and Measurement of Vehicle and Operator Performance, and ABJ95 Visualization in Transportation. The conference brought together two hundred researchers from all over the world demonstrating some of the latest research methods to quantify crash causality and associations, and model road safety. This special issue is a collection of 14 papers that were presented at the conference and then peer-reviewed through this journal. These papers showcase the types of analytical tools needed to examine various crash types, the use of naturalistic and on-road data to validate the use of surrogate measures of safety, and the value of driving simulators to examine high-risk situations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

OpenAIRE

Langabeer, James R.; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

2016-01-01

Introduction Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. T...

Emergency service admissions of patients with burn injury

Directory of Open Access Journals (Sweden)

Sadiye Yolcu

2013-09-01

Full Text Available Objective: In this study, we aimed to investigate the propertiesof burn injured patients who admitted to our hospitalemergency service.Methods: Patients were detected from the hospital recordsof emergency service during six months period andwere divided into five groups according to their ages (60 years. Age, gender totalbody surface area (TBSA, mechanism of injury and theoutcome of emergency evaluation were recorded.Results: Totally 111619 patients admitted to our emergencyservice between 01.07.2011 and 31.12.2011. Duringsix months, 2349 males and 1960 females totally4309 patients were burn injured patients. 1773 patientswere between 0-10 years, 1083 patients were 11-20years, 735 patients were between 21 and 40, 361 patientswere between 41 and 60 and 357 patients were over 60years. Most of the patients were treated in the emergencyservice (90.1%. 0-10% TBSA patients constituted 94.2%.This ratio for burn area >40% was 0.6%. Hot liquid burn(vapored water, milk etc. was 60.2%. There was a significantrelation between mechanism of burn injury andage groups (p<0.05. No corrosive and sunburn injuriesdetermined in females. Age groups were related with hospitalization(p<0.05. The highest intensive care unit admissionwas found in the 0-10 age group (1.3%.Conclusion: Emergency service is the first admission departmentof burn injury patients. Knowing the propertiesof burn injury patients, would help hard-working emergencydoctors in triage of these patients. Also, reportingthe data of emergency service burn injury patients wouldbe helpful for further studies. J Clin Exp Invest 2013; 4(3: 285-288Key words: Burn injury, emergency service, total body surface area

Assessing the physical service setting: a look at emergency departments.

Science.gov (United States)

Steinke, Claudia

2015-01-01

To determine the attributes of the physical setting that are important for developing a positive service climate within emergency departments and to validate a measure for assessing physical service design. The design of the physical setting is an important and contributing factor for creating a service climate in organizations. Service climate is defined as employee perceptions of the practices, procedures, and behaviors that get rewarded, supported, and expected with regard to customer service and customer service quality. There has been research conducted which identifies antecedents within organization that promotes a positive service climate which in turn creates service-oriented behaviors by employees toward clients. The antecedent of the physical setting and its impact on perceptions of service climate has been less commonly explored. Using the concept of the physical service setting (which may be defined as aspects of the physical, built environment that facilitate the delivery of quality service), attributes of the physical setting and their relationship with service climate were explored by means of a quantitative paper survey distributed to emergency nurses (n = 180) throughout a province in Canada. The results highlight the validity and reliability of six scales measuring the physical setting and its relation to service. Respondents gave low ratings to the physical setting of their departments, in addition to low ratings of service climate. Respondents feel that the design of the physical setting in the emergency departments where they work is not conducive to providing quality service to clients. Certain attributes of the physical setting were found to be significant in influencing perceptions of service climate, hence service quality, within the emergency department setting. © The Author(s) 2015.

Taos County Roads

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — Vector line shapefile under the stewardship of the Taos County Planning Department depicting roads in Taos County, New Mexico. Originally under the Emergency...

[Medical coverage of a road bicycle race].

Science.gov (United States)

Reifferscheid, Florian; Stuhr, Markus; Harding, Ulf; Schüler, Christine; Thoms, Jürgen; Püschel, Klaus; Kappus, Stefan

2010-07-01

Major sport events require adequate expertise and experience concerning medical coverage and support. Medical and ambulance services need to cover both participants and spectators. Likewise, residents at the venue need to be provided for. Concepts have to include the possibility of major incidents related to the event. Using the example of the Hamburg Cyclassics, a road bicycle race and major event for professional and amateur cyclists, this article describes the medical coverage, number of patients, types of injuries and emergencies. Objectives regarding the planning of future events and essential medical coverage are consequently discussed. (c) Georg Thieme Verlag Stuttgart-New York.

Road Traffic Injury in Lagos, Nigeria: Assessing Prehospital Care.

Science.gov (United States)

Ibrahim, Nasiru A; Ajani, Abdul Wahab O; Mustafa, Ibrahim A; Balogun, Rufai A; Oludara, Mobolaji A; Idowu, Olufemi E; Solagberu, Babatunde A

2017-08-01

Introduction Injuries are the third most important cause of overall deaths globally with one-quarter resulting from road traffic crashes. Majority of these deaths occur before arrival in the hospital and can be reduced with prompt and efficient prehospital care. The aim of this study was to highlight the burden of road traffic injury (RTI) in Lagos, Nigeria and assess the effectiveness of prehospital care, especially the role of Lagos State Ambulance Service (LASAMBUS) in providing initial care and transportation of the injured to the hospital. A three-year, retrospective review of road traffic injured patients seen at the Surgical Emergency Room (SER) of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria, from January 1, 2012 to December 31, 2014 was conducted. Parameters extracted from the Institution Trauma Registry included bio-data, date and time of injury, date and time of arrival in SER, host status, type of vehicle involved, and region(s) injured. Information on how patients came to the hospital and outcome in SER also were recorded. Results were analyzed using Statistical Package for Social Sciences (SPSS; IBM Corporation; Armonk, New York USA) version 16. A total of 23,537 patients were seen during the study period. Among them, 16,024 (68.1%) had trauma. Road traffic crashes were responsible in 5,629 (35.0%) of trauma cases. Passengers constituted 42.0% of the injured, followed by pedestrians (34.0%). Four wheelers were the most frequent vehicle type involved (54.0%), followed by motor cycles (30.0%). Regions mainly affected were head and neck (40.0%) and lower limb (29.0%). Less than one-quarter (24.0%) presented to the emergency room within an hour, while one-third arrived between one and six hours following injury. Relatives brought 55.4%, followed by bystanders (21.4%). Only 2.3% had formal prehospital care and were brought to the hospital by LASAMBUS. They also had significantly shorter arrival time. One hundred and nine patients

Uncertainty analysis of accident notification time and emergency medical service response time in work zone traffic accidents.

Science.gov (United States)

Meng, Qiang; Weng, Jinxian

2013-01-01

Taking into account the uncertainty caused by exogenous factors, the accident notification time (ANT) and emergency medical service (EMS) response time were modeled as 2 random variables following the lognormal distribution. Their mean values and standard deviations were respectively formulated as the functions of environmental variables including crash time, road type, weekend, holiday, light condition, weather, and work zone type. Work zone traffic accident data from the Fatality Analysis Report System between 2002 and 2009 were utilized to determine the distributions of the ANT and the EMS arrival time in the United States. A mixed logistic regression model, taking into account the uncertainty associated with the ANT and the EMS response time, was developed to estimate the risk of death. The results showed that the uncertainty of the ANT was primarily influenced by crash time and road type, whereas the uncertainty of EMS response time is greatly affected by road type, weather, and light conditions. In addition, work zone accidents occurring during a holiday and in poor light conditions were found to be statistically associated with a longer mean ANT and longer EMS response time. The results also show that shortening the ANT was a more effective approach in reducing the risk of death than the EMS response time in work zones. To shorten the ANT and the EMS response time, work zone activities are suggested to be undertaken during non-holidays, during the daytime, and in good weather and light conditions.

[Road traffic injuries in Catalonia (Spain): an approach using the minimum data set for acute-care hospitals and emergency resources].

Science.gov (United States)

Clèries, Montse; Bosch, Anna; Vela, Emili; Bustins, Montse

2015-09-01

To verify the usefulness of the minimum data set (MDS) for acute-care hospitals and emergency resources for the study of road traffic injuries and to describe the use of health resources in Catalonia (Spain). The study population consisted of patients treated in any kind of emergency service and patients admitted for acute hospitalization in Catalonia in 2013. A descriptive analysis was performed by age, gender, time and clinical variables. A total of 48,150 patients were treated in hospital emergency departments, 6,210 were attended in primary care, and 4,912 were admitted to hospital. There was a higher proportion of men (56.2%), mainly aged between 20 and 40 years. Men accounted for 54.9% of patients with minor injuries and 75.1% of those with severe injuries. Contusions are the most common injury (30.2%), followed by sprains (28.7%). Fractures mostly affected persons older than 64 years, internal injuries particularly affected men older than 64 years, and wounds mainly affected persons younger than 18 years and older than 64 years. In the adult population, the severity of the injuries increased with age, leading to longer length of stay and greater complexity. Hospital mortality was 0.2%. Fractures, internal injuries and wounds were more frequent in the group of very serious injuries, and sprains and contusions in the group of minor injuries. MDS records (acute hospitals and emergency resources) provide information that is complementary to other sources of information on traffic accidents, increasing the completeness of the data. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Barriers to emergency obstetric care services

DEFF Research Database (Denmark)

Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique

2014-01-01

Introduction: Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore...... barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. Methods: A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced...... decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay...

The selective use of emergency shipments for service-contract differentiation

NARCIS (Netherlands)

Alvarez, Elisa; van der Heijden, Matthijs C.; Zijm, Willem H.M.

2013-01-01

Suppliers of capital goods increasingly offer performance-based service contracts with customer-specific service levels. We use selective emergency shipments of spare parts to differentiate logistic performance: We apply emergency shipments in out-of-stock situations for combinations of parts and

Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority.

Science.gov (United States)

Debenham, Sierra; Fuller, Matthew; Stewart, Matthew; Price, Raymond R

2017-12-01

By 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of trauma-related deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks. We suggest that lay providers can become a strong foundation for nascent EMS through a four-fold approach: strengthening and expanding existing lay provider training programs; incentivizing lay providers; strengthening locally available first aid supply chains; and using technology to link lay provider networks. Debenham S , Fuller M , Stewart M , Price RR . Where there is no EMS: lay providers in Emergency Medical Services care - EMS as a public health priority. Prehosp Disaster Med. 2017;32(6):593-595.

Production layout improvement in emergency services: a participatory approach.

Science.gov (United States)

Zanatta, Mateus; Amaral, Fernando Gonçalves

2012-01-01

Volunteer fire department is a service that responds emergency situations in places where there are no military emergency services. These services need to respond quickly, because time is often responsible for the operation success besides work environment and setup time interfere with the prompt response to these calls and care efficiency. The layout design is one factor that interferes with the quick setup. In this case, the spaces arrangement can result in excessive or unnecessary movements; also the equipment provision may hinder the selection and collection of these or even create movement barriers for the workers. This work created a new layout for the emergency assistance service, considering the human factors related to work through the task analysis and workers participation on the alternatives of improvement. The results showed an alternate layout with corridors and minimization of unusable sites, allowing greater flexibility and new possibilities of requirements.

[Characteristics of the emergency health service demand in Southern Brazil].

Science.gov (United States)

Carret, Maria Laura Vidal; Fassa, Anaclaudia Gastal; Paniz, Vera Maria Vieira; Soares, Patrícia Carret

2011-01-01

This study evaluated the demand of emergency health service. It was performed a descriptive analyses of 1647 adults that consulted at emergency public service of Pelotas, Brazil. Older subjects, non white skin color, lower schooling, without partner, and smokers presented higher prevalence of consultations at this service when compared with the general population. Individuals waited, on average, 15 minutes to have their consultations, exams were requested in more than 40% of the visits, and intravenous medication were administered in one third of the visits. Elderly waited longer before searching the service, but they had lowest awaiting time after arriving at emergency service and had higher percentage of regular doctor and social support. Elderly had more diagnosis related to circulatory system, while among the youngest, external causes were the most frequent. The low waiting average for consultation suggest this service provide an immediate care while the great number of ill-defined signs or symptoms indicate that the provided care is provisional. It is necessary to train emergency professionals to reduce the number of tests requested and to assure that either professional as the population is conscious about the importance of a continuity of care.

Effects of a dedicated regional psychiatric emergency service on boarding of psychiatric patients in area emergency departments.

Science.gov (United States)

Zeller, Scott; Calma, Nicole; Stone, Ashley

2014-02-01

Mental health patients boarding for long hours, even days, in United States emergency departments (EDs) awaiting transfer for psychiatric services has become a considerable and widespread problem. Past studies have shown average boarding times ranging from 6.8 hours to 34 hours. Most proposed solutions to this issue have focused solely on increasing available inpatient psychiatric hospital beds, rather than considering alternative emergency care designs that could provide prompt access to treatment and might reduce the need for many hospitalizations. One suggested option has been the "regional dedicated emergency psychiatric facility," which serves to evaluate and treat all mental health patients for a given area, and can accept direct transfers from other EDs. This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the "Alameda Model" on boarding times and hospitalization rates for psychiatric patients in area EDs. Over a 30-day period beginning in January 2013, 5 community hospitals in Alameda County, California, tracked all ED patients on involuntary mental health holds to determine boarding time, defined as the difference between when they were deemed stable for psychiatric disposition and the time they were discharged from the ED for transfer to the regional psychiatric emergency service. Patients were also followed to determine the percentage admitted to inpatient psychiatric units after evaluation and treatment in the psychiatric emergency service. In a total sample of 144 patients, the average boarding time was approximately 1 hour and 48 minutes. Only 24.8% were admitted for inpatient psychiatric hospitalization from the psychiatric emergency service. The results of this study indicate that the Alameda Model of transferring patients from general hospital EDs to a regional psychiatric emergency service reduced the length of boarding times for patients awaiting psychiatric care by over 80% versus

'What if you live on top of a bakery and you like cakes?'-Drug use and harm trajectories before, during and after the emergence of Silk Road.

Science.gov (United States)

Barratt, Monica J; Lenton, Simon; Maddox, Alexia; Allen, Matthew

2016-09-01

Cryptomarkets are digital platforms that use anonymising software (e.g. Tor) and cryptocurrencies (e.g. Bitcoin) to facilitate peer-to-peer (P2P) trade of goods and services. Their emergence has facilitated access to a wide range of high-quality psychoactive substances, according to surveys of users. In this paper, we ask the question 'How does changing access to drugs through cryptomarkets affect the drug use and harm trajectories of their users?' We conducted a digital ethnography spanning 2012-2014, a period that included the seizure of the original Silk Road marketplace and forum by law enforcement. Using encrypted online chat, we interviewed 17 people who reported using Silk Road to purchase illicit drugs. The interviews were in-depth and unstructured, and also involved the use of life history timelines to trace trajectories. Transcripts were analysed thematically using NVivo. For some, Silk Road facilitated initiation into drug use or a return to drug use after cessation. Typically, participants reported experiencing a glut of drug consumption in their first months using Silk Road, described by one participant as akin to 'kids in a candy store'. There was evidence that very high availability reduced the need for drug hoarding which helped some respondents to moderate use and feel more in control of purchases made online. Cryptomarket access also appeared to affect solitary and social drug users differently. Most participants described using other cryptomarkets after the closure of Silk Road, albeit with less confidence. In the context of high levels of drug access, supply and diversity occurring within a community regulated environment online, the impacts of cryptomarkets upon drug use trajectories are complex, often posing new challenges for self-control, yet not always leading to harmful outcomes. A major policy challenge is how to provide support for harm reduction in these highly volatile settings. Copyright © 2016 Elsevier B.V. All rights reserved.

Medical Emergency Workload of a Regional UK HEMS Service.

Science.gov (United States)

McQueen, Carl; Crombie, Nick; Cormack, Stef; Wheaton, Steve

2015-01-01

Regionalized trauma networks have been established in England to centralize specialist care at dedicated centers of excellence throughout the country. Helicopter emergency medical services (HEMS) in the West Midlands region have been redesigned to form an integrated component of such systems. The continued use of such valuable and scarce resources for medical emergencies requires evaluation. A retrospective review of mission data for a regional Air Ambulance Service in England over a two year period. Medical emergencies continue to contribute a large proportion of the overall workload of the service. Requirement for advanced interventions at the scene was rare, with less than 10% of patients attended by HEMS teams having care needs that fall beyond the scope of standard paramedic practice. Dynamic solutions are needed to ensure that HEMS support for cases of medical emergency are appropriately targeted to incidents in which clinical benefit is conferred to the patient. Intelligent tasking of appropriate resources has the potential to improve the HEMS response to medical emergencies while optimizing the availability of resources to respond to other incidents, most notably cases of major trauma. Copyright © 2015 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

PROPOSAL OF VOIVODESHIP ROAD SAFETY IMPROVEMENT PROGRAMME

OpenAIRE

Tomasz SZCZURASZEK; Jan KEMPA

2016-01-01

The article presents a proposal of the ‘GAMBIT KUJAWSKO-POMORSKI’ Road Safety Improvement Programme. The main idea of the Programme is to establish and initiate systems that will be responsible for the most important areas of activity within road safety, including road safety control, supervision, and management systems in the whole Voivodeship. In total, the creation and start of nine such systems has been proposed, namely: the Road Safety Management, the Integrated Road Rescue Service, the ...

47 CFR 25.284 - Emergency Call Center Service.

Science.gov (United States)

2010-10-01

... mobile satellite service to end-user customers (part 25, subparts A-D) must provide Emergency Call Center... Center personnel must determine the emergency caller's phone number and location and then transfer or otherwise redirect the call to an appropriate public safety answering point. Providers of mobile satellite...

Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

Directory of Open Access Journals (Sweden)

James Robert Langabeer

2016-11-01

Full Text Available Introduction Emergency medical services (EMS agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED, affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001. EMS productivity (median time from EMS notification to unit back in service was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median. There were no statistically significant differences in mortality or patient satisfaction. Conclusion We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

EnviroAtlas Estimated Percent Tree Cover Along Walkable Roads Web Service

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

Psychiatric service users' experiences of emergency departments

DEFF Research Database (Denmark)

Carstensen, Kathrine; Lou, Stina; Jensen, Lotte Groth

2017-01-01

Background: There is increased clinical and political attention towards integrating general and psychiatric emergency departments (ED). However, research into psychiatric service users’ experiences regarding general EDs is limited. Aim: To identify and summarize current, qualitative evidence rega...... the discomfort. Overall, the results of this review speak in favour of integrated EDs where service users’ needs are more likely to be recognized and accommodated....

Incidence of emergency contacts (red responses to Norwegian emergency primary healthcare services in 2007 – a prospective observational study

Directory of Open Access Journals (Sweden)

Hansen Elisabeth

2009-07-01

Full Text Available Abstract Background The municipalities are responsible for the emergency primary health care services in Norway. These services include casualty clinics, primary doctors on-call and local emergency medical communication centres (LEMC. The National centre for emergency primary health care has initiated an enterprise called "The Watchtowers", comprising emergency primary health care districts, to provide routine information (patients' way of contact, level of urgency and first action taken by the out-of-hours services over several years based on a minimal dataset. This will enable monitoring, evaluation and comparison of the respective activities in the emergency primary health care services. The aim of this study was to assess incidence of emergency contacts (potential life-threatening situations, red responses to the emergency primary health care service. Methods A representative sample of Norwegian emergency primary health care districts, "The Watchtowers" recorded all contacts and first action taken during the year of 2007. All the variables were continuously registered in a data program by the attending nurses and sent by email to the National Centre for Emergency Primary Health Care at a monthly basis. Results During 2007 the Watchtowers registered 85 288 contacts, of which 1 946 (2.3% were defined as emergency contacts (red responses, corresponding to a rate of 9 per 1 000 inhabitants per year. 65% of the instances were initiated by patient, next of kin or health personnel by calling local emergency medical communication centres or meeting directly at the casualty clinics. In 48% of the red responses, the first action taken was a call-out of doctor and ambulance. On a national basis we can estimate approximately 42 500 red responses per year in the EPH in Norway. Conclusion The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics

Value creation of road infrastructure networks: a structural equation approach

NARCIS (Netherlands)

Hartmann, Andreas; Ling, F.Y.Y.

2016-01-01

Although road agencies need to provide road infrastructure that is beneficial for road users, little is known about how the activities of the agencies influence the value creation of road infrastructure. From a service-dominant logic perspective, the importance of road maintenance and traffic

Developing an active emergency medical service system based on WiMAX technology.

Science.gov (United States)

Li, Shing-Han; Cheng, Kai-An; Lu, Wen-Hui; Lin, Te-Chang

2012-10-01

The population structure has changed with the aging of population. In the present, elders account for 10.63% of the domestic population and the percentage is still gradually climbing. In other words, the demand for emergency services among elders in home environment is expected to grow in the future. In order to improve the efficiency and quality of emergency care, information technology should be effectively utilized to integrate medical systems and facilities, strengthen human-centered operation designs, and maximize the overall performance. The improvement in the quality and survival rate of emergency care is an important basis for better life and health of all people. Through integrated application of medical information systems and information communication technology, this study proposes a WiMAX-based emergency care system addressing the public demands for convenience, speed, safety, and human-centered operation of emergency care. This system consists of a healthcare service center, emergency medical service hospitals, and emergency ambulances. Using the wireless transmission capability of WiMAX, patients' physiological data can be transmitted from medical measurement facilities to the emergency room and emergency room doctors can provide immediate online instructions on emergency treatment via video and audio transmission. WiMAX technology enables the establishment of active emergency medical services.

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

Science.gov (United States)

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.

Road Traffic Accidents - The Number One Killer in Libya

Directory of Open Access Journals (Sweden)

Abdulmajid Ahmed Ali

2007-01-01

and a seatbelt. I had to apologize profusely to the young traffic policeman and explain that I was wearing sunglasses because I was driving facing the sun! The reason for wearing the seatbelt was a habit from living abroad for many years and I was not a "show off" as he put it! This incidence made me wonder how much the traffic police knew about the law?• In Libya the way we behave in the street, the way we drive and our attitude towards pedestrians is not taught in schools at an early age. As a matter of fact, many drivers think it is "cool" to scare pedestrians.• Most of the accidents in Libya occur at school times but unfortunately no measures are taken by the traffic police to help young children to cross roads safely.• Most of the road traffic accidents happen at the same areas but these are never identified as "black spots" to warn drivers of the possible dangers.• Although Zebra Crossings exist in some parts of Libya, they actually do not serve the purpose. We just need to count how many pedestrians (especially foreign visitors have been knocked down at Zebra Crossings.• There is a need for new road signs, clear road markings (lanes, and new traffic lights to replace old and often non-functioning ones.• One study demonstrated that speeding was responsible for about 70% of accidents [4]. There are no speed cameras or road humps to slow down speeding cars, therefore residents who have lost children to road traffic accidents resort to building their own version of street humps made from old pipes, thick ropes or cement.• Most of the main roads are full of holes and in desperate need of maintenance.• Car seats for children are not compulsory.• When accidents happen in Libya, what number do we dial? Do emergency services exist?• It is a known fact that most of the deaths and permanent disabilities in road traffic accidents are caused by people trying to help due to the lack of Advanced Trauma and Life Support (ATLS trained personnel [5,6].• It

36 CFR 212.9 - Principles for sharing use of roads.

Science.gov (United States)

2010-07-01

... roads. 212.9 Section 212.9 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE... of roads. The use of roads under arrangements for sharing costs or performance shall be in accordance with the following: (a) Road improvement. Use of a road for commercial hauling, except occasional or...

AN INFORMATION SERVICE MODEL FOR REMOTE SENSING EMERGENCY SERVICES

Directory of Open Access Journals (Sweden)

Z. Zhang

2017-09-01

Full Text Available This paper presents a method on the semantic access environment, which can solve the problem about how to identify the correct natural disaster emergency knowledge and return to the demanders. The study data is natural disaster knowledge text set. Firstly, based on the remote sensing emergency knowledge database, we utilize the sematic network to extract the key words in the input documents dataset. Then, using the semantic analysis based on words segmentation and PLSA, to establish the sematic access environment to identify the requirement of users and match the emergency knowledge in the database. Finally, the user preference model was established, which could help the system to return the corresponding information to the different users. The results indicate that semantic analysis can dispose the natural disaster knowledge effectively, which will realize diversified information service, enhance the precision of information retrieval and satisfy the requirement of users.

Telehone consultations: At the emergency service, Copenhagen County: Analysis of doctor-patient communication patterns

DEFF Research Database (Denmark)

Larsen, Jan-Helge; Risør, Ole

1997-01-01

Communications patterns, emergency service, out-of-hours service, telehpone consultations, video-supervision......Communications patterns, emergency service, out-of-hours service, telehpone consultations, video-supervision...

Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments.

Science.gov (United States)

Langabeer, James R; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

2016-11-01

Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system's capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

36 CFR 223.37 - Revegetation of temporary roads.

Science.gov (United States)

2010-07-01

... roads. 223.37 Section 223.37 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF... Provisions § 223.37 Revegetation of temporary roads. Timber sale contracts, permits and other documents... roads constructed or used thereunder so as to permit the reestablishment by artificial or natural means...

MODELING A COMPUTER APPLICATION FOR MANAGEMENT OF MAINTENANCE ACTIVITIES OF UNPAVED ROADS

Directory of Open Access Journals (Sweden)

Ludmília de Souza Dias

2015-08-01

Full Text Available ABSTRACTThis study presents a contribution to the modeling of a computer application employing a method of serviceability performance for unpaved roads, aiming the management of maintenance/restoration activities of the primary surface layer. The proposed methodology consisted of field inspections during dry (April to September and rainy (October to March periods, during which objective evaluations were performed to survey of defects and their densities and degrees of severity. To aid the functional classification of analyzed road sections and the determination of the defect with major influence on the serviceability of these roads, the method of serviceability performance proposed by Silva (2009was implemented in the Visual Basic for Applications (VBA language in Microsoft Excel software. With the use of the computer application proposed it was possible to identify among the defects analyzed in field, through the index of serviceability of the sampling unit per defect type (ISUdef, which one had the greatest influence on determining the relative serviceability index per road section (IST. The results allow us to conclude that the computer application Road achieved satisfactory results, since the objective evaluation criteria applied to road sections denotes consistency regarding their serviceability.

Using visual stimuli to explore the social perceptions of ecosystem services in cultural landscapes

DEFF Research Database (Denmark)

López-Santiago, César A.; Oteros-Rozas, Elisa; Martín-López, Berta

2014-01-01

, which are used for herd migration, represent the most outstanding feature of these landscapes. We used visually based landscape interpretation to evaluate social perceptions of ecosystem services provided by the Conquense Drove Road transhumance landscape in Spain. Face-to-face questionnaires (N = 314...... perceptions of 16 ecosystem services supplied by these two landscapes. These 16 services were divided into 3 types: provisioning, such as the production of food and water; regulating, such as the control of climate and disease; and cultural, such as spiritual and recreational benefits. We also identified...... ecosystem services tended to be related to forests. All three types of ecosystem services were more perceived by respondents when a drove road was present in each landscape. However, differences in the visual perception of ecosystem services supply and preference for transhumance landscapes emerged...

Challenges of raising road maintenance funds in developing countries: An analysis of road tolling in Zimbabwe

Directory of Open Access Journals (Sweden)

T. C. Mbara

2010-11-01

Full Text Available The condition of Zimbabwe's roads has been declining due to insufficient maintenance and rehabilitation. Year on year, budget allocations have compared unfavourably with funding considered adequate to maintain highway networks and conduct modest construction work. Road infrastructure shortcomings have manifested themselves in the form of high vehicle operating costs and rampant potholes, leading to a decline in road safety and a deterioration of service levels for those who use roads to deliver goods or connect to international markets. In order to try and stop this vicious cycle of decline, the Government of Zimbabwe, on 8 August 2009, introduced a new policy of road-user charges, which involved the setting-up of 22 toll gates on the trunk road network. The overall objective was to raise revenue in order to close the funding gap, blamed for declining road quality. Although alternative methods of financing road maintenance have been debated for years, a generally accepted understanding is that road users should pay costs for road provisioning. This paper assesses the implementation of a road tolling system in Zimbabwe and describes matters relating to, inter alia, implementation strategy, initial performance outcomes and sustainability.

Characteristics of Emergency Services for the Elderly—A Regional Hospital Example

Directory of Open Access Journals (Sweden)

Ching-Lin Huang

2009-12-01

Conclusion: This study's primary goal was to investigate the most common clinical signs and symptoms of the various diseases most common in elderly patients, who presented to the emergency service, and the care of these patients in Hsinchu County to facilitate a more efficient and useful emergency medical service.

Assessing impacts of roads: application of a standard assessment protocol

Science.gov (United States)

Duniway, Michael C.; Herrick, Jeffrey E.

2013-01-01

Adaptive management of road networks depends on timely data that accurately reflect the impacts those systems are having on ecosystem processes and associated services. In the absence of reliable data, land managers are left with little more than observations and perceptions to support management decisions of road-associated disturbances. Roads can negatively impact the soil, hydrologic, plant, and animal processes on which virtually all ecosystem services depend. The Interpreting Indicators of Rangeland Health (IIRH) protocol is a qualitative method that has been demonstrated to be effective in characterizing impacts of roads. The goal of this study were to develop, describe, and test an approach for using IIRH to systematically evaluate road impacts across large, diverse arid and semiarid landscapes. We developed a stratified random sampling approach to plot selection based on ecological potential, road inventory data, and image interpretation of road impacts. The test application on a semiarid landscape in southern New Mexico, United States, demonstrates that the approach developed is sensitive to road impacts across a broad range of ecological sites but that not all the types of stratification were useful. Ecological site and road inventory strata accounted for significant variability in the functioning of ecological processes but stratification based on apparent impact did not. Analysis of the repeatability of IIRH applied to road plots indicates that the method is repeatable but consensus evaluations based on multiple observers should be used to minimize risk of bias. Landscape-scale analysis of impacts by roads of contrasting designs (maintained dirt or gravel roads vs. non- or infrequently maintained roads) suggests that future travel management plans for the study area should consider concentrating traffic on fewer roads that are well designed and maintained. Application of the approach by land managers will likely provide important insights into

Competitiveness in Road Transport

DEFF Research Database (Denmark)

Borgström, Benedikte; Gammelgaard, Britta; Bruun, Poul

Road transport is an important sector, connecting time and space of production and consumption. Its market conditions has changed. The EU single market implementation has increased price pressure due to supply of low cost road freight transport from counties with lower cost structures. Changes...... in the market also encourage strategic development of some road hauliers into providers of unique services. Such road haulier strategic development contributes to efficiency and effectiveness in basically all business sectors of EU. Little research is available of such strategic and operational management....... In this paper we will explore that knowledge gap and analyze what value proposition(s) and capabilities can transform potential cost disadvantages of acting in a market that includes both high- and low-cost-country actors? And in conceptual terminology, how are capabilities deployed and developed to construct...

Traveling the Silk Road: A Measurement of a Large Anonymous Online Marketplace

Science.gov (United States)

2012-11-28

Silk Road, an anonymous, international online marketplace that operates as a Tor hidden service and uses Bitcoin as its exchange currency. We gather...analysis of Silk Road, an anonymous, international on- line marketplace that operates as a Tor hidden service and uses Bitcoin as its exchange currency. We...anonymity, Silk Road needs to also preserve payment anonymity. To that effect, Silk Road only supports Bitcoin (BTC, [30]) as a trading currency

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

Science.gov (United States)

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.

Factors Impacting Mortality in the Pre-Hospital Period After Road Traffic Accidents in Urban India.

Science.gov (United States)

Chandrasekharan, Ananthnarayan; Nanavati, Aditya J; Prabhakar, Sandhya; Prabhakar, Subramaniam

2016-07-01

India currently has the dubious distinction of experiencing the highest number of road traffic accidents in the world. We believe that this study on road traffic accidents may help to identify factors in the pre-hospital setting that may influence mortality rates. A prospective observational study was carried out in a metro area in India over a period of one year. The study included consecutive patients admitted to the trauma service after road traffic accidents. Demographic information, time and place of accident, and details regarding the vehicle and the events leading up to the hospital admission were recorded. Injury severity, management in the hospital, and final outcomes in terms of mortality were noted. The data were analyzed with SPSS software. A total of 773 patients were enrolled. Of these, there were 197 deaths and 576 survivors. The majority of patients were aged 15 - 40 years (67%) and were male (87.84%). More accidents occurred at night (58.2%) than during the day (41.8%). Mortality was not significantly associated with age, sex, or time of accident. City roads (38.9%) saw more accidents than highways (26.13%), but highway accidents were more likely to be fatal. Two-wheeler riders (37.65%) and pedestrians (35.75%) formed the majority of our study population. Mortality was significantly associated with crossing the road on foot (P = 0.004). Pillion riders on two-wheeler vehicles were more likely to experience poor outcomes (relative risk [RR] = 1.9, P = 0.001). Front-seat occupants in four-wheeler vehicles were at an increased risk of not surviving the accident (61.98%; RR=2.56, P = 0.01). Lack of safety gear, such as helmets, seat belts, and airbags, was significantly associated with mortality (P = 0.05). Delays in transfers of patients to the hospital and a lack of pre-hospital emergency services was significantly associated with increased mortality (P = 0.000). A lack of respect for the law, weak legislation and law enforcement, disregard for

Barriers to formal emergency obstetric care services' utilization.

Science.gov (United States)

Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

2011-06-01

Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be

Improved Performance of Unpaved Roads During Spring Thaw

National Research Council Canada - National Science Library

Henry, Karen S; Olson, James P; Farrington, Stephen P; Lens, John

2005-01-01

Unpaved roads in Vermont are subject to deterioration from seasonal freezing and thawing, and many towns have roads that suffer chronic serviceability problems during the so-called "spring thaw," or mud season...

Emergency residential care settings: A model for service assessment and design.

Science.gov (United States)

Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira

2018-02-01

There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nurses' perception about risk classification in an emergency service

Directory of Open Access Journals (Sweden)

Cristiane Chaves de Souza

2014-04-01

Full Text Available Objective. Get to know how nurses perceive the accomplishment of risk classification in an emergency service. Methodology. In this qualitative study, 11 nurses were included with at least two months of experience in the risk classification of patients who visited the emergency service. Semistructured interviews were used to collect the information. The data were collected between August and December 2011. For data analysis, Bardin's theoretical framework was used. Results. The nurses in the study consider the risk classification as a work organization instruments that permits closer contact between nurses and patients. The nursing skills needed for risk classification were identified: knowledge about the scale used, clinical perspective, patience and agility. The availability of risk classification scales was the main facilitator of this work. The main difficulties were the disorganization of the care network and the health team's lack of knowledge of the protocol. Conclusion. Risk classification offers an opportunity for professional autonomy to the extent that it is the main responsible for regulating care at the entry door of the emergency services.

New optimization strategies of pavement maintenance: A case study for national road network in Indonesia using integrated road management system

Science.gov (United States)

Hamdi, Hadiwardoyo, Sigit P.; Correia, A. Gomes; Pereira, Paulo

2017-06-01

A road network requires timely maintenance to keep the road surface in good condition onward better services to improve accessibility and mobility. Strategies and maintenance techniques must be chosen in order to maximize road service level through cost-effective interventions. This approach requires an updated database, which the road network in Indonesia is supported by a manual and visual survey, also using NAASRA profiler. Furthermore, in this paper, the deterministic model of deterioration was used. This optimization model uses life cycle cost analysis (LCCA), applied in an integrated manner, using IRI indicator, and allows determining the priority of treatment, type of treatment and its relation to the cost. The purpose of this paper was focussed on the aspects of road maintenance management, i.e., maintenance optimization models for different levels of traffic and various initial of road distress conditions on the national road network in Indonesia. The implementation of Integrated Road Management System (IRMS) can provide a solution to the problem of cost constraints in the maintenance of the national road network. The results from this study found that as the lowest as agency cost, it will affect the increasing of user cost. With the achievement of the target plan scenario Pl000 with initial value IRI 2, it was found that the routine management throughout the year and in early reconstruction and periodic maintenance with a 30 mm thick overlay, will simultaneously provide a higher net benefit value and has the lowest total cost of transportation.

Scaling roads and wildlife: The Cinderella principle

Science.gov (United States)

Bissonette, J.A.

2002-01-01

It is clear that a reduction in both direct and indirect effects of roads and road networks must be the goal of management agencies. However, increased permeability of roaded landscapes can only be achieved by up-front planning and subsequent mitigative actions. The key is to understand that roads must be made permeable to the movement of animals. More profoundly, ecosystem services, i.e., clean water, clean air, uncontaminated soil, natural landscapes, recreation opportunities, abundant wildlife, and life sustaining ecological processes must not be seriously impacted. In other words, quality of life as measured by ecosystem services should be a major component of the planning process when roads are constructed or improved. Mitigative structures exist to increase permeability of roads. Wildlife overpasses and underpasses, often referred to as ecoducts or green bridges, with associated structures to enable larger animals to exit the road right of way, e.g., earthen escape ramps (BISSONETTE and HAMMER, 2001), various culvert designs for smaller animals including badger pipes and amphibian and reptile tunnels, and fish ladders are but a small sampling of the structures already in place around the world. What is needed is attention to the big picture. Landscapes need to be reconnected and made more permeable. Responsible agencies and organizations need to be aggressive about promoting mitigations and a conservation ethic into road planning. Only with a broad based effort between a concerned public, a database to work from, and a willingness of responsible agencies, will the now very large virtual footprint of roads and road networks be reduced to more closely approximate the physical footprint. By embracing the Cinderella Principle of making the virtual shoe fit more closely the actual physical footprint of roads, we will be able to achieve a closer connection with ecological harmony with its resultant effect of abundant wildlife.

Geotechnical Monitoring of the Automobile Road

Science.gov (United States)

Matsiy, Vladimir

2017-12-01

In the present article, the results of geotechnical monitoring of A-147 automobile road “Dzhubga-Sochi” are given. Some sections of the automobile road suffered from the landslide adjustment movements; it resulted in many deformations of the retaining structures, the damages of the roadbed and ground crawling over the retaining walls. The observation data made it possible to specify the borders of the active landslide and to form a forecast of the landslide activity in the sections of the automobile roads. Due to monitoring being carried out, there was substantiated the necessity to correct the service forms and records connected with the automobile road reconstruction.

A Systematic Literature Review: Workplace Violence Against Emergency Medical Services Personnel

OpenAIRE

Pourshaikhian, Majid; Abolghasem Gorji, Hassan; Aryankhesal, Aidin; Khorasani-Zavareh, Davood; Barati, Ahmad

2016-01-01

Context In spite of the high prevalence and consequences of much workplace violence against emergency medical services personnel, this phenomenon has been given insufficient attention. A systematic review can aid the development of guidelines to reduce violence. Objectives The research question addressed by this paper is, “What are the characteristics and findings of studies on workplace violence against emergency medical services...

Emerging trends in the evolution of service-oriented and enterprise architectures

CERN Document Server

Zimmermann, Alfred; Jain, Lakhmi

2016-01-01

This book presents emerging trends in the evolution of service-oriented and enterprise architectures. New architectures and methods of both business and IT are integrating services to support mobility systems, Internet of Things, Ubiquitous Computing, collaborative and adaptive business processes, Big Data, and Cloud ecosystems. They inspire current and future digital strategies and create new opportunities for the digital transformation of next digital products and services. Services Oriented Architectures (SOA) and Enterprise Architectures (EA) have emerged as a useful framework for developing interoperable, large-scale systems, typically implementing various standards, like Web Services, REST, and Microservices. Managing the adaptation and evolution of such systems presents a great challenge. Service-Oriented Architecture enables flexibility through loose coupling, both between the services themselves and between the IT organizations that manage them. Enterprises evolve continuously by transforming and ext...

A scenario planning approach for disasters on Swiss road network

Science.gov (United States)

Mendes, G. A.; Axhausen, K. W.; Andrade, J. S.; Herrmann, H. J.

2014-05-01

We study a vehicular traffic scenario on Swiss roads in an emergency situation, calculating how sequentially roads block due to excessive traffic load until global collapse (gridlock) occurs and in this way displays the fragilities of the system. We used a database from Bundesamt für Raumentwicklung which contains length and maximum allowed speed of all roads in Switzerland. The present work could be interesting for government agencies in planning and managing for emergency logistics for a country or a big city. The model used to generate the flux on the Swiss road network was proposed by Mendes et al. [Physica A 391, 362 (2012)]. It is based on the conservation of the number of vehicles and allows for an easy and fast way to follow the formation of traffic jams in large systems. We also analyze the difference between a nonlinear and a linear model and the distribution of fluxes on the Swiss road.

36 CFR 212.56 - Identification of designated roads, trails, and areas.

Science.gov (United States)

2010-07-01

... roads, trails, and areas. 212.56 Section 212.56 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE TRAVEL MANAGEMENT Designation of Roads, Trails, and Areas for Motor Vehicle Use § 212.56 Identification of designated roads, trails, and areas. Designated roads, trails, and areas...

Management of primary headache in emergency services of Santos and surrounding towns

Directory of Open Access Journals (Sweden)

Yara Dadalti Fragoso

Full Text Available OBJECTIVES: Primary headaches are often seen by Clinicians on duty at Emergency Services. We have investigated the treatment of such patients by 43 medical doctors who have been working at Emergency Services in the city of Santos and surrounding towns for many years. RESULTS: We confirmed the high prevalence of primary headaches in Emergency Services. There seem to be diagnosis difficulties concerning differentiating attacks of migraine and tension type headache. We also observed that IV dipirone was the most frequently prescribed treatment for patients with primary headaches in this study. There is no protocol in the literature which recommends IV dipirone for the treatment of migraine attacks or other primary headaches. CONCLUSION: It would be advisable to perform controlled double blind studies in order to verify the advantages of IV dipirone in the treatment of intense attacks primary headaches. We concluded that headache management recycling programs could be of interest for doctors who regularly work at Emergency Services.

Contracting out local road and park services: Economic effects and their strategic, contractual, and competitive conditions

DEFF Research Database (Denmark)

Lindholst, Andrej Christian; Petersen, Ole Helby; Houlberg, Kurt

2018-01-01

such as markets, contracts, municipal strategies and contracting history influence these outcomes. Drawing on original survey data from Danish municipalities, we find that competitive tendering has on average reduced costs. Further analysis shows that savings are not associated with lower quality, thus indicating......The economic rationale for contracting out local services is increasingly contested by empirical research. This article aims to contribute to this literature, first by scrutinising the economic effects of contracting out in local road and park services and, second, by exploring how characteristics...... realise larger savings, whereas the characteristics of markets and contracts do not seem to explain variations in cost savings....

EnviroAtlas Estimated Percent Green Space Along Walkable Roads Web Service

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates green space along walkable roads. Green space within 25 meters of the road centerline is included and the percentage is based on...

Road Anomalies Detection System Evaluation.

Science.gov (United States)

Silva, Nuno; Shah, Vaibhav; Soares, João; Rodrigues, Helena

2018-06-21

Anomalies on road pavement cause discomfort to drivers and passengers, and may cause mechanical failure or even accidents. Governments spend millions of Euros every year on road maintenance, often causing traffic jams and congestion on urban roads on a daily basis. This paper analyses the difference between the deployment of a road anomalies detection and identification system in a “conditioned” and a real world setup, where the system performed worse compared to the “conditioned” setup. It also presents a system performance analysis based on the analysis of the training data sets; on the analysis of the attributes complexity, through the application of PCA techniques; and on the analysis of the attributes in the context of each anomaly type, using acceleration standard deviation attributes to observe how different anomalies classes are distributed in the Cartesian coordinates system. Overall, in this paper, we describe the main insights on road anomalies detection challenges to support the design and deployment of a new iteration of our system towards the deployment of a road anomaly detection service to provide information about roads condition to drivers and government entities.

A seamless ubiquitous emergency medical service for crisis situations.

Science.gov (United States)

Lin, Bor-Shing

2016-04-01

In crisis situations, a seamless ubiquitous communication is necessary to provide emergency medical service to save people's lives. An excellent prehospital emergency medicine provides immediate medical care to increase the survival rate of patients. On their way to the hospital, ambulance personnel must transmit real-time and uninterrupted patient information to the hospital to apprise the physician of the situation and provide options to the ambulance personnel. In emergency and crisis situations, many communication channels can be unserviceable because of damage to equipment or loss of power. Thus, data transmission over wireless communication to achieve uninterrupted network services is a major obstacle. This study proposes a mobile middleware for cognitive radio (CR) for improving the wireless communication link. CRs can sense their operating environment and optimize the spectrum usage so that the mobile middleware can integrate the existing wireless communication systems with a seamless communication service in heterogeneous network environments. Eventually, the proposed seamless mobile communication middleware was ported into an embedded system, which is compatible with the actual network environment without the need for changing the original system architecture. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

25 CFR 170.812 - What is emergency maintenance?

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What is emergency maintenance? 170.812 Section 170.812 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.812 What is emergency maintenance? Emergency maintenance is work that...

PROPOSAL OF VOIVODESHIP ROAD SAFETY IMPROVEMENT PROGRAMME

Directory of Open Access Journals (Sweden)

Tomasz SZCZURASZEK

2016-07-01

Full Text Available The article presents a proposal of the ‘GAMBIT KUJAWSKO-POMORSKI’ Road Safety Improvement Programme. The main idea of the Programme is to establish and initiate systems that will be responsible for the most important areas of activity within road safety, including road safety control, supervision, and management systems in the whole Voivodeship. In total, the creation and start of nine such systems has been proposed, namely: the Road Safety Management, the Integrated Road Rescue Service, the Personnel Continuing Education, the Hazardous Road Behaviour Monitoring, the Social Education for Safe Behaviour on Road, the Teaching Personnel Improvement, the Area Development and Planning Process Improvement, the Road Infrastructure Design Quality Improvement, and the Road and Traffic Management Process Efficiency Improvement. The basic aim of each system has been discussed as well as the most important tasks implemented as its part. The Road Safety Improvement Programme for the Kujawsko-Pomorskie Voivodeship presented in this article is a part of the National Road Safety Programme 2013-2020. Moreover, it is not only an original programme in Poland, but also a universal project that may be adapted for other voivodeships as well.

Access to emergency care services: a transversal ecological study about Brazilian emergency health care network.

Science.gov (United States)

Rocha, T A H; da Silva, N C; Amaral, P V; Barbosa, A C Q; Rocha, J V M; Alvares, V; de Almeida, D G; Thumé, E; Thomaz, E B A F; de Sousa Queiroz, R C; de Souza, M R; Lein, A; Toomey, N; Staton, C A; Vissoci, J R N; Facchini, L A

2017-12-01

Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). Cross-sectional ecological study. Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distribution, 12% of the population was more than 120 km away from a health facility with a neonatal ICU. The maternities situation is different from other specialties, where 81% of the total Brazilian population was within 1 h or less from such health facilities. Our results highlighted a polarization in distribution of Brazilian health care facilities. There is a concentration of hospitals in urban areas more developed and access gaps in rural areas and the Amazon region. Our results demonstrate that the distribution of emergency services in Brazil is not facilitating access to the population due to geographical barriers associated with great distances. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

36 CFR 212.10 - Maximum economy National Forest System roads.

Science.gov (United States)

2010-07-01

... Forest System roads. 212.10 Section 212.10 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT... economy National Forest System roads. The Chief may acquire, construct, reconstruct, improve, and maintain National Forest System roads within and near the National Forests and other lands administered by the...

[New possibilities in emergency medical transportation and emergency services of Polish Medical Air Rescue].

Science.gov (United States)

Gałazkowski, Robert

2010-01-01

In Poland, two types of medical services are accomplished by the Medical Air Rescue (MAR) operating all over the country: emergency transport from the incident scene to hospital and inter-hospital transport. Helicopters or planes are used for this purpose. In 2009, helicopters performed 4359 flights to incidents and 1537 inter-hospital transports whereas planes performed 589 inter-hospital ambulance and 196 rescue flights. MAR operates from 17 bases of the Helicopter Emergency Medical Service (HEMS) and one airbase. Helicopters are mainly used when medical transport is emergent, within the operational region of a given base whereas planes when the distance between the present and target airports exceeds 250 km. In 2008, new modern aircraft were introduced to HEMS-helicopters EC 135. They fulfil all requirements of air transport regulations and are adjusted to visual (VFR) and instrumental (IFR) flights rules, at day and night. The medical cabin of EC 135 is ergonomic and functional considering the majority of rescue activities under life-saving circumstances. It is equipped with ventilator, defibrillator, infusion pumps etc. Defibrillators have 12-lead ECG, E(T)CO2, SpO2, NIBP, and IBP modules. Transport ventilators can work in a variety of ventilation modes including CMV, SIMV, SVV, BILEVEL, PCV, ASB, PPV and CPAP. The purchase of helicopters with modern avionic and medical configuration ensures high quality services of MAR for many years to come.

Achievements in emergency medical rescue service, North-West ...

African Journals Online (AJOL)

2006-08-28

Aug 28, 2006 ... In North-West province this process of provincialisation took place in ... Emergency Medical Rescue Service, Department of Health, North-West. Victor R .... recovery after CPR treatment should be started as soon as possible ...

Effects of Ramadan on Forensic Cases Presenting to Emergency Service

Directory of Open Access Journals (Sweden)

F. Sarı Doğan

2015-06-01

Full Text Available The term "forensic case" is defined as disruption of physical and/or mental health of an individual due to external factors. Forensic cases are most frequently encountered in emergency services. Ramadan, the ninth month of Islamic calendar, is a month of fasting throughout which Muslims from all around the world worship by observing fasting. There are many studies focusing on the effects of fasting on health. The purpose of this study is to examine the effects of Ramadan on forensic cases presenting to emergency service.

An Emergent Micro-Services Approach to Digital Curation Infrastructure

Directory of Open Access Journals (Sweden)

Stephen Abrams

2010-07-01

Full Text Available In order better to meet the needs of its diverse University of California (UC constituencies, the California Digital Library UC Curation Center is re-envisioning its approach to digital curation infrastructure by devolving function into a set of granular, independent, but interoperable micro-services. Since each of these services is small and self-contained, they are more easily developed, deployed, maintained, and enhanced; at the same time, complex curation function can emerge from the strategic combination of atomistic services. The emergent approach emphasizes the persistence of content rather than the systems in which that content is managemed, thus the paradigmatic archival culture is not unduly coupled to any particular technological context. This results in a curation environment that is comprehensive in scope, yet flexible with regard to local policies and practices and sustainable despite the inevitability of disruptive change in technology and user expectation.

[Stress as an occupational risk factor among policemen of road patrol service].

Science.gov (United States)

Fedotova, I V; Chernikova, E F

The hygienic evaluation of occupational factors which characterized working conditions of traffic policemen of road patrol service was performed. The authors found that along with high neuro-emotional occupational stress in traffic policemen, they exposed to unfavorable microclimate, higher level of noise, vibration and their work was classified as heavy. Also, traffic policemen presented subjective complaints about negative impact of polluted air of motorways on their health status. Prevalence of chronic diseases was analyzed in group of 431 traffic policemen. The authors revealed a leading role of the following diseases: musculoskeletal diseases, diseases of connective tissue, digestive diseases, diseases of the nerve system, circulation system; their portion in the morbidity structure was 86.0%. The association of these diseases with occupation was confirmed by the increasing of their incidence with increasing of length of duration of service. Calculation of indices of relative occupational risk showed (that especially important) the increase of the length of service led to the increase in the risk ofpathologies, in which stress played a significant role. In examined group, the authors revealed such diseases as hypertension, autonomous-vascular dystonia, gastric and duodenal ulcer. Risk of the development of these diseases in some age/length of service groups is classified as high and very high. Obtained results provide the evidence that measures aimed to the decrease of the exposure to occupational factors will promote prevention of stress-stipulated diseases among traffic policemen.

36 CFR 223.38 - Standards for road design and construction.

Science.gov (United States)

2010-07-01

... Provisions § 223.38 Standards for road design and construction. Road construction authorized under timber... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Standards for road design and construction. 223.38 Section 223.38 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF...

Developing an operational capabilities index of the emergency services sector.

Energy Technology Data Exchange (ETDEWEB)

Collins, M.J.; Eaton, L.K.; Shoemaker, Z.M.; Fisher, R.E.; Veselka, S.N.; Wallace, K.E.; Petit, F.D. (Decision and Information Sciences)

2012-02-20

In order to enhance the resilience of the Nation and its ability to protect itself in the face of natural and human-caused hazards, the ability of the critical infrastructure (CI) system to withstand specific threats and return to normal operations after degradation must be determined. To fully analyze the resilience of a region and the CI that resides within it, both the actual resilience of the individual CI and the capability of the Emergency Services Sector (ESS) to protect against and respond to potential hazards need to be considered. Thus, a regional resilience approach requires the comprehensive consideration of all parts of the CI system as well as the characterization of emergency services. This characterization must generate reproducible results that can support decision making with regard to risk management, disaster response, business continuity, and community planning and management. To address these issues, Argonne National Laboratory, in collaboration with the U.S. Department of Homeland Security (DHS) Sector Specific Agency - Executive Management Office, developed a comprehensive methodology to create an Emergency Services Sector Capabilities Index (ESSCI). The ESSCI is a performance metric that ranges from 0 (low level of capabilities) to 100 (high). Because an emergency services program has a high ESSCI, however, does not mean that a specific event would not be able to affect a region or cause severe consequences. And because a program has a low ESSCI does not mean that a disruptive event would automatically lead to serious consequences in a region. Moreover, a score of 100 on the ESSCI is not the level of capability expected of emergency services programs; rather, it represents an optimal program that would rarely be observed. The ESSCI characterizes the state of preparedness of a jurisdiction in terms of emergency and risk management. Perhaps the index's primary benefit is that it can systematically capture, at a given point in time, the

First Responders and Prehospital Care for Road Traffic Injuries in Malawi.

Science.gov (United States)

Chokotho, Linda; Mulwafu, Wakisa; Singini, Isaac; Njalale, Yasin; Maliwichi-Senganimalunje, Limbika; Jacobsen, Kathryn H

2017-02-01

Introduction Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians. Problem This study examined the challenges associated with current first response practices in Malawi. In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes. All governmental and nongovernmental first response organizations identified by key informants were contacted, and a checklist was used to identify the services they offer. Access to professional prehospital care in Malawi is almost nonexistent, aside from a few city fire departments and private ambulance services. Rapid transportation to a hospital is usually the primary goal of roadside care because of limited first aid knowledge and a lack of access to basic safety equipment. The key informants recommended: expanding community-based first aid training; emphasizing umunthu (shared humanity) to inspire bystander involvement in roadside care; empowering local leaders to coordinate on-site responses; improving emergency communication systems; equipping traffic police with road safety gear; and expanding access to ambulance services. Prehospital care in Malawi would be improved by the creation of a formal network of community leaders, police, commercial drivers, and other lay volunteers who are trained in basic first aid and are equipped to respond to crash sites to provide roadside care to trauma patients and prepare them for safe transport to hospitals. Chokotho L , Mulwafu W , Singini I , Njalale Y , Maliwichi-Senganimalunje L , Jacobsen KH . First responders and prehospital care for road traffic injuries in Malawi. Prehosp Disaster Med. 2017;32(1):14-19.

[Analysis of characteristics of road traffic injuries in Bao'an District, Shenzhen from 2004 to 2011].

Science.gov (United States)

Liu, Wen-hua; Li, Li-ping; Zhou, Zhi-ming; Liang, Jin-feng; Zhu, Yao; Wang, Gang; Deng, Shao-jie

2012-12-18

To analyze the characteristics of road traffic accidents in Bao'an District, Shenzhen from 2004 to 2011, and to provide scientific basis for the prevention and treatment of traffic accidents. The traffic injury cases recorded by Shenzhen traffic police from 2004 to 2011 were analyzed, including the time (year, month, date); the space (crossings and road segments, road type); the injury of patients (injuries, death). A total of 422 730 accidents from road traffic occurred in Bao'an District, Shenzhen from 2004 to 2011, with 63 809 people injured and 2 790 people died, and the mortality ratio was 22.87:1. Traffic accidents occurred in Bao'an District showed an increasing trend, especially in 2010, and the highest number up to 90 358, while the most deaths occurred in 2007, up to 473 people. As to the single month, the highest traffic accident rate was in August, accounting for 9.77% of the total, while the lowest was in February, accounting for 5.39% of the total; mortality rate in December reached 9.02%. As to one single day, the peaks of accidents occurred in two periods: 9:00-11:00 and 15:00-18:00, and 3:00-6:00 had the smallest number. Traffic injuries often occurred in the intersection, straight line, main road and the section only marked marking. According to the characteristics of regional traffic injury, we should enhance the populace traffic safe awareness, efficiently arrange the human resources, such as emergency personnel, traffic management personnel, set scientific preventive measures, and modify the emergency system and service mode. All of these are essential measures for the prevention and control of traffic injuries.

Model of Emergency and Observation Nursing Services at the Community Health Center in East Java

Directory of Open Access Journals (Sweden)

Dwi Ananto Wibrata

2017-07-01

Full Text Available Public health centers as the spearhead of health services, also provide 'emergency and observation' nursing services, due to the high number of accidents in East Java. The purpose of this study was to develop the nurse's performance model in providing 'emergency and obeservation' nursing services at Puskesgadarsi ('Emergency and Observation' Community Health Center in East Java, using cross sectional design. The subjects of 120 nurses were selected by multi stage sampling technique. Data were collected through questionnaires and FGDs, and then analyzed using structural equation modeling to produce an model of ‘emergency and observation’ nursing service for nurses at Puskesgadarsi. Components of the model were reinforcing factors, personal factors, cognition factors, affection factors, commitment, interpersonal, reinforcement and nurse performance. Nurses can use this model in providing nursing services with due regard to their knowledge and skills, facilities and infrastructure, as well as interaction and self-reinforcement, so as to be able to perform nursing services 'emergency and observation' well.

Cancer patients, emergencies service and provision of palliative care

Directory of Open Access Journals (Sweden)

Bruno Miranda

2016-06-01

Full Text Available SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011 with a minimum length of hospital stay of two hours. Student’s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%. 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%, breast (13.6% and prostate (10.5%; 70.7% were in advanced stages (IV, 47.1%; 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals.

User violence towards nursing professionals in mental health services and emergency units

Directory of Open Access Journals (Sweden)

Bartolomé Llor-Esteban

2017-01-01

Full Text Available Workplace violence is present in many work sectors, but in the area of mental health, nurses have a higher risk due to the close relationship they have with users. This study analyzed hostile user statements against nursing professionals of Mental Health Services and Emergency Units in Health Service (MHS hospitals in Murcia, Spain, and determined the frequency of exposure to the different violent user behaviors. The study was carried out with a sample of 518 nursing professionals from four hospital services: Mental Health, Emergency Units, Medical Hospitalization, and Maternal-and-Child. The nursing staff of Mental Health and Emergency Units was the most exposed to violence. Non-physical violence was more frequent in Emergency Units, whereas physical violence was more frequent in Mental Health. Among the consequences of exposure to non-physical violence are workers’ emotional exhaustion and the presence of psychological distress.

The State of Emergency Medical Services (EMS) Systems in Africa.

Science.gov (United States)

Mould-Millman, Nee-Kofi; Dixon, Julia M; Sefa, Nana; Yancey, Arthur; Hollong, Bonaventure G; Hagahmed, Mohamed; Ginde, Adit A; Wallis, Lee A

2017-06-01

Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment. The discovery of respondents with requisite expertise occurred in multiple phases, including snowball sampling, a review of published scientific literature, and a rigorous search of the Internet. The survey response rate was 46%, and data represented 49 of 54 (91%) African countries. Twenty-five EMS systems were identified and distributed among 16 countries (30% of African countries). There was no evidence of EMS systems in 33 (61%) countries. A total of 98,574,731 (8.7%) of the African population were serviced by at least one EMS system in 2012. The leading causes of EMS transport were (in order of decreasing frequency): injury, obstetric, respiratory, cardiovascular, and gastrointestinal complaints. Nineteen percent of African countries had government-financed EMS systems and 26% had a toll-free public access telephone number. Basic emergency medical technicians (EMTs) and Basic Life Support (BLS)-equipped ambulances were the most common cadre of provider and ambulance level, respectively (84% each). Emergency Medical Services systems exist in one-third of African countries. Injury and obstetric complaints are the leading African prehospital conditions. Only a minority (<9.0%) of Africans have coverage by an EMS system. Most systems were predominantly BLS, government operated, and fee-for-service. Mould-Millman NK , Dixon JM , Sefa N , Yancey A , Hollong BG , Hagahmed M , Ginde AA , Wallis LA . The state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

78 FR 5494 - Off-Road Vehicle Management Plan, Draft Environmental Impact Statement, Lake Meredith National...

Science.gov (United States)

2013-01-25

... DEPARTMENT OF THE INTERIOR National Park Service [NPS-IMR-LAMR-10224; 2310-0091-422] Off-Road... Service (NPS) is releasing a Draft Environmental Impact Statement (DEIS) for the Off- Road Vehicle... impacts of four alternatives that address off-road vehicle (ORV) management in the national recreation...

Service-Learning in the Computer and Information Sciences Practical Applications in Engineering Education

CERN Document Server

Nejmeh, Brian A

2012-01-01

A road map for service-learning partnerships between information science and nonprofit organizations While service-learning is a well-known educational method for integrating learning experiences with community service, it is only now beginning to emerge in computer and information sciences (CIS). Offering a truly global perspective, this book introduces for the first time an essential framework for service learning in CIS, addressing both the challenges and opportunities of this approach for all stakeholders involved-faculty, students, and community nonprofit organizations (NPOs), both dome

Weaknesses and capacities affecting the Prehospital emergency care for victims of road traffic incidents in the greater Kampala metropolitan area: a cross-sectional study.

Science.gov (United States)

Balikuddembe, Joseph Kimuli; Ardalan, Ali; Khorasani-Zavareh, Davoud; Nejati, Amir; Raza, Owais

2017-10-03

Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA). A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims' pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions respectively. Data was descriptively analyzed, and after the principal component analysis was employed to identify the most influential weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTI in the GKMA. From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 2016, 4 and 5 key weaknesses and capacities respectively were identified to affect the pre-hospital emergency care for RTI victims in the GKMA. Although some strengths exist like ambulance facilitation, EMS structuring, coordination and others), the key weaknesses affecting the pre-hospital care for victims were noted to relate to absence of predefined EMS systems particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment; insufficient skills/training of the first responders; inadequate EMS resources; and avoidable delays to respond and transport RTI victims to medical facilities. Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.

36 CFR 9.15 - Use of roads by commercial vehicles.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Use of roads by commercial... INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.15 Use of roads by commercial vehicles. (a) After January 26, 1977, no commercial vehicle shall use roads administered by the National Park Service without...

Resource Roads demonstration project : final report

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-07-15

British Columbia's vast network of resource roads are considered to be amongst the most dangerous, high-risk workplaces in the province. Resource roads, also known as industrial roads, forest service roads, or petroleum development roads, present several unique safety challenges as workplaces. They are built for the purpose of access, egress and transport of materials, resources, equipment and people. However, the lack the same diligence of enforcement and a consistent design, construction, maintenance and standard for use as public highways or municipal roads. There are also safety challenges related to public use of resource roads. This report presented a project, called ResourceRoads by WorkSafe BC that focused on the organization and implementation of a management structure that would provide a system of coordination and a process of compliance for the users of the defined road systems. The project was based on information gathered in two forest districts of Prince George and the South Peace Forest Districts. A committee consisting of the actual owner of the road and other users was formed. The report presented a history of British Columbia's resource road system, and discussed resource roads as industrial workplaces and worksites, as well as resource road fatality statistics. The demonstration project was outlined in terms of project leadership; scope; strategic objectives; project purpose; performance objectives; project communication; demonstration areas; and project stages. Project fundamentals and project findings were also presented along with recommendations and responses to the Auditor General report and the Forest Safety Ombudsman report. It was concluded that potential uses of new technologies for resource road vehicles should be reviewed. tabs., figs.

SmartRoads: training Indonesian workers to become road safety ambassadors in industrial and community settings.

Science.gov (United States)

Montero, Kerry; Spencer, Graham; Ariens, Bernadette

2012-06-01

This paper reports on a programme to improve road safety awareness in an industrial community in the vicinity of Jakarta, in Indonesia. Adapting the model of a successful community and school-based programme in Victoria, in Australia, and using a peer education approach, 16 employees of a major manufacturing company were trained to implement road safety education programmes amongst their peers. Specific target groups for the educators were colleagues, schools and the local community. Over 2 days the employees, from areas as diverse as production, public relations, personnel services, administration and management, learned about road safety facts, causes of traffic casualties, prevention approaches and peer education strategies. They explored and developed strategies to use with their respective target groups and practised health education skills. The newly trained workers received certificates to acknowledge them as 'SmartRoads Ambassadors' and, with follow-up support and development, became road safety educators with a commitment and responsibility to deliver education to their respective work and local communities. This paper argues that the model has potential to provide an effective and locally relevant response to road safety issues in similar communities.

Costs of performance based maintenance for local roads: Case study Albania

OpenAIRE

Jokanović Igor; Grujić Bojana; Zeljić Dragana; Grujić Žarko; Svilar Mila

2017-01-01

The provision and maintenance of road infrastructure is a major global business, consequently it is essential that road maintenance services are provided in the most cost effective manner. Without regular maintenance, roads can rapidly fall into disrepair, preventing realization of the longer term impacts of road improvements on development, such as increased agricultural production and growth in school enrollment, which is of particular importance for a network of local (access) roads. Inade...

MODERN CONDITIONS OF ROAD FACILITIES AND INTERNATIONAL AUTOMOTIVE TRANSPORTATION OF THE REPUBLIC OF BELARUS

Directory of Open Access Journals (Sweden)

I. M. Tsarenkova

2008-01-01

Full Text Available For analysis of technical and economic conditions of automotive roads and determination of reserves for improvement of financial situation and usage of capital in road facilities operational efficiency of road facilities and automotive freight-traffic services that provide significant currency receipt for Republic budget. The main ways for higher export of construction services are involvement of road facilities enterprises in this activity and introduction of highly-productive technologies in their operation. The paper demonstrates an importance of non-conventional sources of investment attractions such as leasing which is used for renovation of capital assets and invests resources in the basic capital on the return basis in the natural form. For application of new technologies and modern technique it is justifiable to establish joint road-construction enterprises with foreign sub-contractors. The paper reveals main reasons of profit increase due to operation and services of road branch.

Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014

DEFF Research Database (Denmark)

Christensen, Erika Frischknecht; Bendtsen, Mette Dahl; Larsen, Thomas Mulvad

2017-01-01

) to allow comparison by year, with 2007 as reference year. RESULTS: The annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48......: Population-based cohort study with linkage of Danish national registries. SETTING: The North Denmark Region in 2007-2014. PARTICIPANTS: Cohort of 148 757 patients transported to hospital by ambulance after calling emergency services. MAIN OUTCOME MEASURES: The number of emergency ambulance service patients......, the incidence of emergency ambulance service patients, the proportion of women, elderly, and non-specific diagnoses increased. The level of comorbidity increased substantially, whereas the 1-day and 30-day mortality decreased....

Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014

DEFF Research Database (Denmark)

Christensen, Erika Frischknecht; Bendtsen, Mette Dahl; Larsen, Thomas Mulvad

) to allow comparison by year, with 2007 as reference year. RESULTS: The annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48......: Population-based cohort study with linkage of Danish national registries. SETTING: The North Denmark Region in 2007-2014. PARTICIPANTS: Cohort of 148 757 patients transported to hospital by ambulance after calling emergency services. MAIN OUTCOME MEASURES: The number of emergency ambulance service patients......, the incidence of emergency ambulance service patients, the proportion of women, elderly, and non-specific diagnoses increased. The level of comorbidity increased substantially, whereas the 1-day and 30-day mortality decreased....

Increased ICU resource needs for an academic emergency general surgery service*.

Science.gov (United States)

Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

2014-04-01

ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all psurgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p surgery (13.7% vs 6.7% and 3.5%, all p surgery and general surgery, whereas transplant had fewer. Emergency general surgery patients have increased ICU needs in terms of length of stay, ventilator usage, and continuous renal replacement therapy usage compared with other services, perhaps due to the higher percentage of transfers and emergent surgery required. These patients represent a distinct population. Understanding their resource needs

Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study.

Science.gov (United States)

Togher, Fiona J; O'Cathain, Alicia; Phung, Viet-Hai; Turner, Janette; Siriwardena, Aloysius Niroshan

2015-12-01

There is an increasing need to assess the performance of emergency ambulance services using measures other than the time taken for an ambulance to arrive on scene. In line with government policy, patients and carers can help to shape new measures of ambulance service performance. To investigate the aspects of emergency ambulance service care valued by users. Qualitative interview study. One of 11 ambulance services in England. Twenty-two users and eight of their spouses (n = 30). Users of the emergency ambulance service, experiencing different types of ambulance service response, valued similar aspects of their pre-hospital care. Users were often extremely anxious about their health, and the outcome they valued was reassurance provided by ambulance service staff that they were receiving appropriate advice, treatment and care. This sense of being reassured was enhanced by the professional behaviour of staff, which instilled confidence in their care; communication; a short wait for help; and continuity during transfers. A timely response was valued in terms of allaying anxiety quickly. The ability of the emergency ambulance service to allay the high levels of fear and anxiety felt by users is crucial to the delivery of a high quality service. Measures developed to assess and monitor the performance of emergency ambulance services should include the proportion of users reporting feeling reassured by the response they obtained. © 2014 John Wiley & Sons Ltd.

Interpreter services in emergency medicine.

Science.gov (United States)

Chan, Yu-Feng; Alagappan, Kumar; Rella, Joseph; Bentley, Suzanne; Soto-Greene, Marie; Martin, Marcus

2010-02-01

Emergency physicians are routinely confronted with problems associated with language barriers. It is important for emergency health care providers and the health system to strive for cultural competency when communicating with members of an increasingly diverse society. Possible solutions that can be implemented include appropriate staffing, use of new technology, and efforts to develop new kinds of ties to the community served. Linguistically specific solutions include professional interpretation, telephone interpretation, the use of multilingual staff members, the use of ad hoc interpreters, and, more recently, the use of mobile computer technology at the bedside. Each of these methods carries a specific set of advantages and disadvantages. Although professionally trained medical interpreters offer improved communication, improved patient satisfaction, and overall cost savings, they are often underutilized due to their perceived inefficiency and the inconclusive results of their effect on patient care outcomes. Ultimately, the best solution for each emergency department will vary depending on the population served and available resources. Access to the multiple interpretation options outlined above and solid support and commitment from hospital institutions are necessary to provide proper and culturally competent care for patients. Appropriate communications inclusive of interpreter services are essential for culturally and linguistically competent provider/health systems and overall improved patient care and satisfaction. Copyright (c) 2010 Elsevier Inc. All rights reserved.

36 CFR 9.50 - Use of roads by commercial vehicles.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Use of roads by commercial... INTERIOR MINERALS MANAGEMENT Non-Federal Oil and Gas Rights § 9.50 Use of roads by commercial vehicles. (a) After January 8, 1978, no commercial vehicle shall use roads administered by the National Park Service...

Helicopter Emergency Medical Services: effects, costs and benefits

NARCIS (Netherlands)

A.N. Ringburg (Akkie)

2009-01-01

textabstractAdvanced prehospital medical care with air transport was introduced in the Netherlands in May 1995. The fi rst helicopter Mobile Medical Team, also called Helicopter Emergency Medical Service (HEMS) was a joint venture initiative of the VU Medical Center in Amsterdam and the Algemene

36 CFR 223.41 - Payment when purchaser elects government road construction.

Science.gov (United States)

2010-07-01

... government road construction. 223.41 Section 223.41 Parks, Forests, and Public Property FOREST SERVICE... Conditions and Provisions § 223.41 Payment when purchaser elects government road construction. Each contract having a provision for construction of specified roads with total estimated construction costs of $50,000...

NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory

Data.gov (United States)

Federal Laboratory Consortium — The NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory is a 2005 Wheeled Coach Type III ambulance mounted on a Ford E-450 cut-away van chassis....

Impact of international humanitarian service-learning on emerging adult social competence: A mixed-methods evaluation

Directory of Open Access Journals (Sweden)

Paul Schvaneveldt

2016-09-01

Full Text Available This article presents the results from a study into international humanitarian service-learning experiences on young adult volunteers. Specifically, the service-learning experiences of emerging adults who had served in orphanages in Latin America were assessed, in a pre- and post-test design, for their development in areas of social competency such as identity, self-efficacy, self-esteem and ethnocentric attitudes. A mixed-methods design using both qualitative and quantitative measures was used. Both qualitative and quantitative results identified significant and important impacts on the development of the social competencies of these emerging adults. In addition, several qualitative themes illustrated that longer term international service-learning experiences have a profound impact on the social competence of emerging adults. Keywords: International humanitarian service, service-learning, emerging adult competency

Major incidents in Kenya: the case for emergency services development and training.

Science.gov (United States)

Wachira, Benjamin W; Smith, Wayne

2013-04-01

Kenya's major incidents profile is dominated by droughts, floods, fires, terrorism, poisoning, collapsed buildings, accidents in the transport sector and disease/epidemics. With no integrated emergency services and a lack of resources, many incidents in Kenya escalate to such an extent that they become major incidents. Lack of specific training of emergency services personnel to respond to major incidents, poor coordination of major incident management activities, and a lack of standard operational procedures and emergency operation plans have all been shown to expose victims to increased morbidity and mortality. This report provides a review of some of the major incidents in Kenya for the period 2000-2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.

Unofficial Road Building in the Amazon: Socioeconomic and Biophysical Explanations

Science.gov (United States)

Perz, Stephen G.; Caldas, Marcellus M.; Arima, Eugenio; Walker, Robert J.

2007-01-01

Roads have manifold social and environmental impacts, including regional development, social conflicts and habitat fragmentation. 'Road ecology' has emerged as an approach to evaluate the various ecological and hydrological impacts of roads. This article aims to complement road ecology by examining the socio-spatial processes of road building itself. Focusing on the Brazilian Amazon, a heavily-studied context due to forest fragmentation by roads, the authors consider non-state social actors who build 'unofficial roads' for the purpose of gaining access to natural resources to support livelihoods and community development. They examine four case studies of roads with distinct histories in order to explain the socio-spatial processes behind road building in terms of profit maximization, land tenure claims, co-operative and conflictive political ecologies, and constraints as well as opportunities afforded by the biophysical environment. The study cases illustrate the need for a multi-pronged theoretical approach to understanding road building, and call for more attention to the role of non-state actors in unofficial road construction.

Effects of off-road recreation on mule deer and elk.

Science.gov (United States)

Michael J. Wisdom; Alan A. Ager; Haiganoush K. Preisler; Norman J. Cimon; Bruce K. Johnson

2004-01-01

Off-road recreation is increasing rapidly in the United States, especially on public land (Havlick 2002, U.S. Department of Agriculture Forest Service 2004). An expansive network of roads provides easy access to much public land, which facilitates off-road uses in the form of all-terrain vehicles (ATVs), horses, mountain bikes and foot traffic. No research, however,...

Occupational injury rates in personnel of emergency medical services

Directory of Open Access Journals (Sweden)

Robert Gałązkowski

2015-12-01

Full Text Available [i][/i][b]Introduction and objectives. [/b]The system of emergency medical services (EMS in Poland was established in 2006. The risk of occupational injuries to EMS personnel is very high, irrespective of the country where they operate, as they face many hazards in their everyday work. The aim of this study is to describe the type, incidence and consequences of occupational accidents among the personnel of the National Emergency Medical Services in Poland (NEMS – land and air ambulance crews in 2008–2012. [b]Material and methods:[/b] The study reviewed all occupational accidents among the EMS personnel reported to the National Labour Inspectorate in 2008–2012. [b]Results[/b]: In the period reported, the number of accidents decreased from 32 in 2008 to just 6 in 2012. Traffic accidents predominated and most of the victims were male paramedics under 30 years of age. The most common injuries included multiple organ injuries and injuries of the cervical spine, chest and trunk. [b]Conclusions:[/b] The growing professional experience of the EMS personnel has a beneficial effect on occupational injury rates as they tend to decrease with longer employment. Occupational accidents are definitely more common among ambulance crews than in the personnel of other organizational units of the National Emergency Medical Services.

Epidemiology of road traffic crashes among long distance drivers in ...

African Journals Online (AJOL)

Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan. 2. Anaesthetist, Emergency ... long-distance drivers studied. Reconstruction of bad roads and implementation of road safety education ... transport and occur on a traffic way or while the vehi- cle is still in motion after ...

Economic development and road traffic fatalities in two neighbouring African nations

Directory of Open Access Journals (Sweden)

Douglas J. Wiebe

2016-06-01

Conclusion: Road crash fatalities increased in recent decades in both Zambia and Botswana. But the rapid economic development in Botswana over this time period appears to have driven proportionate road traffic fatality increases. There are opportunities for newly emerging economies such as Zambia, Angola, and others to learn from the Botswana experience. Evidence-based investments in road safety interventions should be concomitant with economic development.

Intelligent Transport Systems in the Management of Road Transportation

Science.gov (United States)

Kalupová, Blanka; Hlavoň, Ivan

2016-11-01

Extension of European Union causes increase of free transfer of people and goods. At the same time they raised the problems associated with the transport, e.g. congestion and related accidents on roads, air traffic delays and more. To increase the efficiency and safety of transport, the European Commission supports the introduction of intelligent transport systems and services in all transport sectors. Implementation of intelligent transport systems and services in the road transport reduces accident frequency, increases the capacity of existing infrastructure and reduces congestions. Use of toll systems provides resources needed for the construction and operation of a new road network, improves public transport, cycling transport and walking transport, and also their multimodal integration with individual car transport.

36 CFR 223.47 - Date of completion of permanent road construction.

Science.gov (United States)

2010-07-01

... permanent road construction. 223.47 Section 223.47 Parks, Forests, and Public Property FOREST SERVICE... Conditions and Provisions § 223.47 Date of completion of permanent road construction. (a) The date of completion of permanent road construction obligations as set forth in the Notice of Sale shall be...

75 FR 27917 - Emergency Medical Services Week, 2010

Science.gov (United States)

2010-05-18

... enhancing our country's preparedness and resilience. During Emergency Medical Services Week, we recommit to... physicians. From rural regions of our Nation to our busiest urban centers, EMS teams provide access to... to arrive at the scene of a crisis. These heroic professionals, volunteers, and citizens form a...

Benchmarking online dispatch algorithms for Emergency Medical Services

NARCIS (Netherlands)

Jagtenberg, C.J.; Berg, P.L.; van der Mei, R.D.

2016-01-01

Providers of Emergency Medical Services (EMS) face the online ambulance dispatch problem, in which they decide which ambulance to send to an incoming incident. Their objective is to minimize the fraction of arrivals later than a target time. Today, the gap between existing solutions and the optimum

[Clinical epidemiological assessments on 3521 patients suffering from road traffic injuries, in relation with trauma localisation and severity, assisted in "Sf. Ioan" Emergency Unit, during 2002-2009].

Science.gov (United States)

Manole, M; Ciuhodaru, T; Zanoschi, Georgeta; Manole, Alina; Ivan, A

2011-01-01

The aim of study was to assess road traffic injuries in relation with their localisation and severity. A sample of 3521 patients suffering from road traffic injuries and assisted in "Sf. Ioan" Emergency Unit, Iaşi, Romania was assess regarding age group, sex and residence area, type of lesions and ther localisation and severity, between 2002-2009. Data were collected using a special epidemiological inquiry and processed using SPSS and MS Excel statistical softs. The incidence of road traffic injuries increased during the last decade, with a report men/women of 1.5, urban and 21-30 age group predominance. The most frequent were leg fractures (16.7%) and thoracal contusions (19.1%), cranial and facial trauma (32.4%), with open injuries (10.5%). Prevention programmes with a high efficiency at the national level, as well as a concret identification of risk factors with a multidisciplinar approach of road traffic accidents, are needed.

Emergency healthcare process automation using mobile computing and cloud services.

Science.gov (United States)

Poulymenopoulou, M; Malamateniou, F; Vassilacopoulos, G

2012-10-01

Emergency care is basically concerned with the provision of pre-hospital and in-hospital medical and/or paramedical services and it typically involves a wide variety of interdependent and distributed activities that can be interconnected to form emergency care processes within and between Emergency Medical Service (EMS) agencies and hospitals. Hence, in developing an information system for emergency care processes, it is essential to support individual process activities and to satisfy collaboration and coordination needs by providing readily access to patient and operational information regardless of location and time. Filling this information gap by enabling the provision of the right information, to the right people, at the right time fosters new challenges, including the specification of a common information format, the interoperability among heterogeneous institutional information systems or the development of new, ubiquitous trans-institutional systems. This paper is concerned with the development of an integrated computer support to emergency care processes by evolving and cross-linking institutional healthcare systems. To this end, an integrated EMS cloud-based architecture has been developed that allows authorized users to access emergency case information in standardized document form, as proposed by the Integrating the Healthcare Enterprise (IHE) profile, uses the Organization for the Advancement of Structured Information Standards (OASIS) standard Emergency Data Exchange Language (EDXL) Hospital Availability Exchange (HAVE) for exchanging operational data with hospitals and incorporates an intelligent module that supports triaging and selecting the most appropriate ambulances and hospitals for each case.

Working styles of medicine professionals in emergency medical service

Directory of Open Access Journals (Sweden)

Lazarević Marija

2015-01-01

Full Text Available Introduction: Transactional analysis is a personality and communication theory established by psychiatrist Eric Berne, at the end of the fifties. Counter script is the way of life in accordance with parental imperative. The person with a counter-script has a compulsion to fulfill the required task in order to avoid the disaster of ban. There are five drivers that are considered essential, and these are: 'Be perfect!', 'Be strong!', 'Hurry up!', 'Please others!' and 'Work hard!' Objective: a Determination of the most dominant driver in this medical service. b Because of the specifics of this job which requires speed and humanity, the emphasis will be on doublet: 'Hurry up!' and 'Please others!' Method: The study was conducted on a group of subjects employed in a general service with medical emergency. The instrument used in the study was Julie Hay's questionnaire for diagnosing the working styles. Results: Statistical research was conducted on a sample of 30 subjects employed in the emergency medical service. Availability of all afore mentioned drivers was tested. The research hypotheses were formulated as follows: H0: The driver is not present among the employees in this service; H1: The driver is present among the employees in this service. Calculated value of the t-statistics for the driver 'Hurry up!' is 1.398; for the driver 'Be perfect!' 3.616; for the driver 'Please others!' 11.693; for the driver 'Work hard!' -0.673; and for the driver 'Be strong!' 3.880. Since the realizable value of the t-statistics for the drivers: 'Be perfect!' and 'Please others!' and 'Be strong!' is bigger than the critical value 1.699, and p<0.05 we reject the null hypothesis and we accept the alternative hypothesis on the significance level of 95%. For the drivers 'Hurry up!' and 'Work hard!' the values of t-statistics are lower than the critical value 1.699 for significance level of 95%, so the alternative hypothesis are not acceptable. Conclusion: The results of

Frequent users of emergency services: associated factors and reasons for seeking care

Directory of Open Access Journals (Sweden)

Aline Marques Acosta

2015-04-01

Full Text Available Aim: to identify the profile of frequent users of emergency services, to verify the associated factors and to analyze the reasons for the frequent use of the services. METHOD: An explanatory sequential type mixed method was adopted. Quantitative data were collected from the electronic medical records, with a sample of 385 users attended four or more times in an emergency service, during the year 2011. Qualitative data were collected through semi-structured interviews with 18 users, intentionally selected from the results of the quantitative stage. Quantitative data were analyzed using descriptive and inferential statistics and qualitative data using thematic analysis. RESULTS: It was found that 42.9% were elderly, 84.9% had chronic diseases, 63.5% were classified as urgent, 42.1% stayed for more than 24 hours in the service and 46.5% were discharged. Scheduled follow-up appointment, risk classification, length of stay and outcome were factors associated with frequent use. The reasons for seeking the services were mainly related to the exacerbation of chronic diseases, to easier access and concentration of technology, to the bond, and to the scheduled appointments. CONCLUSIONS: The results contribute to comprehending the repeated use of emergency services and provide additional data to plan alternatives to reduce frequent use.

Emergency and Disaster Information Service

Science.gov (United States)

Boszormenyi, Zsolt

2010-05-01

The Hungarian National Association of Radio Distress-Signalling and Infocommunications (RSOE) operates Emergency and Disaster Information Service (EDIS) within the frame of its own website which has the objective to monitor and document all the events on the Earth which may cause disaster or emergency. Our service is using the speed and the data spectrum of the internet to gather information. We are monitoring and processing several foreign organisation's data to get quick and certified information. The EDIS website operated together by the General-Directorate of National Disaster Management (OKF) and RSOE, in co-operation with the Crisis Management Centre of the Ministry of Foreign Affairs, provides useful information regarding emergency situations and their prevention. Extraordinary events happening in Hungary, Europe and other areas of the World are being monitored in 24 hours per day. All events processed by RSOE EDIS are displayed real time - for the sake of international compatibility - according to the CAP protocol on a secure website. To ensure clear transparency all events are categorized separately in the RSS directory (e.g. earthquake, fire, flood, landslide, nuclear event, tornado, vulcano). RSOE EDIS also contributes in dissemination of the CAP protocol in Hungary. Beside the official information, with the help of special programs nearly 900-1000 internet press publication will be monitored and the publication containing predefined keywords will be processed. However, these "news" cannot be considered as official and reliable information, but many times we have learnt critical information from the internet press. We are screening the incoming information and storing in a central database sorted by category. After processing the information we are sending it immediately via E-Mail (or other format) for the organisations and persons who have requested it (e.g. National Disaster Management, United Nations etc.). We are aspiring that the processed data

Guidelines for Induction and Intubation Sequence Fast in Emergency Service

OpenAIRE

Pérez Perilla, Patricia; Pontificia Universidad Javeriana-Hospital Universitario San Ignacio; Moreno Carrillo, Atilio; Pontificia Universidad Javeriana-Hospital Universitario San Ignacio; Gempeler Rueda, Fritz E.; Pontificia Universidad Javeriana-Hospital Universitario San Ignacio

2012-01-01

The rapid sequence intubation (RSI) is a procedure designed to minimize the time spent in securing the airway by endotracheal tube placement in emergency situations in patients at high risk of aspiration. Being clear about this situation, it is unquestionable the importance of education and training related to rapid sequence intubation to be made to the physicians responsible for the recovery rooms, emergency services and paramedics responsible for managing emergencies and disasters field . T...

14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

General dependencies and causality analysis of road traffic fatalities in OECD countries.

Science.gov (United States)

Yaseen, Muhammad Rizwan; Ali, Qamar; Khan, Muhammad Tariq Iqbal

2018-05-07

in the emergency services in the country. The research and development activities should be enhanced especially for the health and transportation sectors. The trade of environment-friendly technology should be promoted for the protection of environment.

Nonfatal road traffic injuries: can road safety campaigns prevent hazardous behavior? An Italian experience.

Science.gov (United States)

Zampetti, R; Messina, G; Quercioli, C; Vencia, F; Genco, L; Di Bartolomeo, L; Nante, N

2013-01-01

Road traffic injuries are a widespread problem and are very difficult to prevent. The purpose of this study was to verify whether intensive versus basic road safety education programs are associated with different incidence and severity of nonfatal road injuries. The study had an ecological design and involved Local Health Authority One (LHA1) in Salerno, Italy, which includes 20 municipalities. Data on nonfatal road injuries occurring in the periods June to August 2003 and June to August 2008 were obtained from trained operators through the information system of the emergency department. All 20 municipalities received a basic community road safety education program (publicity campaign using bill-posting, brochures, mass media communication with press conferences, articles in local papers, radio and television interviews, and a dedicated LHA1 web site), and 12 municipalities also received an intensive education campaign (in secondary schools, community conferences, and activities organized by police and firefighters). The incidence and severity of nonfatal road traffic injuries were compared between June to August 2003 (before the campaign) and June to August 2008. The total number of injuries in all 20 municipalities in 2003 and 2008 was 907 and 755, respectively. The incidence of injuries decreased in the study period both in the 8 municipalities where only the basic campaign was run (difference in incidence = -0.4; P = .053) and in the 12 municipalities where the intensive campaign was implemented (difference in incidence = -0.5; P road safety education. This does not mean that such campaigns are useless (they are important to raise awareness) but that they should be supplemented with complementary activities in order to be really effective.

Research into Australian emergency services personnel mental health and wellbeing: An evidence map.

Science.gov (United States)

Varker, Tracey; Metcalf, Olivia; Forbes, David; Chisolm, Katherine; Harvey, Sam; Van Hooff, Miranda; McFarlane, Alexander; Bryant, Richard; Phelps, Andrea J

2018-02-01

Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. 'Evidence-mapping' methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations' wellbeing policies and procedures.

A Public Health Perspective of Road Traffic Accidents

Science.gov (United States)

Gopalakrishnan, S.

2012-01-01

Road traffic accidents (RTAs) have emerged as an important public health issue which needs to be tackled by a multi-disciplinary approach. The trend in RTA injuries and death is becoming alarming in countries like India. The number of fatal and disabling road accident happening is increasing day by day and is a real public health challenge for all the concerned agencies to prevent it. The approach to implement the rules and regulations available to prevent road accidents is often ineffective and half-hearted. Awareness creation, strict implementation of traffic rules, and scientific engineering measures are the need of the hour to prevent this public health catastrophe. This article is intended to create awareness among the health professionals about the various modalities available to prevent road accidents and also to inculcate a sense of responsibility toward spreading the message of road safety as a good citizen of our country. PMID:24479025

Healthcare Service Auditing and Intervention in an Emergency ...

African Journals Online (AJOL)

A pre- and post-intevention randomized cross-sectional study was carried out from January to February and April to May 2001, respectively, to audit and intervene in the timeliness of health services delivery in an Emergency Paediatric Unit (EPU) of Jos University Teaching Hospital. A structured questionnaire was used to ...

78 FR 30727 - Emergency Medical Services Week, 2013

Science.gov (United States)

2013-05-22

.... During Emergency Medical Services Week, we pause to offer our gratitude to these remarkable men and women, whose dedication is fundamental to our society's well-being. In recent weeks, we have again seen the... thousand thirteen, and of the Independence of the United States of America the two hundred and thirty...

The appropriateness of emergency medical service responses in the ...

African Journals Online (AJOL)

2015-10-10

Oct 10, 2015 ... in the eThekwini district of KwaZulu-Natal, South Africa ... Rescue, Faculty of Health Sciences, Durban University of Technology, South Africa ... Emergency medical services (EMS) are sometimes required to respond to cases ...

An Emergent Micro-Services Approach to Digital Curation Infrastructure

OpenAIRE

Abrams, Stephen; Kunze, John; Loy, David

2010-01-01

In order better to meet the needs of its diverse University of California (UC) constituencies, the California Digital Library UC Curation Center is re-envisioning its approach to digital curation infrastructure by devolving function into a set of granular, independent, but interoperable micro-services. Since each of these services is small and self-contained, they are more easily developed, deployed, maintained, and enhanced; at the same time, complex curation function can emerge from the str...

Innovation as Road Safety Felicitator

Science.gov (United States)

Sahoo, S.; Mitra, A.; Kumar, J.; Sahoo, B.

2018-03-01

Transportation via Roads should only be used for safely commuting from one place to another. In 2015, when 1.5 Million people, across the Globe started out on a journey, it was meant to be their last. The Global Status Report on Road Safety, 2015, reflected this data from 180 countries as road traffic deaths, worldwide. In India, more than 1.37 Lakh[4] people were victims of road accidents in 2013 alone. That number is more than the number of Indians killed in all the wars put together. With these disturbing facts in mind, we found out some key ambiguities in the Indian Road Traffic Management systems like the non-adaptive nature to fluctuating traffic, pedestrians and motor vehicles not adhering to the traffic norms strictly, to name a few. Introduction of simple systems would greatly erase the effects of this silent epidemic and our Project aims to achieve the same. It would introduce a pair of Barricade systems to cautiously separate the pedestrians and motor vehicles to minimise road mishaps to the extent possible. Exceptional situations like that of an Ambulance or any emergency vehicles will be taken care off by the use of RFID tags to monitor the movement of the Barricades. The varied traffic scenario can be guided properly by using the ADS-B (Automatic Detection System-Broadcast) for monitoring traffic density according to the time and place.

Enabling Routes as Context in Mobile Services

DEFF Research Database (Denmark)

Brilingaite, Agne; Jensen, Christian Søndergaard; Zokaite, Nora

With the continuing advances in wireless communications, geo-positioning, and portable electronics, an infrastructure is emerging that enables the delivery of on-line, location-enabled services to very large numbers of mobile users. A typical usage situation for mobile services is one characteriz...... and accumulates the routes of a user along with their usage patterns and that makes the routes available to services. Experiences from using the component on logs of GPS positions acquired from vehicles traveling within a real road network are reported....... by a small screen and no keyboard, and by the service being only a secondary focus of the user. Under such circumstances, it is particularly important to deliver the "right" information and service at the right time, with as little user interaction as possible. This may be achieved by making services context...

Costs of performance based maintenance for local roads: Case study Albania

Science.gov (United States)

Jokanović, Igor; Grujić, Bojana; Zeljić, Dragana; Grujić, Žarko; Svilar, Mila

2017-12-01

The provision and maintenance of road infrastructure is a major global business, consequently it is essential that road maintenance services are provided in the most cost effective manner. Without regular maintenance, roads can rapidly fall into disrepair, preventing realization of the longer term impacts of road improvements on development, such as increased agricultural production and growth in school enrollment, which is of particular importance for a network of local (access) roads. Inadequate local roads maintenance in Albania is proposed to be solved by implementing performance based maintenance approach for which the costing exercise is presented within the paper.

Helicopter emergency medical service patient transport safe at night?

NARCIS (Netherlands)

Peters, J.H.; Wageningen, B. van; Hoogerwerf, N.; Biert, J.

2014-01-01

OBJECTIVE: Dutch helicopter emergency medical services are available 24/7. Working without daylight brings additional challenges, both in patient care and in-flight operation. We retrospectively evaluated the safety of this nighttime helicopter transportation of patients. METHODS: Our helicopter

Very fast road database verification using textured 3D city models obtained from airborne imagery

Science.gov (United States)

Bulatov, Dimitri; Ziems, Marcel; Rottensteiner, Franz; Pohl, Melanie

2014-10-01

Road databases are known to be an important part of any geodata infrastructure, e.g. as the basis for urban planning or emergency services. Updating road databases for crisis events must be performed quickly and with the highest possible degree of automation. We present a semi-automatic algorithm for road verification using textured 3D city models, starting from aerial or even UAV-images. This algorithm contains two processes, which exchange input and output, but basically run independently from each other. These processes are textured urban terrain reconstruction and road verification. The first process contains a dense photogrammetric reconstruction of 3D geometry of the scene using depth maps. The second process is our core procedure, since it contains various methods for road verification. Each method represents a unique road model and a specific strategy, and thus is able to deal with a specific type of roads. Each method is designed to provide two probability distributions, where the first describes the state of a road object (correct, incorrect), and the second describes the state of its underlying road model (applicable, not applicable). Based on the Dempster-Shafer Theory, both distributions are mapped to a single distribution that refers to three states: correct, incorrect, and unknown. With respect to the interaction of both processes, the normalized elevation map and the digital orthophoto generated during 3D reconstruction are the necessary input - together with initial road database entries - for the road verification process. If the entries of the database are too obsolete or not available at all, sensor data evaluation enables classification of the road pixels of the elevation map followed by road map extraction by means of vectorization and filtering of the geometrically and topologically inconsistent objects. Depending on the time issue and availability of a geo-database for buildings, the urban terrain reconstruction procedure has semantic models

VT Green Mountain National Forest - Roads

Data.gov (United States)

Vermont Center for Geographic Information — (Link to Metadata) GMNFTRAILS contains minor Forest Service roads and all trails within the proclamation boundary of the Green Mountain National Forest and many of...

Addams, Day, and Dewey: The Emergence of Community Service in American Culture.

Science.gov (United States)

Morton, Keith; Saltmarsh, John

1997-01-01

Chronicles the emergence of community service in the United States, beginning with the turn-of-the-century collision of capitalism and democracy which generated a crisis of community and profound rethinking of the meaning and practice of charity. Three service "paths" are identified: nonprofit human services organizations; active…

36 CFR 212.55 - Criteria for designation of roads, trails, and areas.

Science.gov (United States)

2010-07-01

... roads, trails, and areas. 212.55 Section 212.55 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE TRAVEL MANAGEMENT Designation of Roads, Trails, and Areas for Motor Vehicle Use § 212.55 Criteria for designation of roads, trails, and areas. (a) General criteria for designation of...

Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept.

Science.gov (United States)

Choi, Bryan Y; Blumberg, Charles; Williams, Kenneth

2016-03-01

Mobile integrated health care and community paramedicine are models of health care delivery that use emergency medical services (EMS) personnel to fill gaps in local health care infrastructure. Community paramedics may perform in an expanded role and require additional training in the management of chronic disease, communication skills, and cultural sensitivity, whereas other models use all levels of EMS personnel without additional training. Currently, there are few studies of the efficacy, safety, and cost-effectiveness of mobile integrated health care and community paramedicine programs. Observations from existing program data suggest that these systems may prevent congestive heart failure readmissions, reduce EMS frequent-user transports, and reduce emergency department visits. Additional studies are needed to support the clinical and economic benefit of mobile integrated health care and community paramedicine. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Incremental cost-effectiveness of trauma service improvements for road trauma casualties: experience of an Australian major trauma centre.

Science.gov (United States)

Dinh, Michael M; Bein, Kendall J; Hendrie, Delia; Gabbe, Belinda; Byrne, Christopher M; Ivers, Rebecca

2016-09-01

Objective The aim of the present study was to estimate the cost-effectiveness of trauma service funding enhancements at an inner city major trauma centre. Methods The present study was a cost-effectiveness analysis using retrospective trauma registry data of all major trauma patients (injury severity score >15) presenting after road trauma between 2001 and 2012. The primary outcome was cost per life year gained associated with the intervention period (2007-12) compared with the pre-intervention period (2001-06). Incremental costs were represented by all trauma-related funding enhancements undertaken between 2007 and 2010. Risk adjustment for years of life lost was conducted using zero-inflated negative binomial regression modelling. All costs were expressed in 2012 Australian dollar values. Results In all, 876 patients were identified during the study period. The incremental cost of trauma enhancements between 2007 and 2012 totalled $7.91million, of which $2.86million (36%) was attributable to road trauma patients. After adjustment for important covariates, the odds of in-hospital mortality reduced by around half (adjusted odds ratio (OR) 0.48; 95% confidence interval (CI) 0.27, 0.82; P=0.01). The incremental cost-effectiveness ratio was A$7600 per life year gained (95% CI A$5524, $19333). Conclusion Trauma service funding enhancements that enabled a quality improvement program at a single major trauma centre were found to be cost-effective based on current international and Australian standards. What is known about this topic? Trauma quality improvement programs have been implemented across most designated trauma hospitals in an effort to improve hospital care processes and outcomes for injured patients. These involve a combination of education and training, the use of audit and key performance indicators. What does this paper add? A trauma quality improvement program initiated at an Australian Major Trauma Centre was found to be cost-effective over 12 years with

A Public Health Perspective of Road Traffic Accidents

Directory of Open Access Journals (Sweden)

S Gopalakrishnan

2012-01-01

Full Text Available Road traffic accidents (RTAs have emerged as an important public health issue which needs to be tackled by a multi-disciplinary approach. The trend in RTA injuries and death is becoming alarming in countries like India. The number of fatal and disabling road accident happening is increasing day by day and is a real public health challenge for all the concerned agencies to prevent it. The approach to implement the rules and regulations available to prevent road accidents is often ineffective and half-hearted. Awareness creation, strict implementation of traffic rules, and scientific engineering measures are the need of the hour to prevent this public health catastrophe. This article is intended to create awareness among the health professionals about the various modalities available to prevent road accidents and also to inculcate a sense of responsibility toward spreading the message of road safety as a good citizen of our country.

Severe hypoglycaemia requiring the assistance of emergency medical services - frequency, causes and symptoms

Czech Academy of Sciences Publication Activity Database

Krnačová, V.; Kuběna, Aleš Antonín; Macek, K.; Bezděk, M.; Šmahelová, A.; Vlček, J.

2012-01-01

Roč. 156, č. 3 (2012), s. 271-277 ISSN 1213-8118 Grant - others:GA UK(CZ) SVV-2010-261-004 Keywords : regression trees * causes * symptoms * incidence * emergency medical service * severe hypoglycaemia Subject RIV: EI - Biotechnology ; Bionics Impact factor: 0.990, year: 2012 http://library.utia.cas.cz/separaty/2013/E/kubena-severe hypoglycaemia requiring the assistance of emergency medical services - frequency causes and symptoms.pdf

Capacity of two-lane roads

CSIR Research Space (South Africa)

Kennedy, DA

1991-01-01

Full Text Available Relationships of speed vs density, volume and percentage loop occupation are investigated. The effect of differing directional splits in traffic volumes is also examined. A method of determining the Level-of Service of two-lane roads in terms...

Injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia: a prospective hospital based study.

Science.gov (United States)

Seid, Mohammed; Azazh, Aklilu; Enquselassie, Fikre; Yisma, Engida

2015-05-20

Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world's roads, and the risk of dying as a result of a road traffic injury is highest in Africa. A prospective hospital based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 20.0. Hierarchical multiple regression analysis was used to identify predictors of fatalities among the road traffic crash victims. A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims' ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4%. Hierarchical multiple regression analysis showed that age of the victims (ß = 0.16, p road traffic accident is a major public health problem. Urgent road traffic accident preventive measures and prompt treatment of the victims are warranted in order to reduce morbidity and mortality among the victims.

Hand hygiene in emergency medical services.

Science.gov (United States)

Teter, Jonathan; Millin, Michael G; Bissell, Rick

2015-01-01

Hospital-acquired infections (HAIs) affect millions of patients annually (World Health Organization. Guidelines on Hand Hygiene in Healthcare. Geneva: WHO Press; 2009). Hand hygiene compliance of clinical staff has been identified by numerous studies as a major contributing factor to HAIs around the world. Infection control and hand hygiene in the prehospital environment can also contribute to patient harm and spread of infections. Emergency medical services (EMS) practitioners are not monitored as closely as hospital personnel in terms of hand hygiene training and compliance. Their ever-changing work environment is less favorable to traditional hospital-based aseptic techniques and education. This study aimed to determine the current state of hand hygiene practices among EMS providers and to provide recommendations for improving practices in the emergency health services environment. This study was a prospective, observational prevalence study and survey, conducted over a 2-month period. We selected participants from visits to three selected hospital emergency departments in the mid-Atlantic region. There were two data components to the study: a participant survey and hand swabs for pathogenic cultures. This study recruited a total sample of 62 participants. Overall, the study revealed that a significant number of EMS providers (77%) have a heavy bacterial load on their hands after patient care. All levels of providers had a similar distribution of bacterial load. Survey results revealed that few providers perform hand hygiene before (34%) or in between patients (24%), as recommended by the Centers for Disease Control and Prevention guidelines. This study demonstrates that EMS providers are potential vectors of microorganisms if proper hand hygiene is not performed properly. Since EMS providers treat a variety of patients and operate in a variety of environments, providers may be exposed to potentially pathogenic organisms, serving as vectors for the exposure of

What is 5G? Emerging 5G Mobile Services and Network Requirements

OpenAIRE

Heejung Yu; Howon Lee; Hongbeom Jeon

2017-01-01

In this paper, emerging 5G mobile services are investigated and categorized from the perspective of not service providers, but end-users. The development of 5G mobile services is based on an intensive analysis of the global trends in mobile services. Additionally, several indispensable service requirements, essential for realizing service scenarios presented, are described. To illustrate the changes in societies and in daily life in the 5G era, five megatrends, including the explosion of mobi...

The Barbados Emergency Ambulance Service: High Frequency of Nontransported Calls

Directory of Open Access Journals (Sweden)

Sherwin E. Phillips

2012-01-01

Full Text Available Objectives. There are no published studies on the Barbados Emergency Ambulance Service and no assessment of the calls that end in nontransported individuals. We describe reasons for the nontransport of potential clients. Methods. We used the Emergency Medical Dispatch (Medical Priority Dispatch System instrument, augmented with five local call types, to collect information on types of calls. The calls were categorised under 7 headings. Correlations between call types and response time were calculated. Results. Most calls were from the category medical (54%. Nineteen (19% percent of calls were in the non-transported category. Calls from call type Cancelled accounted for most of these and this was related to response time, while Refused service was inversely related (. Conclusions. The Barbados Ambulance Service is mostly used by people with a known illness and for trauma cases. One-fifth of calls fall into a category where the ambulance is not used often due to cancellation which is related to response time. Other factors such as the use of alternative transport are also important. Further study to identify factors that contribute to the non-transported category of calls is necessary if improvements in service quality are to be made.

Organization structure and the performance of hospital emergency services.

Science.gov (United States)

Georgopoulos, B S

1985-07-01

A comparative study of 30 hospital emergency departments (EDs) and nearly 1,500 individuals associated with them was conducted. Data were obtained from institutional records, physicians, patients, and other sources. The object was to investigate the relationship between the organization and performance of these health service systems. The study assessed the quality of medical care, the quality of nursing care, and the economic efficiency of hospital EDs. The results show substantial interinstitutional differences in these criteria. They also show a significant relationship between medical and nursing care, but not between the quality of care and economic efficiency. Differences in ED performance are related to medical staffing patterns, medical teaching affiliation, personnel training, scope of emergency services, number of patient visits processed, and hospital size and complexity. Not all of these variables, however, correlate positively with all three criteria of performance, nor are they equally important to each.

Incidence and severity of head and neck injuries in victims of road traffic crashes: In an economically developed country.

Science.gov (United States)

Bener, Abdulbari; Rahman, Yassir S Abdul; Mitra, Biswadev

2009-01-01

Head and neck injuries following the road traffic crashes (RTCs) are the most common cause of morbidity and mortality in most developed and developing countries and may also result in temporary or permanent disability. The aim of this study was to determine the incidence pattern of head and neck injuries, investigate its trend and identify the severity of injuries involved with road traffic crashes (RTCs) during the period 2001-2006. This is a retrospective descriptive hospital based study. The patients with head and neck injuries were seen and treated in the Accident and Emergency Department of the Hamad General Hospital and other Trauma Centers of the Hamad Medical Corporation following the road traffic crashes during the period 2001-2006. This study is a retrospective analysis of 6709 patients attended and treated at the Accident and Emergency and Trauma centers for head and neck injuries over a 6 year period. Head and neck injuries were determined according to the ICD 10 criteria. Of these, 3013 drivers, 2502 passengers, 704 pedestrians and 490 two wheel riders (motor bike and cyclists). Details of all the road traffic crash patients were compiled in the database of the Emergency Medical Services (EMS), and the data of patients with head and neck injuries were extracted from this database. A total of 6709 patients with head and neck injuries was reported during the study period. Majority of the victims were non-Qataris (68.7%), men (85.9%) and in the age group 20-44 years (68.5%). There were statistical significant differences in relation to age, nationality, gender, and accident during week ends for head and neck injuries (pQatar from road traffic crashes. The incidence of head and neck injuries is still very high in Qatar, but the severity of injury was mild in most of the victims. The findings of the study highlighted the need for taking urgent steps for safety of people especially drivers and passengers.

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service.

NARCIS (Netherlands)

Gerritse, B.M.; Schalkwijk, A.; Pelzer, B.J.; Scheffer, G.J.; Draaisma, J.M.T.

2010-01-01

BACKGROUND: To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures

[Suicidal behaviour and attempted suicide occurring during assessment by the outreach psychiatric emergency service].

Science.gov (United States)

de Winter, R F P; de Groot, M H; van Dassen, M; Deen, M L; de Beurs, D P

The outreach emergency psychiatric service plays an important role in recognising, arranging interventions and preventing suicide and suicidal behaviour. However, little is known about the assessments that members of the emergency team make when faced with patients showing suicidal behaviour. AIM: To describe the relationships that are revealed between patient characteristics, suicidal thoughts and attempted suicide during assessments made by the emergency psychiatric service in The Hague. METHOD: The emergency service kept a detailed record of 14,705 consultations. We compared the characteristics of patients who had suicidal thoughts with those of patients who had no such thoughts and we also compared the characteristics of patients who had attempted to commit suicide with those of patients who had not. We drew these comparisons by using logistic regression models, adjusting for clustering. RESULTS: 32.2% of the patients showed signs of suicidal behaviour and 9.2 % appeared likely to attempt suicide. Suicidal behaviour occurred most often in patients with depression. Suicidal patients were more often admitted to hospital than were non-suicidal patients and they were more likely to have been referred by a general practitioner or a general hospital. Medication was the most frequent means employed in attempts to commit suicide. CONCLUSION: In about one third of the consultations of the outreach emergency psychiatric service, the patient showed suicidal behaviour. The actions and the policy of the emergency psychiatric service with regard to suicidal behaviour were diverse and dependent on factors that could change over the course of time.

Investigating emergency room service quality using lean manufacturing.

Science.gov (United States)

Abdelhadi, Abdelhakim

2015-01-01

The purpose of this paper is to investigate a lean manufacturing metric called Takt time as a benchmark evaluation measure to evaluate a public hospital's service quality. Lean manufacturing is an established managerial philosophy with a proven track record in industry. A lean metric called Takt time is applied as a measure to compare the relative efficiency between two emergency departments (EDs) belonging to the same public hospital. Outcomes guide managers to improve patient services and increase hospital performances. The patient treatment lead time within the hospital's two EDs (one department serves male and the other female patients) are the study's focus. A lean metric called Takt time is used to find the service's relative efficiency. Findings show that the lean manufacturing metric called Takt time can be used as an effective way to measure service efficiency by analyzing relative efficiency and identifies bottlenecks in different departments providing the same services. The paper presents a new procedure to compare relative efficiency between two EDs. It can be applied to any healthcare facility.

The road safety audit and road safety inspection.

NARCIS (Netherlands)

2007-01-01

A road safety audit (RSA) and a road safety inspection (RSI) are used to test the safety level of the road infrastructure. The RSA tests the design of new roads or the reconstruction of existing roads, whereas the RSI is used for testing existing roads. An RSA, therefore, aims to 'improve' the road

[Incidence of acute agitation and variation in acute agitation management by emergency services].

Science.gov (United States)

Casado Flórez, Isabel; Sánchez Santos, Luis; Rodríguez Calzada, Rafael; Rico-Villademoros, Fernando; Roset Arissó, Pere; Corral Torres, Ervigio

2017-07-01

To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. Observational descriptive study based on aggregate data from unpublished internal EMS reports. Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients.

Where the rubber meets the road

Energy Technology Data Exchange (ETDEWEB)

Carter, R.A.

1998-12-01

The basic principles of haul-road design are well-known by most mine operators. Build a road with the proper surface, crown, width, and grade, and production will likely benefit while operating costs may come down. Likewise, the elements of tire maintenance are familiar throughout the industry. Choose the right compound for the application, keep the haul roads in good shape, maintain proper tire inflation, and you can reasonably expect truck tires to wear evenly and predictably throughout their useful lives. What is not so apparent is the interplay between these two important areas of mine operation and the benefits that can accrue from increased attention to their needs. This interaction and its effects on cost and service life are discussed. 5 figs.

Building capacity in VA to provide emergency gynecology services for women.

Science.gov (United States)

Cordasco, Kristina M; Huynh, Alexis K; Zephyrin, Laurie; Hamilton, Alison B; Lau-Herzberg, Amy E; Kessler, Chad S; Yano, Elizabeth M

2015-04-01

Visits to Veterans Administration (VA) emergency departments (EDs) are increasingly being made by women. A 2011 national inventory of VA emergency services for women revealed that many EDs have gaps in their resources and processes for gynecologic emergency care. To guide VA in addressing these gaps, we sought to understand factors acting as facilitators and/or barriers to improving VA ED capacity for, and quality of, emergency gynecology care. Semistructured interviews with VA emergency and women's health key informants. ED directors/providers (n=14), ED nurse managers (n=13), and Women Veteran Program Managers (n=13) in 13 VA facilities. Leadership, staff, space, demand, funding, policies, and community were noted as important factors influencing VA EDs building capacity and improving emergency gynecologic care for women Veterans. These factors are intertwined and cross multiple organizational levels so that each ED's capacity is a reflection not only of its own factors, but also those of its local medical center and non-VA community context as well as VA regional and national trends and policies. Policies and quality improvement initiatives aimed at building VA's emergency gynecologic services for women need to be multifactorial and aimed at multiple organizational levels. Policies need to be flexible to account for wide variations across EDs and their medical center and community contexts. Approaches that build and encourage local leadership engagement, such as evidence-based quality improvement methodology, are likely to be most effective.

Vehicular-networking- and road-weather-related research in Sodankylä

Science.gov (United States)

Sukuvaara, Timo; Mäenpää, Kari; Ylitalo, Riika

2016-10-01

Vehicular-networking- and especially safety-related wireless vehicular services have been under intensive research for almost a decade now. Only in recent years has road weather information also been acknowledged to play an important role when aiming to reduce traffic accidents and fatalities via intelligent transport systems (ITSs). Part of the progress can be seen as a result of the Finnish Meteorological Institute's (FMI) long-term research work in Sodankylä within the topic, originally started in 2006. Within multiple research projects, the FMI Arctic Research Centre has been developing wireless vehicular networking and road weather services, in co-operation with the FMI meteorological services team in Helsinki. At the beginning the wireless communication was conducted with traditional Wi-Fi type local area networking, but during the development the system has evolved into a hybrid communication system of a combined vehicular ad hoc networking (VANET) system with special IEEE 802.11p protocol and supporting cellular networking based on a commercial 3G network, not forgetting support for Wi-Fi-based devices also. For piloting purposes and further research, we have established a special combined road weather station (RWS) and roadside unit (RSU), to interact with vehicles as a service hotspot. In the RWS-RSU we have chosen to build support to all major approaches, IEEE 802.11, traditional Wi-Fi and cellular 3G. We employ road weather systems of FMI, along with RWS and vehicle data gathered from vehicles, in the up-to-date localized weather data delivered in real time. IEEE 802.11p vehicular networking is supported with Wi-Fi and 3G communications. This paper briefly introduces the research work related to vehicular networking and road weather services conducted in Sodankylä, as well as the research project involved in this work. The current status of instrumentation, available services and capabilities are presented in order to formulate a clear general view of

36 CFR 261.56 - Use of vehicles off National Forest System roads.

Science.gov (United States)

2010-07-01

... Forest System roads. 261.56 Section 261.56 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT... National Forest System roads. When provided by an order, it is prohibited to possess or use a vehicle off National Forest System roads. [42 FR 2957, Jan. 14, 1977, as amended at 66 FR 3218, Jan. 12, 2001] ...

THE PREDICTOR FACTORS OF EMERGENCY NURSES' PERFORMANCES TO THE PROFESSIONAL SERVICES EXCELLENCE

Directory of Open Access Journals (Sweden)

Rina Annisa

2017-10-01

Full Text Available Emergency nurses’ performances remains long standing determinates of quality services rendered for patients admitted to get emergency treatments in the hospitals. It has been viewed as a dimension of professional services excellence. The purpose of this study focused on the predictive correlation of five predictors; namely human resources management, transformational leadership, incentives, hospital structure, and job rotation on the emergency nurses’ performance. This descriptive quantitative study used total sampling technique of 100 nurses in the Emergency Department, in four Government Hospital in Banjarmasin, Bajarbaru, and Martapura. All data obtained by administering questionnaires to the participances. The analytical procedure of multiple linear regression was utilized to determine the predicting strength correlation between the dependent and the independent variables. The result of Pearson product‑moment correlation coefficients revealed that positive correlation established between emergency nurses’ performances and human resources management, transformational leadership, incentives, hospital structure, and job rotation, as the independent variables. The summary of multiple linear regression analysis of all independent variables indicated that incentives was the most strongly predictor to the emergency nurses’ performances.

A new approach to road accident rescue.

Science.gov (United States)

Morales, Alejandro; González-Aguilera, Diego; López, Alfonso I; Gutiérrez, Miguel A

2016-01-01

This article develops and validates a new methodology and tool for rescue assistance in traffic accidents, with the aim of improving its efficiency and safety in the evacuation of people, reducing the number of victims in road accidents. Different tests supported by professionals and experts have been designed under different circumstances and with different categories of damaged vehicles coming from real accidents and simulated trapped victims in order to calibrate and refine the proposed methodology and tool. To validate this new approach, a tool called App_Rescue has been developed. This tool is based on the use of a computer system that allows an efficient access to the technical information of the vehicle and sanitary information of the common passengers. The time spent during rescue using the standard protocol and the proposed method was compared. This rescue assistance system allows us to make vital information accessible in posttrauma care services, improving the effectiveness of interventions by the emergency services, reducing the rescue time and therefore minimizing the consequences involved and the number of victims. This could often mean saving lives. In the different simulated rescue operations, the rescue time has been reduced an average of 14%.

Emergency Medical Services Capacity for Prehospital Stroke Care

Centers for Disease Control (CDC) Podcasts

2013-09-05

In this audio podcast, lead author and Preventing Chronic Disease’s 2013 Student Research Contest Winner, Mehul D. Patel, talks about his article on stroke care and emergency medical services.  Created: 9/5/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/5/2013.

Environmental Management Model for Road Maintenance Operation Involving Community Participation

Science.gov (United States)

Triyono, A. R. H.; Setyawan, A.; Sobriyah; Setiono, P.

2017-07-01

Public expectations of Central Java, which is very high on demand fulfillment, especially road infrastructure as outlined in the number of complaints and community expectations tweeter, Short Mail Massage (SMS), e-mail and public reports from various media, Highways Department of Central Java province requires development model of environmental management in the implementation of a routine way by involving the community in order to fulfill the conditions of a representative, may serve road users safely and comfortably. This study used survey method with SEM analysis and SWOT with Latent Independent Variable (X), namely; Public Participation in the regulation, development, construction and supervision of road (PSM); Public behavior in the utilization of the road (PMJ) Provincial Road Service (PJP); Safety in the Provincial Road (KJP); Integrated Management System (SMT) and latent dependent variable (Y) routine maintenance of the provincial road that is integrated with the environmental management system and involve the participation of the community (MML). The result showed the implementation of routine maintenance of road conditions in Central Java province has yet to implement an environmental management by involving the community; Therefore developed environmental management model with the results of H1: Community Participation (PSM) has positive influence on the Model of Environmental Management (MML); H2: Behavior Society in Jalan Utilization (PMJ) positive effect on Model Environmental Management (MML); H3: Provincial Road Service (PJP) positive effect on Model Environmental Management (MML); H4: Safety in the Provincial Road (KJP) positive effect on Model Environmental Management (MML); H5: Integrated Management System (SMT) has positive influence on the Model of Environmental Management (MML). From the analysis obtained formulation model describing the relationship / influence of the independent variables PSM, PMJ, PJP, KJP, and SMT on the dependent variable

Are You Ready for Emergency Medical Services in Your Oral and Maxillofacial Surgery Office?

Science.gov (United States)

Rayner, Clive; Ragan, Michael R

2018-05-01

Efficient responses to emergencies in the oral and maxillofacial surgery office require preparation, communication, and thorough documentation of the event and response. The concept of team anesthesia is showcased with these efforts. Emergency medical services training and response times vary greatly. The oral and maxillofacial surgery office should be prepared to manage the patient for at least 15 minutes after making the call to 911. Patient outcomes are optimized when providers work together to manage and transport the patient. Oral and maxillofacial surgery offices should develop and rehearse emergency plans and coordinate these protocols with local Emergency medical services teams. Copyright © 2018 Elsevier Inc. All rights reserved.

Mobile phone use for contacting emergency services in life-threatening circumstances.

Science.gov (United States)

Wu, Olivia; Briggs, Andrew; Kemp, Tom; Gray, Alastair; MacIntyre, Kate; Rowley, Jack; Willett, Keith

2012-03-01

The potential health benefits of mobile phone use have not been widely studied, except for telemedicine-type applications. This study seeks to determine whether initial contact with emergency services via a mobile phone in life-threatening situations is associated with potential health benefits when compared to contact via a landline. A record-linkage study was carried out in which data from all emergency dispatches for immediately life-threatening events from a United Kingdom county ambulance service were linked to the Patient Admission System at two major local hospitals. Mortality (at the scene, at the emergency department [ED], and during hospitalization); transfer to the ED; admission (inpatient care, and intensive care unit); and length of stay were analyzed for calls classified as Code Red (immediately life-threatening) by initial exposure (mobile phone vs. landline), while controlling for potential confounding variables. Of 354,199 ambulances dispatched to attend emergency incidents, 66% transported patients to the hospital while 2% stood down due to death at the scene. Mobile phone compared to landline reporting of emergencies resulted in significant reductions in the risk of death at the scene (odds ratio [OR] 0.77), but not for death in the ED or during inpatient admission. The risk of being transferred to the ED and subsequent inpatient admission were significantly lower with reporting from mobile phones compared to landline (OR 0.93 and OR 0.82, respectively). In this study, evidence of statistical association was demonstrated between the use of mobile phones to alert ambulance services in life-threatening situations and improved outcomes for patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Every Second Counts: Integrating Edge Computing and Service Oriented Architecture for Automatic Emergency Management

Directory of Open Access Journals (Sweden)

Lei Chen

2018-01-01

Full Text Available Emergency management has long been recognized as a social challenge due to the criticality of the response time. In emergency situations such as severe traffic accidents, minimizing the response time, which requires close collaborations between all stakeholders involved and distributed intelligence support, leads to greater survival chance of the injured. However, the current response system is far from efficient, despite the rapid development of information and communication technologies. This paper presents an automated collaboration framework for emergency management that coordinates all stakeholders within the emergency response system and fully automates the rescue process. Applying the concept of multiaccess edge computing architecture, as well as choreography of the service oriented architecture, the system allows seamless coordination between multiple organizations in a distributed way through standard web services. A service choreography is designed to globally model the emergency management process from the time an accident occurs until the rescue is finished. The choreography can be synthesized to generate detailed specification on peer-to-peer interaction logic, and then the specification can be enacted and deployed on cloud infrastructures.

36 CFR 254.33 - Road rights-of-way.

Science.gov (United States)

2010-07-01

... parcels subject to conveyance under this subpart are limited to those which are substantially surrounded by lands not owned by the United States. (b) Forest Service officials shall consider public road... Section 254.33 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LANDOWNERSHIP...

36 CFR 261.12 - National Forest System roads and trails.

Science.gov (United States)

2010-07-01

... and trails. 261.12 Section 261.12 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE PROHIBITIONS General Prohibitions § 261.12 National Forest System roads and trails. The following... by a sign. (c) Damaging and leaving in a damaged condition any such road, trail, or segment thereof...

Commentary: Status of road safety in Asia.

Science.gov (United States)

Wismans, Jac; Skogsmo, Ingrid; Nilsson-Ehle, Anna; Lie, Anders; Thynell, Marie; Lindberg, Gunnar

2016-01-01

hand, lack of good high-quality accident data should not be an excuse to postpone interventions. There are many opportunities for evidence-based transport safety improvements, including measures concerning the 5 key risk factors: speed, drunk driving, not wearing motorcycle helmets, not wearing seat belts, and not using child restraints in cars, as specified in the Decade of Action for Road Safety 2011-2020. In this commentary, a number of additional measures are proposed that are not covered in the Decade of Action Plan. These new measures include separate roads or lanes for pedestrians and cyclists; helmet wearing for e-bike riders; special attention to elderly persons in public transportation; introduction of emerging collision avoidance technologies, in particular automatic emergency braking (AEB) and alcohol locks; improved truck safety focusing on the other road user (including blind spot detection technology; underride protection at the front, rear, and side; and energy-absorbing fronts); and improvements in motorcycle safety concerning protective clothing, requirements for advanced braking systems, improved visibility of motorcycles by using daytime running lights, and better guardrails.

Three Types of Memory in Emergency Medical Services Communication

Science.gov (United States)

Angeli, Elizabeth L.

2015-01-01

This article examines memory and distributed cognition involved in the writing practices of emergency medical services (EMS) professionals. Results from a 16-month study indicate that EMS professionals rely on distributed cognition and three kinds of memory: individual, collaborative, and professional. Distributed cognition and the three types of…

Modeling factors influencing the demand for emergency department services in ontario: a comparison of methods

OpenAIRE

Meaney Christopher; Moineddin Rahim; Agha Mohammad; Zagorski Brandon; Glazier Richard Henry

2011-01-01

Abstract Background Emergency departments are medical treatment facilities, designed to provide episodic care to patients suffering from acute injuries and illnesses as well as patients who are experiencing sporadic flare-ups of underlying chronic medical conditions which require immediate attention. Supply and demand for emergency department services varies across geographic regions and time. Some persons do not rely on the service at all whereas; others use the service on repeated occasions...

Cooperation as a Service in VANET: Implementation and Simulation Results

Directory of Open Access Journals (Sweden)

Hajar Mousannif

2012-01-01

Full Text Available The past decade has witnessed the emergence of Vehicular Ad-hoc Networks (VANET, specializing from the well-known Mobile Ad Hoc Networks (MANET to Vehicle-to-Vehicle (V2V and Vehicle-to-Infrastructure (V2I wireless communications. While the original motivation for Vehicular Networks was to promote traffic safety, recently it has become increasingly obvious that Vehicular Networks open new vistas for Internet access, providing weather or road condition, parking availability, distributed gaming, and advertisement. In previous papers [27,28], we introduced Cooperation as a Service (CaaS; a new service-oriented solution which enables improved and new services for the road users and an optimized use of the road network through vehicle's cooperation and vehicle-to-vehicle communications. The current paper is an extension of the first ones; it describes an improved version of CaaS and provides its full implementation details and simulation results. CaaS structures the network into clusters, and uses Content Based Routing (CBR for intra-cluster communications and DTN (Delay–and disruption-Tolerant Network routing for inter-cluster communications. To show the feasibility of our approach, we implemented and tested CaaS using Opnet modeler software package. Simulation results prove the correctness of our protocol and indicate that CaaS achieves higher performance as compared to an Epidemic approach.

Future road salt use in Switzerland: an example of an effective climate service

Science.gov (United States)

Zubler, Elias M.; Fischer, Andreas M.; Schlegel, Thomas H.; Liniger, Mark A.

2015-04-01

The application of salt is the predominant measure taken to enhance road safety in Switzerland by clearing the roads from snow or preventing frozen surfaces during winter. The need for road salt exhibits a strong interannual variability, according to Schweizer Salinen AG - the Swiss monopolist for production and distribution of road salt. These fluctuations are to a large extent a direct consequence of the year-to-year variability in winter climate. In the course of the 21st century, Swiss climate is projected to depart significantly from present and past conditions. By the end of the century, winter temperatures over Switzerland are expected to rise by about 2-4°C relative to the mean over the period 1980-2009, while winter precipitation may either increase or decrease based on ENSEMBLES regional climate model projections under the SRES-scenario A1B. Faced with these changes, Schweizer Salinen AG asked for an estimate of the expected future road salt use for designing their long-term business strategy. The study is based on climate change projections from the CH2011 initiative and later extensions thereof as well as monthly sales data of road salt from Schweizer Salinen AG. For the period 1997-2013, a linear relationship was derived between the average number of days with snowfall and the road salt amount sold over "saltation years" defined from October 1st to September 30th in the 26 cantons (provinces) of Switzerland. The ad-hoc linear relationship was applied to the climate change projections to obtain future salt use information in three future periods for the greenhouse gas emission scenarios A1B, A2 and RCP3PD. We find that the expected future salt use is likely to be reduced by about 50% in 2045-2074 under the scenario A1B. Currently, the countrywide mean annual road salt use corresponds to about 220'000 tons. In a particularly snow-rich year, the company sells up to 400'000 tons. At the end of the century, following a pessimistic scenario such as A1B or A

Emergency medical service systems in Japan : Past, present, and future

OpenAIRE

Tanigawa, Koichi; Tanaka, Keiichi

2006-01-01

Emergency medical services are provided by the fire defense headquarter of the local government in Japan. We have a one-tiered EMS system. The ambulance is staffed by three crews trained in rescue, stabilization, transportation, and advanced care of traumatic and medical emergencies. There are three levels of care provided by ambulance personnel including a basic-level ambulance crew (First Aid Class one, FAC-1), a second level (Standard First Aid Class, SFAC), and the highest level (Emergenc...

Just-In-Time eTraining Applied To Emergency Medical Services

OpenAIRE

Vico Vela, Francisco José; Sánchez Canteli, Vicente; Lobo Fernández, Daniel; Fernández Rodríguez, Jose David; Bandera, César; Rivas, Ramón; Rosen, M.; Schlegel, M.

2013-01-01

While the applications of just-in-time training are more and more spread, the ubiquitous mobile technology has not found practical uses of this training strategy. As an original example of services for healthcare, we present in this work an application of eTraining that makes use of mobile telephones to transmit medical and on-site information content to emergency medical personnel that attend and emergency. The state-of-the-art in related technologies, overall architectu...

Cloud based emergency health care information service in India.

Science.gov (United States)

Karthikeyan, N; Sukanesh, R

2012-12-01

A hospital is a health care organization providing patient treatment by expert physicians, surgeons and equipments. A report from a health care accreditation group says that miscommunication between patients and health care providers is the reason for the gap in providing emergency medical care to people in need. In developing countries, illiteracy is the major key root for deaths resulting from uncertain diseases constituting a serious public health problem. Mentally affected, differently abled and unconscious patients can't communicate about their medical history to the medical practitioners. Also, Medical practitioners can't edit or view DICOM images instantly. Our aim is to provide palm vein pattern recognition based medical record retrieval system, using cloud computing for the above mentioned people. Distributed computing technology is coming in the new forms as Grid computing and Cloud computing. These new forms are assured to bring Information Technology (IT) as a service. In this paper, we have described how these new forms of distributed computing will be helpful for modern health care industries. Cloud Computing is germinating its benefit to industrial sectors especially in medical scenarios. In Cloud Computing, IT-related capabilities and resources are provided as services, via the distributed computing on-demand. This paper is concerned with sprouting software as a service (SaaS) by means of Cloud computing with an aim to bring emergency health care sector in an umbrella with physical secured patient records. In framing the emergency healthcare treatment, the crucial thing considered necessary to decide about patients is their previous health conduct records. Thus a ubiquitous access to appropriate records is essential. Palm vein pattern recognition promises a secured patient record access. Likewise our paper reveals an efficient means to view, edit or transfer the DICOM images instantly which was a challenging task for medical practitioners in the

[Structure, organization and capacity problems in emergency medical services, emergency admission and intensive care units].

Science.gov (United States)

Dick, W

1994-01-01

clinical pictures. Cost effectiveness is clearly in favor of emergency medicine. Future developments will be characterized by the consequences of new health care legislation and by effects of financial stringencies on the emergency medical services.

Modeling factors influencing the demand for emergency department services in ontario: a comparison of methods

Directory of Open Access Journals (Sweden)

Meaney Christopher

2011-08-01

Full Text Available Abstract Background Emergency departments are medical treatment facilities, designed to provide episodic care to patients suffering from acute injuries and illnesses as well as patients who are experiencing sporadic flare-ups of underlying chronic medical conditions which require immediate attention. Supply and demand for emergency department services varies across geographic regions and time. Some persons do not rely on the service at all whereas; others use the service on repeated occasions. Issues regarding increased wait times for services and crowding illustrate the need to investigate which factors are associated with increased frequency of emergency department utilization. The evidence from this study can help inform policy makers on the appropriate mix of supply and demand targeted health care policies necessary to ensure that patients receive appropriate health care delivery in an efficient and cost-effective manner. The purpose of this report is to assess those factors resulting in increased demand for emergency department services in Ontario. We assess how utilization rates vary according to the severity of patient presentation in the emergency department. We are specifically interested in the impact that access to primary care physicians has on the demand for emergency department services. Additionally, we wish to investigate these trends using a series of novel regression models for count outcomes which have yet to be employed in the domain of emergency medical research. Methods Data regarding the frequency of emergency department visits for the respondents of Canadian Community Health Survey (CCHS during our study interval (2003-2005 are obtained from the National Ambulatory Care Reporting System (NACRS. Patients' emergency department utilizations were linked with information from the Canadian Community Health Survey (CCHS which provides individual level medical, socio-demographic, psychological and behavioral information for

Modeling factors influencing the demand for emergency department services in Ontario: a comparison of methods.

Science.gov (United States)

Moineddin, Rahim; Meaney, Christopher; Agha, Mohammad; Zagorski, Brandon; Glazier, Richard Henry

2011-08-19

Emergency departments are medical treatment facilities, designed to provide episodic care to patients suffering from acute injuries and illnesses as well as patients who are experiencing sporadic flare-ups of underlying chronic medical conditions which require immediate attention. Supply and demand for emergency department services varies across geographic regions and time. Some persons do not rely on the service at all whereas; others use the service on repeated occasions. Issues regarding increased wait times for services and crowding illustrate the need to investigate which factors are associated with increased frequency of emergency department utilization. The evidence from this study can help inform policy makers on the appropriate mix of supply and demand targeted health care policies necessary to ensure that patients receive appropriate health care delivery in an efficient and cost-effective manner. The purpose of this report is to assess those factors resulting in increased demand for emergency department services in Ontario. We assess how utilization rates vary according to the severity of patient presentation in the emergency department. We are specifically interested in the impact that access to primary care physicians has on the demand for emergency department services. Additionally, we wish to investigate these trends using a series of novel regression models for count outcomes which have yet to be employed in the domain of emergency medical research. Data regarding the frequency of emergency department visits for the respondents of Canadian Community Health Survey (CCHS) during our study interval (2003-2005) are obtained from the National Ambulatory Care Reporting System (NACRS). Patients' emergency department utilizations were linked with information from the Canadian Community Health Survey (CCHS) which provides individual level medical, socio-demographic, psychological and behavioral information for investigating predictors of increased emergency

Designing smartphone mental health applications for emergency service workers.

Science.gov (United States)

Deady, M; Peters, D; Lang, H; Calvo, R; Glozier, N; Christensen, H; Harvey, S B

2017-08-01

Emergency service workers are often exposed to trauma and have increased risk of a range of mental health (MH) conditions. Smartphone applications have the potential to provide this group with effective psychological interventions; however, little is known about the acceptability and preferences regarding such initiatives. To describe the preferences and opinions of emergency service workers regarding the use of smartphone MH applications and to examine the impact of age on these preferences. Participants were recruited from four metropolitan Fire and Rescue NSW stations and responded to questionnaire items covering three key domains: current smartphone use, potential future use and preferences for design and content as well as therapeutic techniques. Overall, approximately half the sample (n = 106) claimed they would be interested in trying a tailored emergency-worker MH smartphone application. There were few differences between age groups on preferences. The majority of respondents claimed they would use an app for mental well-being daily and preferred terms such as 'well-being' and 'mental fitness' for referring to MH. Confidentiality, along with a focus on stress, sleep, exercise and resiliency were all considered key features. Behavioural therapeutic techniques were regarded most favourably, compared with other therapies. Emergency workers were interested in utilizing smartphone applications focused on MH, but expressed clear preferences regarding language used in promotion, features required and therapeutic techniques preferred. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs.

Science.gov (United States)

Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Rhoads, Richard; Carson, Chris A

2016-01-01

Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components-the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

Geographic analysis of road accident severity index in Nigeria.

Science.gov (United States)

Iyanda, Ayodeji E

2018-05-28

Before 2030, deaths from road traffic accidents (RTAs) will surpass cerebrovascular disease, tuberculosis, and HIV/AIDS. Yet, there is little knowledge on the geographic distribution of RTA severity in Nigeria. Accident Severity Index is the proportion of deaths that result from a road accident. This study analysed the geographic pattern of RTA severity based on the data retrieved from Federal Road Safety Corps (FRSC). The study predicted a two-year data from a historic road accident data using exponential smoothing technique. To determine spatial autocorrelation, global and local indicators of spatial association were implemented in a geographic information system. Results show significant clusters of high RTA severity among states in the northeast and the northwest of Nigeria. Hence, the findings are discussed from two perspectives: Road traffic law compliance and poor emergency response. Conclusion, the severity of RTA is high in the northern states of Nigeria, hence, RTA remains a public health concern.

[Assessment of quality indicators in pediatric poisoning in an emergency service].

Science.gov (United States)

Giménez Roca, C; Martínez Sánchez, L; Calzada Baños, Y; Trenchs Sainz de la Maza, V; Quintilla Martínez, J M; Luaces Cubells, C

2014-01-01

Assessment of quality indicators allows clinicians to evaluate clinical assistance with a standard, to detect deficiencies and to improve medical assistance. Patients who came to emergency services of a tertiary level hospital for suspicion of poisoning from January 2011 to June 2012 were assessed using 20 quality indicators of pediatric poisoning. Data collection was performed by retrospective review of clinical reports. A total of 393 patients were admitted for suspicion of poisoning (0.3% of all admissions).The standard was reached in 11 indicators and not reached in 6: administration of activated charcoal within 2hours of poison ingestion (standard=90%, result=83.5%); attention within the first 15minutes of arriving in the emergency service (standard=90%, result=60.4%); start of gastrointestinal decontamination within 20minutes of arrival in emergency services (standard=90%, result=29.7%); performing of electrocardiogram on the patients poisoned with cardiotoxic substances (standard=95%, result=87%); judicial communication of cases of poisoning that could conceal a crime (standard=95%, result=31.3%), and collection of the minimal set of information of poisoned patients (standard=90%, result=1.9%). Three indicators could not be evaluated as a consequence of the limited number of cases where they could be applied (de Pediatría. Published by Elsevier Espana. All rights reserved.

Efficient and Flexible KNN Query Processing in Real-Life Road Networks

DEFF Research Database (Denmark)

Lu, Yang; Bui, Bin; Zhao, Jiakui

2008-01-01

are included into the RNG index, which enables the index to support both distance-based and time-based KNN queries and continuous KNN queries. Our work extends previous ones by taking into account more practical scenarios, such as complexities in real-life road networks and time-based KNN queries. Extensive......Along with the developments of mobile services, effectively modeling road networks and efficiently indexing and querying network constrained objects has become a challenging problem. In this paper, we first introduce a road network model which captures real-life road networks better than previous...

Road roughness evaluation using in-pavement strain sensors

Science.gov (United States)

Zhang, Zhiming; Deng, Fodan; Huang, Ying; Bridgelall, Raj

2015-11-01

The international roughness index (IRI) is a characterization of road roughness or ride quality that transportation agencies most often report. The prevalent method of acquiring IRI data requires instrumented vehicles and technicians with specialized training to interpret the results. The extensive labor and high cost requirements associated with the existing approaches limit data collection to at most once per year for portions of the national highway system. Agencies characterize roughness only for some secondary roads but much less frequently, such as once every five years, resulting in outdated roughness information. This research developed a real-time roughness evaluation approach that links the output of durable in-pavement strain sensors to prevailing indices that summarize road roughness. Field experiments validated the high consistency of the approach by showing that it is within 3.3% of relative IRI estimates. After their installation and calibration during road construction, the ruggedized strain sensors will report road roughness continuously. Thus, the solution will provide agencies a real-time roughness monitoring solution over the remaining service life of road assets.

Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review

Directory of Open Access Journals (Sweden)

Fiona Cocker

2016-06-01

Full Text Available Compassion fatigue (CF is stress resulting from exposure to a traumatized individual. CF has been described as the convergence of secondary traumatic stress (STS and cumulative burnout (BO, a state of physical and mental exhaustion caused by a depleted ability to cope with one’s everyday environment. Professionals regularly exposed to the traumatic experiences of the people they service, such as healthcare, emergency and community service workers, are particularly susceptible to developing CF. This can impact standards of patient care, relationships with colleagues, or lead to more serious mental health conditions such as posttraumatic stress disorder (PTSD, anxiety or depression. A systematic review of the effectiveness of interventions to reduce CF in healthcare, emergency and community service workers was conducted. Thirteen relevant studies were identified, the majority of which were conducted on nurses (n = 10. Three included studies focused on community service workers (social workers, disability sector workers, while no studies targeting emergency service workers were identified. Seven studies reported a significant difference post-intervention in BO (n = 4 or STS (n = 3. This review revealed that evidence of the effectiveness of CF interventions in at-risk health and social care professions is relatively recent. Therefore, we recommend more research to determine how best to protect vulnerable workers at work to prevent not only CF, but also the health and economic consequences related to the ensuing, and more disabling, physical and mental health outcomes.

47 CFR 74.690 - Transition of the 1990-2025 MHz band from the Broadcast Auxiliary Service to emerging technologies.

Science.gov (United States)

2010-10-01

... Broadcast Auxiliary Service to emerging technologies. 74.690 Section 74.690 Telecommunication FEDERAL... of the 1990-2025 MHz band from the Broadcast Auxiliary Service to emerging technologies. (a) New... licensed emerging technology services will maintain primary status in the band until the Existing Licensee...

On the Deployment and Noise Filtering of Vehicular Radar Application for Detection Enhancement in Roads and Tunnels

Directory of Open Access Journals (Sweden)

Young-Duk Kim

2018-03-01

Full Text Available Recently, radar technology has attracted attention for the realization of an intelligent transportation system (ITS to monitor, track, and manage vehicle traffic on the roads as well as adaptive cruise control (ACC and automatic emergency braking (AEB for driving assistance of vehicles. However, when radar is installed on roads or in tunnels, the detection performance is significantly dependent on the deployment conditions and environment around the radar. In particular, in the case of tunnels, the detection accuracy for a moving vehicle drops sharply owing to the diffuse reflection of radio frequency (RF signals. In this paper, we propose an optimal deployment condition based on height and tilt angle as well as a noise-filtering scheme for RF signals so that the performance of vehicle detection can be robust against external conditions on roads and in tunnels. To this end, first, we gather and analyze the misrecognition patterns of the radar by tracking a number of randomly selected vehicles on real roads. In order to overcome the limitations, we implement a novel road watch module (RWM that is easily integrated into a conventional radar system such as Delphi ESR. The proposed system is able to perform real-time distributed data processing of the target vehicles by providing independent queues for each object of information that is incoming from the radar RF. Based on experiments with real roads and tunnels, the proposed scheme shows better performance than the conventional method with respect to the detection accuracy and delay time. The implemented system also provides a user-friendly interface to monitor and manage all traffic on roads and in tunnels. This will accelerate the popularization of future ITS services.

On the Deployment and Noise Filtering of Vehicular Radar Application for Detection Enhancement in Roads and Tunnels

Science.gov (United States)

Kim, Young-Duk; Son, Guk-Jin; Song, Chan-Ho

2018-01-01

Recently, radar technology has attracted attention for the realization of an intelligent transportation system (ITS) to monitor, track, and manage vehicle traffic on the roads as well as adaptive cruise control (ACC) and automatic emergency braking (AEB) for driving assistance of vehicles. However, when radar is installed on roads or in tunnels, the detection performance is significantly dependent on the deployment conditions and environment around the radar. In particular, in the case of tunnels, the detection accuracy for a moving vehicle drops sharply owing to the diffuse reflection of radio frequency (RF) signals. In this paper, we propose an optimal deployment condition based on height and tilt angle as well as a noise-filtering scheme for RF signals so that the performance of vehicle detection can be robust against external conditions on roads and in tunnels. To this end, first, we gather and analyze the misrecognition patterns of the radar by tracking a number of randomly selected vehicles on real roads. In order to overcome the limitations, we implement a novel road watch module (RWM) that is easily integrated into a conventional radar system such as Delphi ESR. The proposed system is able to perform real-time distributed data processing of the target vehicles by providing independent queues for each object of information that is incoming from the radar RF. Based on experiments with real roads and tunnels, the proposed scheme shows better performance than the conventional method with respect to the detection accuracy and delay time. The implemented system also provides a user-friendly interface to monitor and manage all traffic on roads and in tunnels. This will accelerate the popularization of future ITS services. PMID:29534483

On the Deployment and Noise Filtering of Vehicular Radar Application for Detection Enhancement in Roads and Tunnels.

Science.gov (United States)

Kim, Young-Duk; Son, Guk-Jin; Song, Chan-Ho; Kim, Hee-Kang

2018-03-11

Recently, radar technology has attracted attention for the realization of an intelligent transportation system (ITS) to monitor, track, and manage vehicle traffic on the roads as well as adaptive cruise control (ACC) and automatic emergency braking (AEB) for driving assistance of vehicles. However, when radar is installed on roads or in tunnels, the detection performance is significantly dependent on the deployment conditions and environment around the radar. In particular, in the case of tunnels, the detection accuracy for a moving vehicle drops sharply owing to the diffuse reflection of radio frequency (RF) signals. In this paper, we propose an optimal deployment condition based on height and tilt angle as well as a noise-filtering scheme for RF signals so that the performance of vehicle detection can be robust against external conditions on roads and in tunnels. To this end, first, we gather and analyze the misrecognition patterns of the radar by tracking a number of randomly selected vehicles on real roads. In order to overcome the limitations, we implement a novel road watch module (RWM) that is easily integrated into a conventional radar system such as Delphi ESR. The proposed system is able to perform real-time distributed data processing of the target vehicles by providing independent queues for each object of information that is incoming from the radar RF. Based on experiments with real roads and tunnels, the proposed scheme shows better performance than the conventional method with respect to the detection accuracy and delay time. The implemented system also provides a user-friendly interface to monitor and manage all traffic on roads and in tunnels. This will accelerate the popularization of future ITS services.

Road Traffic Injuries Among Iranian Children and Adolescents: An Epidemiological Review

Directory of Open Access Journals (Sweden)

Salar Behzadnia

2016-01-01

Full Text Available Context: Road traffic injuries (RTIs are the leading cause of death and globally kill 1.2 million people every year and leave 20 - 50 million people injured and disabled. In Iran, traffic related fatalities are the leading cause of death among all inadvertent fatal injuries imposed on children under five. Herein, authors review the epidemiological studies performed on vehicle accidents among Iranian children and adolescents to improve the knowledge about these preventable events. Evidence Acquisition: International databases including PubMed, Google scholar, science direct Cochrane library, and national data bases such as scientific information database (SID were searched for terms; children, motor vehicle accident, road traffic injuries, Iran 2000 - 2015. Publication in Persian or English language related to the subject including Iranian children and adolescent's age groups were included. Among the 312 articles, 11 (two abstracts and nine full texts were selected. Nine full texts were reviewed. Results: From 22865 victims, about 3578 children and adolescents under 19 years old were identified. Males were more affected than females. Pedestrian injury with 43.66% was the most common case of road traffic injuries. Head trauma was the most common cause of injuries reported by eight of the reviewed articles. Most of the accidents occurred between 1:00 - 6:00 PM. Most of RTIs occurred in summer. Care by emergency medical services (EMS (29.14% was reported by five out of the nine reviewed article. Conclusions: Most of the road traffic injuries among Iranian children and adolescents are preventable using appropriate preventive strategies such as safety facilities, safe vehicles, and safe traffic behavior, and establishing comprehensive public education programs for older children and their parents.

Performance of Chemically Treated Jute Geotextile in Unpaved Roads at Different in situ Conditions

Science.gov (United States)

Midha, Vinay Kumar; Joshi, Shubham; Suresh Kumar, S.

2017-06-01

Biodegradable jute geotextiles are an effective reinforcing material for unpaved roads, but its serviceability is limited because of faster microbial degradation. Different methods are in use to improve the serviceability of jute geotextiles. In this paper, influence of chemical treatment (transesterification and bitumen coating), road design and rainfall intensity on the time dependent serviceability of jute geotextiles has been studied. Chemically treated jute geotextiles, were laid in unpaved road designs with and without sand layer, for 30, 60 and 90 days' duration, and subjected to simulated rainfall intensities of 50 and 100 mm/h. With increase in time of usage, tensile strength and puncture resistance decrease due to microbial attack, and pore size decreases due to clogging of soil in jute geotextiles. Chemical treatment was observed to have greater influence on the serviceability, followed by the presence of sand layer in road design and the rainfall intensity. Further, overall performance of bitumen coated jute geotextiles was observed to be better than transesterified jute geotextile, due to its hydrophobic nature.

Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

Science.gov (United States)

Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

2014-12-01

Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

Trauma center accessibility for road traffic injuries in Hanoi, Vietnam.

Science.gov (United States)

Nagata, Takashi; Takamori, Ayako; Kimura, Yoshinari; Kimura, Akio; Hashizume, Makoto; Nakahara, Shinji

2011-09-30

Rapid economic growth in Vietnam over the last decade has led to an increased frequency of road traffic injury (RTI), which now represents one of the leading causes of death in the nation. Various efforts toward injury prevention have not produced a significant decline in the incidence of RTIs. Our study sought to describe the geographic distribution of RTIs in Hanoi, Vietnam and to evaluate the accessibility of trauma centers to those injured in the city. We performed a cross-sectional study using Hanoi city police reports from 2006 to describe the epidemiology of RTIs occurring in Hanoi city. Additionally, we identified geographic patterns and determined the direct distance from injury sites to trauma centers by applying geographical information system (GIS) software. Factors associated with the accessibility of trauma centers were evaluated by multivariate regression analysis. We mapped 1,271 RTIs in Hanoi city. About 40% of RTIs occurred among people 20-29 years of age. Additionally, 63% of RTIs were motorcycle-associated incidents. Two peak times of injury occurrence were observed: 12 am-4 pm and 8 pm-0 am. "Hot spots" of road traffic injuries/fatalities were identified in the city area and on main highways using Kernel density estimation. Interestingly, RTIs occurring along the two north-south main roads were not within easy access of trauma centers. Further, fatal cases, gender and injury mechanism were significantly associated with the distance between injury location and trauma centers. Geographical patterns of RTIs in Hanoi city differed by gender, time, and injury mechanism; such information may be useful for injury prevention. Specifically, RTIs occurring along the two north-south main roads have lower accessibility to trauma centers, thus an emergency medical service system should be established.

Assessment of emergency medical services in the Ashanti region of ...

African Journals Online (AJOL)

Deficient areas in need of development are governance, reliable revenue, public access, community integration, clinical care guidelines, research and quality assurance processes. Conclusions: The Ashanti Region has a growing and thriving emergency medical services system. Although many essential areas for ...

The perceived impact of an emergency department immediate reporting service: An exploratory survey

International Nuclear Information System (INIS)

Snaith, Beverly; Hardy, Maryann

2013-01-01

Background: Immediate reporting, commonly referred to as a ‘hot reporting’, has been advocated as a method of effectively supporting clinical decision making. However, its implementation nationally has been limited with poor understanding of its value in practice. Method: A cross sectional attitudinal survey was distributed to emergency department clinicians (medical and nursing staff) and radiographers to explore perceptions of an immediate reporting service in terms of its influence on professional role and autonomy, patient care and service quality. Results: A total of 87 (n = 87/155; 56.1%) completed questionnaires were returned. The findings suggest that significant support for immediate reporting exists. Immediate reporting is believed to improve service quality, reduce clinical errors and provide opportunity for image interpretation skills development. However, responses were not consistent across clinical professions and staff grades. Conclusion: The immediate reporting of emergency department images is perceived to benefit patient, emergency department clinicians and hospital organisation

Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis.

Directory of Open Access Journals (Sweden)

Gavin Tansley

Full Text Available Injury is a leading cause of the global disease burden, accounting for 10 percent of all deaths worldwide. Despite 90 percent of these deaths occurring in low and middle-income countries (LMICs, the majority of trauma research and infrastructure development has taken place in high-income settings. Furthermore, although accessible services are of central importance to a mature trauma system, there remains a paucity of literature describing the spatial accessibility of emergency services in LMICs. Using data from the Service Provision Assessment component of the Demographic and Health Surveys of Namibia and Haiti we defined the capabilities of healthcare facilities in each country in terms of their preparedness to provide emergency services. A Geographic Information System-based network analysis method was used to define 5- 10- and 50-kilometer catchment areas for all facilities capable of providing 24-hour care, higher-level resuscitative services or tertiary care. The proportion of a country's population with access to each level of service was obtained by amalgamating the catchment areas with a population layer. A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care. Spatial access to tertiary care was considerably lower with 51% of Haitians and 72% of Namibians having no access to these higher-level services within 50 kilometers. These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries. Routine collection of georeferenced patient and facility data in LMICs will be important to understanding

Trajectory of a road vehicle during road maintenance

OpenAIRE

Stachová Darina

2017-01-01

Consider a vehicle moving on a road whose usage over time creates an uneven surface on the road. Road unevenness that we encounter on surface communications often arises as a consequence of dynamical effects of moving vehicles, of weather changes, and due to road construction works. This article concerns with mathematical modeling of the trajectory of a road vehicle moving on such a surface during the course of road maintenance.

Factors associated with emergency services use in Taiwanese advanced cancer patients receiving palliative home care services during out-of-hours periods: a retrospective medical record study.

Science.gov (United States)

Kao, Yee-Hsin; Liu, Yao-Ting; Koo, Malcolm; Chiang, Jui-Kun

2018-03-12

For patients receiving palliative home care, the need to visit the emergency department is considered to be an indicator of poor quality care. The situation can be particularly distressing when it occurs outside of normal hours of palliative home care service. The aim of this study was to investigate the factors for emergency department use during out-of-hours periods of palliative home care service among advanced cancer patients in Taiwan. This case-control study was based on a retrospective medical chart review (January 2010 to December 2012) of advanced cancer patients who were receiving palliative home care in a community hospital in south Taiwan. The use of emergency medical services by these patients was dichotomized into either normal hours (8 a.m. to midnight, Monday to Friday, excluding public holidays) of palliative home care or outside normal hours. Logistic regression analyses were performed to evaluate factors associated with emergency services use during out-of-hours period of palliative home care. Of the 94 patients receiving palliative home care, 65 had used emergency services at least once during the 3-year study period. Of these 65 patients, 40% used emergency services during out-of-hours of palliative home care. Patients with distressing conditions (defined as the occurrence of any two conditions of dyspnea, change of consciousness, or gastrointestinal bleeding) were significantly more likely to use emergency services during out-of-hours of palliative home care. Patients at risk of developing dyspnea, change of consciousness, or gastrointestinal bleeding should be provided with relevant information regarding these symptoms and signs.

Functional classification of the Gauteng provincial road network using the South African road classification and access management manual (TRH26)

CSIR Research Space (South Africa)

Veramoothea, P

2015-08-01

Full Text Available and safety. This approach can be standardised throughout the country to make inferences to road safety, speed regulation, driver behaviour, traffic studies and accessibility to services....

[Emergency care for victims of violence and accidents: differences in the epidemiological profile between the public and private health services. VIVA--Campinas, São Paulo, Brazil, 2009].

Science.gov (United States)

Belon, Ana Paula; da Silveira, Naoko Yanagizawa Jardim; Barros, Marilisa Berti de Azevedo; Baldo, Caroline; da Silva, Marta Maria Alves

2012-09-01

The scope of this study is to analyze the differences in the profile of emergency care for external causes between public and private emergency departments. With data come from VIVA-Campinas 2009, the association between the nature of healthcare and the characteristics of the victims was verified using the chi-square test. Using Poisson regression, proportion ratios of care in the public and private network were estimated. In the sample of 1094 victims, 67.8% were treated by public health. Traffic accidents, animal-related accidents, and assaults were 2 times higher in public units, whereas collisions with objects and sprains were 75% and 2.7 times higher in private units. Cranium-encephalic trauma/polytrauma and cuts/lacerations were 3.8 times and 61% more frequent in public care, while victims with no injuries, with dislocations/sprains or fractures being predominant in private care. Head and multiple organ injuries, road accident and work-related injuries, the use of public transport or mobile emergency care services/ambulances were predominant in public care. Revealing significant differences in care in public and private care can contribute to the organization of healthcare.

How Much Time Do Unhospitalized Patients Applying for Emergency Services Stay in Emergency Department

Directory of Open Access Journals (Sweden)

Mansur Kürsad Erkuran

2013-12-01

Full Text Available INTRODUCTION: The patients applying to a emergency service may stay longer than necessary for diagnosis, monitoring and treatment. This can be due to the inadequacy of the treatment performed in emergency department or to the absence of the required unit in the hospital. In this study, we analyzed the waiting period of the patients who have not been hospitalized. METHODS: The patients applying to Bolu İzzet Baysal Public Hospital Emergency Unit between 24.11.2009 and 25.08.2011 have been studied regarding their application date, the season, and their waiting period in the emergency unit. The data have been analyzed using the statistics software Package for the Social Sciences (SPSS, Inc., Chicago, IL, version 17.0 for Windows. The chi-square χ2 test has been used for the determination of the percentage distribution and significance and p<0,05 has been considered significant. RESULTS: 4215 patients applying to Bolu İzzet Baysal Public Hospital Emergency Unit between 24.11.2009 and 25.08.2011 and monitored without hospitalization have been studied. The patients mainly presented during spring (p<0.05. The application occurred more often between 20.00 PM – 23.59 PM (p<0.005. The mean duration of the accept-standby of the patients in emergency unit was 09±12 (minimum 0 minute, maximum 130 minutes. The patients waited 0,26 ±70 minutes in emergency unit examination (minimum 0 minute, maximum 1292 minutes. The total waiting time in emergency unit was 52 ±100 minutes (minimum 10, maximum 1435 minutes. DISCUSSION AND CONCLUSION: In this study, we observed that the duration of the hospitalization in emergency unit is longer than the ideal duration.

Experience in accident liquidation at the Chernobyl' NPP and problems of organization of the emergency-engineering service

International Nuclear Information System (INIS)

Andreev, Yu.B.; Samojlenko, Yu.N.

1989-01-01

The efficiency of measures realized in order to eliminate the Chernobyl' accident effects is estimated. The principles of organization of the emergency-engineering service for accident elimination in nuclear power engineering are described. The automated information safety system should from the technical basis for this service. The information system structure is determined. The list of main directions of research and design works realized in the emergency-engineering service interests is given. It is noted that all parts of the emergency-engineering service must prepare the plants of works together with the USSR civil defense service, and they should interact in the process of accident elimination basing on coordinated organizational and technical solutions

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

Directory of Open Access Journals (Sweden)

Scheffer Gert J

2010-03-01

Full Text Available Abstract Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS and a Helicopter Emergency Medical Service (HEMS for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.

EnviroAtlas Estimated Intersection Density of Walkable Roads Web Service

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in each EnviroAtlas community....

Quantifying the key factors that create road flooding.

Science.gov (United States)

2013-01-01

Road flooding is a serious operational hazard in the low-lying areas of southern Louisiana. This hazard is especially acute for the regions emergency evacuation routes, which must be accessible by coastal residents who plan evacuations ahead of an...

Emergency medical service providers' experiences with traffic congestion.

Science.gov (United States)

Griffin, Russell; McGwin, Gerald

2013-02-01

The population's migration from urban to suburban areas has resulted in a more dispersed population and has increased traffic flow, possibly resulting in longer emergency response times. Although studies have examined the effect of response times on time to definitive care and survival, no study has addressed the possible causes of slowed response time from the point of view of emergency medical services (EMS) first responders. To assess the variables most commonly associated with increased emergency response time as described by the opinions and views of EMS first responders. A total of 500 surveys were sent to randomly selected individuals registered as first responders with the Alabama Department of Public Health, and 112 surveys were returned completed. The survey included questions regarding roadway design, response to emergency calls, in-vehicle technology aimed at decreasing travel time, and public education regarding emergency response. Respondents reported traveling on city streets most often during emergency calls, and encountering traffic more often on interstates and national highways. Traffic congestion, on average, resulted in nearly 10min extra response time. Most agreed that the most effective in-vehicle technology for reducing response time was a pre-emptive green light device; however, very few reported availability of this device in their emergency vehicles. Public education regarding how to react to approaching emergency vehicles was stated as having the greatest potential impact on reducing emergency response time. The results of the survey suggest that the best methods for reducing emergency response times are those that are easy to implement (e.g., public education). Copyright © 2013 Elsevier Inc. All rights reserved.

78 FR 801 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

Science.gov (United States)

2013-01-04

...The NHTSA announces a meeting of NEMSAC to be held in the Metropolitan Washington, DC, area. This notice announces the date, time, and location of the meeting, which will be open to the public. The purpose of NEMSAC, a nationally recognized council of emergency medical services representatives and consumers, is to provide advice and recommendations regarding Emergency Medical Services (EMS) to DOT's NHTSA and to the Federal Interagency Committee on EMS (FICEMS).

Patient expectations of emergency dental services: a qualitative interview study.

Science.gov (United States)

Anderson, R

2004-09-25

To describe the expectations of walk-in patients seeking emergency dental care out-of-hours. Consecutive patients attending two emergency dental clinics at weekends were interviewed prior to seeing the dentist. The audio-recorded interview transcripts were analysed using the "framework" method of applied qualitative data analysis. Forty-four walk-in emergency dental patients at a community-based dental clinic and a dental hospital emergency clinic at the weekend. In addition to symptom relief, the main desired outcome for emergency dental patients may be informational and psychological--especially reassurance that the problem is not serious, and reduced uncertainty about the cause of the pain. In general, patients' stated expectations for specific treatments (such as antibiotics, or tooth extraction) were not absolute: rather, they implied these expectations were conditional upon the dentist deciding they were necessary. Emergency dental services, some of which are still dominantly treatment-focused, should reflect that many emergency dental attenders want advice and reassurance as much as relief from symptoms. This reinforces the importance of effective and sympathetic dentist-patient communication within emergency or out-of-hours consultations. It also implies that dentists' skills in listening, explaining and reassuring should be captured in any patient satisfaction or outcome measure designed for this patient group.

Road transport of LWR spent fuel in the Federal Republic of Germany

International Nuclear Information System (INIS)

Bach, R.

1987-01-01

Since 1967, when fuel from LWRs was first transported by road from the Kahl reactor in the Federal Republic of Germany to the Eurochemic reprocessing plant in Belgium, a total of more than 400 road transports have been performed without any adverse effect on the environment. In the beginning, road transport was the dominant mode. However, in recent years large capacity rail flasks with a weight ranging from 80 to 110 tonnes have been put into service in order to cope with the increasing demand of transport services and to replace existing smaller flasks designed primarily for road transport. Therefore, the number of spent fuel transports by road has declined. However, road transport of heavy flasks from reactor sites without a direct rail link to a nearby rail terminal has become an important task and a number of special problems have had to be solved. The following items are discussed, with special emphasis placed on heavy load transports by road from the reactor to a nearby rail terminal: design of road transport equipment to meet the requirements of the national traffic law; application of technical and administrative procedures to meet the IAEA Regulations; transport restrictions due to overload/oversize; transfer of the flask from the reactor to the transport vehicle; handling of the flask at the rail terminal; turn-around inspection and periodic maintenance of equipment to ensure safe performance of transport; and physical protection during transport and handling at rail terminals. (author). 4 figs

Barriers and facilitators to provide effective pre-hospital trauma care for road traffic injury victims in Iran: a grounded theory approach

Directory of Open Access Journals (Sweden)

Hasselberg Marie

2010-11-01

Full Text Available Abstract Background Road traffic injuries are a major global public health problem. Improvements in pre-hospital trauma care can help minimize mortality and morbidity from road traffic injuries (RTIs worldwide, particularly in low- and middle-income countries (LMICs with a high rate of RTIs such as Iran. The current study aimed to explore pre-hospital trauma care process for RTI victims in Iran and to identify potential areas for improvements based on the experience and perception of pre-hospital trauma care professionals. Methods A qualitative study design using a grounded theory approach was selected. The data, collected via in-depth interviews with 15 pre-hospital trauma care professionals, were analyzed using the constant comparative method. Results Seven categories emerged to describe the factors that hinder or facilitate an effective pre-hospital trauma care process: (1 administration and organization, (2 staff qualifications and competences, (3 availability and distribution of resources, (4 communication and transportation, (5 involved organizations, (6 laypeople and (7 infrastructure. The core category that emerged from the other categories was defined as "interaction and common understanding". Moreover, a conceptual model was developed based on the categories. Conclusions Improving the interaction within the current pre-hospital trauma care system and building a common understanding of the role of the Emergency Medical Services (EMS emerged as key issues in the development of an effective pre-hospital trauma care process.

Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil.

Science.gov (United States)

Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thumé, Elaine; Thomaz, Erika Bárbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

2017-08-22

Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access

Understanding the assistance dynamic of the psychiatric emergency service using the fourth generation assessment

Directory of Open Access Journals (Sweden)

Aline Aparecida Buriola

2017-12-01

Full Text Available A study to comprehend the requests, concerns, and questions of professionals about the assistance dynamic of a psychiatric emergency service. We conducted a case study, using the Fourth Generation assessment method, with 15 participants. We collected data using documental analysis, semi-structured interview and observation and, we used the constant comparative method for analysis. Therefore, two thematic axes arose: a Comprehending the assistance dynamic of the Psychiatric emergency service and, b The disarticulation of the psychosocial attention network as a barrier to satisfaction with the assistance in the psychiatric emergency. We considered that the assistance dynamic in the Psychiatric Emergency extrapolated the simple, unique character of stabilizing patients with acute mental disorders, once it directs the user’s flow to the adequate treatment in the psychosocial attention network.

Self-organized natural roads for predicting traffic flow: a sensitivity study

International Nuclear Information System (INIS)

Jiang, Bin; Zhao, Sijian; Yin, Junjun

2008-01-01

In this paper, we extended road-based topological analysis to both nationwide and urban road networks, and concentrated on a sensitivity study with respect to the formation of self-organized natural roads based on the Gestalt principle of good continuity. Both annual average daily traffic (AADT) and global positioning system (GPS) data were used to correlate with a series of ranking metrics including five centrality-based metrics and two PageRank metrics. It was found that there exists a tipping point from segment-based to road-based network topology in terms of correlation between ranking metrics and their traffic. To our great surprise, (1) this correlation is significantly improved if a selfish rather than utopian strategy is adopted in forming the self-organized natural roads, and (2) point-based metrics assigned by summation into individual roads tend to have a much better correlation with traffic flow than line-based metrics. These counter-intuitive surprising findings constitute emergent properties of self-organized natural roads, which are intelligent enough for predicting traffic flow, thus shedding substantial light on the understanding of road networks and their traffic from the perspective of complex networks

Automatic Road Centerline Extraction from Imagery Using Road GPS Data

Directory of Open Access Journals (Sweden)

Chuqing Cao

2014-09-01

Full Text Available Road centerline extraction from imagery constitutes a key element in numerous geospatial applications, which has been addressed through a variety of approaches. However, most of the existing methods are not capable of dealing with challenges such as different road shapes, complex scenes, and variable resolutions. This paper presents a novel method for road centerline extraction from imagery in a fully automatic approach that addresses the aforementioned challenges by exploiting road GPS data. The proposed method combines road color feature with road GPS data to detect road centerline seed points. After global alignment of road GPS data, a novel road centerline extraction algorithm is developed to extract each individual road centerline in local regions. Through road connection, road centerline network is generated as the final output. Extensive experiments demonstrate that our proposed method can rapidly and accurately extract road centerline from remotely sensed imagery.

Emerging solutions in reference services implications for libraries in the new millennium

CERN Document Server

Edwards, John D

2013-01-01

How can you enhance reference services without adding staff?Modern law librarians are under growing pressure to keep up with new technologies, deal instantly with the demands of patrons, keep the library safe and user-friendly, and generally offer the best possible service while keeping costs down. Emerging Solutions in Reference Services: Implications for Libraries in the New Millennium is a very practical guide for coping with rapidly changing technology and increasing demands for services. Its sane, well-researched advice and suggestions can help you deal with the hectic days and

Absenteeism and its implications for nursing care in emergency services

Directory of Open Access Journals (Sweden)

Ione Carvalho Pinto

2017-11-01

Full Text Available The aim of this study was to identify the frequency of absenteeism among nursing teams and its determinants in healthcare emergency services. A cross-sectional study was carried out by means of secondary data from records of a coordination of human resources. Occurrences with 208 nursing professionals were identified. Univariate analysis was carried out with frequency calculation of the variables age, gender, professional category, workplace, and days and reasons for absenteeism. Fisher’s exact test was applied, fixing the error type I in 5%. The mean age of the participants was 47.2 years, with a prevalence of the female gender (79.8%. A total of 5,778 occurrences of absenteeism were found (mean of 28 per professional, and illness was the main determinant for absenteeism (2,671 occurrences; 46.2%. There was a prevalence of short-term absenteeism (3,020 occurrences; 52.3%. The findings observed in emergency services were similar, with a potential impact on planning, workforce, and quality of care.

Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study

Directory of Open Access Journals (Sweden)

Bigdeli Maryam

2010-07-01

Full Text Available Abstract Background Road traffic injuries (RTIs are a major public health problem, requiring concerted efforts both for their prevention and a reduction of their consequences. Timely arrival of the Emergency Medical Service (EMS at the crash scene followed by speedy victim transportation by trained personnel may reduce the RTIs' consequences. The first 60 minutes after injury occurrence - referred to as the "golden hour"- are vital for the saving of lives. The present study was designed to estimate the average of various time intervals occurring during the pre-hospital care process and to examine the differences between these time intervals as regards RTIs on urban and interurban roads. Method A retrospective cross-sectional study was designed and various time intervals in relation to pre-hospital care of RTIs identified in the ambulance dispatch centre in Urmia, Iran from 20 March 2005 to 20 March 2007. All cases which resulted in ambulance dispatches were reviewed and those that had complete data on time intervals were analyzed. Results In total, the cases of 2027 RTI victims were analysed. Of these, 61.5 % of the subjects were injured in city areas. The mean response time for city locations was 5.0 minutes, compared with 10.6 minutes for interurban road locations. The mean on-scene time on the interurban roads was longer than on city roads (9.2 vs. 6.1 minutes, p Conclusion The response, transport and total time intervals among EMS responding to RTI incidents were longer for interurban roads, compared to the city areas. More research should take place on needs-to and access-for EMS on city and interurban roads. The notification interval seems to be a hidden part of the post-crash events and indirectly affects the "golden hour" for victim management and it needs to be measured through the establishment of the surveillance systems.

Vulnerability analysis methods for road networks

Science.gov (United States)

Bíl, Michal; Vodák, Rostislav; Kubeček, Jan; Rebok, Tomáš; Svoboda, Tomáš

2014-05-01

Road networks rank among the most important lifelines of modern society. They can be damaged by either random or intentional events. Roads are also often affected by natural hazards, the impacts of which are both direct and indirect. Whereas direct impacts (e.g. roads damaged by a landslide or due to flooding) are localized in close proximity to the natural hazard occurrence, the indirect impacts can entail widespread service disabilities and considerable travel delays. The change in flows in the network may affect the population living far from the places originally impacted by the natural disaster. These effects are primarily possible due to the intrinsic nature of this system. The consequences and extent of the indirect costs also depend on the set of road links which were damaged, because the road links differ in terms of their importance. The more robust (interconnected) the road network is, the less time is usually needed to secure the serviceability of an area hit by a disaster. These kinds of networks also demonstrate a higher degree of resilience. Evaluating road network structures is therefore essential in any type of vulnerability and resilience analysis. There are a range of approaches used for evaluation of the vulnerability of a network and for identification of the weakest road links. Only few of them are, however, capable of simulating the impacts of the simultaneous closure of numerous links, which often occurs during a disaster. The primary problem is that in the case of a disaster, which usually has a large regional extent, the road network may remain disconnected. The majority of the commonly used indices use direct computation of the shortest paths or time between OD (origin - destination) pairs and therefore cannot be applied when the network breaks up into two or more components. Since extensive break-ups often occur in cases of major disasters, it is important to study the network vulnerability in these cases as well, so that appropriate

Soil geohazard mapping for improved asset management of UK local roads

Science.gov (United States)

Pritchard, O. G.; Hallett, S. H.; Farewell, T. S.

2015-09-01

Unclassified roads comprise 60 % of the road network in the United Kingdom (UK). The resilience of this locally important network is declining. It is considered by the Institution of Civil Engineers to be "at risk" and is ranked 26th in the world. Many factors contribute to the degradation and ultimate failure of particular road sections. However, several UK local authorities have identified that in drought conditions, road sections founded upon shrink-swell susceptible clay soils undergo significant deterioration compared with sections on non-susceptible soils. This arises from the local road network having little, if any, structural foundations. Consequently, droughts in East Anglia have resulted in millions of pounds of damage, leading authorities to seek emergency governmental funding. This paper assesses the use of soil-related geohazard assessments in providing soil-informed maintenance strategies for the asset management of the locally important road network of the UK. A case study draws upon the UK administrative county of Lincolnshire, where road assessment data have been analysed against mapped clay-subsidence risk. This reveals a statistically significant relationship between road condition and susceptible clay soils. Furthermore, incorporation of UKCP09 future climate projections within the geohazard models has highlighted roads likely to be at future risk of clay-related subsidence.

Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil

OpenAIRE

Rocha, Thiago Augusto Hernandes; da Silva, N?bia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, Jo?o Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thum?, Elaine; Thomaz, Erika B?rbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A.; Vissoci, Jo?o Ricardo Nickenig

2017-01-01

Background Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. Methods The present work can be classified as a c...

Systematic Review Methodology for the Fatigue in Emergency Medical Services Project

Science.gov (United States)

2018-01-11

Background: Guidance for managing fatigue in the Emergency Medical Services (EMS) setting is limited. The Fatigue in EMS Project sought to complete multiple systematic reviews guided by seven explicit research questions, assemble the best available e...

Birds and Roads: Reduced Transit for Smaller Species over Roads within an Urban Environment

Directory of Open Access Journals (Sweden)

Christopher D. Johnson

2017-05-01

Full Text Available Roads provide humans with a means of mobility between destinations, be it for transportation of goods and services or as a means of connecting with others. However, roads are also known to contribute toward a number of deleterious landscape processes, such as habitat destruction and fragmentation, pollution (e.g., chemical, noise and light and animal mortality. Few studies however have investigated their effects on avifauna. We investigated the influence of road width on movements of nearby bird assemblages in Australia by comparing crossing counts of four species guilds and sizes over roads of varying widths in Southern Brisbane. In addition, we also sought to determine the association of seasonality with species crossing richness and abundance. Species guild affiliations were based on definitions from previous literature: small forest dependent, large forest dependent, honeyeater, and urban tolerant; whereas body size classifications were arbitrarily defined: small (< 20 cm, medium (20–29 cm, and large (>30 cm. Road sites were selected based on their vegetation likeness, both within and between sites, and this was assessed using the Specht classification system. We detected strong, negative correlations between road width and forest species richness, crossing species richness and species crossing abundance. In particular, analysis of species guild classifications revealed species richness and crossing likelihoods of the small forest dependent guild to be consistently lower than those of large forest dependent, honeyeater and urban tolerant guilds. Analysis of species by body size classification yielded similar outcomes: small birds were consistently less likely to be present nearby and cross over roads of all widths compared to medium and large birds. We believe gap permeability, particularly changes in vegetation structure and complexity that may restrict a species ability to access to the gap, as well as competition and predation, play an

Triage in an adult emergency service: patient satisfaction

Directory of Open Access Journals (Sweden)

Pollyane Liliane Silva

2016-06-01

Full Text Available Abstract OBJECTIVE Assess the degree of patient satisfaction with triage in the adult emergency service of a public hospital. METHOD Exploratory, descriptive, cross-sectional study with a quantitative approach. Three hundred patients were interviewed and the data were analyzed using descriptive statistics based on sociodemographic variables and those related to patient satisfaction. RESULTS There was a predominance of women, with elementary education and a mean age of 41 years. Most of the interviewees reported being satisfied in regard to the following items: timely service, embracement, trust, environment (comfort, cleanliness and signage, humanization (courtesy, respect, and interest, timely referral/scheduling of appointments and care expectations. CONCLUSION There was a high level of patient satisfaction, evidenced by the strong association of user satisfaction with the items investigated.

A Model Curriculum for an Emergency Medical Services (EMS Rotation for Emergency Medicine Residents

Directory of Open Access Journals (Sweden)

Michael Mancera

2018-01-01

Full Text Available Audience: This EMS curriculum is designed for Emergency Medicine residents at all levels of training. Introduction: Emergency Medicine (EM physicians have routine interaction with Emergency Medical Services (EMS in their clinical practice. Additionally, the American College of Graduate Medical Education (ACGME mandates that all Emergency Medicine resident physicians receive specific training in the area of EMS.1 Historically, EMS training for EM residents has been conducted in the absence of a standardized didactic curriculum. Despite advancements in the area of prehospital training, there remains wide inconsistency in EMS training experiences among EM residency training programs.2 To our knowledge a standardized and reproducible EMS curriculum for EM residents does not exist. Objectives: The aim of this curriculum is to provide a robust learning experience for EM residents around prehospital care and EMS that fulfills the ACGME requirements and which can be easily replicated and implemented in a variety of EM residency training programs. Method: The educational strategies used in this curriculum include didactics, asynchronous learning through online modules and a focused reading list, experiential learning through ride-alongs, structured small group discussion, supervised medical command shifts, and mentored practice in organizing and delivering didactics to EMS providers.

Police referrals at the psychiatric emergency service in Taiwan.

Science.gov (United States)

Wang, Jen-Pang; Wu, Chia-Yi; Chiu, Chih-Chiang; Yang, Tsu-Hui; Liu, Tzong-Hsien; Chou, Pesus

2015-12-01

The police are the frontline workers in crisis situations involving patients with severe mental illness and act as a primary referral source for psychiatric emergency services (PES) in the community. The aims of this study were to investigate the distribution and characteristics of police referral among psychiatric patients in Taiwan. The study cohort consisted of patients who visited the PES of Taipei City Psychiatric Center from January 2009 to December 2010. The associations between the factors of demographics, clinical characteristics, and psychiatric service utilization and police referral were evaluated. Among the 7656 psychiatric emergency visits, 3029 (39.6%) were referred by the police. These patients referred by police were more likely to be male and aged between 30 to 49 years. Clinical factors related to police referrals including a higher triage assessment level, chief problems included violence, disturbance, substance use, less anxiety, and a diagnosis of unspecified psychosis. The triage assessment level and chief problems assessed by nurses were major predictors. These patients tended to be referred from the catchment area and during the nighttime shift, were discharged during the daytime shift, and stayed longer in the PES. Disposition arrangements such as discharge against medical advice and involuntary admission were also associated with police referrals. Patients referred by the police to the PES were those with more severe psychiatric problems and illnesses assessed by psychiatric nurses and psychiatrists. They tended to have more complex service utilization at the PES. © 2015 Wiley Publishing Asia Pty Ltd.

36 CFR 223.84 - Small business bid form provisions on sales with specified road construction.

Science.gov (United States)

2010-07-01

... provisions on sales with specified road construction. 223.84 Section 223.84 Parks, Forests, and Public... specified road construction. For each sale described in § 223.82(b), the bid form must include provision for a small business concern: (a) To elect road construction by the Forest Service and where such...

Physiological scoring: an aid to emergency medical services transport decisions?

Science.gov (United States)

Challen, Kirsty; Walter, Darren

2010-01-01

Attendance at UK emergency departments is rising steadily despite the proliferation of alternative unscheduled care providers. Evidence is mixed on the willingness of emergency medical services (EMS) providers to decline to transport patients and the safety of incorporating such an option into EMS provision. Physiologically based Early Warning Scores are in use in many hospitals and emergency departments, but not yet have been proven to be of benefit in the prehospital arena. The use of a physiological-social scoring system could safely identify patients calling EMS who might be diverted from the emergency department to an alternative, unscheduled, care provider. This was a retrospective, cohort study of patients with a presenting complaint of "shortness of breath" or "difficulty breathing" transported to the emergency department by EMS. Retrospective calculation of a physiological social score (PMEWS) based on first recorded data from EMS records was performed. Outcome measures of hospital admission and need for physiologically stabilizing treatment in the emergency department also were performed. A total of 215 records were analyzed. One hundred thirty-nine (65%) patients were admitted from the emergency department or received physiologically stabilizing treatment in the emergency department. Area Under the Receiver Operating Characteristic Curve (AUROC) for hospital admission was 0.697 and for admission or physiologically stabilizing treatment was 0.710. No patient scoringemergency department to alternative, unscheduled, care providers.

Emerging indirect and long-term road salt effects on ecosystems.

Science.gov (United States)

Findlay, Stuart E G; Kelly, Victoria R

2011-03-01

Widespread use of salts as deicing agents on roads has been perceived as a significant source of environmental and economic damage. Early studies focused on near-road and short-term effects where concentrations can exceed several grams per liter. Evidence is accumulating that the use of salts has significant effects over broader areas, longer time frames, and is affecting a range of ecological processes. Concentrations of NaCl can be elevated throughout an ecosystem to >100 mg Cl(-) /L, which may have nonlethal and possibly subtle effects on sensitive life stages of several organisms. NaCl seems subject to retention within terrestrial and aquatic ecosystems, thus prolonging the actual duration of exposure and leading to elevated warm-season concentrations when reproduction may be occurring or other sensitive life stages are present. Many of the alternatives to NaCl reduce some of these negative effects, although are currently cost prohibitive for large-scale use. Some techniques for managing application rates are improvements in technology, while others involve novel mixtures of organic compounds that may have new environmental consequences. The increasing evidence of these widespread and persistent environmental consequences must be brought into decisions on deicing procedures. © 2011 New York Academy of Sciences.

Injury patterns in road traffic victims comparing road user categories: Analysis of 811 consecutive cases in the emergency department of a level I institution in a low-income country

Directory of Open Access Journals (Sweden)

A. Chichom-Mefire

popularization of motorized two-wheelers who are exposed to collision with tourist cars. Victims mostly tend to develop external lesions resulting in minor injuries. However, there is need to emphasize on the need to associate to current preventive measures an appropriate policy of management of the injured. Keywords: Road traffic victims, Pattern of injury, Emergency department, Laquintinie hospital, Road user category, Low-income country, Outcome

Roads at risk: traffic detours from debris flows in southern Norway

Science.gov (United States)

Meyer, N. K.; Schwanghart, W.; Korup, O.; Nadim, F.

2015-05-01

Globalisation and interregional exchange of people, goods, and services has boosted the importance of and reliance on all kinds of transport networks. The linear structure of road networks is especially sensitive to natural hazards. In southern Norway, steep topography and extreme weather events promote frequent traffic disruption caused by debris flows. Topographic susceptibility and trigger frequency maps serve as input into a hazard appraisal at the scale of first-order catchments to quantify the impact of debris flows on the road network in terms of a failure likelihood of each link connecting two network vertices, e.g. road junctions. We compute total additional traffic loads as a function of traffic volume and excess distance, i.e. the extra length of an alternative path connecting two previously disrupted network vertices using a shortest-path algorithm. Our risk metric of link failure is the total additional annual traffic load, expressed as vehicle kilometres, because of debris-flow-related road closures. We present two scenarios demonstrating the impact of debris flows on the road network and quantify the associated path-failure likelihood between major cities in southern Norway. The scenarios indicate that major routes crossing the central and north-western part of the study area are associated with high link-failure risk. Yet options for detours on major routes are manifold and incur only little additional costs provided that drivers are sufficiently well informed about road closures. Our risk estimates may be of importance to road network managers and transport companies relying on speedy delivery of services and goods.

The Viability of Mobile Services (SMS and Cell Broadcast in Emergency Management Solutions: An Exploratory Study

Directory of Open Access Journals (Sweden)

Mahmoud Al-dalahmeh

2018-01-01

Full Text Available In this paper the path forward in location-based mobile phone warning systems is given against a concise backdrop of their deployment worldwide. Of relevance here is (i how the systems are implemented using legislation, contractual service level agreement instruments or a hybrid approach, (ii whether or not governments who deploy these systems will carry the cost of the deployment during an emergency or disaster, and (iii whether or not carrier participation is mandated. Of particular importance are also the underlying technologies of this kind of emergency systems. To date, the short message service and cell broadcast service have been the main technologies to be utilised by governments in the application of location-based services in modern emergency management solutions. However, these technologies will most certainly be superseded by newer, more powerful capabilities. A comprehensive list of requirements for the future location-based emergency systems is presented also in this paper. In essence, these are recommendations to be adhered to if robust solutions using new technologies are to be deployed in a nation state.

Absence and Need for Fatigue Risk Management in Emergency Medical Services

Science.gov (United States)

2018-01-11

Fatigue in the Emergency Medical Services (EMS) workplace is widespread. Reports of fatigue-related events that involve ambulance crashes, personnel injury, patient death, and other negative outcomes are on the rise (1-7). There is growing evidence t...

Road user behaviour changes following a self-explaining roads intervention.

Science.gov (United States)

Mackie, Hamish W; Charlton, Samuel G; Baas, Peter H; Villasenor, Pablo C

2013-01-01

The self-explaining roads (SER) approach uses road designs that evoke correct expectations and driving behaviours from road users to create a safe and user-friendly road network. Following the implementation of an SER process and retrofitting of local and collector roads in a suburb within Auckland City, lower speeds on local roads and less variation in speed on both local and collector roads were achieved, along with a closer match between actual and perceived safe speeds. Preliminary analyses of crash data shows that the project has resulted in a 30% reduction crash numbers and an 86% reduction in crash costs per annum, since the road changes were completed. In order to further understand the outcomes from this project, a study was carried out to measure the effects of the SER intervention on the activity and behaviour of all road users. Video was collected over nine separate days, at nine different locations, both before and after SER construction. Road user behaviour categories were developed for all potential road users at different location types and then used to code the video data. Following SER construction, on local roads there was a relatively higher proportion of pedestrians, less uniformity in vehicle lane keeping and less indicating by motorists along with less through traffic, reflecting a more informal/low speed local road environment. Pedestrians were less constrained on local roads following SER construction, possibly reflecting a perceptually safer and more user-friendly environment. These behaviours were not generally evident on collector roads, a trend also shown by the previous study of speed changes. Given that one of the objectives of SER is to match road user behaviour with functionally different road categories, the road user behaviour differences demonstrated on different road types within the SER trial area provides further reinforcement of a successful SER trial. Copyright © 2012 Elsevier Ltd. All rights reserved.

Tethered Balloon Technology in Design Solutions for Rescue and Relief Team Emergency Communication Services.

Science.gov (United States)

Alsamhi, Saeed Hamood; Ansari, Mohd Samar; Ma, Ou; Almalki, Faris; Gupta, Sachin Kumar

2018-05-23

The actions taken at the initial times of a disaster are critical. Catastrophe occurs because of terrorist acts or natural hazards which have the potential to disrupt the infrastructure of wireless communication networks. Therefore, essential emergency functions such as search, rescue, and recovery operations during a catastrophic event will be disabled. We propose tethered balloon technology to provide efficient emergency communication services and reduce casualty mortality and morbidity for disaster recovery. The tethered balloon is an actively developed research area and a simple solution to support the performance, facilities, and services of emergency medical communication. The most critical requirement for rescue and relief teams is having a higher quality of communication services which enables them to save people's lives. Using our proposed technology, it has been reported that the performance of rescue and relief teams significantly improved. OPNET Modeler 14.5 is used for a network simulated with the help of ad hoc tools (Disaster Med Public Health Preparedness. 2018;page 1 of 8).

Verification of road databases using multiple road models

Science.gov (United States)

Ziems, Marcel; Rottensteiner, Franz; Heipke, Christian

2017-08-01

In this paper a new approach for automatic road database verification based on remote sensing images is presented. In contrast to existing methods, the applicability of the new approach is not restricted to specific road types, context areas or geographic regions. This is achieved by combining several state-of-the-art road detection and road verification approaches that work well under different circumstances. Each one serves as an independent module representing a unique road model and a specific processing strategy. All modules provide independent solutions for the verification problem of each road object stored in the database in form of two probability distributions, the first one for the state of a database object (correct or incorrect), and a second one for the state of the underlying road model (applicable or not applicable). In accordance with the Dempster-Shafer Theory, both distributions are mapped to a new state space comprising the classes correct, incorrect and unknown. Statistical reasoning is applied to obtain the optimal state of a road object. A comparison with state-of-the-art road detection approaches using benchmark datasets shows that in general the proposed approach provides results with larger completeness. Additional experiments reveal that based on the proposed method a highly reliable semi-automatic approach for road data base verification can be designed.

The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: a systematic review.

Science.gov (United States)

Jennings, Natasha; Clifford, Stuart; Fox, Amanda R; O'Connell, Jane; Gardner, Glenn

2015-01-01

To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. The delivery of quality care in the emergency department is emerging as one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. A comprehensive search of four electronic databases from 2006 to 2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. A three step approach was used. Following a comprehensive search, two reviewers assessed all identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data were extracted using standardised tools. Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding outcomes of a cost benefit analysis. Synthesis of the available research attempts to provide an

38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

Science.gov (United States)

2010-07-01

... for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1000 Payment...

77 FR 3123 - Special Regulations, Areas of the National Park System, Cape Hatteras National Seashore-Off-Road...

Science.gov (United States)

2012-01-23

..., Areas of the National Park System, Cape Hatteras National Seashore--Off-Road Vehicle Management AGENCY: National Park Service, Interior. ACTION: Final rule. SUMMARY: This rule designates off-road vehicle (ORV... operation of motor vehicles off of roads within areas [[Page 3124

Reporting Helicopter Emergency Medical Services in Major Incidents

DEFF Research Database (Denmark)

Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M

2016-01-01

OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...... variables were determined by consensus. These variables were formatted in a template with 4 main categories: HEMS background information, the major incident characteristics relevant to HEMS, the HEMS response to the major incident, and the key lessons learned. CONCLUSION: Based on opinions from European...

VIRMS: A VEHICLE INFORMATION AND ROAD MONITORING SYSTEM

Directory of Open Access Journals (Sweden)

Fabio Arnéz

2014-01-01

Full Text Available Intelligent Transport Systems (ITS are emerging technologies for building collaborative vehicular networks to increase road safety and to improve driver’s experience. Unfortunately these technologies require heavy infrastructure to be deployed inside and outside the vehicle that is difficult to extend. In this article we present VIRMS (Vehicle Information and Road Monitoring System, an ITS that is based on low-cost and small footprint client and server infrastructure that was designed to increase vehicular security and reduce accident rates along highways. The VIRMS remote client device is an on board vehicle electronic device that gathers data from sensors and processes the collected data that is sent to the VIRMS server in order to keep drivers informed with precise context information through the detection and identification of events (accidents, traffic jams, bad weather conditions, etc. along the roads. A prototype running tests on Bolivian highways show that VIRMS can give a technological answer to a real problem where road safety is one of the highest issues and cause of mortality.

Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services

Science.gov (United States)

2018-01-11

Background: Administrators of Emergency Medical Services (EMS) operations lack guidance on how to mitigate workplace fatigue, which affects greater than half of all EMS personnel. The primary objective of the Fatigue in EMS Project was to create an e...

Small rural emergency services can electronically collect accurate episode-level data: A cross-sectional study.

Science.gov (United States)

Dawson, Samantha L; Baker, Tim; Salzman, Scott

2015-04-01

There is little evidence that useful electronic data could be collected at Australian small rural emergency services. If in future their funding model changed to the Activity-Based Funding model, then they would need to collect and submit more data. We determine whether it is possible to collect episode-level data at six small rural emergency services and quantify the accuracy of eight fields. A prospective cross-sectional study. South-West Victoria, Australia. Six small rural emergency services. We collected and audited episode-level emergency data from participating services between 1 February 2011 and 31 January 2012. A random sample of these data were audited monthly. Research assistants located at each service supported data entry and audited data accuracy for four hours per week. Rates for data completeness, accuracy and total accuracy were calculated using audit data. Episode-level data were collected for 20 224 presentations across six facilities. The audit dataset consisted of 8.5% (1504/17 627) of presentations from five facilities. For all fields audited, the accuracy of entered data was high (>93%).Triage category was deemed appropriate for 95.9% (95% confidence interval (CI): 94.9-96.9%) of the patient records reviewed. Some procedures were missing (28.7%, 95%CI: 27.2-30.3%). No significant improvement in data accuracy over 12 months was observed. All six services collected useful episode-level data for 12-months with four hours per week of assistance. Data entry accuracy was high for all fields audited, and data entry completeness was low for procedures. © 2015 National Rural Health Alliance Inc.

Strabo's roads

DEFF Research Database (Denmark)

Bekker-Nielsen, Tønnes

2017-01-01

in the Geography, and the world-view, of Strabo. Strabo did not take much interest in roads as artefacts or monuments, in the technology of road construction, or in the mythological and historical background of individual roads. He is primarily interested in roads from a functional point of view. For the general......To ancient geographers, roads were important not only as arteries of communication, but also as sources of information, since mileages measured along the Roman highways were among the very few precise distances available to the ancient geographer. This chapter explores the place of roads...... or the statesman, roads provide routes of communication; for the systematic geographer, they provide measured distances and directions. Through case studies of Spain, Gaul, Italy, Greece and Anatolia, this chapter attempts to reach a better understanding of the place of roads in Strabo’s universe, especially two...

Where there are no emergency medical services-prehospital care for the injured in Mumbai, India.

Science.gov (United States)

Roy, Nobhojit; Murlidhar, V; Chowdhury, Ritam; Patil, Sandeep B; Supe, Priyanka A; Vaishnav, Poonam D; Vatkar, Arvind

2010-01-01

In a populous city like Mumbai, which lacks an organized prehospital emergency medical services (EMS) system, there exists an informal network through which victims arrive at the trauma center. This baseline study describes the prehospital care and transportation that currently is available in Mumbai. A prospective trauma database was created by interviewing 170 randomly selected patients from a total of 454 admitted over a two-month period (July-August 2005) at a Level-I, urban, trauma center. The injured victim in Mumbai usually is rescued by a good Samaritan passer-by (43.5%) and contrary to popular belief, helped by the police (89.7%). Almost immediately after rescue, the victim begins transport to the hospital. No one waits for the EMS ambulance to arrive, as there is none. A taxi cab is the most popular substitute for the ambulance (39.3%). The trauma patient in India usually is a young man in his late-twenties, from a lower socioeconomic class. He mostly finds himself in a government hospital, as private hospitals are reluctant to provide trauma care to the seriously injured. The injured who do receive prehospital care receive inadequate and inappropriate care due to the high cost of consumables in resuscitation, and in part due to the providers' lack of training in emergency care. Those who were more likely to receive prehospital care suffered from road traffic injuries (odds ratio (OR) = 2.3) and those transported by government ambulances (OR = 10.83), as compared to railway accident victims (OR = 0 .41) and those who came by taxi (OR = 0.54). Currently, as a result of not having an EMS system, prehospital care is a citizen responsibility using societal networks. It is easy to eliminate this system and shift the responsibility to the state. The moot point is whether the state-funded EMS system will be robust enough in a resource-poor setting in which public hospitals are poorly funded. Considering the high funding cost of EMS systems in developed countries

Alternatives to conventional gravel wearing courses on low volume rural roads: Phase 1

CSIR Research Space (South Africa)

Paige-Green, P

2003-01-01

Full Text Available Adviser Abstract Gundo Lashu, the ‘Labour Intensive Rural Roads Maintenance Programme’ that is currently being implemented in Limpopo Province, South Africa has set out to train 24 emerging contractors in rehabilitation of rural gravel roads. All.... The proposal is to treat the in situ materials and sand with a diluted emulsion and a nominal cement application (to assist with breaking of the emulsion) and surface the road with an Otta seal. The aggregate for the Otta seal can be obtained form...

The road maintenance funding models in Indonesia use earmarked tax

Science.gov (United States)

Gultom, Tiopan Henry M.; Tamin, Ofyar Z.; Sjafruddin, Ade; Pradono

2017-11-01

One of the solutions to get a sustainable road maintenance fund is to separate road sector revenue from other accounts, afterward, form a specific account for road maintenance. In 2001, Antameng and the Ministry of Public Works proposed a road fund model in Indonesia. Sources of the road funds proposal was a tariff formed on the nominal total tax. The policy of road funds was proposed to finance the road network maintenance of districts and provincials. This research aims to create a policy model of road maintenance funds in Indonesia using an earmarked tax mechanism. The research method is qualitative research, with data collection techniques are triangulation. Interview methods conducted were semi-structured. Strength, Weakness, Opportunities, and Threat from every part of the models were showen on the survey format. Respondents were representative of executives who involved directly against the financing of road maintenance. Validation model conducted by a discussion panel, it was called the Focus Group Discussion (FGD). The FGD involved all selected respondents. Road maintenance financing model that most appropriately applied in Indonesia was a model of revenue source use an earmarked PBBKB, PKB and PPnBM. Revenue collection mechanism was added tariff of registered vehicle tax (PKB), Vehicle Fuel Tax (PBBKB) and the luxury vehicle sales tax (PPnBM). The funds are managed at the provincial level by a public service agency.

3D-FEM Analysis on Geogrid Reinforced Flexible Pavement Roads

Science.gov (United States)

Calvarano, Lidia Sarah; Palamara, Rocco; Leonardi, Giovanni; Moraci, Nicola

2017-12-01

Nowadays, the need to increase pavement service life, guarantee high performance, reduce service and maintenance costs has been turned a greater attention on the use of reinforcements. This paper presents findings of a numerical investigation on geogrid reinforced flexible pavement roads, under wheel traffic loads, using a three-dimensional Finite Element Method (FEM). The results obtained show the effectiveness of glass fibre grids as reinforcement which, with appropriate design and correct installation, by improving interface shear resistance, can be used to expand the performance of flexible pavements in different ways: by increasing the road service life providing a relevant contribution against superficial rutting or by decreasing the construction costs due to the reduction in the reinforced HMA layer thickness and thus of mineral aggregate required for its construction.

Road profile estimation of city roads using DTPS

Science.gov (United States)

Wang, Qi; McDaniel, J. Gregory; Sun, Nian X.; Wang, Ming L.

2013-04-01

This work presents a non-destructive and non-contact acoustic sensing approach for measuring road profile of road and bridge deck with vehicles running at normal speed without stopping traffic. This approach uses an instantaneous and real-time dynamic tire pressure sensor (DTPS) that can measure dynamic response of the tire-road interaction and increases the efficiency of currently used road profile measuring systems with vehicle body-mounted profilers and axle-mounted accelerometers. In this work, a prototype of real-time DTPS system has been developed and demonstrated on a testing van at speeds from 5 to 80 miles per hour (mph). A data analysis algorithm has been developed to remove axle dynamic motions from the measured DTPS data and to find the transfer function between dynamic tire pressure change and the road profile. Field test has been performed to estimate road profiles. The road profile resolution is approximately 5 to 10 cm in width and sensitivity is 0. 3 cm for the height road surface features at driving speeds of 5 to 80 mph.

Nearest Neighbor Queries in Road Networks

DEFF Research Database (Denmark)

Jensen, Christian Søndergaard; Kolar, Jan; Pedersen, Torben Bach

2003-01-01

in road networks. Such queries may be of use in many services. Specifically, we present an easily implementable data model that serves well as a foundation for such queries. We also present the design of a prototype system that implements the queries based on the data model. The algorithm used...

Provision of prehospital emergency medical services in Punjab, Pakistan: Case study of a public sector provider.

Science.gov (United States)

Sriram, Veena M; Naseer, Rizwan; Hyder, Adnan A

2017-12-01

The availability and quality of emergency medical services in low- and middle-income countries, including Pakistan, are extremely limited. New models for prehospital emergency medical services provision have recently emerged across multiple sectors, and research on these models is urgently needed to inform current and future emergency medical services systems in low-resource settings. The objective of this case study was to provide a comprehensive description of the organizational structure and service delivery model of a public sector provider in the Punjab Province of Pakistan, Rescue 1122, with a focus on operations in Lahore. We used case study methodology to systematically describe the organizational model of Rescue 1122. Qualitative data were collected during an in-person site visit to Lahore in June 2013. Three sources were utilized-semi-structured in-depth interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. Rescue 1122 is based on a legal framework that provides public financing for EMS, resulting in financial stability for the service. The organization has also reportedly taken positive steps in engaging with communities, and in coordinating across EMS, fire and rescue. We noted benefits and challenges in scaling up the service to all districts in Punjab. Finally, some areas of improvement include supply chain management and expanded data utilization. Our case study highlights key components of the model, areas for strengthening, and opportunities for further research. Rescue 1122 provides an example of a government-financed and operated emergency medical system in a low-resource setting. Copyright © 2017. Published by Elsevier Inc.

[Factors related to patient satisfaction with hospital emergency services].

Science.gov (United States)

Parra Hidalgo, Pedro; Bermejo Alegría, Rosa María; Más Castillo, Adelia; Hidalgo Montesinos, María Dolores; Gomis Cebrián, Rafael; Calle Urra, José Eduardo

2012-01-01

To determine the perceived quality variables related to satisfaction and to identify the influence of sociodemographic factors on user satisfaction with hospital emergencies. A telephone survey was conducted with a specifically designed questionnaire for use in a sample of 3,600 users of hospital emergency services in nine public hospitals in 2008 and 2009. The adjusted model including all perceived quality and sociodemographic variables explained 47.1% of the variance (adjusted R(2)). Of all the independent variables included, only eight were significant in predicting the level of patient satisfaction. These variables were related to the patient's opinion of the relationship with medical staff (p = 0.041), nurses' and porters' professionalism (p = 0.010 and 0.022), infrastructure (cleanliness and comfort) (p = 0.033 and 0.008), information received at discharge (p = 0.000), waiting time in the emergency department (p = 0.000) and the perception of treatment-diagnosis without failure (p = 0.028). The variables influencing emergency patients' satisfaction were determined, allowing areas where corrective action could be introduced to be identified. In addition, possible confounding factors that should be controlled for when comparing results among distinct hospitals were identified. The emergency satisfaction questionnaire is a useful instrument to evaluate and improve quality of care. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

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

NARCIS (Netherlands)

Garner, A.A. (Alan A.); P.L. van den Berg (Pieter)

2017-01-01

textabstractBackground: 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

Usage of psychiatric emergency services by asylum seekers

DEFF Research Database (Denmark)

Reko, Amra; Bech, Per; Wohlert, Cathrine

2015-01-01

predominantly male and married. The group consisted primarily (61%) of failed asylum seekers. Most patients (81%) presented with relevant mental health problems. The main reasons for presenting to the acute psychiatric emergency service were suicidal ideation and/or behaviour (60%). The most frequent diagnosis...... by asylum seekers in Denmark shows some of the acute mental health needs asylum seekers present with. The findings of high levels of suicidal ideation and possible diagnostic difficulties are discussed, as well as possible improvements of the referral and psychiatric evaluation processes....

Case Study – Idling Reduction Technologies for Emergency Service Vehicles

Energy Technology Data Exchange (ETDEWEB)

Laughlin, Michael [Argonne National Lab. (ANL), Argonne, IL (United States); Owens, Russell J. [Argonne National Lab. (ANL), Argonne, IL (United States)

2016-01-01

This case study explores the use of idle reduction technologies (IRTs) on emergency service vehicles in police, fire, and ambulance applications. Various commercially available IRT systems and approaches can decrease, or ultimately eliminate, engine idling. Fleets will thus save money on fuel, and will also decrease their criteria pollutant emissions, greenhouse gas emissions, and noise.

Measuring disaster preparedness of local emergency medical services agencies

OpenAIRE

Elliott, Ross W.

2010-01-01

CHDS State/Local Approved for public release; distribution is unlimited Emergency Medical Services (EMS) plays a key role in disaster response. Yet, determining how much preparedness is enough to achieve an acceptable level of preparedness is challenging. After conducting an extensive literature review, it is evident no nationally accepted method exists to evaluate an EMS system's level of disaster preparedness systematically. Research was conducted to define the skills and equipmen...

Mobility and Access for Off-Road Rural Farmers in West-Akim District

African Journals Online (AJOL)

The study is on the rural transportation problem in Ghana and its consequences on the rural people, especially those who live in off road villages (villages that do not have access to regular transportation systems). The study specifically discusses the failure of the existing road transport network to provide sufficient services ...

Educational topics for school from the perspective of professionals in the Mobile Emergency Service.

Science.gov (United States)

Mota, Larissa Larie; Andrade, Selma Regina de

2016-06-01

To systematize, with professionals from the Mobile Emergency Care Service of Santa Catarina municipality, the main issues for the development of an educational tool of attention to the emergency room, dedicated to the school-age population. Qualitative study, conducted through meetings in the focus group format, with 19 professionals who develop their activities in the city Emergency Mobile Emergency Service. Data were categorized and analyzed using thematic analysis technique. The contents discussed at the meetings were grouped into four thematic categories: The Mobile Emergency Service and the school: education and health promotion for children; As the Mobile Emergency Care Service works: What is important to know ?; Something's wrong, what now? and; We are nearly finished, give your opinion. The specific issues arising from the meetings contributed to the production of an educational tool on the activities of the Mobile Emergency Service, which may be used by the School Health Program to promote health education in the care area to the emergency room with the population schoolchildren. Sistematizar, junto aos profissionais do Serviço de Atendimento Móvel de Urgência de um município catarinense, os principais temas para a elaboração de um instrumento educativo sobre atenção às urgências, dedicado à população em idade escolar. Estudo qualitativo, realizado por meio de encontros no formato de grupo focal, com 19 profissionais que desenvolvem suas atividades no Serviço de Atendimento Móvel de Urgência municipal. Os dados foram categorizados e analisados com a técnica de análise temática. Os conteúdos debatidos nos encontros foram agrupados em quatro categorias temáticas: O Serviço de Atendimento Móvel de Urgência e a escola: educação e promoção da saúde para as crianças; Como o Serviço de Atendimento Móvel de Urgência funciona: o que é importante saber?; Tem algo errado, e agora? e; Estamos quase concluindo, dê sua opinião. Os

A spatial DB model to simulate the road network efficiency in hydrogeological emergency

Science.gov (United States)

Michele, Mangiameli; Giuseppe, Mussumeci

2015-12-01

We deal with the theme of the simulation of risk analysis using a technological approach based on the integration of exclusively free and open source tools: PostgreSQL as Database Management System (DBMS) and Quantum GIS-GRASS as Geographic Information System (GIS) platform. The case study is represented by a seismic land in Sicily characterized by steep slopes and frequent instability phenomena. This area includes a city of about 30.000 inhabitants (Enna) that lies on the top of a mountain at about 990 m a.s.l.. The access to the city is assured by few and very winding roads that are also highly vulnerable to seismic and hydrogeological hazards. When exceptional rainfall events occur, the loss of efficiency of these roads should compromise timeliness and effectiveness of rescue operations. The data of the sample area have been structured into the adopted DBMS, and the connection to the GIS functionalities allows simulating the exceptional events. We analyzed the hazard, vulnerability and exposure related to these events and calculated the final risk defining three classes for each scenario: low (L), medium (M) and high (H). This study can be a valuable tool to prioritize risk levels and set priorities for intervention to the main road networks..

A spatial DB model to simulate the road network efficiency in hydrogeological emergency

International Nuclear Information System (INIS)

Michele, Mangiameli; Giuseppe, Mussumeci

2015-01-01

We deal with the theme of the simulation of risk analysis using a technological approach based on the integration of exclusively free and open source tools: PostgreSQL as Database Management System (DBMS) and Quantum GIS-GRASS as Geographic Information System (GIS) platform. The case study is represented by a seismic land in Sicily characterized by steep slopes and frequent instability phenomena. This area includes a city of about 30.000 inhabitants (Enna) that lies on the top of a mountain at about 990 m a.s.l.. The access to the city is assured by few and very winding roads that are also highly vulnerable to seismic and hydrogeological hazards. When exceptional rainfall events occur, the loss of efficiency of these roads should compromise timeliness and effectiveness of rescue operations. The data of the sample area have been structured into the adopted DBMS, and the connection to the GIS functionalities allows simulating the exceptional events. We analyzed the hazard, vulnerability and exposure related to these events and calculated the final risk defining three classes for each scenario: low (L), medium (M) and high (H). This study can be a valuable tool to prioritize risk levels and set priorities for intervention to the main road networks.

A spatial DB model to simulate the road network efficiency in hydrogeological emergency

Energy Technology Data Exchange (ETDEWEB)

Michele, Mangiameli, E-mail: michele.mangiameli@dica.unict.it; Giuseppe, Mussumeci [Dept. of Civil Engineering and Architecture, University of Catania, Catania (Italy)

2015-12-31

We deal with the theme of the simulation of risk analysis using a technological approach based on the integration of exclusively free and open source tools: PostgreSQL as Database Management System (DBMS) and Quantum GIS-GRASS as Geographic Information System (GIS) platform. The case study is represented by a seismic land in Sicily characterized by steep slopes and frequent instability phenomena. This area includes a city of about 30.000 inhabitants (Enna) that lies on the top of a mountain at about 990 m a.s.l.. The access to the city is assured by few and very winding roads that are also highly vulnerable to seismic and hydrogeological hazards. When exceptional rainfall events occur, the loss of efficiency of these roads should compromise timeliness and effectiveness of rescue operations. The data of the sample area have been structured into the adopted DBMS, and the connection to the GIS functionalities allows simulating the exceptional events. We analyzed the hazard, vulnerability and exposure related to these events and calculated the final risk defining three classes for each scenario: low (L), medium (M) and high (H). This study can be a valuable tool to prioritize risk levels and set priorities for intervention to the main road networks.

Road network - land use interaction model: Malang City in Indonesian case

Science.gov (United States)

Waloejo, B. S.

2017-06-01

Urban population in Indonesia is significantly increasing from 44% of total population in 2002 to approximately 60% in 2015. Rapid population growth has resulted in rapid urban land use changes. The problems became more complicated since the changes created mixed use development along the main urban corridors that resulted in higher trip generation and attraction while urban land very limited that made road widening and creation of new road less possible. This led to an accumulation of movement, worse road’s level of service and congestion in the main urban corridor. The aims of the research are to analyse trip generation/attraction of the mixed- land uses of the main corridors Malang City; and to formulate road network - land use interaction model in the case of Malang (a nearly 1 million population city in 2015). The selected corridors in Malang City a main road in the west district of Malang City - Indonesia. Correlational method (Pearson Product Moment) and regression method (stepwise, anova for land use’s trip generation/attraction), and analysis of road’s level of service (LOS), using Indonesian Road Capacity Manual, are employed in this research. The research formulated the interaction model as: \\begin{eqnarray}\\begin{array}{lll}{V}{total} & = & \\displaystyle \\sum {V}{internal}+\\displaystyle \\sum {V}{external} {Where}\\ \\displaystyle \\sum {V}{internal} & = & {e}{residential}{Y}{residential}+{e}{schools}{Y}{schools}+{e}{unis}{Y}{unis}+{e}{offices}{Y}{offices}+{e}{hospital}{Y}{hospital}+{e}{chemists}{Y}{chemists}+{e}{commercial}{Y}{commercial}+{e}{market}{Y}{market}+{e}{fuel {station}}{Y}{fuel {station}}+{e}{bus {station}}{Y}{bus {station}} {and}\\ \\displaystyle \\sum {V}{external} & = & \\displaystyle \\sum {V}{local {roads}}+{V}{continous {traffic} {flow}}\\end{array}\\end{eqnarray} The research showed that V_total=23,033 car unit/day (internal) + 32,746 car unit/day (external) = 55,779 car unit/day. The trip higher than the road’s capacity

An anthropological analysis on the casuistry of the emergency medical service

Directory of Open Access Journals (Sweden)

Baciu Adina

2014-01-01

Full Text Available The objective of this study is to observe the contribution of the current distribution of diseases in a group of patients from the urban area, considering their sex and age, contribution which is visible in the emergency medical service and the importance of the computed-tomography in the process of diagnosing. This cross-sectional study was taken during two months in the emergency medical service of Bucharest, studying a group of 600 patients (236 women, 364 men, 1-92 years of age, based on the diagnostics agreed when the subjects concerned had been hospitalized and the computed-tomography had already completed. The results were processed using statistical methods. 27.12% of women involved were diagnosed with tumor conditions and 20.60% of the men involved were diagnosed with CCT. 27.78% of men above 80 years of age usually need emergency medical services because of intracranial expansive processes and cerebral vascular accidents (strokes. The percentage of women (55.17% having tumors is higher than that of men included in the study (44.83%, the difference being statistically significant (p<0.05. This study reveals that men under the age of 60 and women under the age of 40 are affected by traumas, in comparison with the people of both sexes over this age, for whom the most frequent diseases visible are tumors. Consequently, we consider that it is necessary to promote the primary prevention method, to fight the risk factors, so that such severe conditions are avoided.

Is road safety management linked to road safety performance?

Science.gov (United States)

Papadimitriou, Eleonora; Yannis, George

2013-10-01

This research aims to explore the relationship between road safety management and road safety performance at country level. For that purpose, an appropriate theoretical framework is selected, namely the 'SUNflower' pyramid, which describes road safety management systems in terms of a five-level hierarchy: (i) structure and culture, (ii) programmes and measures, (iii) 'intermediate' outcomes'--safety performance indicators (SPIs), (iv) final outcomes--fatalities and injuries, and (v) social costs. For each layer of the pyramid, a composite indicator is implemented, on the basis of data for 30 European countries. Especially as regards road safety management indicators, these are estimated on the basis of Categorical Principal Component Analysis upon the responses of a dedicated road safety management questionnaire, jointly created and dispatched by the ETSC/PIN group and the 'DaCoTA' research project. Then, quasi-Poisson models and Beta regression models are developed for linking road safety management indicators and other indicators (i.e. background characteristics, SPIs) with road safety performance. In this context, different indicators of road safety performance are explored: mortality and fatality rates, percentage reduction in fatalities over a given period, a composite indicator of road safety final outcomes, and a composite indicator of 'intermediate' outcomes (SPIs). The results of the analyses suggest that road safety management can be described on the basis of three composite indicators: "vision and strategy", "budget, evaluation and reporting", and "measurement of road user attitudes and behaviours". Moreover, no direct statistical relationship could be established between road safety management indicators and final outcomes. However, a statistical relationship was found between road safety management and 'intermediate' outcomes, which were in turn found to affect 'final' outcomes, confirming the SUNflower approach on the consecutive effect of each layer

Experiences of military CRNAs with service personnel who are emerging from general anesthesia.

Science.gov (United States)

Wilson, John Tyler; Pokorny, Marie E

2012-08-01

We conducted this qualitative study to understand the experiences of military Certified Registered Nurse Anesthetists (CRNAs) working with service personnel who have traumatic brain injury (TBI) and/or posttraumatic stress disorder (PTSD) and are emerging from general anesthesia. This study is important because there are no studies in the literature that describe the experiences of anesthetists working with patients with these specific problems. The leading questions were: "Out of all the anesthesia cases both abroad and stateside (post 9/11/2001), have you noticed service members wake from general anesthesia (not utilizing total intravenous anesthesia (TIVA), in a state of delirium? If so, can you tell me your experiences and thought processes as to why it was occurring?" Five themes emerged: (1) Emergence delirium (ED) exists and to a much higher degree in the military than in the general population. (2) ED was much more prevalent in the younger military population. (3) TIVA was a superior anesthetic for patients thought to have TBI and/or PTSD. (4) Talking to all patients suspected of having TBI and/or PTSD before surgery and on emergence was vital for a smooth emergence. (5) There is something profound happening in regard to ketamine and PTSD and TBI.

Assessing the 'system' in safe systems-based road designs: using cognitive work analysis to evaluate intersection designs.

Science.gov (United States)

Cornelissen, M; Salmon, P M; Stanton, N A; McClure, R

2015-01-01

While a safe systems approach has long been acknowledged as the underlying philosophy of contemporary road safety strategies, systemic applications are sparse. This article argues that systems-based methods from the discipline of Ergonomics have a key role to play in road transport design and evaluation. To demonstrate, the Cognitive Work Analysis framework was used to evaluate two road designs - a traditional Melbourne intersection and a cut-through design for future intersections based on road safety safe systems principles. The results demonstrate that, although the cut-through intersection appears different in layout from the traditional intersection, system constraints are not markedly different. Furthermore, the analyses demonstrated that redistribution of constraints in the cut-through intersection resulted in emergent behaviour, which was not anticipated and could prove problematic. Further, based on the lack of understanding of emergent behaviour, similar design induced problems are apparent across both intersections. Specifically, incompatibilities between infrastructure, vehicles and different road users were not dealt with by the proposed design changes. The importance of applying systems methods in the design and evaluation of road transport systems is discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

What is 5G? Emerging 5G Mobile Services and Network Requirements

Directory of Open Access Journals (Sweden)

Heejung Yu

2017-10-01

Full Text Available In this paper, emerging 5G mobile services are investigated and categorized from the perspective of not service providers, but end-users. The development of 5G mobile services is based on an intensive analysis of the global trends in mobile services. Additionally, several indispensable service requirements, essential for realizing service scenarios presented, are described. To illustrate the changes in societies and in daily life in the 5G era, five megatrends, including the explosion of mobile data traffic, the rapid increase in connected devices, everything on the cloud, hyper-realistic media for convergence services and knowledge as a service enabled by big-data analysis, are examined. Based on such trends, we classify the new 5G services into five categories in terms of the end-users’ experience as follows: immersive 5G services, intelligent 5G services, omnipresent 5G services, autonomous 5G services and public 5G services. Moreover, several 5G service scenarios in each service category are presented, and essential technical requirements for realizing the aforementioned 5G services are suggested, along with a competitiveness analysis on 5G services/devices/network industries and the current condition of 5G technologies.

Distributed road assessment system

Science.gov (United States)

Beer, N. Reginald; Paglieroni, David W

2014-03-25

A system that detects damage on or below the surface of a paved structure or pavement is provided. A distributed road assessment system includes road assessment pods and a road assessment server. Each road assessment pod includes a ground-penetrating radar antenna array and a detection system that detects road damage from the return signals as the vehicle on which the pod is mounted travels down a road. Each road assessment pod transmits to the road assessment server occurrence information describing each occurrence of road damage that is newly detected on a current scan of a road. The road assessment server maintains a road damage database of occurrence information describing the previously detected occurrences of road damage. After the road assessment server receives occurrence information for newly detected occurrences of road damage for a portion of a road, the road assessment server determines which newly detected occurrences correspond to which previously detected occurrences of road damage.

Recovery and well-being among Helicopter Emergency Medical Service (HEMS) pilots

NARCIS (Netherlands)

Radstaak, M.; Geurts, S.A.E.; Beckers, D.G.J.; Brosschot, J.F.; Kompier, M.A.J.

2014-01-01

This study investigated the effects of a compressed working week with high cognitive and emotional work demands within the population of Dutch Helicopter Emergency Medical Service (HEMS) pilots. Work stressors were measured and levels of well-being were examined before, during and after a series of

Quantifying the key factors that create road flooding : [tech summary].

Science.gov (United States)

2013-01-01

Road fl ooding is a serious operational hazard for many low-lying areas across southern Louisiana. This hazard is especially acute for : the regions emergency evacuation routes, which must be accessible for safe evacuation prior to an approaching ...

CLEAN-ROADS project: air quality considerations after the application of a novel MDSS on winter road maintenance activities

Science.gov (United States)

Pretto, Ilaria; Malloci, Elisa; Tonidandel, Gabriele; Benedetti, Guido; Di Napoli, Claudia; Piazza, Andrea; Apolloni, Roberto; Cavaliere, Roberto

2016-04-01

With this poster we present the environmental benefit on air quality derived by the application of the CLEAN-ROADS pilot project. The CLEAN-ROADS project addresses the problem of the environmental pollution caused by de-icing salts during winter road maintenance activities in the Province of Trento (Italy). A demonstrative Maintenance Decision Support System (MDSS) has been developed in order to improve the intervention procedures of the road management service. Specifically it aims to optimize the efficiency of how available resources (e.g., salt consumption) are currently used while guaranteeing the current level of road safety. The CLEAN-ROADS project has been tested and validated on a test area located in a valley bottom (Adige Valley), where the highest optimization margins are to be expected. The project supports current road maintenance practices, which has proved to be reliable and accurate, with a new scalable and energy-efficient road monitoring system. This system is based on a network of road weather stations (road weather information system, RWIS) installed on the test route. It is capable to collect real-time data about the road conditions and to perform short-term and now-cast road weather forecasts, which actively integrate weather data and bulletins covering the target area [1]. This poster presents the results obtained from a three-year monitoring activity with the aim to (1) determine the impact of de-icing salts on air quality and (2) quantify the improvements obtained by the application of the CLEAN-ROADS project on air quality. The Ambient Air Quality and Cleaner Air for Europe Directive (2008/50/EC) states that contributions to exceedances of particulate matter PM10 limit values that are attributable to road winter salting may be subtracted when assessing compliance with air quality limit values, once provided that reasonable measures have been taken to lower concentrations [2]. As the de-icing salts used in road maintenance are mainly based

78 FR 49332 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

Science.gov (United States)

2013-08-13

... Departments of Transportation, Homeland Security, and Health & Human Services (4) Presentation and discussion... Public Good and Essential Service b. Research in Prehospital Care: Models for Success c. Emerging Digital.... Improving Internal NEMSAC Processes e. Safety (7) Other Business of the Council (8) Public Comment Period (3...

Performance of Roads In Seismic Conditions: A Theoretical And Experimental Study

International Nuclear Information System (INIS)

Pratico, Filippo Giammaria

2008-01-01

As is well known, the role of the road network during and after an earthquake is of paramount relevance. In the light of the above, the main goal of the paper has been confined to the analyses of road performance in seismic conditions, as a result of intrinsic (structural and functional conditions, redundancy, etc.) and extrinsic (loads, flows, etc.) characteristics. Such interaction has been analysed for the area of Reggio Calabria and Messina Strait, through 28 equations and a number of models and simulations. Analyses proved that redundancy is a key-factor, able to affect the overall performance of the road network. Simulations demonstrated that in the long term road serviceability could be partly compromised, but accident risk, due to speed limitations, could result decreased

Research on Dynamic Optimization for Road-friendly Vehicle Suspension

Directory of Open Access Journals (Sweden)

Lu Yongjie

2014-10-01

Full Text Available The heavy vehicle brings large dynamic loads to the road surface, which would reduce vehicle ride comfort and shorten road service life. The structure characteristic of heavy vehicle suspension has a significant impact on vehicle performance. Based on the D'Alembert principle, the dynamics models of independent and integral balanced suspension are proposed considering mass and inertia of balancing rod. The sprung mass acceleration and the tire dynamic force for two kinds of balanced suspension and the traditional quarter vehicle model are compared in frequency-domain and time-domain respectively. It is concluded that a quarter vehicle model simplified for balanced suspension could be used to evaluate the ride comfort of vehicle well, but it has some limitations in assessing the vehicle road-friendliness. Then, the sprung mass acceleration and the road damage coefficients are also analyzed under different vehicle design and running parameters at detail. Some conclusions are obtained: low suspension stiffness, high suspension damping and low tire stiffness are all favorable to improve vehicle performance; there is a saturation range of suspension damping enhancing vehicle performance; improving the road surface roughness and avoiding the no-load running are two effective methods to accomplish the better ride comfort and road-friendliness. The suspension stiffness and damping parameters are chosen for optimal parameters matching of road friendliness based on the approximation optimization method.

"Them or Us": Perceptions, cognitions, emotions, and overt behavior associated with cyclists and motorists sharing the road

DEFF Research Database (Denmark)

Kaplan, Sigal; Prato, Carlo Giacomo

2014-01-01

In emerging cycling regions, cyclists and motorists share the road due to cycling infrastructure scarcity. This study investigates the chain of stimuli, cognition, emotion, and behavior associated with the road-sharing experience through the thematic analysis of talk-backs posted in response...... to news items related to cyclist-motorist crashes. Results show: (a) cycling infrastructure scarcity and perceived road use rights trigger emotional stress; (b) motorists and cyclists perceive the road-sharing experience as life-threatening and experience anxiety, anger, and fear; (c) drivers' coping...

A survey of quality gap of Khoramabad medical emergency services using SERVQUAL model

Directory of Open Access Journals (Sweden)

gholamreza Toushmal

2015-05-01

Full Text Available Background : Awareness of perceptions and expectations of receivers of health centers services, as well as determination of gap between these two subjects can play an important role in better services rendering of these centers. Thise survey was conducted to evaluate quality of emergency centers of Khorramabad city by use of SERVQUAL model in 2012. Materials and Methods: This analytic-descriptive research was carried out on 400 people receiving services of Khorramabad emergency centers, selected using continuous sampling method. Data was gathered using standard SERVQUAL questionnaire and then analyzed by SPSS software, descriptive and inferential statistics such as Kruskal-wallis, paired T test And ANOVA. Results: The results showed that there was negative gap of quality in all five dimensions of services (sensible thing, guarantee and trust, responsibility, and empathy. The most quality gap was in empathy aspect and the least belonged to politeness and trust, and this gap among all dimensions, exception for trust, was statistically significant. But no significant statistical relation was found between age, sex and educational level and quality gap score. Conclusion: Expectation of customers in all dimensions was higher than their perceptions, and it should promote the quality of all dimensions, specially empathy. It is suggested to evaluate services quality in these centers and other centers periodically to promote their quality of services.

AN INVESTIGATION ON THE FOREST ROAD PLANNING AND ROAD GROUND

Directory of Open Access Journals (Sweden)

Hafız Hulusi ACAR

2001-01-01

Full Text Available It is required that the capital used for construction of road must be technical, economical and used in its location. For this reason, the projects must be prepared for forest roads and all operations belong to roads must be guided according to these projects. In this investigation, available forest road network plan and constructed forest roads were investigated at the point of view technical and forest transportation. After this, it were studied to reach the highest exploitation rate as can as possible. Available forest road density were found as 11.9 m/ha in forest areas for Yesiltepe District. In this condition, exploitation rate was 78 %. After that, optimum forest road network were planned and road density were reached to 22 m/ha and exploitation rate to 86 %. Directed sample method were used from taking soil sample methods and samples were took in mixed system. According to results of the experiments, available forest roads were found in a good degree at the point of view endurance, pressing and transportation capacity. With these results, it is aimed to reach higher exploitation rate with given attention to landslide areas during planning of forest roads on the mountain areas such as Black Sea Region. For this reason, required importance must be given to planning of truck and logging roads. Ground analysis must be done and took care before during planning process of forest road network.

The nurse’s leadership within the context of emergency care services

Directory of Open Access Journals (Sweden)

Danielle Soares Silva

2014-03-01

Full Text Available The objective of this study was to analyze the contributions that research has made to leadership in nursing within the context of emergency care services from 2001 to 2012. This Integrative Literature Review included studies indexed in the following databases: Latin American and Caribbean Health Sciences (LILACS, Medical Literature Analysis and Retrieval Systems Online (MEDLINE and SCOPUS. Publications were grouped into three categories: “The styles of leadership adopted by the nurses of the emergency unit”; “Leadership as a strategy to improve nursing care management”; “The development of the nurses’ leadership in emergency care services”. A large part of the publications have a poor level of evidence and is indexed in international journals, showing that there is need for investments from both national and international scientific communities. In conclusion, the most commonly used theories among the nurses are: situational and transformational. Larger investments are necessary in communication and leadership training for nurses. Descriptors: Leadership; Emergency Relief; Emergency Nursing; Nursing Administration Research; Practice Management.

Impact of road traffic accidents on the elderly.

Science.gov (United States)

Etehad, H; Yousefzadeh-Chabok, Sh; Davoudi-Kiakalaye, A; Moghadam Dehnadi, A; Hemati, H; Mohtasham-Amiri, Z

2015-01-01

Older adults are a vulnerable road user group with high mortality and morbidity in road crash. The aim of this study was to show pattern of road traffic injuries in this special aging group. In a cross sectional study, pre-hospital emergency system reports, hospital and police records of all motor vehicle collisions injured above 60 years old who were admitted to Pour-Sina hospital from April 2011 to March 2012 were studied. Demographic data, characteristic of road traffic incidents and in-hospital medical profiles were derived. Data were analyzed with SPSS ver. 18. Differences between demographic and injuries situation were calculated by chi square test. A p-value of road accident injured. Mean age of them was 70.9 ± 6.7 years. Most of them were male (74.7%). 40.5% were pedestrians, 22.1% were car occupants and 19.1% were motorcyclists.76.7% had multiple trauma. Head and neck were the most prevalent regions of injured. Total in-hospital mortality rate was 10.1% that was higher in old elderly pedestrians and motorcyclists in comparison to young elderly (16.1% vs. 7.9%) and other type of victims (ρroad accident injured. Mean age of them was 70.9 ± 6.7 years. Most of them were male (74.7%). 40.5% were pedestrians, 22.1% were car occupants and 19.1% were motorcyclists.76.7% had multiple trauma. Head and neck were the most prevalent regions of injured. Total in-hospital mortality rate was 10.1% that was higher in old elderly pedestrians and motorcyclists in comparison to young elderly (16.1% vs. 7.9%) and other type of victims (ρroad traffic injuries in this group especially in pedestrians should be taken into consideration and strategies aimed at the road-user safety including periodic medical examination and improvement of road structure and facilities. Copyright © 2015. Published by Elsevier Ireland Ltd.

Miscellaneous Roads

Data.gov (United States)

Minnesota Department of Natural Resources — This data set contains roadway centerlines for miscellanous roads, a catch-all category for all road types not present in the other DNR derived products. These road...

DEVELOPMENT OF CARGO TRANSPORTATION SYSTEM BY ROAD ON THE BASIS OF LOGISTICS PRINCIPLES

Directory of Open Access Journals (Sweden)

I. M. Tsarenkova

2017-10-01

Full Text Available Рurpose. The article is aimed to develop and adapt the theoretical and methodological foundations for improving logistics system of cargo delivery by road transport in the framework of the scientific support of formation processes of transport-logistical system of the country. Methodology. The theory of system functioning control requires formalization of connections within the system. The qualitative and quantitative characteristics of entity were performed and the regularities of elements interaction in the system of road goods transportation were found out. The role of the road in transport industry and the influence of transportation and logistics space on the road itself in the process of its functioning were clarified. In the study of this topic the system approach, methods of synthesis and rational problem solving, theory of mass service were used. Findings. The work presents the highway as an element of the cargo transportation system that will make it possible to increase its economic efficiency in a constantly changing environment of transportation and logistics space according to the chosen criterion, the lower total costs to promote material flow. Theoretical-methodological bases of perfection of logistics system of cargo delivery by road transport include substantiation for the use of logistics as an effective control element to reduce the costs associated with goods transportation. They are distinguished by the presence of evidence-based methods for calculating the timing and sequence of execution of road works, logistic integration involved in the carriage of goods of the enterprises, structure and volume of material and accompanying flows and the formation of the logistics chain of its promotion. Originality. The road is represented by the link of single integral process of creation and management of the material flows. We propose formation of sub-system of the elements of road and transportation components with their further

The requirements and challenges in preventing of road traffic injury in Iran. A qualitative study.

Science.gov (United States)

Khorasani-Zavareh, Davoud; Mohammadi, Reza; Khankeh, Hamid Reza; Laflamme, Lucie; Bikmoradi, Ali; Haglund, Bo J A

2009-12-23

Road traffic injuries (RTIs) are a major public health problem, especially in low- and middle-income countries. Among middle-income countries, Iran has one of the highest mortality rates from RTIs. Action is critical to combat this major public health problem. Stakeholders involved in RTI control are of key importance and their perceptions of barriers and facilitators are a vital source of knowledge. The aim of this study was to explore barriers to the prevention of RTIs and provide appropriate suggestions for prevention, based on the perceptions of stakeholders, victims and road-users as regards RTIs. Thirty-eight semi-structured interviews were conducted with informants in the field of RTI prevention including: police officers; public health professionals; experts from the road administrators; representatives from the General Governor, the car industry, firefighters; experts from Emergency Medical Service and the Red Crescent; and some motorcyclists and car drivers as well as victims of RTIs. A qualitative approach using grounded theory method was employed to analyze the material gathered. The core variable was identified as "The lack of a system approach to road-user safety". The following barriers in relation to RTI prevention were identified as: human factors; transportation system; and organizational coordination. Suggestions for improvement included education (for the general public and targeted group training), more effective legislation, more rigorous law enforcement, improved engineering in road infrastructure, and an integrated organization to supervise and coordinate preventive activities. The major barriers identified in this study were human factors and efforts to change human behaviour were suggested by means of public education campaigns and stricter law enforcement. However, the lack of a system approach to RTI prevention was also an important concern. There is an urgent need for both an integrated system to coordinate RTI activities and prevention

The requirements and challenges in preventing of road traffic injury in Iran. A qualitative study

Directory of Open Access Journals (Sweden)

Laflamme Lucie

2009-12-01

Full Text Available Abstract Background Road traffic injuries (RTIs are a major public health problem, especially in low- and middle-income countries. Among middle-income countries, Iran has one of the highest mortality rates from RTIs. Action is critical to combat this major public health problem. Stakeholders involved in RTI control are of key importance and their perceptions of barriers and facilitators are a vital source of knowledge. The aim of this study was to explore barriers to the prevention of RTIs and provide appropriate suggestions for prevention, based on the perceptions of stakeholders, victims and road-users as regards RTIs. Methods Thirty-eight semi-structured interviews were conducted with informants in the field of RTI prevention including: police officers; public health professionals; experts from the road administrators; representatives from the General Governor, the car industry, firefighters; experts from Emergency Medical Service and the Red Crescent; and some motorcyclists and car drivers as well as victims of RTIs. A qualitative approach using grounded theory method was employed to analyze the material gathered. Results The core variable was identified as "The lack of a system approach to road-user safety". The following barriers in relation to RTI prevention were identified as: human factors; transportation system; and organizational coordination. Suggestions for improvement included education (for the general public and targeted group training, more effective legislation, more rigorous law enforcement, improved engineering in road infrastructure, and an integrated organization to supervise and coordinate preventive activities. Conclusion The major barriers identified in this study were human factors and efforts to change human behaviour were suggested by means of public education campaigns and stricter law enforcement. However, the lack of a system approach to RTI prevention was also an important concern. There is an urgent need for both

[Regional Study of Patient Safety Incidents (ERIDA) in the Emergency Services].

Science.gov (United States)

Alcaraz-Martínez, J; Aranaz-Andrés, J M; Martínez-Ros, C; Moreno-Reina, S; Escobar-Álvaro, L; Ortega-Liarte, J V

2016-01-01

Evaluate the patient safety incidents that occur in the emergency departments of our region. Observational study conducted in all the hospital emergency departments in the Regional Health Service of Murcia. After systematic random sampling, data were collected during care and a week later by telephone survey. Health professionals of each service were trained and collected the information, following the methodology of the National Study of Adverse Events Related to Hospitalization -ENEAS- and the Adverse Events Related to Spanish Hospital Emergency Department Care -EVADUR-. A total of 393 samples were collected, proportional to the cases treated in each hospital. In 10 cases (3.1%) the complaint was a previous safety incident. At least one incident was detected in 47 patients (11.95%; 8.7 to 15.1%). In 3 cases there were 2 incidents, bringing the number of incidents to 50. Regarding the impact, the 51% of incidents caused harm to the patients. The effects more frequent in patients were the need for repeat visits (9 cases), and mismanagement of pain (8 cases). In 24 cases (51.1%) health care was not affected, although 3 cases required an additional test, 11 cases required further consultation, and led to hospitalisation in 2 cases. The most frequent causal factors of these incidents were medication (14) and care (12). The incidents were considered preventable in 60% of cases. A rate of incidents in the emergency departments, representative of the region, has been obtained. The implications of the results for the population means that 12 out of every 100 patients treated in emergency departments have an adverse event, and 7 of these are avoidable. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Traffic Analysis and Road Accidents: A Case Study of Hyderabad using GIS

International Nuclear Information System (INIS)

Bhagyaiah, M; Shrinagesh, B

2014-01-01

Globalization has impacted many developing countries across the world. India is one such country, which benefited the most. Increased, economic activity raised the consumption levels of the people across the country. This created scope for increase in travel and transportation. The increase in the vehicles since last 10 years has put lot of pressure on the existing roads and ultimately resulting in road accidents. It is estimated that since 2001 there is an increase of 202 percent of two wheeler and 286 percent of four wheeler vehicles with no road expansion. Motor vehicle crashes are a common cause of death, disability and demand for emergency medical care. Globally, more than 1 million people die each year from traffic crashes and about 20-50 million are injured or permanently disabled. There has been increasing trend in road accidents in Hyderabad over a few years. GIS helps in locating the accident hotspots and also in analyzing the trend of road accidents in Hyderabad

Determining Level of Service for Multilane Median Opening Zone

Science.gov (United States)

Ali, Paydar; Johnnie, Ben-Edigbe

2017-08-01

The road system is a capital-intensive investment, requiring thorough schematic framework and funding. Roads are built to provide an intrinsic quality of service which satisfies the road users. Roads that provide good services are expected to deliver operational performance that is consistent with their design specifications. Level of service and cumulative percentile speed distribution methods have been used in previous studies to estimate the quality of multilane highway service. Whilst the level of service approach relies on speed/flow curve, the cumulative percentile speed distribution is based solely speed. These estimation methods were used in studies carried out in Johor Malaysia. The aim of the studies is to ascertain the extent of speed reduction caused by midblock U-turn facilities as well as verify which estimation method is more reliable. At selected sites, road segments for both directional flows were divided into free-flow and midblock zones. Traffic volume, speed and vehicle type data for each zone were collected continuously for six weeks. Both estimation methods confirmed that speed reduction would be caused by midblock u-turn facilities. However level of service methods suggested that the quality of service would improve from level F to E or D at midblock zone in spite of speed reduction. Level of service was responding to traffic volume reduction at midblock u-turn facility not travel speed reduction. The studies concluded that since level of service was more responsive to traffic volume reduction than travel speed, it cannot be solely relied upon when assessing the quality of multilane highway service.

Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study.

Science.gov (United States)

Bigdeli, Maryam; Khorasani-Zavareh, Davoud; Mohammadi, Reza

2010-07-09

Road traffic injuries (RTIs) are a major public health problem, requiring concerted efforts both for their prevention and a reduction of their consequences. Timely arrival of the Emergency Medical Service (EMS) at the crash scene followed by speedy victim transportation by trained personnel may reduce the RTIs' consequences. The first 60 minutes after injury occurrence--referred to as the "golden hour"--are vital for the saving of lives. The present study was designed to estimate the average of various time intervals occurring during the pre-hospital care process and to examine the differences between these time intervals as regards RTIs on urban and interurban roads. A retrospective cross-sectional study was designed and various time intervals in relation to pre-hospital care of RTIs identified in the ambulance dispatch centre in Urmia, Iran from 20 March 2005 to 20 March 2007. All cases which resulted in ambulance dispatches were reviewed and those that had complete data on time intervals were analyzed. In total, the cases of 2027 RTI victims were analysed. Of these, 61.5% of the subjects were injured in city areas. The mean response time for city locations was 5.0 minutes, compared with 10.6 minutes for interurban road locations. The mean on-scene time on the interurban roads was longer than on city roads (9.2 vs. 6.1 minutes, p transport times from the scene to the hospital were also significantly longer for interurban incidents (17.1 vs. 6.3 minutes, p transport and total time intervals among EMS responding to RTI incidents were longer for interurban roads, compared to the city areas. More research should take place on needs-to and access-for EMS on city and interurban roads. The notification interval seems to be a hidden part of the post-crash events and indirectly affects the "golden hour" for victim management and it needs to be measured through the establishment of the surveillance systems.

Energy, emissions and emergency medical services: Policy matters

International Nuclear Information System (INIS)

Brown, Lawrence H.; Blanchard, Ian E.

2012-01-01

Understanding the energy consumption and emissions associated with health services is important for minimizing their environmental impact and guiding their adaptation to a low-carbon economy. In this post-hoc analysis, we characterize the energy burden of North American emergency medical services (EMS) agencies and estimate the potential marginal damage costs arising from their emissions as an example of how and why health services matter in environmental and energy policy, and how and why environmental and energy policy matter to health services. We demonstrate EMS systems are energy intensive, and that vehicle fuels represent 80% of their energy burden while electricity and natural gas represent 20%. We also demonstrate that emissions from EMS operations represent only a small fraction of estimated health sector emissions, but for EMS systems in the United States the associated marginal damage costs are likely between $2.7 million and $9.7 million annually. Significant changes in the supply or price of energy, including changes that arise from environmental and energy policy initiatives designed to constrain fossil fuel consumption, could potentially affect EMS agencies and other health services. We encourage cross disciplinary research to proactively facilitate the health system's adaptation to a low-carbon economy. - Highlights: ► Estimated EMS-related emissions less than 1% of health sector emissions. ► Damage costs of U.S. EMS-related emissions estimated at $2.7 to $9.7 million. ► EMS energy burden is approximately 442 MJ per ambulance response. ► Approximately 80% of EMS energy burden is vehicle fuels. ► Energy supply, price and policy could impact EMS (and other health) services. ► Research needed to facilitate health services’ adaptation to a low carbon economy.

Invasive Brown Treesnake movements at road edges indicate road-crossing avoidance

Science.gov (United States)

Siers, Shane R.; Savidge, Julie S; Reed, Robert N.

2014-01-01

Roads have significant impacts on the dispersal of wildlife. Although this poses a threat to the abundance and diversity of desirable flora and fauna, it also affords some opportunity for enhancing control of invasive species. Roads are the most common terrain features that may affect the rate of landscape-scale movements of invasive Brown Treesnakes (Boiga irregularis) throughout Guam. We radio tracked 45 free-ranging Brown Treesnakes in close proximity to two roads in Guam and recorded instances where daily relocations of snakes spanned roads. Then we reconstructed observed movement histories with randomized turning angles, which served as a useful null hypothesis for assessing the effect of roads or road edge habitat on Brown Treesnake movement patterns. Random walk simulations demonstrated that Brown Treesnakes crossed these roads at a rate far lower than would be expected if snake movement was random with respect to roads and road edge habitat. We discuss two alternative hypotheses for these results: 1) habitat gaps posed by roads physically or behaviorally restrict snake movement; or 2) road edges provide preferred foraging habitat from which snakes are reluctant to depart. Because roads often form the boundaries of jurisdictional and management units, the effects of roads on the movement of invasive Brown Treesnakes will influence the prospects for success of future landscape-level suppression efforts.

Waiting room crowding and agitation in a dedicated psychiatric emergency service.

Science.gov (United States)

El-Mallakh, Rif S; Whiteley, Amanda; Wozniak, Tanya; Ashby, McCray; Brown, Shawn; Colbert-Trowel, Danya; Pennington, Tammy; Thompson, Michael; Tasnin, Rokeya; Terrell, Christina L

2012-05-01

Emergency department crowding is a growing problem that impacts patient care and safety. The effect of crowding has not been examined in emergency psychiatric services. The association between patient census and use of restraints, seclusion, and anti-agitation medications as needed was examined for 1 month. A total of 689 patients were seen in 31 days. The average hourly census was 6.8 ± 2.8 (range 0 to 18). There were 33 incidences of seclusion or restraint and an additional 15 instances of medications administered for agitation. The use of seclusion, restraint, or medication for agitation was significantly associated with census (r2 = 0.3, F = 5.47, P = .036). Crowding in emergency psychiatric waiting rooms may increase the need for seclusion, restraint, or medications for agitation.

Emergency presentations to an inner-city psychiatric service for children and adolescents.

NARCIS (Netherlands)

Dil, L.M.; Vuijk, P.J.

2012-01-01

Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of

Demand and supply of emergency help: an economic analysis of Red Cross services.

Science.gov (United States)

Hackl, Franz; Pruckner, Gerald Josef

2006-08-01

This paper analyzes supply and demand side characteristics of (voluntary) Red Cross services in Austria. The demand side analysis is based on a contingent valuation study on people's willingness to pay for emergency treatment, transportation services and disaster relief activities. The supply side is identified by a high percentage of volunteers in the Red Cross organization which makes the provision of emergency help at low cost possible. We find that aggregate benefits of Red Cross services exceed their cost of production. Policy conclusions are drawn with respect to future recruitment and funding: whereas intrinsic motivation is important for the decision to volunteer, and financial incentives play a minor role in general, the young Red Cross activists work voluntarily for self-realization reasons and to continue their education. Age-specific recruitment strategies accompanied by word-of-mouth advertising are recommended to address potential volunteers. As long as the volunteering character of Red Cross services will be maintained and cost of production will not go up an increase of funds does not seem necessary in the future. Moreover, a radical change in the structure of funding may crowd out both donations and voluntary labor supply.

The effect of industrial vehicles on the road’s level of service of industrial area in Malang City

Science.gov (United States)

Agustin, I. W.; Sumantri, Y.

2017-06-01

Malang was a great city that has the characteristics of diverse industries and it was spread in each district. Industry was one of the activities that have the characteristics of the movement with the goal of shipping and distribution. The vehicles used are large vehicles such as trucks and trailers. Problems related to the road’s performance that is the emergence of several points of delay and congestion due to the movement and the volume of vehicles as well as the limited capacity of existing roads. It encourages researchers to do research related to the effect of the industrial vehicle movements on the performance of existing roads in the city of Malang. The main purpose of the research is to analyze the effect of industrial vehicles movement on the road’s level of service of industrial area and to find out alternative solutions to improve the road’s level of service of industrial area. The research used multiple linear regression and do something analysis. The results showed that the types of industry in the city of Malang are ILMETTA, IATT, Agrokim, Sentra and Large Industries. Determining the location of the main observation based on the distribution of industry, have a major impact directly on the street, and the class of the national road are located in Sunandar Priyo Sudarmo Street. Existing land use in Sunandar Priyo Sudarmo Street are industrial, healthcare, office and it dominated by trade and services. Related to the variables that affect the movement of industrial vehicles are the number of employees (X3) and the delivery frequency (X6). The road’s level of service of Sunandar Priyo Sudarmo Street are D and E. While the effect of industrial vehicles movement on the road’s level of service which ranged from 13.77 per cent to 22.13 per cent of the total volume of vehicles on the road. Some referrals will be used to handle the problems that the road widening and the selection of alternative routes for the industrial vehicles.

Hurricane Hugo: Emergency Preparedness Planning and Response for Mental Health Services.

Science.gov (United States)

Carter, Nancy C.; And Others

This report describes how, in the aftermath of Hurricane Hugo, the South Carolina Department of Mental Health activated its Emergency Preparedness Plan to assist mental health centers and their staff in providing crisis counseling services to the general public. The first section explains the history and structure of the involvement by the…

Who’s Boarding in the Psychiatric Emergency Service?

Directory of Open Access Journals (Sweden)

Scott A. Simpson

2014-09-01

Full Text Available Introduction: When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. Methods: We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s t-tests and multivariate regression. Results: 521 of 5363 patient encounters (9.7% resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/ seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Conclusion: Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients. [West J Emerg Med. 2014;15(6:669-674

Severe road traffic injuries in Kenya, quality of care and access ...

African Journals Online (AJOL)

Severe road traffic injuries in Kenya, quality of care and access. ... hospitals were interviewed on availability of emergency care and resources. ... Training of motorists and general public in first aid should be considered in RTI control initiatives.

Predictability by recognizable road design. [previously called: Recognizable road design.

NARCIS (Netherlands)

2007-01-01

One of the Sustainable Safety principles is that a road should have a recognizable design and a predictable alignment. If this is the case, road users know how they are expected to behave and what they can expect from other road users, so that crashes may be prevented. For roads to be recognizable,

Road analysis: a tool for cost-effective rehabilitation measures for Finnish roads

Science.gov (United States)

Roimela, Petri; Salmenkaita, Seppo; Maijala, Pekka; Saarenketo, Timo

2000-04-01

Public funding for road network maintenance has decreased 30% during the last few years in Finland. Reduced resources, together with the current rehabilitation strategies, will in the long term result in increasing deterioration of the Finnish road network. For this reason road rehabilitation funding should be focused more specifically on those roads and road sections requiring measures and these measures should be optimized to ensure that only the specific problem structure will be repaired. Roadscanners Oy, in cooperation with the Finnish National Road Administration (Finnra), has developed a new and effective Road Analysis technique to survey the condition of roads and road networks. Road Analysis is based on the integrated analysis of the measured data collected from the road under survey. The basic survey methods used in Road Analysis include Ground Penetrating Data (GPR), falling weight deflectometer (FWD), roughness and rutting measurements, pavement distress mapping and GPS-positioning, as well as reference drilling based on preliminary GPR data analysis. The collected road survey data is processed, interpreted, analyzed and classified using Road Doctor software, specifically developed for this purpose. GPR measurements in road analysis are carried out using a 400 MHz ground-coupled antenna and a 1.0 GHz horn antenna. Horn antenna data is used to measure the thickness of the pavement and base course layers, as well as to evaluate their quality based on their dielectric properties. The 400 MHz ground-coupled data is used to estimate the thickness of the pavement structure and embankment. Ground-coupled antenna data is used for subgrade quality estimations and in evaluating the causes of subgrade- related frost defects. GPR data also provides important location information about special structures, such as steel reinforcements, cables and pipelines. Road Analysis includes a classification of the critical elements affecting the lifetime of the road: (1

The Influence of Servant Leadership Theory on the Emergency Services Student

Science.gov (United States)

Russell, Eric James

2013-01-01

The purpose of this qualitative case study was to explore how participation in a class on servant leadership influenced the emergency services student's understanding of the role and characteristics of a servant leader. The setting for the study was a state university in the Western United States, with the six participants being declared emergency…

Who's boarding in the psychiatric emergency service?

Science.gov (United States)

Simpson, Scott A; Joesch, Jutta M; West, Imara I; Pasic, Jagoda

2014-09-01

When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a "boarder." The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student's t-tests and multivariate regression. 521 of 5363 patient encounters (9.7%) resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients.

Quantifying the key factors that create road flooding : research project capsule.

Science.gov (United States)

2012-02-01

Road fl ooding is a serious operational hazard for low-lying areas of south Louisiana. This is : especially true for emergency evacuation routes, which must be accessible for coastal residents : evacuating ahead of an approaching hurricane or tropica...

Geriatric infrastructure, BRAC, and ecosystem service markets? End-of-life decisions for dams, roads, and offshore platforms (Invited)

Science.gov (United States)

Doyle, M. W.

2010-12-01

US infrastructure expanded dramatically in the mid-20th century, and now includes more than 79,000 dams, 15,000 miles of levees, 3.7 million miles of roads, 600,000 miles of sewer pipe, 500,000 onshore oil wells, and over 4,000 offshore oil platforms. Many structures have been in place for 50 years or more, and an increasing portion of national infrastructure is approaching or exceeding its originally intended design life. Bringing national infrastructure to acceptable levels would cost nearly 10% of the US annual GDP. Decommissioning infrastructure can decrease public spending and increase public safety while facilitating economic expansion and ecological restoration. While most infrastructure remains critical to the national economy, a substantial amount is obsolete or declining in importance. Over 11,000 dams are abandoned, and of nearly 400,000 miles of road on its lands, the U.S. Forest Service considers one-fourth non-essential and often non-functional. Removing obsolete infrastructure allows greater focus and funding on maintaining or improving infrastructure most critical to society. Moreover, a concerted program of infrastructure decommissioning promises significant long-term cost savings, and is a necessary step before more substantial, systematic changes are possible, like those needed to address the new energy sources and shifting climate. One key challenge for infrastructure reform is how to prioritize and implement such a widespread and politically-charged series of decisions. Two approaches are proposed for different scales. For small, private infrastructure, emerging state and federal ecosystem service markets can provide an economic impetus to push infrastructure removal. Ecosystem market mechanisms may also be most effective at identifying those projects with the greatest ecological bang for the buck. Examples where this approach has proved successful include dam removal for stream mitigation under the Clean Water Act, and levee decommissioning on

Marketization trajectories in the Danish road and park sectors

DEFF Research Database (Denmark)

Lindholst, Andrej Christian; Hansen, Morten Balle; Petersen, Ole Helby

2016-01-01

(as providers of maintenance services) in the municipal road and park sectors in Denmark over the past 30 years. The study draws theoretically on historical institutionalism as an interpretive framework and empirically on findings from earlier research, register data from municipal accounts as well...... as new survey data. Findings – Marketization within the road and park sectors has historically taken place through gradual changes, in particular by processes of layering and displacement, which has added up to substantial transformations in both sectors. Transformations relate to the levels of private...... sector involvement, the purpose of using private contractors, the extent of competition and the design of contractual arrangements. The road sector has been a frontrunner in this marketization process, while the park sector increasingly has been “catching up.” Originality/value – The paper contributes...

Transport accident emergency response plan

International Nuclear Information System (INIS)

Vallette-Fontaine, M.; Frantz, P.

1998-01-01

To comply with the IAEA recommendations for the implementation of an Emergency Response Plan as described in Safety Series 87, Transnucleaire, a company deeply involved in the road and rail transports of the fuel cycle, masters means of Emergency Response in the event of a transport accident. This paper aims at analyzing the solutions adopted for the implementation of an Emergency Response Plan and the development of a technical support and adapted means for the recovery of heavy packagings. (authors)

Road pricing and road safety : possible effects on road safety of 23 variants of road pricing.

NARCIS (Netherlands)

Eenink, R.G. Dijkstra, A. Wijnen, W. & Janssen, S.T.M.C.

2007-01-01

The Nouwen Committee (National Platform Paying Differently for Mobility) advised the Cabinet in 2005 about the introduction of a system of road pricing. Part of this advice consisted of a calculation of the expected road safety effects of such a system. In a letter to the Minister of Transport, SWOV

Chloride dynamics in a restored urban stream and the influence of road salts on water quality

Science.gov (United States)

Understanding the connection between road salts and water quality is essential to assess the implications for human health and ecosystem services from these widely used de-icers. Preliminary analysis identified a probable connection between road salt application and a stream wat...

Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: a cross-sectional, active surveillance study

Science.gov (United States)

Miranda, J Jaime

2013-01-01

Background: Road injuries are the second-leading cause of disease and injury in the Andean region of South America. Adequate management of road traffic crash victims is important to prevent and reduce deaths and serious long-term injuries. Objective: To evaluate the promptness of health care services provided to those injured in road traffic incidents (RTIs) and the satisfaction with those services during the pre-hospital and hospital periods. Methods: We conducted a cross-sectional study with active surveillance to recruit participants in emergency departments at eight health care facilities in three Peruvian cities: a large metropolitan city (Lima) and two provincial cities (an urban center in the southern Andes and an urban center in the rainforest region), between August and September 2009. The main outcomes of interest were promptness of care, measured by time between injury and each service offered, as well as patient satisfaction measured by the Service Quality (SERVQUAL) survey. We explored the association between outcomes and city, type of health care facility (HCF), and type of provider. Results: We recruited 644 adults seeking care for RTIs. This active surveillance strategy yielded 34% more events than anticipated, suggesting under-reporting in traditional registries. Median response time between a RTI and any care at a HCF was 33 minutes overall and only 62% of participants received professional care during the initial “golden” hour after the RTI. After adjustment for various factors, there was strong evidence of higher global dissatisfaction levels among those receiving care at public HCFs compared to private ones (odds ratio (OR) 5.05, 95% confidence interval (CI) 1.88-13.54). This difference was not observed when provincial sites were compared to Lima (OR 1.41, 95% CI 0.42-4.70). Conclusions: Response time to RTIs was adequate overall, though a large proportion of RTI victims could have received more prompt care. Overall, dissatisfaction was

Reliability analysis of road network for estimation of public evacuation time around NPPs

Energy Technology Data Exchange (ETDEWEB)

Bang, Sun-Young; Lee, Gab-Bock; Chung, Yang-Geun [Korea Electric Power Research Institute, Daejeon (Korea, Republic of)

2007-07-01

The most strong protection method of radiation emergency preparedness is the evacuation of the public members when a great deal of radioactivity is released to environment. After the Three Mile Island (TMI) nuclear power plant meltdown in the United States and Chernobyl nuclear power plant disaster in the U.S.S.R, many advanced countries including the United States and Japan have continued research on estimation of public evacuation time as one of emergency countermeasure technologies. Also in South Korea, 'Framework Act on Civil Defense: Radioactive Disaster Preparedness Plan' was established in 1983 and nuclear power plants set up a radiation emergency plan and have regularly carried out radiation emergency preparedness trainings. Nonetheless, there is still a need to improve technology to estimate public evacuation time by executing precise analysis of traffic flow to prepare practical and efficient ways to protect the public. In this research, road network for Wolsong and Kori NPPs was constructed by CORSIM code and Reliability analysis of this road network was performed.

Customer satisfaction measurement in emergency medical services.

Science.gov (United States)

Kuisma, Markku; Määttä, Teuvo; Hakala, Taisto; Sivula, Tommi; Nousila-Wiik, Maria

2003-07-01

The annual patient volume in emergency medical services (EMS) systems is high worldwide. However, there are no comprehensive studies on customer satisfaction for EMS. The authors report how a customer satisfaction survey on EMS patients was conducted, the results, and the possible causes for dissatisfaction. Two prospective customer satisfactions surveys were conducted in an urban EMS system. Consecutive patients treated by EMS received a postal questionnaire approximately two weeks after service. Satisfaction was measured in a scale from 1 (very poor) to 5 (excellent). Neither EMS personnel nor patients were made aware prospectively that patient satisfaction would be measured. Response rates to the surveys were 36.8% (432/1,175) in 2000 and 40.0% (464/1,150) in 2002. The mean general grades for the service were 4.6 and 4.5, respectively. Patients reported the highest degree of dissatisfaction when they were not taken to their hospital of choice, when they perceived that the paramedics were not able to meet their needs, and when paramedics did not introduce themselves or communicate directly with the patient's relatives. In high-volume calls (i.e., frequent chief complaints), the general satisfaction was highest in patients with arrhythmias, breathing difficulties, and hypoglycemia. Patients with drug overdose included the highest proportion of unsatisfied patients. None of the background variables (e.g., gender, transport decision, working shift) was statistically related to general patient satisfaction. This study shows that customer satisfaction surveys can be successfully conducted for EMS. EMS systems should consider routinely using customer satisfaction surveys as a tool for quality measurement and improvement.

Fleet size estimation for spreading operation considering road geometry, weather and traffic

Directory of Open Access Journals (Sweden)

Steven I-Jy Chien

2014-02-01

Full Text Available Extreme weather conditions(i.e. snow storm in winter time have caused significant travel disruptions and increased delay and traffic accidents. Snow plowing and salt spreading are the most common counter-measures for making our roads safer for motorists. To assist highway maintenance authorities with better planning and allocation of winter maintenance resources, this study introduces an analytical model to estimate the required number of trucks for spreading operation subjective to pre-specified service time constraints considering road geometry, weather and traffic. The complexity of the research problem lies in dealing with heterogeneous road geometry of road sections, truck capacities, spreading patterns, and traffic speeds under different weather conditions and time periods of an event. The proposed model is applied to two maintenance yards with seven road sections in New Jersey (USA, which demonstrates itself fairly practical to be implemented, considering diverse operational conditions.

Road safety performance indicators for the interurban road network.

NARCIS (Netherlands)

Yannis, G. Weijermars, W.A.M. Gitelman, V. Vis, M. Chazirisa, A. Papadimitriou, E. & Lima Azevedo, C.

2013-01-01

Various road safety performance indicators (SPIs) have been proposed for different road safety research areas, mainly as regards driver behaviour (e.g. seat belt use, alcohol, drugs, etc.) and vehicles (e.g. passive safety); however, no SPIs for the road network and design have been developed. The

Prioritizing Road Treatments using the Geomorphic Roads Analysis and Inventory Package (GRAIP) to Improve Watershed Conditions in the Wall Creek Watershed, Oregon

Science.gov (United States)

Day, K. T.; Black, T.; Clifton, C.; Luce, C.; McCune, S.; Nelson, N.

2010-12-01

Wall Creek, tributary to the North Fork John Day River in eastern Oregon, was identified as a priority watershed by the Umatilla National Forest for restoration in 2002. Most streams in this 518 km2 multi-ownership watershed are designated critical habitat for threatened steelhead. Eight streams are listed on the Oregon 303(d) list for elevated temperatures and excess sedimentation. Over 1000 km of public and private roads in the watershed present a major source of potential water quality and habitat impairment. We conducted a watershed-wide inventory of roads using the Geomorphic Roads Analysis and Inventory Package (GRAIP) in 2009 to quantify sediment contributions from roads to streams. GRAIP is a field and GIS-based model developed by the Forest Service Rocky Mountain Research Station and Utah State University that georeferences and quantifies road hydrologic connectivity, sediment production and delivery, mass wasting, and risk of diversion and plugging at stream crossings. Field survey and modeling produced data for 6,473 drainage locations on 726 km of road (most of the publically owned roads) quantifying the location and mass of sediment produced and delivered to streams. Findings indicate a relatively small subset of roads deliver the majority of road-produced fine sediment; 12 percent of the road length delivers 90 percent of the total fine sediment to streams. Overall fine sediment production in the watershed is relatively low (with an estimated background erosion rate of 518,000 kg/yr for the watershed) and sediment produced and delivered from the road system appears to be a modest addition. Road surfaces produce approximately 81,455 kg of fine sediment per year, with 20,976 kg/year delivered to the stream network. Fifty-nine gullies were observed, 41 of which received road runoff. Sixteen road-related landslides were also observed. The excavated volume of these features totals 3,922,000 kg which is equivalent to 175 years of fine sediment delivery at

Training Librarians for 21st Century Repository Services: Emerging Trends

Directory of Open Access Journals (Sweden)

Helen Emasealu

2016-05-01

Full Text Available The paper reviewed the emerging roles of the 21st century librarians, charged with the responsibility to manage repository services across libraries in present-day information technology environment. Librarians need to be trained and empowered with requisite skills and knowledge needed for successful management of the ICT driven repository initiatives that the 21st century demands. Literature was reviewed on the roles and responsibilities of librarians, training needs and opportunities, career path and recruitment of librarians, and community support necessary for effective and efficient implementation and management of repository initiatives. This entails the ability to comprehend trends and change patterns which are essential for providing research focused and user-friendly models in open repository services that are based on thorough analytical understanding of the challenges of emerging trends. To achieve this requires the training and retraining of librarians to reposition them as information specialists in their career path. The role of the library as an integral part of its social environment is to educate the community about the existence of an open repository by building partnership with community-oriented research centres through seminars, workshops, symposium, training, and awareness programmes. The study recommends that librarians should strategize and collaborate with researchers to make open repository an essential research tool.

How effective is road mitigation at reducing road-kill? A meta-analysis

NARCIS (Netherlands)

Rytwinski, Trina; Soanes, Kylie; Jaeger, Jochen A.G.; Fahrig, Lenore; Findlay, C.S.; Houlahan, Jeff; Ree, van der Rodney; Grift, van der Edgar A.

2016-01-01

Road traffic kills hundreds of millions of animals every year, posing a critical threat to the populations of many species. To address this problem there are more than forty types of road mitigation measures available that aim to reduce wildlife mortality on roads (road-kill). For road planners,

Prevalence and relief of pain in trauma patients in Emergency Medical Services

NARCIS (Netherlands)

Lisette Schoonhoven; T. Meijs; Sivera Berben; A. van Vugt; P. van Grunsven

2011-01-01

The aim of this study was to give insight in the prevalence of pain, and the (effect of) pain management according to the national emergency medical services analgesia protocol in trauma patients in the Netherlands. The retrospective document study included adult and alert trauma patients. Data

Review of road traffic accident admissions in a Nigerian tertiary ...

African Journals Online (AJOL)

Background: Road traffic accident remains a leading cause of trauma and admissions to the accidents and emergency units of most hospitals. The aim of this study was to determine the pattern and epidemiological characteristics of trauma admissions to the Obafemi Awolowo University Teaching Hospital. Methods: This ...

Understanding the value of mixed methods research: the Children's Safety Initiative-Emergency Medical Services.

Science.gov (United States)

Hansen, Matthew; O'Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

2016-07-01

Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children's Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. 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 burden of road traffic injuries in an emergency department in Addis Ababa, Ethiopia

Science.gov (United States)

Ali, E.; Tayler-Smith, K.; Hedt-Gauthier, B.; Silkondez, W.; Abebe, D.; Deressa, W.; Enquessilase, F.; Edwards, J. K.

2016-01-01

Setting: The emergency department (ED) of Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Objective: To document the proportion, trend, characteristics and outcomes of road traffic injury (RTI) related ED admissions (⩾15 years) between 2014 and 2015. Design: A retrospective, cross-sectional study using routinely collected ED data. Results: Of 10 007 ED admissions, 779 (8%) were RTI cases; this proportion peaked in the month of January (11%). Medical records were available for 522 (67%) of these RTI cases. The median age was 28 years and 69% were males. The majority were pedestrians (69%) injured by an automobile (78%). On triage, 32% were classified as needing urgent/immediate intervention. Head injuries (20%) were the second most common injury after lower limb injuries (36%). ED outcomes were as follows: discharged (68%), hospitalised (17%), referred (17%) and died (1%). Among the 78 hospitalised cases, respectively 62% and 16% were admitted to the surgical and orthopaedic departments. Of 146 RTI cases with head injuries, 25% were hospitalised, of whom 82% were admitted to the surgical department. Conclusion: Our findings can guide policy makers in referral hospitals in improving the planning of hospital resources and the prioritisation of public health needs linked to further urban development. A comprehensive plan to prevent RTIs, particularly among pedestrians in Addis Ababa, is urgently needed. PMID:27358798

Emergency Health Services Selected Bibliography.

Science.gov (United States)

Health Services and Mental Health Administration (DHEW), Bethesda, MD.

This annotated bibliography contains books, journal articles, visual aids, and other documents pertaining to emergency health care, which are organized according to: (1) publications dealing with day-to-day health emergencies that occur at home, work, and play, (2) documents that will help communities prepare for emergencies, including natural…

Appraisals and Cognitive Coping Styles Associated with Chronic Post-Traumatic Symptoms in Child Road Traffic Accident Survivors

Science.gov (United States)

Stallard, Paul; Smith, Elisabeth

2007-01-01

Background: Comparatively little is known about the cognitive appraisals and coping styles of child road traffic accident (RTA) survivors that are associated with chronic post-traumatic reactions. Methods: Seventy-five children and young people aged 7-18 who were involved in a road traffic accident and attended an accident and emergency department…

Is the travel time of private roads too short, too long, or just right?

NARCIS (Netherlands)

van den Berg, V.A.C.; Verhoef, E.T.

2012-01-01

We consider price and service-quality setting in oligopolistic markets for congestible services, applied to the case of private roads. Previous studies show that parallel competitors set a volume/capacity ratio (and thereby a travel time or service quality) that is socially optimal if they take the

Traffic calming for the prevention of road traffic injuries: systematic review and meta-analysis.

Science.gov (United States)

Bunn, F; Collier, T; Frost, C; Ker, K; Roberts, I; Wentz, R

2003-09-01

To assess whether area-wide traffic calming schemes can reduce road crash related deaths and injuries. Systematic review and meta-analysis. Cochrane Injuries Group Specialised Register, Cochrane Central Register of Controlled Trials, Medline, EMBASE, Sociological Abstracts Science (and social science) citation index, National Technical Information service, Psychlit, Transport Research Information Service, International Road Research Documentation, and Transdoc, and web sites of road safety organisation were searched; experts were contacted, conference proceedings were handsearched, and relevant reference lists were checked. Randomised controlled trials, and controlled before/after studies of area-wide traffic calming schemes designed to discourage and slow down through traffic on residential roads. Data were collected on road user deaths, injuries, and traffic crashes. For each study rate ratios were calculated, the ratio of event rates before and after intervention in the traffic calmed area divided by the corresponding ratio of event rates in the control area, which were pooled to give an overall estimate using a random effects model. Sixteen controlled before/after studies met our inclusion criteria. Eight studies reported the number of road user deaths: pooled rate ratio 0.63 (95% confidence interval (CI) 0.14 to 2.59). Sixteen studies reported the number of injuries (fatal and non-fatal): pooled rate ratio 0.89 (95% CI 0.80 to 1.00). All studies were in high income countries. Area-wide traffic calming in towns and cities has the potential to reduce road traffic injuries. However, further rigorous evaluations of this intervention are needed, especially in low and middle income countries.

Joint road safety operations in tunnels and open roads

Science.gov (United States)

Adesiyun, Adewole; Avenoso, Antonio; Dionelis, Kallistratos; Cela, Liljana; Nicodème, Christophe; Goger, Thierry; Polidori, Carlo

2017-09-01

The objective of the ECOROADS project is to overcome the barrier established by the formal interpretation of the two Directives 2008/96/EC and 2004/54/EC, which in practice do not allow the same Road Safety Audits/Inspections to be performed inside tunnels. The projects aims at the establishment of a common enhanced approach to road infrastructure and tunnel safety management by using the concepts and criteria of the Directive 2008/96/CE on road infrastructure safety management and the results of related European Commission (EC) funded projects. ECOROADS has already implemented an analysis of national practices regarding Road Safety Inspections (RSI), two Workshops with the stakeholders, and an exchange of best practices between European tunnel experts and road safety professionals, which led to the definition of common agreed safety procedures. In the second phase of the project, different groups of experts and observers applied the above common procedures by inspecting five European road sections featuring both open roads and tunnels in Belgium, Albania, Germany, Serbia and Former Yugoslav Republic of Macedonia. This paper shows the feedback of the 5 joint safety operations and how they are being used for a set of - recommendations and guidelines for the application of the RSA and RSI concepts within the tunnel safety operations.

Performance Comparison of Geobroadcast Strategies for Winding Roads

Directory of Open Access Journals (Sweden)

Edgar Talavera

2018-03-01

Full Text Available Vehicle-to-X (V2X communications allow real-time information sharing between vehicles and Roadside Units (RSUs. These kinds of technologies allow for the improvement of road safety and can be used in combination with other systems. Advanced Driver Assistance Systems (ADAS are an example and can be used along with V2X communications to improve performance and enable Cooperative Systems. A key element of vehicular communications is that the information transmitted through the network is always linked to a GPS position related to origin and destination (GeoNetworking protocol in order to adjust the data broadcast to the dynamic road environment needs. In this paper, we present the implementation and development of Institute for Automobile Research (INSIA V2X communication modules that follow the European vehicular networking standards in a close curve in a winding road where poor visibility causes a risk to the safety of road users. The technology chosen to support these communications is ETSI ITS-G5, which has the capability to enable specific services that support GeoNetworking protocols, specifically the Geobroadcast (GBC algorithm. These functionalities have been implemented and validated in a real environment in order to demonstrate the performance of the communication devices in real V2V (Vehicle-to-Vehicle and V2I (Vehicle-to-Infrastructure situations. GBC messages are also compared with two different configurations of emission area. A comparison with/without RSU modules in critical areas of the road with previous knowledge of the road cartography has also been made.

How Effective Is Road Mitigation at Reducing Road-Kill? A Meta-Analysis

OpenAIRE

Rytwinski, Trina; Soanes, Kylie; Jaeger, Jochen A. G.; Fahrig, Lenore; Findlay, C. Scott; Houlahan, Jeff; van der Ree, Rodney; van der Grift, Edgar A

2016-01-01

Road traffic kills hundreds of millions of animals every year, posing a critical threat to the populations of many species. To address this problem there are more than forty types of road mitigation measures available that aim to reduce wildlife mortality on roads (road-kill). For road planners, deciding on what mitigation method to use has been problematic because there is little good information about the relative effectiveness of these measures in reducing road-kill, and the costs of these...

Tire-road noise: an experimental study of tire and road design parameters

OpenAIRE

Bekke, Dirk; Wijnant, Ysbrand H.; Weegerink, Thijs; de Boer, Andries

2013-01-01

It is widely known that road traffic noise has negative influences on human health. Hence, as tire-road noise is considered to be the most dominant cause of road traffic noise above 30-50 km/h, a lot of research is performed by the two involving industries: road authorities/manufacturers and tire manufacturers. Usually, the parameters influencing exterior tire-road noise are often examined separately, whereas it is the tire-road interaction which obviously causes the actual noise. An integral...

How Effective Is Road Mitigation at Reducing Road-Kill? A Meta-Analysis.

Science.gov (United States)

Rytwinski, Trina; Soanes, Kylie; Jaeger, Jochen A G; Fahrig, Lenore; Findlay, C Scott; Houlahan, Jeff; van der Ree, Rodney; van der Grift, Edgar A

2016-01-01

Road traffic kills hundreds of millions of animals every year, posing a critical threat to the populations of many species. To address this problem there are more than forty types of road mitigation measures available that aim to reduce wildlife mortality on roads (road-kill). For road planners, deciding on what mitigation method to use has been problematic because there is little good information about the relative effectiveness of these measures in reducing road-kill, and the costs of these measures vary greatly. We conducted a meta-analysis using data from 50 studies that quantified the relationship between road-kill and a mitigation measure designed to reduce road-kill. Overall, mitigation measures reduce road-kill by 40% compared to controls. Fences, with or without crossing structures, reduce road-kill by 54%. We found no detectable effect on road-kill of crossing structures without fencing. We found that comparatively expensive mitigation measures reduce large mammal road-kill much more than inexpensive measures. For example, the combination of fencing and crossing structures led to an 83% reduction in road-kill of large mammals, compared to a 57% reduction for animal detection systems, and only a 1% for wildlife reflectors. We suggest that inexpensive measures such as reflectors should not be used until and unless their effectiveness is tested using a high-quality experimental approach. Our meta-analysis also highlights the fact that there are insufficient data to answer many of the most pressing questions that road planners ask about the effectiveness of road mitigation measures, such as whether other less common mitigation measures (e.g., measures to reduce traffic volume and/or speed) reduce road mortality, or to what extent the attributes of crossing structures and fences influence their effectiveness. To improve evaluations of mitigation effectiveness, studies should incorporate data collection before the mitigation is applied, and we recommend a

How Effective Is Road Mitigation at Reducing Road-Kill? A Meta-Analysis.

Directory of Open Access Journals (Sweden)

Trina Rytwinski

Full Text Available Road traffic kills hundreds of millions of animals every year, posing a critical threat to the populations of many species. To address this problem there are more than forty types of road mitigation measures available that aim to reduce wildlife mortality on roads (road-kill. For road planners, deciding on what mitigation method to use has been problematic because there is little good information about the relative effectiveness of these measures in reducing road-kill, and the costs of these measures vary greatly. We conducted a meta-analysis using data from 50 studies that quantified the relationship between road-kill and a mitigation measure designed to reduce road-kill. Overall, mitigation measures reduce road-kill by 40% compared to controls. Fences, with or without crossing structures, reduce road-kill by 54%. We found no detectable effect on road-kill of crossing structures without fencing. We found that comparatively expensive mitigation measures reduce large mammal road-kill much more than inexpensive measures. For example, the combination of fencing and crossing structures led to an 83% reduction in road-kill of large mammals, compared to a 57% reduction for animal detection systems, and only a 1% for wildlife reflectors. We suggest that inexpensive measures such as reflectors should not be used until and unless their effectiveness is tested using a high-quality experimental approach. Our meta-analysis also highlights the fact that there are insufficient data to answer many of the most pressing questions that road planners ask about the effectiveness of road mitigation measures, such as whether other less common mitigation measures (e.g., measures to reduce traffic volume and/or speed reduce road mortality, or to what extent the attributes of crossing structures and fences influence their effectiveness. To improve evaluations of mitigation effectiveness, studies should incorporate data collection before the mitigation is applied, and we

How Effective Is Road Mitigation at Reducing Road-Kill? A Meta-Analysis

Science.gov (United States)

Rytwinski, Trina; Soanes, Kylie; Jaeger, Jochen A. G.; Fahrig, Lenore; Findlay, C. Scott; Houlahan, Jeff; van der Ree, Rodney; van der Grift, Edgar A

2016-01-01

Road traffic kills hundreds of millions of animals every year, posing a critical threat to the populations of many species. To address this problem there are more than forty types of road mitigation measures available that aim to reduce wildlife mortality on roads (road-kill). For road planners, deciding on what mitigation method to use has been problematic because there is little good information about the relative effectiveness of these measures in reducing road-kill, and the costs of these measures vary greatly. We conducted a meta-analysis using data from 50 studies that quantified the relationship between road-kill and a mitigation measure designed to reduce road-kill. Overall, mitigation measures reduce road-kill by 40% compared to controls. Fences, with or without crossing structures, reduce road-kill by 54%. We found no detectable effect on road-kill of crossing structures without fencing. We found that comparatively expensive mitigation measures reduce large mammal road-kill much more than inexpensive measures. For example, the combination of fencing and crossing structures led to an 83% reduction in road-kill of large mammals, compared to a 57% reduction for animal detection systems, and only a 1% for wildlife reflectors. We suggest that inexpensive measures such as reflectors should not be used until and unless their effectiveness is tested using a high-quality experimental approach. Our meta-analysis also highlights the fact that there are insufficient data to answer many of the most pressing questions that road planners ask about the effectiveness of road mitigation measures, such as whether other less common mitigation measures (e.g., measures to reduce traffic volume and/or speed) reduce road mortality, or to what extent the attributes of crossing structures and fences influence their effectiveness. To improve evaluations of mitigation effectiveness, studies should incorporate data collection before the mitigation is applied, and we recommend a

Emergency Contraception Education for Health and Human Service Professionals: An Evaluation of Knowledge and Attitudes

Science.gov (United States)

Colarossi, Lisa; Billowitz, Marissa; Breitbart, Vicki

2010-01-01

Objective: To assess the knowledge and attitudes of health care providers, health educators, and social service providers before and after a training session on emergency contraceptive pills. Design: A survey study using pre-post training measurements. Setting: Two hundred and twenty-three medical, social service, and health education providers in…

Road Network Selection Based on Road Hierarchical Structure Control

Directory of Open Access Journals (Sweden)

HE Haiwei

2015-04-01

Full Text Available A new road network selection method based on hierarchical structure is studied. Firstly, road network is built as strokes which are then classified into hierarchical collections according to the criteria of betweenness centrality value (BC value. Secondly, the hierarchical structure of the strokes is enhanced using structural characteristic identification technique. Thirdly, the importance calculation model was established according to the relationships among the hierarchical structure of the strokes. Finally, the importance values of strokes are got supported with the model's hierarchical calculation, and with which the road network is selected. Tests are done to verify the advantage of this method by comparing it with other common stroke-oriented methods using three kinds of typical road network data. Comparision of the results show that this method had few need to semantic data, and could eliminate the negative influence of edge strokes caused by the criteria of BC value well. So, it is better to maintain the global hierarchical structure of road network, and suitable to meet with the selection of various kinds of road network at the same time.

Soil-related geohazard assessments for maintaining the UK's minor road network

Science.gov (United States)

Pritchard, Oliver; Hallett, Stephen; Farewell, Timothy

2015-04-01

The minor road network of the UK (United Kingdom) encompasses 98% of the overall road network. In recent years the UK's roads have been deteriorating, currently rated 26th in the world and considered at risk and declining by the Institution of Civil Engineers (ICE). Many factors contribute to the degradation and ultimately, to the failure of particular road sections. However, several UK local authorities have identified that during drought conditions, road sections founded upon clay soils which are susceptible to volumetric shrinkage and swelling undergo significant deterioration compared to those sections on non-susceptible soils. Droughts in East Anglia recently resulted in estimated damages of £26 million, leading several local authorities to apply to Central Government for emergency funding. The minor or evolved road network is most at risk due to them having often little, if any, structural foundations. This paper addresses the use of soil-related geohazard assessments and GIS (Geographical Information Systems) in helping to provide a soil-informed maintenance strategy for the asset management of the important (both socially and commercially) local road network of the UK. Furthermore, to establish future subsidence risk, UKCP09 climate projections have been used to model the likely potential soil moisture deficit (PSMD) for baseline (1961-1990), 2030 (2020-2049) and 2050 (2040-2069) scenarios. The incorporation of probabilistic PSMD data into clay-related subsidence models has allowed an assessment of potential subsidence risk, with a range of uncertainties, for these scenarios. Intersection of road networks with future projections of subsidence risk has enabled metrics of potential vulnerability to be established. This will aid prioritisation of areas which require further maintenance to make them more climate resilient, avoiding emergency funding situations. Subsequently, this approach can then be extrapolated to the entire UK minor road network, on a local

Road pricing policy implementation

NARCIS (Netherlands)

Vonk Noordegraaf, D.M.

2016-01-01

Urban areas suffer from the negative externalities of road transport like congested road networks, air pollution and road traffic accidents. A measure to reduce these negative externalities is road pricing, meaning policies that impose direct charges on road use (Jones and Hervik, 1992). Since the

Technology road mapping to guide development planning

International Nuclear Information System (INIS)

Goossen, J.E.; Congedo, T.V.

2004-01-01

For the past five years, Westinghouse Electric Company, has made ever increasing use of Technology Road Mapping, to direct company development efforts to achieve maximum benefits for our customers and ourselves. Comprised of business units in Nuclear Fuels, Nuclear Services and Nuclear Power Plants, including domestic and international business segments, Westinghouse must pay particular attention to coordinating development to satisfy the diverse needs of our growing international customer base. We must develop products which both benefit the individual Business Unit customer base, and which create synergy to produce the best possible offerings to the broader marketplace. The knowledge we gain through customer contacts and direct customer participation provides the basis from which we develop the Technology Road Map. This Road Map development process can be compared to painting a picture, where the background colors and features correspond to drivers related to the Customer and the prevailing features of the market environment. The subsequent layers of detail include broad Technical Objectives and then specific Technical Goals which will support achieving those objectives. The process is described in detail, and examples are provided. (authors)

How do we capture the emergency nurse practitioners' contribution to value in health service delivery?

Science.gov (United States)

Jennings, Natasha; Lutze, Matthew; Clifford, Stuart; Maw, Michael

2017-03-01

The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid nature of the emergency nurse practitioner role and focusing on the value they contribute to health care delivery.

Factors Influencing Quality of Pain Management in a Physician Staffed Helicopter Emergency Medical Service.

Science.gov (United States)

Oberholzer, Nicole; Kaserer, Alexander; Albrecht, Roland; Seifert, Burkhardt; Tissi, Mario; Spahn, Donat R; Maurer, Konrad; Stein, Philipp

2017-07-01

Pain is frequently encountered in the prehospital setting and needs to be treated quickly and sufficiently. However, incidences of insufficient analgesia after prehospital treatment by emergency medical services are reported to be as high as 43%. The purpose of this analysis was to identify modifiable factors in a specific emergency patient cohort that influence the pain suffered by patients when admitted to the hospital. For that purpose, this retrospective observational study included all patients with significant pain treated by a Swiss physician-staffed helicopter emergency service between April and October 2011 with the following characteristics to limit selection bias: Age > 15 years, numerical rating scale (NRS) for pain documented at the scene and at hospital admission, NRS > 3 at the scene, initial Glasgow coma scale > 12, and National Advisory Committee for Aeronautics score helicopter emergency service associated with insufficient pain management. A total of 778 patients were included in the analysis. Insufficient pain management (NRS > 3 at hospital admission) was identified in 298 patients (38%). Factors associated with insufficient pain management were higher National Advisory Committee for Aeronautics scores, high NRS at the scene, nontrauma patients, no analgesic administration, and treatment by a female physician. In 16% (128 patients), despite ongoing pain, no analgesics were administered. Factors associated with this untreated persisting pain were short time at the scene (below 10 minutes), secondary missions of helicopter emergency service, moderate pain at the scene, and nontrauma patients. Sufficient management of severe pain is significantly better if ketamine is combined with an opioid (65%), compared to a ketamine or opioid monotherapy (46%, P = .007). In the studied specific Swiss cohort, nontrauma patients, patients on secondary missions, patients treated only for a short time at the scene before transport, patients who receive no

Effect of the Road Environment on Road Safety in Poland

Science.gov (United States)

Budzynski, Marcin; Jamroz, Kazimierz; Antoniuk, Marcin

2017-10-01

Run-off-road accidents tend to be very severe because when a vehicle leaves the road, it will often crash into a solid obstacle (tree, pole, supports, front wall of a culvert, barrier). A statistical analysis of the data shows that Poland’s main roadside hazard is trees and the severity of vehicles striking a tree in a run-off-road crash. The risks are particularly high in north-west Poland with many of the roads lined up with trees. Because of the existing rural road cross-sections, i.e. having trees directly on road edge followed immediately by drainage ditches, vulnerable road users are prevented from using shoulders and made to use the roadway. With no legal definition of the road safety zone in Polish regulations, attempts to remove roadside trees lead to major conflicts with environmental stakeholders. This is why a compromise should be sought between the safety of road users and protection of the natural environment and the aesthetics of the road experience. Rather than just cut the trees, other road safety measures should be used where possible to treat the hazardous spots by securing trees and obstacles and through speed management. Accidents that are directly related to the road environment fall into the following categories: hitting a tree, hitting a barrier, hitting a utility pole or sign, vehicle rollover on the shoulder, vehicle rollover on slopes or in ditch. The main consequence of a roadside hazard is not the likelihood of an accident itself but of its severity. Poland’s roadside accident severity is primarily the result of poor design or operation of road infrastructure. This comes as a consequence of a lack of regulations or poorly defined regulations and failure to comply with road safety standards. The new analytical model was designed as a combination of the different factors and one that will serve as a comprehensive model. It was assumed that it will describe the effect of the roadside on the number of accidents and their consequences

Are trends in billing for high-intensity emergency care explained by changes in services provided in the emergency department? An observational study among US Medicare beneficiaries

Science.gov (United States)

Burke, Laura G; Wild, Robert C; Orav, E John; Hsia, Renee Y

2018-01-01

Objective There has been concern that an increase in billing for high-intensity emergency care is due to changes in coding practices facilitated by electronic health records. We sought to characterise the trends in billing for high-intensity emergency care among Medicare beneficiaries and to examine the degree to which trends in high-intensity billing are explained by changes in patient characteristics and services provided in the emergency department (ED). Design, setting and participants Observational study using traditional Medicare claims to identify ED visits at non-federal acute care hospitals for elderly beneficiaries in 2006, 2009 and 2012. Outcomes measures Billing intensity was defined by emergency physician evaluation and management (E&M) codes. We tested for overall trends in high-intensity billing (E&M codes 99285, 99291 and 99292) and in services provided over time using linear regression models, adjusting for patient characteristics. Additionally, we tested for time trends in rates of admission to the hospital and to the intensive care unit (ICU). Next, we classified outpatient visits into 39 diagnosis categories and analysed the change in proportion of high-intensity visits versus the change in number of services. Finally, we quantified the extent to which trends in high-intensity billing are explained by changes in patient demographics and services provided in the ED using multivariable modelling. Results High-intensity visits grew from 45.8% of 671 103 visits in 2006 to 57.8% of 629 010 visits in 2012 (2.0% absolute increase per year; 95% CI 1.97% to 2.03%) as did the mean number of services provided for admitted (1.28 to 1.41; +0.02 increase in procedures per year; 95% CI 0.018 to 0.021) and discharged ED patients (7.1 to 8.6; +0.25 increase in services per year; 95% CI 0.245 to 0.255). There was a reduction in hospital admission rate from 40.1% to 35.9% (−0.68% per year; 95% CI −0.71% to −0.65%; Pbilled as high intensity