Decisions In Emergency Situations Research Articles

Management decisions in emergency situations

Management decisions in emergency situations

An investigation into the influence of context effects on crowd exit selection under gender difference in indoor evacuation

IntroductionExit selection is crucial in indoor emergency evacuation. Domestic and foreign scholars have found that exit choice behavior is influenced by three factors: environmental factors, social interactions, and individual internal factors. Previous studies have shown that in addition to a single environmental factor affecting exit decisions, the influence of other available exit options in the context can ultimately lead to a reversal of exit decisions -The context effect. However, the impact of context effects on exit decisions in emergency situations has not been thoroughly explored. Therefore, this article identifies three basic independent variables: context effects, crowd flows, and gender differences, to study the exit decisions of different gender groups facing different crowd flows, as well as how context effects affect existing exit decisions.MethodsIn this paper, we used virtual reality technology to construct an indoor fire scene and designed a total of 15 virtual experiments with different crowd distribution or context effects. 131 participants were divided into two groups, male and female, and their exit decisions were observed under different crowd flows and contextual effects.ResultsThe research results show that: 1) Both men and women have an innate preference to avoid crowded exits, and the proportion of following crowd evacuation significantly decreases when there are crowded crowds in the scene; 2) The exit decisions of female participants are more influenced by the crowd, while men tend to be more influenced by context effects when evacuating independently; 3) The context effects on exit decisions in emergency situations is statistically significant, and this performance is more significant in the male population. Further analysis reveals that similarity effects have a more significant impact on exit decisions than attraction effects.DiscussionsThese findings provide deeper insights into the exit choice behavior of the population and may contribute to the design of safe exits in indoor buildings. In addition, this article emphasizes the importance of context effects and provides a foundation for future research.

Ethical and legal aspects in anesthesiology, ethical and legal issues, an overview

Introduction: The practice of anesthesiology plays a crucial role in medicine, ensuring the comfort and safety of patients during medical and surgical procedures. However, this specialty faces a series of ethical and legal challenges. This article provides an overview of these issues, considering the importance of respecting patient autonomy and compliance with legal standards. Methods: To conduct this review, the following descriptors were used to search the PubMed and MEDLINE databases: "Anesthesiology", "Ethical", "Questions", "Aspects", "Legal". These descriptors were combined using the boolean operator AND to ensure search accuracy. Initially, 165 relevant studies were identified. After excluding duplicates, editorials, and incomplete articles, 122 articles were considered for analysis. The final selection included the full reading of 24 articles, of which 13 were considered relevant to compose this review. Results: Anesthesiologists face complex ethical dilemmas, from obtaining informed consent to making decisions in emergency situations. Additionally, there are concerns about fair resource allocation and balancing risks and benefits. In the legal realm, there are comprehensive regulations related to professional liability, documentation of procedures, and the use of medications and equipment. Conclusion: The practice of anesthesiology requires a solid understanding of the ethical and legal aspects involved. It is essential to respect patient autonomy by obtaining their informed consent. Constant ethical reflection and compliance with legal regulations are fundamental to ensuring the delivery of high-quality care.

Ambulance clinicians' understanding of older patients' self-determination: A vignette study.

Older patients are often vulnerable and highly dependent on healthcare professionals' assessment in the event of acute illness. In the context of ambulance services, this poses challenges as the assessment is normally conducted with a focus on identifying life-threatening conditions. Such assessment is not fully satisfactory in a patient relationship that also aims to promote and protect patient autonomy. To describe ambulance clinicians' understanding of older patients' self-determination when the patient's decision-making ability is impaired. A qualitative design with an inductive approach, guided by descriptive phenomenology. In total, 30 ambulance clinicians, comprised of 25 prehospital emergency nurses, 1 nurse and 4 emergency medical technicians participated in 15 dyadic interviews. The research was conducted in accordance with the Declaration of Helsinki, and permission was granted by the Swedish Ethical Review Authority. The findings are presented in two themes: (1) Movement between explicit and implicit will; and (2) Contradictions about the patient's best interests. The clinicians' interpretations are based on an understanding of the patient's situation using substitute decision-making in emergency situations and conversations that reveal the patient's explicit wishes. Sometimes the clinicians collaborate to validate the patient's implicit will, while they at other times subordinate themselves to others' opinions. The clinicians find themselves in conflict between personal values and organisational values as they try to protect the patient's self-determination. The results indicate that older patients with an impaired decision-making ability risk losing the right to self-determination in the context of ambulance services. The clinicians face challenges that significantly affect their ability to handle the older patient's unique needs based on a holistic perspective and their ability to be autonomous.

Prevalence of living wills among older adults in Germany.

Living wills regulate medical decisions in emergency situations. Those who create a living will can have it registered voluntarily in the Central Register of Lasting Powers of Attorney. Little is known about the general prevalence of living wills. The German Ageing Survey is an ongoing, population-representative study. 4,185 people aged 50 and older were surveyed about living wills in 2020/2021. 44.8 % of people aged 50 and older have a living will, women more often than men (50.1 % vs. 39.2 %), older people more often than middle-aged people. Educational differences do not exist. Living wills increase the autonomy in medical emergency situations because the patient's wishes are specified in written form. People of all age groups should inform themselves about the significance of living wills and should seek advice about the contents, for example from the general practitioner or one's own health insurance.

Опыт внедрения тренажерных комплексов на объектах газовой промышленности территориально-производственного предприятия «Ямалнефтегаз»

Relevance of the development of computer simulator complexes, their advantages, disadvantages, as well as the experience of their implementation at gas industry facilities on the example of computer simulator complexes for checking emergency protection of technological facilities of the territorial production enterprise «Yamalneftegaz» are considered. Complexity of the production technologies and process control, the risks of accidents, the huge industrial and environmental risk in the management of oil and gas facilities, as well as the significant weight of operator control errors in the total number of causes of accidents determine the relevance of efficient personnel training. The use of computer simulators can significantly improve the skills of operational personnel and reduce the risks of accidents at the oil and gas sector enterprises. Simulators give operators and dispatchers the opportunity to learn in practice how to make the right decisions in emergency situations and work with modern process control systems, which in turn can significantly improve fire and industrial safety, the safety of technological equipment and even save human lives. In general, the article emphasizes the importance of using computer simulators in the training of operational personnel at oil and gas enterprises, which can help reduce the risks of accidents and increase the level of industrial safety.

Relationship between virtual reality balloon analogue risk task and risky decision-making.

The balloon analogue risk task (BART) is widely used to assess risk-taking tendencies on behavioral tests. However, biases or unstable results are sometimes reported, and there are concerns about whether the BART can predict risk behavior in the real world. To address this problem, the present study developed a virtual reality (VR) BART to enhance the reality of the task and narrow the gap between performance on the BART and risk behavior in the real world. We evaluated the usability of our VR BART through assessments of the relationships between BART scores and psychological metrics and additionally implemented an emergency decision-making VR driving task to investigate further whether the VR BART can predict risk-related decision-making in emergency situations. Notably, we found that the BART score significantly correlated with both sensation-seeking and risky driving behavior. Additionally, when we split participants into groups with high and low BART scores and compared their psychological metrics, we found that the high-score BART group included more male participants and exhibited higher sensation-seeking and more risky decision-making in an emergency situation. Overall, our study shows the potential of our new VR BART paradigm to predict risky decision-making in the real world.

Spinal oncologic paraparesis: Analysis of neurological and surgical outcomes in patients with intramedullary, extramedullary, and extradural tumors.

Paraparesis due to oncologic lesions of the spine warrants swift neurosurgical intervention to prevent permanent disability and hence maintain independence of affected patients. Clinical parameters that predict a favorable outcome after surgical intervention could aid decision-making in emergency situations. Patients who underwent surgical intervention for paraparesis (grade of muscle strength <5 according to the British Medical Research Council grading system) secondary to spinal neoplasms between 2006 and 2020 were included in a single-center retrospective analysis. Pre- and postoperative clinical data were collected. The neurological status was assessed using the modified McCormick Disability Scale (mMcC) Score. In a univariate analysis, patients with favorable (discharge mMcC improved or stable at <3) and non-favorable outcome (discharge mMcC deteriorated or stable at >2) and different tumor anatomical compartments were statistically compared. 117 patients with oncologic paraparesis pertaining to intramedullary lesions (n=17, 15%), intradural extramedullary (n=24, 21%) and extradural lesions (n=76, 65%) with a mean age of 65.3 ± 14.6 years were included in the analysis. Thoracic tumors were the most common (77%), followed by lumbar and cervical tumors (13% and 12%, respectively). Surgery was performed within a mean of 36±60 hours of admission across all tumors and included decompression over a median of 2 segments (IQR:1-3) and mostly subtotal tumor resection (n=83, 71%). Surgical and medical complications were documented in 9% (n=11) and 7% (n=8) of cases, respectively. The median hospital length-of-stay was 9 (7-13) days. Upon discharge, the median mMcC score had improved from 3 to 2 (p<0.0001). At last follow-up (median 180; IQR 51-1080 days), patients showed an improvement in their mean Karnofsky Performance Score (KPS) from 51.7±18.8% to 65.3±20.4% (p<0.001). Localization in the intramedullary compartment, a high preoperative mMcC score, in addition to bladder and bowel dysfunction were associated with a non-favorable outcome (p<0.001). The data presented on patients with spinal oncologic paraparesis provide a risk-benefit narrative that favors surgical intervention across all etiologies. At the same time, they outline clinical factors that confer a less-favorable outcome like intramedullary tumor localization, a high McCormick score and/or bladder and bowel abnormalities at admission.

Mathematical modeling of the operating mode of the South Golodnostepsk main channel

The article presents the results of a study of operation and considers the application of mathematical modeling to the movement of water flow in the South Golodnostepsk main channel. A convenient, simple and cheap mathematical apparatus is proposed, which gives sufficiently reliable predictive results for making the right decisions in emergency situations during the operation of the South Golodnostepsk main channel. It is also given to apply recommendations for the numerical calculation of other irrigation channel in the region.

Method for determining the levels of detail of spatial objects as part of a three-dimensional information model of an urban area

The article proposes a method for determining the levels of detail for spatial objects, which is part of the three-dimensional information model of the urban area in order to reduce the computational load in operations related to visualization. The method adapts the concept of multi-level detailing to the list of spatial objects of the urban territory, where ranges of levels of detail are chosen for each of them, based on the needs of different management subjects when making decisions in emergency situations. Figs.: 4. Refs.: 14 titles.&#x0D; Keywords: information model of the urban area, modeling of spatial objects, levels of detail, LoD; CityGML.

First Aid Approaches, Teaching, and Knowledge and Technology Transfer to Undergraduate Engineering Students

First aid and prehospital care practices are fundamental in helping victims, often saving lives. This study aims to present the results of a bibliometric analysis regarding first aid, as well as a case report on teaching in first aid to a group of undergraduate students. The latter presents a project developed at a Brazilian public university for engineering students. The core modules addressed in the project were: first aid concepts, specialized distress calling, site safety, injury mechanism, primary and secondary approaches, bleeding control, cardiopulmonary resuscitation, clinical emergences, seizures, intoxications, fractures, burns, immobilizations, and victim transport. A systematic literature review was conducted, which was based on structured protocols, in four databases: Scopus, Web of Science, PubMed, and ScienceDirect. Significant data were analyzed, such as years of publication, main journals, and more frequent terms in first aid teaching. The SOS-UTFPR Project aims to provide scholars of engineering and related fields with theoretical-practical knowledge about first aid. As of 2021, it has 3 graduated groups, thus generating relevant data for this research. Its main purpose is to train citizens capable of making assertive decisions in emergency situations, whether at the university, work, home, etc. With this, it was possible to promote the dissemination of the Transfer of Knowledge and Technology (KTT) by training individuals to multiply information, techniques, and acquired knowledge, in order to act preventively and save lives.

Dynamic probabilistic risk assessment of decision-making in emergencies for complex systems, case study: Dynamic positioning drilling unit

Decision-making in emergency situations is a risky and uncertain process due to the limited information and lack of time. Some key problem parameters, such as the time required to complete important response tasks, must be estimated and are therefore prone to errors. Other parameters, such as the probability of occurrence of a consequential event, will typically change as the response operation progresses. As a result, there should be a dynamic probabilistic risk assessment framework to assess the risk level of decision scenarios and facilitate the decision-making process.In this paper, a methodology for dynamic probabilistic risk assessment of decision making in emergencies for complex marine systems is proposed. In this method, a dynamic event sequence diagram is introduced that helps to quantify events probabilities as a function of time, as well as environmental and operational variables, considering events interdependencies and uncertainties. In addition, the effects of time required11Time required refers to the time needed to perform each level of decision-making process (detection, diagnosis, decision-making, execution). and time available22Time available is the time remaining before an accident happens in a system. It is derived from the dynamic simulator of the system. The dynamic simulator calculates the time remaining before a collision based on the system components status, operation and environmental conditions at the time of incident. for performing a decision in emergency are considered in the risk model. In this methodology, probabilistic models including Bayesian network and Monte Carlo simulation are utilized to quantify the uncertain behavior of the decision-making process in complex marine systems.A computational study is also conducted to evaluate the methodology performance, in terms of effectiveness and efficiency. Computational results show that the proposed approach can obtain optimal solutions for large and practical problem sizes.

Analysis of crowdsourcing technology tasks for geoinformation systems in the field of emergency management

In recent decades, there has been a trend of increasing the number of emergencies (EM) and the scale of their consequences. This forces humanity to look for new ways to increase the effectiveness of protection of the population and territories from emergencies, to anticipate future threats, risks and dangers, to develop methods for their forecasting and prevention [1]. Emergencies are always accompanied by both material and human losses, so it is very important to make quick and correct decisions to eliminate their consequences. One of the main areas of improving the efficiency, validity and quality of management decisions to prevent and eliminate emergencies is the creation of information systems to support decision-making based on broad and comprehensive automation of resource management processes, which are designed to prevent and eliminate emergencies. Peculiarities of the decision-making process in emergency situations are incomplete and unreliable presentation of information and a small reserve of time for decision-making, and the peculiarity of the functioning of information systems to support decision-making in emergency situations is the need to ensure adequate and effective modeling of different classes NS. The use of modeling in the management of complex objects of different physical nature, operating, as a rule, in conditions of uncertainty, can significantly increase the efficiency of management due to the fact that provides the ability to analyze changes in the properties of the object when choosing control influences. Given the above, information systems to support decision-making can be supplemented by systems for the rapid collection of information about the state of the environment in emergency areas. Today, the management of the acquisition, integration and analysis of large and heterogeneous data obtained from various sources is carried out on the basis of a new paradigm of computing, called crowdsourcing, and one of the options for obtaining information about the state of the environment in emergency zones there are crowdsourcing systems [2]. Such systems will be able to provide up-to-date information on the state of the environment in the emergency zone, on the basis of which the decision support system will be able to provide the necessary management decisions to prevent, reduce or eliminate negative consequences. Thus, the urgent task of supporting management decisions to improve the efficiency and validity of measures to prevent and eliminate emergencies is the creation of information crowdsourcing systems for collecting information about the state of the environment in emergency areas.

ЧИСЛЕННОЕ ИМИТАЦИОННОЕ МОДЕЛИРОВАНИЕ РАСПРОСТРАНЕНИЯ ТЕМПЕРАТУРЫ ПРИ САМОНАГРЕВАНИИ УГЛЯ В ВЫРАБОТАННОМ ПРОСТРАНСТВЕ

Researches of thermodynamic processes of oxidation, self-heating and self-ignition of coal are necessary for studying of dependence of terminal parameters on a set of the influencing factors. In practice of coal mining by the underground method cases of coal self-ignition in the mined-out spaces of production units (lavas) are frequent. In this case one of the tasks consists in determination of temperature in arbitrary point of the nubbly-porous medium of the mined-out space. Need of the solution of this difficult task is caused by the probability of emergency situations in places with the explosive concentration of methane. It is possible that for each seam and grade of coal it is necessary to develop, substantiate and accept an individual indicator for assessing the state of fire hazard. It is proposed to systematize and methodically process the results of field measurements and observations on the analyzed and investigated cases of endogenous fires in problem areas of mines in order to create basin databases for subse- quent operational decisions in emergency situations.

ОПТИМИЗАЦИЯ УПРАВЛЕНИЯ ГОРОДСКИМИ СВЕТОФОРАМИ С ПРИМЕНЕНИЕМ НЕЙРОННЫХ СЕТЕЙ

One of the most pressing problems of large cities is the problem of traffic management of vehicles. The reason for this problem is an imperfect way to manage traffic flows. Traffic light regulation is of particular importance in traffic management. Most modern traffic light control systems operate at set time intervals and are not able to cope with the constantly changing situation on the road. A promising direction for solving this problem is to optimize the system using artificial neural networks. The advantage of neural networks is self-learning, which allows the system to adapt to the changing situation on the road. Despite numerous attempts, it has not yet been possible to obtain a high-quality mathematical model of urban traffic management. This model should determine the functional dependence of transport flow parameters on control parameters. Nowadays, traffic flows are regulated everywhere by means of traffic lights. If we can get a fairly accurate mathematical model of traffic flows, we can determine the optimal duration of the traffic signal phases to achieve the maximum capacity of the road network node. A fairly accurate mathematical model of traffic management that works in predictive mode will display an estimate of the optimal control parameters, as well as make correct decisions in emergency situations. Well-known mathematical models of road traffic take into account only the average values of traffic flows, and not the exact number of cars on each road section at a particular time.

Approximation of emicizumab plasma levels in emergency situations. A practical approach.

A dedicated emicizumab assay based on the modified one-stage factor VIII (FVIII) assay (mOSA) is mainly available in haemophilia treatment centres (HTC). A method to estimate emicizumab plasma levels based on a widely available assay would be desirable, especially for emergency situations. A method for emicizumab plasma level approximation (ELA) using a routine FVIII activity measurement with standard one-stage assay (sOSA) was developed and evaluated. Within this pilot study, 59 samples from patients with severe haemophilia A with (n=8) and without (n=8) inhibitors under emicizumab treatment were analysed using sOSA following a manual 1:8 sample pre-test dilution with saline. The sOSA was determined in two different laboratories, using two different analyser platforms each. The results demonstrated an excellent correlation of approximated emicizumab plasma levels (ELA) with the emicizumab plasma concentration determined with mOSA (r>.9; p<.05). The ELA showed a sensitivity of 93.3% and a specificity of 89.6% to predict a pre-defined cut-off-value of ≤30µg/ml for the discrimination between subtherapeutic and therapeutic emicizumab plasma levels. Approximation of emicizumab levels by standard one-stage FVIII assay discriminates between subtherapeutic and therapeutic emicizumab levels and might facilitate clinical decision-making in emergency situations, such as bleeding, trauma or urgent surgery in case that dedicated emicizumab assays are not available.

Antifouling Strategies for Sensors Used in Water Monitoring: Review and Future Perspectives.

Water monitoring sensors in industrial, municipal and environmental monitoring are advancing our understanding of science, aid developments in process automatization and control and support real-time decisions in emergency situations. Sensors are becoming smaller, smarter, increasingly specialized and diversified and cheaper. Advanced deployment platforms now exist to support various monitoring needs together with state-of-the-art power and communication capabilities. For a large percentage of submersed instrumentation, biofouling is the single biggest factor affecting the operation, maintenance and data quality. This increases the cost of ownership to the extent that it is prohibitive to maintain operational sensor networks and infrastructures. In this context, the paper provides a brief overview of biofouling, including the development and properties of biofilms. The state-of-the-art established and emerging antifouling strategies are reviewed and discussed. A summary of the currently implemented solutions in commercially available sensors is provided and current trends are discussed. Finally, the limitations of the currently used solutions are reviewed, and future research and development directions are highlighted.

Asthma patients in Saudi Arabia – preferences, health beliefs and experiences that shape asthma management

ABSTRACT Objectives: The aim of this study was to explore the experience of Saudi participants in managing their asthma and their perspectives about using future pharmacy-based services for asthma management. Methods: Semi-structured interviews were conducted with adult Saudis with asthma or those who were a carer of a child with asthma. Participants were recruited from medical practices and community centres in Riyadh, Saudi Arabia. Verbatim transcribed interviews were inductively analysed using thematic analysis. Results: Twenty-three Saudi participants with asthma or caring for those with asthma took part in interviews which lasted on average for 25 min. Most participants did not have well-controlled asthma. Thematic analyses of the interview transcripts highlighted four key emergent themes: participants experience of asthma, participants’ beliefs and perceptions about health and medicines, perception of health professionals and advocacy and social support. Many participants expressed an emotional burden in their lived experience of asthma. Lack of self-management skills were evident in participants’ reluctance to make decisions in emergency situations. Some participants had strong beliefs about using herbal medicines rather than western medicines. Using social media or consulting with their family members with asthma was a common preference, rather than consulting healthcare professionals. Participants’ were rather unclear about pharmacy asthma care services and reported not having experienced such services in their pharmacies. Conclusion: Inadequate self-management behaviours may affect the level of asthma control in people with asthma in Saudi Arabia. Improved primary care models with extensive focus on asthma education are needed to relieve the over-reliance on tertiary care help-seeking models that are currently the norm. Current evidence-based information also needs to be prepared in patient friendly formats and disseminated widely. Community pharmacists would need to be trained and skilled inpatient engagement and would have to win the public trust for viable asthma services provision.

Improving Evacuation Compliance through Control: Implications for Emergency Management Policy and Disaster Communications

ABSTRACT Federal and local emergency management agencies and policymakers often ask: Why do individuals refuse to leave their homes when emergency evacuations are mandated during life-threatening natural disasters? In three experimental studies, the current research establishes that during a natural disaster, individuals become aware of their mortality. Existential anxiety is high and a need for control is instantiated. This makes following the directive to evacuate relatively less appealing. If, however, individuals can meet their need for control while in the process of making the evacuation decision (e.g., choice of shelter), the likelihood of evacuating increases. In light of increasing concerns related to global climate change, terrorist threats, pandemics, and other natural disasters, calls for more interdisciplinary work in understanding human decision-making in emergency situations have been made. The current work has timely implications for emergency management agencies, policymakers, and those required to communicate during natural disasters.

Информационные технологии управления в условиях чрезвычайных ситуаций: концептуальные основы

Цель. Проанализировать существующие информационные системы с учетом акцентуации на выявлении базовых критериев в процессе оценки информации, необходимой для поддержки принятия максимально эффективного решения в условиях чрезвычайных ситуаций.&#x0D; Методы. В исследовании был использован метод сравнительного анализа.&#x0D; Результаты. Раскрыты вопросы, касающиеся информационных технологий и концептуальных основ управления, затронуты существующие информационно-управляющие системы, целенаправленно используемые для предупреждения и ликвидации последствий чрезвычайных ситуаций, раскрыт проблемный характер происходящих многомерных процессов, касающихся информационных структур, а также принципов переработки информации, характеризующих деятельность современных информационных служб МЧС Республики Беларусь.&#x0D; Область применения исследований. Выводы статьи могут быть использованы в исследованиях гражданской защиты.