Emergency Response Team Research Articles

Emotet exposed: looking inside highly destructive malware

As malware, Emotet is so prolific and dominant that the US Cyber Emergency Response Team (US-CERT), the body tasked with tracking cyberthreats to the country, named Emotet in July 2018, as: “among the most costly and destructive malware” to affect governments, enterprises and organisations large and small, as well as individual computer users. 1 Emotet is so prolific that the US Cyber Emergency Response Team (US-CERT) said it is, “among the most costly and destructive malware” to affect governments and enterprises. The best way to combat a threat is to understand it. So in this article, the SophosLabs Research Team picks the malware apart to see how it functions. They examine the infection vectors and delivery mechanisms, how the malware tries to hide and how Emotet uses the Windows system itself to persist and carry out its malicious work.

A Multidisciplinary Approach to Hemorrhage Strives to Decrease Morbidity and Mortality in Texas

With maternal morbidity and mortality increasing, measures are being taken to decrease incidence. The Texas Alliance for Innovation on Maternal Health focuses on implementing safety bundles to prevent morbidity and mortality through four components: readiness, recognition and prevention, response, and reporting–systems learning. This presentation discusses the multidisciplinary management of a multiparous patient admitted to the labor and delivery unit who was experiencing abruption, with an estimated liter of blood loss before arrival. This case involves a gravida 2, para 1 woman who was at 30.6-weeks gestation. The current pregnancy was uncomplicated. She had a history of term, emergency cesarean with postpartum hemorrhage. She presented via ambulance with an estimated 1-L blood loss before arrival. The labor and delivery unit notified the medical team before the patient’s arrival. The obstetrics unit completed an ultrasound on arrival, and bradycardic fetal heart tones were noted. The patient was transferred to the operating room (OR) for an emergency cesarean under general anesthesia. The newborn had Apgars of 0/2/4. The infant was stabilized and transferred to Cook Children’s. A massive transfusion protocol (MTP) was implemented on arrival in the OR. Hemostasis was achieved and the patient was transferred to the intensive care unit (ICU). In the ICU, the patient’s status deteriorated with continual bleeding. The obstetric and emergency response teams were notified. Because they were unable to obtain a central line, an intraosseous line was initiated. Vital signs stabilized, the patient was transferred to the OR for surgical assessment, which resulted in a hysterectomy. The patient was then transferred back to ICU; she continued to bleed and was diagnosed with disseminated intravascular coagulation. With vaginal packing in place, a second MTP was started. After depleting the hospital supply of blood components, community resources were initiated. After partnering with a tertiary medical center, consultation was obtained with maternal–fetal medicine, obstetric hospitalists, and a nursing team. The patient stabilized and was transferred to the tertiary medical center with blood components hanging and sent with her. A total of 30 units were given. The presentation of real cases can impact the health care team and provide greater support for implementation of evidenced-based practices. This case raised awareness of practices that needed to be changed, including implementation of quantification of blood loss (QBL) and incorporating different medical management for blood loss. Learning opportunities were identified, including tranexamic acid administration, QBL implementation, and participation in the state’s Alliance for Innovation on Maternal Health initiative. We partnered with a tertiary medical center’s outreach coordinator to bring their hemorrhage program to this community setting.

A conceptual framework for developing solutions that organise social media information for emergency response teams

ABSTRACTSocial media have great power to spread information, and this is particularly noticeable when an emergency occurs. The extraction of accurate information from social media can offer an important resource for emergency management, both in terms of decision-making and increasing situational awareness. This paper describes a conceptual framework for the development of applications to treat messages from social media. It is designed to select, classify and prioritise, using parameters, messages containing information that is relevant to the emergency context. It allows a team to act on this information and to generate rescue actions that contribute to the emergency solution. It has a collaborative bias, providing perceptual, coordination and communication mechanisms. We also present an instantiation and the simulation of its use in the treatment of tweets (Twitter messages) about two emergencies: an earthquake in Mexico City (19/09/2017) and a California fire (December, 2017). The volume of messages is enormous, but most of them do not present significant value to the emergency response. We categorised those that contained relevant information. With only 2% of the tweets, it was possible to identify and prioritise messages with potential to aid in response and rescue operations.

Tracking Precarious Aerial Swaggers using IoT-Enabled Drone

Emergency response teams are accused with ensuring citizen safety from life-threatening events such as structural fires, gas leakages, vehicle accidents, and precarious material spills. While overseeing such occasions is dangerous, the release of precarious materials, such as toxic chemicals, into the atmosphere is particularly challenging. Upon landing in a scene, response teams must quickly identify the precarious substance and the contaminated area to limit exposure to nearby population centres. For airborne toxins, this appraisal is confounded by natural conditions, for example, alters in wind speed and course that can cause unstable, elevated swaggers to move powerfully. Without a way to dynamically monitor and assess atmospheric conditions during these events, response teams must conservatively predict the extent of the contaminated area, then orchestrate evacuations, and reroute traffic to ensure the safety of nearby populations. In this paper, we propose outfitting drone with Internet of Things (IoT) sensor platforms to enable dynamic tracking of precarious aerial swaggers. Augmenting drone with sensors enables emergency response teams to maintain safe distances during precarious identification, minimizing first response team exposure. Additionally, we integrate sensor-based particulate detection with autonomous drone flight control providing the capability to dynamically identify and track the boundaries of aerial swaggers in real time. This empowers specialists on call for outwardly recognize swagger development and better foresee and disconnect the effect zone. We describe the composition of our prototype IoT-enhanced drone system and describe our initial evaluations.

P046: Students as first responders: A survey of Canadian campus emergency medical response teams

Introduction: Canadian post-secondary campuses are densely-populated communities and the first home-away-from-home to many students participating in various academic programs, new social activities, and on-campus athletic activities. The diversity of on-campus activities combined with the high-stress of academic programs results in illness and injury rates that may increase the strain on emergency medical systems. Existing on some campuses for more than 30 years, campus emergency medical response teams (CEMRTs) address the need for a local emergency medical service that can provide first-aid in low-acuity situations and rapid response to high-acuity emergencies. In Canada, many student-run volunteer-responder CEMRTs exist but the range of their service capabilities, operations, and their call-volumes have not been described previously. This study aims to fill this knowledge gap. Methods: We surveyed the 30 known campus emergency medical response teams identified through membership in the Canadian Association of Campus Emergency Response Teams. The 32-question survey asked information on their level of training (standard first aid [SFA], first responder [FR], emergency medical responder [EMR]), service operations including call volume, and funding model. This study was approved by the Western University Institutional Review Board. Results: Twenty-four teams completed the survey (80%); the majority of which are located in Ontario (70%, 16 teams). One team reported that they are no longer in operation. Eleven teams (48%) have medical directors. Nine teams (39%) reported responding to ≤100 calls/year, 11 teams (48%) reported 100-500 calls/year, and 3 teams (13%) reported >500 calls/year. Responders of two teams (9%) maintain training at SFA level; 14 teams (61%) have some or all responders with FR training; and 6 teams (26%) have some or all members certified at EMR level. Twenty-one teams (91%) are equipped with AEDs and 19 teams (83%) are equipped with oxygen. Common medications carried include epinephrine (13 teams, 57%), naloxone (12 teams, 52%), and acetylsalicylic acid (9 teams, 39%). Conclusion: Canadian post-secondary campuses have highly-active student-run volunteer CMERTs. Considerable variability in the services provided may reflect the unique needs of the campuses they serve. CEMRTs may reduce low-acuity case demand on local emergency medical response and emergency department services in some communities; their impact on system demand and costs is the subject of future work.

Liver Macrophages: Old Dogmas and New Insights.

Inflammation is a hallmark of virtually all liver diseases, such as liver cancer, fibrosis, nonalcoholic steatohepatitis, alcoholic liver disease, and cholangiopathies. Liver macrophages have been thoroughly studied in human disease and mouse models, unravelling that the hepatic mononuclear phagocyte system is more versatile and complex than previously believed. Liver macrophages mainly consist of liver‐resident phagocytes, or Kupffer cells (KCs), and bone marrow‐derived recruited monocytes. Although both cell populations in the liver demonstrate principal functions of macrophages, such as phagocytosis, danger signal recognition, cytokine release, antigen processing, and the ability to orchestrate immune responses, KCs and recruited monocytes retain characteristic ontogeny markers and remain remarkably distinct on several functional aspects. While KCs dominate the hepatic macrophage pool in homeostasis (“sentinel function”), monocyte‐derived macrophages prevail in acute or chronic injury (“emergency response team”), making them an interesting target for novel therapeutic approaches in liver disease. In addition, recent data acquired by unbiased large‐scale techniques, such as single‐cell RNA sequencing, unraveled a previously unrecognized complexity of human and murine macrophage polarization abilities, far beyond the old dogma of inflammatory (M1) and anti‐inflammatory (M2) macrophages. Despite tremendous progress, numerous challenges remain in deciphering the full spectrum of macrophage activation and its implication in either promoting liver disease progression or repairing injured liver tissue. Being aware of such heterogeneity in cell origin and function is of crucial importance when studying liver diseases, developing novel therapeutic interventions, defining macrophage‐based prognostic biomarkers, or designing clinical trials. Growing knowledge in gene expression modulation and emerging technologies in drug delivery may soon allow shaping macrophage populations toward orchestrating beneficial rather than detrimental inflammatory responses.

Psychiatric Emergencies in Nonpsychiatric Settings: Perception Precludes Preparedness

The implementation of emergency codes has become standard practice in hospitals to provide system-wide preparedness for the early detection and prevention of crises. Psychiatric emergencies in medical/surgical locations, however, are not typically regarded as distinct entities from general security threats. The "security-first" paradigm is a nonclinical intervention that focuses on behavioral containment rather than onthe treatment of underlying psychopathology. This article provides the perspective that countless opportunities to medically intervene upon mental health emergencies are being overlooked due to a national misconception of these entities as security-based functions. A secondary consequence of this misperception is that hospital systems often fail to prioritize an infrastructure onto which clinically-informed emergency response protocols similar to other medical emergency codes may be dependably mounted in the event of accurately detecting psychiatric emergencies. Numerous adverse clinical, workplace safety, and financial outcomes ensue. Using a behavioral emergency response team as a collaborative care model in medical/surgical locations is a promising alternative. Behavioral emergency response teams re-establish patient care within the intervention without omitting security containment. They help rapidly address acute comorbid psychiatric needs without demanding additional psychiatric resources by functioning as trained surrogates of consult-liaison psychiatry as they provide direct clinical oversight into primary teams who would otherwise be unsupported in navigating clinical scenarios extending beyond their typical range of expertise. An analysis using the "Swiss cheese" model of human error trapping offers a comprehensive illustration of how behavioral emergency response teams add multilayered perceptual and mechanistic advantages to barriers commonly encountered when psychiatric emergencies arise in nonpsychiatric settings.

Overview of Leafy Greens–Related Food Safety Incidents with a California Link: 1996 to 2016

An increase in the number of foodborne illness outbreaks associated with produce has been noted in the literature, and leafy greens have been the most common produce category associated with these outbreaks. California is the largest leafy greens producer in the United States, and many related foodborne illness incidents were traced to this state. A systematic overview of leafy greens incidents linked to California was conducted by the California Department of Public Health, Food and Drug Branch through analysis of complaints, routine surveillance sampling, disease outbreaks, and investigations covering 1996 to 2016. The goal was to develop a risk assessment tool to modernize emergency response efforts to foodborne illnesses related to leafy greens. A database including environmental, epidemiologic, and laboratory information for each incident was developed, and descriptive analysis was performed to identify trends. In the 21-year period analyzed, 134 incidents were identified, the majority of which were surveillance related. Approximately 2,240 U.S. cases of confirmed illness were reported (298 California cases resulting in 50 hospitalizations). Romaine lettuce and spinach were the most commonly implicated vehicles. The most prevalent hazard type was microbiological, in particular bacterial, specifically associated with pathogenic strains of Escherichia coli. In California, the overview provided the Food and Drug Branch with a platform to (i) enhance its Food Safety Program, Emergency Response Unit, and California Food Emergency Response Team; (ii) assist in more efficient investigation, response, control, and prevention of California-linked foodborne illness incidents; and (iii) identify knowledge gaps and develop effective definitions, procedures, training, guidelines, and policies that will be used to help prevent future outbreaks. Outcomes provide insight into the situation in the largest leafy greens-producing state and may be used to prioritize limited national food safety resources and aid in future leafy greens-related research and foodborne incident investigations.

In-situ Interprofessional Perinatal Drills: The Impact of a Structured Debrief on Maximizing Training While Sensing Patient Safety Threats.

IntroductionIn-situ interprofessional emergency team training improves participants’ with confidence and knowledge and identifies latent safety threats. This study examined the impact of a structured debrief on an interprofessional perinatal team’s ability to identify latent safety threats and assess competency in managing perinatal emergencies. It was hypothesized that latent safety threats would be reduced and checklist compliance would increase during subsequent in-situ perinatal team training.MethodsTwo in-situ training sessions were held six months apart. The perinatal emergency response team provided care for a standardized patient with preterm twin gestation. Each session included off-ward delivery and resuscitation of the first infant, transportation to appropriate inpatient units, cesarean delivery, and resuscitation of the second twin. Postpartum hemorrhage ensued, requiring massive transfusion protocol activation. Medical experts assessed team performance with critical action checklists. A structured debrief identified latent safety threats, developed action plans, and reviewed checklist compliance. Checklist compliance rates were analyzed using a z-ratio test.ResultsThe first training session: seven teams (75 staff) completed 75% (292/391) critical action checklist items and identified 34 latent safety threats. Second training session: four teams (45 staff) completed 89% (94/106) critical action checklist items. Ten latent safety threats were mitigated during the second session. Utilizing a z-ratio, a significant difference was detected between the overall checklist compliance rates of the two sessions, z = -3.069, p = .002. Post-hoc power calculation was <10%.ConclusionsIn-situ interprofessional perinatal emergency team training is feasible, identifies latent patient safety threats, and may improve team competency.

Detective Casey and the April 2010 shooting

Theoretical basis Several theories emerge in a reading of this case; however, the primary or overarching focus of the case is the role of communication and how ineffective or non-existent communication during training, coordination and follow-up of a critical incident can impact officers, departments and communities. Furthermore, this case provides valuable insights for civilian businesses on the importance of formal and informal communication. Research methodology The case was based upon extensive interviews with a police officer involved in a shooting. In addition to extensive semi-structured interviews, research for the case also included review of psychological evaluations of the officer involved, journalism pieces and blogs written about the shooting under study, and reports from the Attorney General’s investigation of this shooting. Case overview/synopsis Detective Keith Casey, an undercover Narcotics Officer for 12 years, had trained and served as a member and point person for the Emergency Response Team (i.e. Special Weapons and Tactics (SWAT) team) for seven years. On April 25, 2010, Casey was working on an electronic surveillance (i.e. a wiretap) out of the FBI office when he received the call about a barricaded suspect in Hammonton, New Jersey. The barricaded suspect had pulled a gun on an EMT in Deptford New Jersey and threatened to kill himself and others. At approximately, 4:10 a.m. because he was perceived to be a danger to himself and others, the SWAT team was sent into the home where the suspect was barricaded. After ignoring repeated commands to drop his weapon, the barricaded suspect was struck down by cases moments after the SWAT team entered the home. Preparation and training on intervention and team management has become increasingly more important for police departments around the world. In recent years, a great deal of attention has been placed on officer bias; however, little attention has been placed on officers who pull the trigger and the events that follow. This case offers a first-hand account of how communication, between all players, before, during and after an officer involved shooting impacts all phases of the critical incident. Complexity academic level This case is targeted to undergraduate and graduate students in organizational communication, but may include public relations, introduction to management, strategic management and organizational behavior, especially if the course includes a discussion of communication and crisis management.

Obstetric Triage Scales; a Narrative Review.

The growing demand for high-quality obstetric care and treatment has led to the advent and development of a field known as obstetric triage. The present review study aimed to examine the development of tools and criteria for obstetric triage services. In this narrative review, two authors searched for related articles using the keywords of "obstetric triage, gynecology triage, perinatal Triage, maternity triage, midwifery triage" AND "tool, index, scale, questionnaire, system". With Persian and English language limitation, searches were performed in Scopus, Google Scholar, Scientific Information Database, ProQuest, Medline, Embase and Web of Science databases for articles published from 2000 to 2018. Out of the 289 articles reviewed in this study, 8 articles met the eligibility criteria. Out of these 8 articles, 6 were dedicated to introducing a tool designed and only 2 introduced an obstetric triage system. The obstetric triage tools and systems covered included Emergency Severity Index (ESI), Obstetric Triage Acuity Scale (OTAS), Birmingham symptom specific obstetric triage system (BSOTS), Maternal Fetal Triage Index (MFTI), Florida Hospital Obstetric Triage Acuity Tool, self-assessment questionnaire for gynecologic emergencies (SAQ-GE) and Perinatal Emergency Team Response Assessment (PETRA). Overall, the validity and reliability of the studied method were investigated and found to be acceptable in only 5 of the reviewed studies. The review showed the lack of consensus on how to devise a single standardized tool or system for obstetric triage. The comparison of different obstetric triage tools and systems demonstrated the need for a standardized and widely-approved system with high validity and reliability and standard definitions for obstetric triage to determine the right priority and waiting times of obstetric care services.

Streets, storm surge, and the frailty of urban transport systems: A grid-based approach for identifying informal street network connections to facilitate mobility

A variety of real-world infrastructure systems, including power grids, telecommunications, roads and social networks can be conceptualized and modeled using basic concepts from graph theory and network science. The abstraction of real-world systems into an edge-node topology enables analysts to quantify and characterize a range of network properties, including structure, connectivity, and modularity, as well as the attributes of individual nodes and edges such as degree, criticality, and betweenness. One major problem with the abstraction process associated with traditional network analysis is that edges and nodes are stripped of important proximal, contextual information that is critical for understanding how network elements operate in situ. For example, the geographic context of an elevated causeway is significantly different than a landlocked residential street, yet they are both simply represented as edges in traditional network modeling. The purpose of this paper is to explore the implications associated with network abstractions, including the loss of geographic fidelity, and why it matters for vulnerability analysis and emergency response during extreme events. Specifically, this paper introduces an alternative network conceptualization that preserves important on-network information, but also provides in situ context for local network elements, helping to deepen our understanding of local operating conditions. A case study for hurricane storm surge flooding in Volusia County, Florida is utilized to highlight how the developed approach better captures the realities of how evacuees and emergency response teams can leverage information for both on- and off-network space during a major disaster.

What structural factors influencing emergency and disaster medical response teams? A comparative review study.

INTRODUCTION:An important indicator increasing the survival chances of patients and injured people immediately after emergency and disaster is the rapid access to medical services. The establishment of Emergency and Disaster Medical Response Teams (EDMRTs) is one of the main strategies to improve response capacity and capability in the field of EDMRT. This study aimed to probe the structural factors influencing of EDMRTs.METHODOLOGY:In this study, a comparative review method was used. The current study was conducted between March 2017 and September 2018. For this, articles, books, formal reports, and information concerning the available websites regarding the structure of EDMRTs were analyzed. To access relevant scientific articles, an extensive search was carried out in several steps using divergent keywords in the Scopus, ProQuest, PubMed, ScienceDirect, and Google Scholar databases. After accessing the resources and documents, the process of analyzing and comparing different team structures was carried out using content analysis.RESULTS:Following the search of relevant databases and websites, the structure of EDMRTs in the United States, Australia, Japan, Turkey, New Zealand, Canada, and the World Health Organization were taken into consideration and compared. Two areas of “Organization and Management” as well as “Capacity and Capability Development” were explored along with multiple subsets.CONCLUSION:The results of this study revealed that the model and structure of EDMRTs have direct relationship with such elements as the structure of the disaster risk management system, risk assessment, impact of the hazards and medical needs of the affected area, population distribution, level of team activity, and timing of the teams' presence after disasters. The research team recommends designing and conducting studies for determine the roles and responsibilities of the teams.

Developing a Portable, Reusable, and Inexpensive Magnesium-Air Fuel Cell

Global warming is becoming an increasingly bigger problem, and it is important that we work to find alternative sources of electricity. The goal of this project was to determine what metal is best for use in a portable and reusable metal-air fuel cell. The three metals tested for use in a metal-air fuel cell were aluminum, zinc, and magnesium. These metals were selected due to their high theoretical voltage, faradic capacity, and widespread usage as sacrificial anodes in the naval shipbuilding industry. We created a design for a portable and reusable fuel cell frame in Google Sketchup and then 3D-printed. For each of the three types of metal, we tested the fuel cell three times over a total span of six hours. Every hour, we recorded the voltage and current produced by the fuel cell. After the three trials, we averaged the data at every measurement point. Our data shows that magnesium produced the greatest voltage and current. On average, magnesium produced 197% more voltage and 740% more current than zinc. Additionally, magnesium produced a voltage 280% greater and a current 1593% greater than aluminum during the six hours of testing. This project indicates that magnesium produces the greatest voltage and current in a metal-air fuel cell, as well as the viability of magnesium-air fuel cells. Due to their long shelf life and self-sufficiency, they can be used by emergency response teams and in developing areas.

Two-Year Mortality in Patients with New- Onset Atrial Fibrillation in Hospital: A Comparison Analysis with Pre-Existing Atrial Fibrillation

Background: Mortality rate of atrial fibrillation(AF) is high in hospitalised populations. Medical Emergency Team (MET) response is frequently activated in the context of care for patients with AF with rapid ventricular response (AFRVR). Incidence of long-term mortality and predictors of mortality in patients with either pre-existing or new-onset AF have not been extensively compared. Aim: To study long-term mortality in patients with new-onset AF diagnosed from MET response cohort compared to those with pre-existing AF Methods: Between 2015 and 2016, consecutive patients with new (n = 137) and pre-existing AFRVR (n = 137) defined by ventricular rate of >130 beats per minute were identified from the MET database. New AF was confirmed by a cardiologist on electrocardiogram and the primary outcome was defined as all-cause mortality at 2-year follow-up. Results: New-onset AF group were younger (74 ± 12 vs. 78 ± 11years, p = 0.003), with comparable gender distribution (Male:Female = 0.53:0.47 vs. 0.45:0.55,p = 0.23) and lower prevalence of hypertension (63% vs.76%,p = 0.02) and diabetes (28% vs.32%, p = 0.41) compared to those with pre-existing AF. Between new and pre-existing AF groups, there were no difference in mean temperature(36.8 ± 0.8 vs. 36.8 ± 0.9, p = 0.71) and systolic blood pressure (130 ± 25 vs. 128 ± 23, p = 0.63). Two-year mortality was high in both new and pre-existing AF group (27% vs.19%, p = 0.11). On multivariable analysis, anticoagulant therapy commenced after MET response, but not new AF (OR = 1.8,0.96–3.4, p = 0.069) was associated with 50% mortality reduction (OR = 0.51, 95%CI = 0.27–0.97, p = 0.04) whereas patients requiring a medical unit admission were 3.8 times more likely to die (OR = 3.8, 1.87–7.7, p < 0.0001). Conclusion: Amongst patients meeting MET team response for AFRVR, all-cause mortality at 2-year follow-up is high. Furthermore, anticoagulation therapy associates with a reduced risk, regardless of time of AF onset. Further prospective controlled trials are required to support the evidence.

Milestones Related to the Development of Organizational Aspects of Cybersecurity and Protection against Cyber-Threats in the Czech Republic

Although the Czech Republic belongs to the most “internetised” countries in the world, its information and communication security policy (as well as the protection of the critical information infrastructure) lagged behind for a relatively long time, when compared to most of the remaining European countries. Building the hierarchy regarding the umbrella teams of the Cybernetic Emergency Response Teams (CERT) and Computer Security Incident Response Teams (CSIRT) type (regardless of whether we call them governmental, national or otherwise) was unthinkable without the contribution of the private sector that substituted many functions of the state in this field. The whole process can be understood as an interaction of international and national pressures appealing to the solution of the situation.

A Model for Afghanistan’s Cyber Security Incident Response Team

Persistent cyber threats require effective and efficient mitigation techniques. The cyber security incident response team (CSIRT) is expected to respond to external and internal cyber threats or incidents. Various organizational, national, and international level CSIRTs have been developed for defending and protecting such kinds of threats. Developing countries like Afghanistan have also formed a Computer Emergency Response Team for handling national cyber incidents although it provides limited services to only a few constituencies and depends on funding from foreign donors. Therefore, a new organizational model was proposed to provide guidelines for a specific country, instead of a provision from a constitutional context. Five national CSIRTs were compared to identify their features and characteristics to provide basis for the proposed framework. The study presented the proposed model based on two CSIRT organizational models that incorporated a new funding strategy to achieve a Sustainable National CSIRT for developing countries. Our model combined coordinate and security teams; if consists of constituency’s mission, services, resources, organizational framework, and funding strategy. This study employed qualitative method by using document analysis and interview techniques. CSIRT for Afghanistan known as AFCERT was evaluated in terms of structure, services, resources, and funding. AFCERT services level were below the standard of a national CSIRT. Therefore, a more sustainable service need to be provided based on the proposed model components. Findings showed the suitability and potential of the model in controlling and mitigating cyber-attacks, more specifically in the context of Afghanistan.

Model of data for improving cybersecurity IP-PBX

The current state of development of information and telecommunication systems is impressive with its pace of implementation, scope and variety of technologies. Introduction of IP-telephony in various spheres of human activity allows ordinary people to simplify their lives, implement the main aspects for business, such as: increasing sales, improving employee efficiency, improving customer service quality, automating work processes, presenting the necessary information for management, etc. This technology (IP-telephony) has become a vivid symbiosis of classical telephony and the Internet, combining all the most important functions of these technologies. However, using IP telephony is important to ensure the necessary level of cybersecurity, since failure to implement this aspect can lead to significant financial and image losses, so the development and research of new effective methods for improving the cyber security of IP-telephony is an urgent task. Therefore, the purpose of this work is to build a data model for improving the cyber security IP-PBX. To achieve the goal, we will create a variety of types of IP-PBX vulnerabilities, a set of steps to implement cyberattack on the IP-PBX and a set of actions to improve the cyber security of the IP-PBX, which will identify possible types of vulnerabilities for the IP-PBX, investigate the sequence of steps to implement cyberattacks on IP-PBX and after performing preventive actions to improve the level of cybersecurity IP-PBX. After setting up an IP telephony server, following the example presented in the article, successful implementation of a cyberattack requires a very high level of intruder qualification of hacker and significant logistical costs. The developed model will be useful, first of all, for system administrators, as well as for information security specialists in the response teams for cyber incidents such as Computer Emergency Response Team / Computer Security Incident Response Team, which are responsible for the security of information and telecommunication systems within enterprises and organizations.

BRUNEI DARUSSALAM'S E-GOVERNMENT STRATEGY IN OVERCOMING CYBER THREATS

&lt;p&gt;&lt;span style="font-size: medium;"&gt;&lt;span style="font-family: Times New Roman;"&gt;&lt;span&gt;E&lt;/span&gt;&lt;span lang="EN-US"&gt;-Government is a government administration system that plays a vital role in the international global communication, and greatly determines the progress of a state. However, the government administration system that utilizes Information and Communication Technology may be exposed to threats, especially threats originating from cyberspace. This research was carried out with the aim to analyze Brunei Darussalam's E-Government strategy in overcoming cyber threats. This study uses descriptive qualitative research methods accompanied by data obtained from the presentations and interviews during the overseas field study visits in Brunei Darussalam by the representatives of the Ministry of Foreign Affairs and Trade (MOFAT), IT Protective Security Services (ITPSS), and the Prime Minister’s Office (PMO) of Brunei Darussalam, as part of a research related to Brunei Darussalam's e-Government strategy in overcoming cyber threats. The results of this study indicate that the Brunei Darussalam’s e-Government strategy in overcoming cyber threats was carried out by focusing on citizen-centric service delivery in stages. It begins with the establishment of a law on computer abuse in 2000, followed by the establishment of Brunei National Computer Emergency Response Team (BruCERT) in 2004, introduction of Internet Ethics and Cyber Security Awareness Program in 2009, and the development of a national cyber security framework in 2014. All are integrated into a common policy coined as Brunei Insight 2035. This can be an input for the implementation of e-Government in Indonesia, in order to improve the equality and openness of access to information and communication in Indonesia, without neglecting the principles of security and comfort in communicating and obtaining information.&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

The meaning of ‘worried’ in MET call activations: A regional hospital examination of the clinical indicator

Little is known about why nurses escalate a Medical Emergency Team (MET) response based on ‘worried’ criteria or what clinical findings define a ‘worried’ MET call. Limited clarity exists in nursing literature regarding the clinical definition of ‘worried’ in medical emergencies. Commonly ‘worried’ terminology is associated with nursing intuition about a patient’s condition before signs of decline in clinical condition. This research has identified the exact clinical cause of ‘worried’ escalations, with evidence to support that clinical reasoning and patient deterioration are the main cause of ‘worried’ activation. This research has also highlighted areas for further professional development to enhance levels of patient safety and quality care within a regional hospital setting.