Emergency Management Research Articles

Evaluating the Contribution of Healthcare Administrators in Promoting Occupational Safety

The role manager’s play in fostering safety at work has attracted much attention as healthcare environments increasingly more complex. Though they front lines in providing vital services, healthcare professionals also run several hazards in their jobs. The need of healthcare managers in supporting a mentality of safety in healthcare institutions is examined in this article. It looks at how managers may change safety rules, provide training courses, use safety safeguards, and guarantee legal observance to lower dangers at their place of work. The research underlines how important it is for leaders to establish safety targets, monitor staff members’ health and safety, and guarantee that medical professionals have the right tools and expertise to sustain their as least possible safety. The study also covers how laws, organisational structure, and budget allocation might contribute to improve safety results. Several research and case studies are investigated in this study in order to pinpoint the most important steps healthcare managers should follow in managing problems including mental health, stress, accident prevention, and infections. It also underlines the necessity of ongoing evaluation and change of safety rules to fit changing problems in the medical field. This article investigates how crucial managers are for reducing workplace hazards and ensuring everyone is safe by means of their decisions impacting safety outcomes. Ultimately, it emphasises that effective healthcare administration entails prioritising the health and safety of healthcare professionals above mere seamless execution of activities.

Research on the relationship between key risk factors of university emergencies based on ISM-MICMAC.

In order to accurately analyze the interaction among the risk factors of university emergencies, firstly, based on the key performance indicator (KPI) concept, by initially extracting risk factors, identifying initial risk factors, and correcting initial risk factors, and the risk factors of emergencies in universities were divided into three categories: human factors, environmental factors, and management factors, and 18 key risk factors of emergencies in universities, including psychological problems, weak legal awareness and lack of safety awareness, were subdivided and determined. Secondly, the interpretive structure model (ISM) was used to construct a multi-layer hierarchical model of the relationship between university emergencies risk factors, clarified the hierarchical affiliation between the risk factors of university emergencies, divided the risk factors of university emergencies into surface direct factors, middle indirect factors and deep fundamental factors, and analyzed the coupling effect of various risk factors on university emergencies. Thirdly, combined with the matrix impacts cross-reference multiplication applied to a classification (MICMAC), the driving force and dependence force of each risk factor of university emergencies were obtained, and the risk factors of university emergencies were divided into spontaneous factors, independent factors, dependent factors, linkage factors, etc. 4 categories, and targeted governance and prevention measures were proposed for different types of risk factors. Finally, the research results will help universities to accurately identify, warn and manage the key risks of emergencies, and provide a reference for the management of emergencies in universities.

Study on disaster-causing probability evaluation of gas pipeline in karst area.

In this paper, a disaster-causing probability evaluation method of gas pipelines in karst areas based on disaster system theory and vulnerability theory is proposed. The hazard evaluation index system of gas pipeline disaster events in karst areas is established from three aspects: the activity of disaster-prone environment, the risk of disaster factors and the vulnerability of disaster-bearing bodies. Combined with the advantages of information transmission and updating of the Bayesian network model, the hazard probability of disaster events is gradually calculated from a multi-level perspective. Based on the structural reliability theory, the vulnerability evaluation function of gas pipelines in karst areas is established by considering the interaction between disaster hazard intensity and disaster resistance ability. Meanwhile, the design checkpoint method and finite element simulation are used to calculate the vulnerability probability. Finally, a new disaster-causing probability evaluation approach for gas pipelines in karst areas is formed, which comprehensively considers the event hazard and the pipeline vulnerability. The work presented in this paper can provide a reference for the safety management and accident prevention of gas pipelines crossing the karst areas.

Crisis response strategies of universities during the ongoing war: Beyond experience and responsibilities

Extraordinary threats of the large-scale stage of the Russian-Ukrainian war challenged the resilience and capability of all higher education institutions. However, their influence varied with location, infrastructure damage, internal capacity for changes and academic community resilience, external support, and solidarity initiatives. The purpose of this study is to assess the implementation of crisis management decisions and the formation of a crisis response strategy for a university in wartime (on the example of Kherson State University). The assessment draws on thematic analysis, the case method, statistical data analysis, and a survey of academic community members in 2023 (664 students and 150 staff), which focused on identifying a vision of the university’s values and strategic priorities. It showed the priorities of ensuring education quality and research, expanding international cooperation, diversifying funding, and strengthening cooperation with external stakeholders, including employers. The analysis of the university management’s actions in 2022–2024 demonstrated that the university transitioned from a resistance strategy (2022) as the first situational response to the large-scale invasion and occupation to a resilience strategy and the return to progressive development in the years ahead. The paper concludes that successful crisis management follows the key principles: flexibility, value orientation, and scaling up. It offers management guidance for developing a crisis response strategy that can be adapted to the unique needs of other universities: a comprehensive analysis of the crisis situation, crisis communication, planning of resource maintenance, and transparent and participatory decision-making for crisis management based on values and ethical implications. AcknowledgmentThis study is part of project No.101129236+DigiUni-ERASMUS-EDU-2023-CBHE). The research was partly supported by the 2024 BridgeUSA Ukrainian Academic Fellows Program, funded by the U.S. Department of State’s Bureau of Educational and Cultural Affairs (ECA), with additional funding provided by Harvard University and administered by the American Councils for International Education. The opinions expressed herein are the authors’ own and do not necessarily express the views of either the Bridge USA or American Councils.The authors express their gratitude to the vice-presidents, deans of faculties, and academic and non-academic staff of Kherson State University who participated in the development of institutional documents that implement crisis management decisions presented in this paper and form a crisis response strategy for the university during martial law.

Beyond Crisis: Enhancing Behavioral Response Through a Conceptual Framework.

The objective of the study is to present a conceptual model informed by existing literature surrounding behavioral health crises and response teams. The Behavioral Crisis Response Model (BCRM) was developed through a comprehensive literature review, synthesizing existing knowledge to clarify the structure, relationships, and processes between patients and Behavioral Response Teams (BRTs), focusing on published literature from 2018 to 2023. Themes to inform the BCRM were developed through iterative review and discussion with an expert panel. The BCRM framework comprises five key domains: Patient-Centered Care, Preparation, Planning, Execution, and Evaluation. Each domain encompasses specific actions and strategies to ensure comprehensive and effective crisis intervention. The Patient-Centered Care domain ensures the patient remains the focus during a crisis. The Preparation domain focuses on readiness through training and resource verification. The Planning domain involves initial and risk assessments, followed by devising a tailored response plan. The Execution domain emphasizes the implementation of the response plan with adaptable leadership styles. The Evaluation domain involves debriefing, root cause analysis, and performance reviews to promote continuous improvement. The BCRM offers a patient-centered, structured approach to managing behavioral health crises and enhancing team cohesion and effectiveness. Further evaluation of adopting the BCRM is needed within health care institutions to improve patient outcomes, reduce harm, and advance better care quality.

Emergency managers' challenges with wildfires and related cascading hazards in California.

This study investigates the complexities faced by emergency managers in wildfire-prone areas to uncover pressing issues and potential solutions. Four themes are discerned through three focus group discussions with emergency managers from nine counties across California. First, there is unequal access to resources for both risk assessment and response, with counties that have fewer resources facing significant challenges in effectively managing wildfire risks. Second, effective risk communication depends on the available resources and the unique characteristics of each community. Participants stress the need for improved communication tools to reach vulnerable groups (e.g., seniors, individuals with disabilities, non-English-speaking residents). Third, the complexity and confusion surrounding multi-level collaboration in wildfire management is a recurring theme. Participants note that unclear roles and responsibilities between state and federal agencies hinder response efforts, underscoring the need for better coordination and transparent communication at all levels. Fourth, innovative responses (e.g., creative evacuation strategies, collaborative efforts) are recognized as imperative for managing wildfires and their cascading impacts in resource-constrained areas. The findings highlight that achieving equitable and effective preparation, response, and resilience for vulnerable communities requires a comprehensive understanding of wildfire severity and community susceptibility, coupled with active collaboration among emergency managers, policymakers, and both governmental and non-governmental organizations.

Research on risk evolution, prevention, and control of fire and explosion accidents in hydrogen refueling stations based on the AcciMap-FTA model

Research on risk evolution, prevention, and control of fire and explosion accidents in hydrogen refueling stations based on the AcciMap-FTA model

V-FCW: Vector-based forward collision warning algorithm for curved road conflicts using V2X networks

The implementation of advanced driver assistance systems (ADAS) has significantly impacted the prevention of traffic accidents, particularly through the forward collision warning (FCW) algorithm. Nevertheless, traffic conflicts on traffic routes remain a significant issue, since most FCW algorithms cannot accurately determine the distance between the host vehicle (HV) and remote vehicle (RV) on curved roads. Hence, this study proposes a vector-based FCW (V-FCW) algorithm to address the issue of false warnings on unconventional road sections. The V-FCW algorithm employs vector relationships to estimate the poses of HV and RV at the current and next moments, thereby effectively calculating the relative angles. Firstly, the HV and RV transmit their position vector, velocity vector, and heading angle in real time via the vehicle-to-vehicle (V2V) communication technique. Subsequently, the localization of lanes is conducted through the vehicle-to-infrastructure (V2I) communication technique, with the assistance of roadside unit (RSU)-based local maps. Finally, a V-FCW algorithm was implemented on the Simcenter Prescan simulation platform and a cellular vehicle-to-everything (C-V2X, i.e., the combination of V2V and V2I) communication platform. The simulation results demonstrate that the proposed V-FCW algorithm can accurately identify and warn dangerous vehicles on both straight and curved roads. Moreover, the experimental results obtained from the hardware-in-the-loop approach illustrate the efficacy of the proposed V-FCW algorithm in accurately forecasting four warning levels on both straight and curved roads. Consequently, this study yields a significant contribution to the field of vehicle-road cooperation in C-V2X-enable intelligent driving.

Managing Select Medical Emergencies During Long-Duration Space Missions

INTRODUCTION: Space agencies and private industries worldwide are planning long-duration missions, which come with complex medical challenges. Crews must be prepared for medical emergencies due to longer mission durations, increased travel distance, communication delays, and higher levels of isolation. This study aimed to systematically review the existing literature and knowledge gaps that could be related to the management of medical emergencies during long-duration space missions. METHODS: A scoping review was conducted following the PRISMA extension for scoping reviews. Electronic databases, including ARC, Embase, IEEE Xplore, Medline Ovid, PsycINFO, and Web of Science, were searched from inception to June 1, 2023. Empirical study designs published in English or French were eligible for inclusion provided they described the management of at least 1 of 10 prioritized potentially mission-critical medical conditions. RESULTS: A total of 484 full-text studies were assessed for eligibility, with 99 included in this review. Conditions with the highest representation were spaceflight-associated neuro-ocular syndrome (N = 23), herniated disk (N = 22), and nephrolithiasis (N = 22). Conditions with the least representation were cerebrovascular accidents (N = 4), eye penetration (N = 3), and retinal detachment (N = 2). The duration of missions varied between 5 and 438 d for studies conducted in space. The data reflected the scarcity of evidence concerning prolonged deep-space exposure beyond the Earth’s magnetosphere. DISCUSSION: Substantial medical autonomy is essential for the success of long-duration space missions, when medical support and even communication will be limited. Future research should prioritize knowledge gaps to improve preparedness and medical autonomy for space exploration activities. Tran K-A, Pollock NW, Dion P-M, Lapierre M, Tremblay S, Witteman W, Rhéaume C, Lafond D, Fortier F-A, Marion A, Dutil-Fafard L, Morin C, LePabic G, Monnot DPM, Archambault PM. Managing select medical emergencies during long-duration space missions. Aerosp Med Hum Perform. 2025; 96(2):143–154.

Pandemic preparedness: analyzing national plans for respiratory pathogen pandemics in the Americas region.

The International Health Regulations (2005) (IHR), requires that States Parties develop their capacities to detect, assess, and respond to public health threats and report to the World Health Assembly through the States Parties Annual Report (SPAR). The National Pandemic Preparedness and Response Plans (PPRP) contribute to countries capacities however there are some discrepancies between both tools. To identify gaps and define priority actions to strengthen pandemic plans, we assessed the concordance between national pandemic preparedness and response plans for respiratory pathogens against the pandemic checklist published in 2023 and the SPAR. In this retrospective, semi-quantitative study, conducted in August 2024, we reviewed the most recent respiratory pandemic plans for 35 PAHO member states and assessed their concordance with (1) actionable guidelines in the World Health Organization pandemic checklist and (2) IHR (2005) core capacities using the latest SPAR tool. We developed 25 tracking questions to identify gaps, strengths, and opportunities for improvement in the pandemic plans, using the pandemic checklist built on the capacities and capabilities described in the WHO's Preparedness and Resilience for Emerging Threats (PRET) Module 1. We used a five-point scale (from 1, when the subcomponent was not mentioned, to 5, when the subcomponent was described at all levels), and we calculated the average pandemic plans score (PP score) for each component. Data from pandemic plans (2005-2024) were compiled, selected, analyzed, and scored. We compared the average SPAR score and the PP score to assess areas of convergence and variance between preparedness and capacities. The analysis was carried out using R and Excel. We analyzed 35 respiratory pandemic plans: 29 were influenza-specific, five were COVID-19-specific, and one was not pathogen-specific. Most current national plans showed limited alignment with the content recommended in the PRET pandemic checklist. At regional level, the lowest concordance between plans and pandemic checklist was in the following subcomponents Public Health and Social Measures (80% of the plans had a score of 1); Emergency, Logistics and Supply Chain Management (74%); and Research and Development (71%). Conversely, the strongest subcomponents (≥40% of plans with a score of 4 or 5) were: Policy, Legal, and Normative Instruments (45%); Coordination (46%); and Surveillance: early detection and assessment (43%). In most countries, the SPAR scores tended to be higher than PP scores, except for Argentina (the newest plan reviewed) for which the pattern was reversed, and the PP scores exceeded the SPAR scores. Given the gaps identified between current plans and the global standards espoused by the PRET Module 1 initiative, it is recommended that countries build on the strengths of their national pandemic preparedness and response plans and update them using PRET module 1. This will support countries advance the capacities required by the IHR.

A Systematic Literature Review of Trauma Systems: An Operations Management Perspective.

Trauma systems provide comprehensive care across various settings, from prehospital services to rehabilitation, integrating clinical and social care aspects. Established in the 1970s, these systems are pivotal yet under-researched in their operational management. This study aims to fill this gap by focussing on the integration of operations management (OM) techniques to enhance the efficiency and effectiveness of trauma systems. By leveraging proven OM strategies from other healthcare sectors, we seek to improve patient outcomes and optimise system performance, addressing a crucial need for innovation in trauma care operations. A systematic literature review was conducted using the PICOTS framework to explore operational aspects of trauma systems across varied settings, from emergency departments to specialised centres. Searches were performed in 5 databases, focussing on articles published from 2006 to 2024. Keywords related to operational research and management targeted both trauma systems and emergency management services. Our method involved identifying, synthesising, and summarising studies to evaluate operational performance, with a specific emphasis on articles that applied operational research/management techniques in trauma care. All eligible articles were critically appraised using 2 quality assessment tools. Employing Donabedian's framework to analyse the quality of trauma systems through structure, process, and outcome dimensions, our systematic review included 160 studies. Of these, 5 studies discussed the application of the Donabedian evaluation framework to trauma systems, and 14 studies examined structural elements, focussing on the location of healthcare facilities, trauma resource management, and EMS logistics. The 63 studies on process indicators primarily assessed triage procedures, with some exploring the timeliness of trauma care. Meanwhile, the 78 outcome-oriented studies predominantly evaluated mortality rates, alongside a smaller number assessing functional outcomes. Existing evaluation metrics primarily focussed on triage accuracy and mortality are inadequate. We propose expanding these metrics to include patient length of stay (LOS) and rehabilitation trajectory analyses. There is a critical gap in understanding patient flow management and long-term outcomes, necessitating focussed research on LOS modelling and improved rehabilitation data collection. Addressing these areas is essential for optimising trauma care and improving patient recovery outcomes.

A Geospatial Model for Real-Time Predicting Rural Fire Propagation Velocity Using Dynamic Algorithms and Open Data for Advanced Emergency Management

A Geospatial Model for Real-Time Predicting Rural Fire Propagation Velocity Using Dynamic Algorithms and Open Data for Advanced Emergency Management

Knowledge, attitudes, and practices of elderly diabetes patients regarding home emergency management of acute complications.

This study aims to assess the knowledge, attitudes, and practices (KAP) of elderly diabetic patients regarding the home emergency management of acute diabetic complications, which is critical for preventing severe outcomes and ensuring timely intervention in emergencies. This cross-sectional study was conducted between September and October 2024 at the Second Hospital of Shanxi Medical University, among all elderly diabetic patients who voluntarily participated. Demographic information and KAP scores were evaluated. A total of 409 valid questionnaires were analyzed, yielding an effective rate of 98.32%. Among the participants, 218 (53.3%) were female, and 134 (32.76%) had been diagnosed with diabetes for less than 1year. The mean scores for KAP were 12.98±6.65 (possible range: 0-28), 45.76±6.30 (possible range: 11-55), and 51.74±8.24 (possible range: 13-65), respectively. Structural equation modeling (SEM) revealed that education level, diabetes health education, and main treatment method significantly influenced knowledge. Additionally, knowledge and complicating diseases impacted attitude, while both knowledge and attitude strongly influenced practice. Education level, diabetes health education, and main treatment method also indirectly affected attitude and practice. Elderly diabetic patients demonstrated inadequate knowledge but exhibited generally positive attitudes and practices regarding the home emergency management of acute diabetic complications.

Developing a comprehensive framework for evaluating public health emergency management program implementation: A scoping review.

Public health emergencies and disasters highlight gaps in health systems' emergency preparedness capabilities. Developing robust public health emergency management (PHEM) programs is crucial yet challenging. Existing assessment tools are limited in scope or lack standardized measurement. The aim of this study was to identify core domains of PHEM implementation status and key influencing factors. A scoping review. A literature review and focused desk review were conducted. We searched PubMed, Web of Science, Scopus, and Google Scholar to retrieve relevant studies that explored existing PHEM frameworks, core components, factors influencing implementation, and evaluation tools presented in empirical studies. Additionally, a systematic search of authoritative organizational websites was performed to identify relevant guidelines and frameworks. Subject matter experts consolidated the findings from these diverse data sources through a consultative desk review process. Out of 7232 studies identified, 50 studies met the eligibility criteria and were included in this review. Four core domains of PHEM implementation status were identified: overall implementation level; individual factors (capacity building, resources, engagement, and attitudes); organizational factors (information sharing, community involvement, planning, responsibilities, resources, leadership, monitoring/evaluation, coordination, infrastructure, and policies); and overarching factors (workforce, funding, governance, and collaboration. Nineteen key influencing factors emerged, including elements such as leadership, resource allocation, and stakeholder engagement. A conceptual framework was developed that incorporates these thematic domains from major health agencies and determinants identified through qualitative, quantitative, and mixed-methods research. This review developed a preliminary evaluation framework for PHEM programs based on a comprehensive synthesis of global evidence. The framework lays the groundwork for further validation and application to advance standardized assessments of PHEM capabilities across diverse contexts, ultimately aiming to strengthen health system resilience against emergencies.

Examining the Efficacy, Safety, and Future Prospects of Tirofiban in Managing Myocardial Infarction among Diabetic Patients.

Myocardial infarction (MI) is a leading cause of death worldwide, particularly in patients with diabetes mellitus (DM). Tirofiban, a platelet GP IIb/IIIa receptor inhibitor, has shown promise as adjunctive therapy in the emergency management of MI in diabetic patients. However, a comprehensive understanding of its use, efficacy, safety, and limitations in this patient population is necessary to optimize treatment strategies and improve patient outcomes. This review article utilized a systematic approach to gather relevant research articles, clinical trials, and studies on the use of tirofiban in the therapy of MI in diabetic patients. Databases, such as PubMed and Google Scholar, were extensively searched using specific keywords related to tirofiban, MI, DM, STEMI, and antiplatelet therapy. The collected data were carefully examined, summarized, and analyzed to provide an extensive overview of using tirofiban in the management of MI in diabetic individuals. The analysis of the gathered literature revealed that tirofiban has demonstrated efficacy in improving clinical outcomes, reducing myocardial ischemia-reperfusion injury, and promoting early recovery of heart function in diabetic patients with MI undergoing percutaneous coronary intervention. The fast on- and off-rate and dose-dependent effect of the drug on platelet aggregation contribute to its effectiveness. However, caution should be exercised due to the potential risk of tirofiban-associated thrombocytopenia. Clinical trials and studies have provided evidence- based dosing guidelines, enabling the safe and effective administration of tirofiban in this patient population. Tirofiban, a platelet GP IIb/IIIa receptor inhibitor, shows promise as adjunctive therapy in the emergency management of MI in diabetic patients. It has demonstrated efficacy in improving clinical outcomes, reducing myocardial ischemia-reperfusion injury, and promoting early recovery of heart function. However, healthcare providers should be cautious regarding the potential risk of tirofiban-associated thrombocytopenia. Further research is needed to optimize dosing guidelines, evaluate long-term safety, and fully understand the benefits and limitations of tirofiban in this patient population. The comprehensive insights provided in this review aim to enhance treatment strategies and improve patient outcomes in the emergency management of MI in diabetic individuals.

Scaling up access to antiretroviral treatment for HIV: lessons from a key populations program in Nigeria.

Over the years, Nigeria has recorded significant progress in controlling the HIV epidemic in the country. HIV prevalence has reduced from 4.1% in 2010 to 1.4 in 2019. The number of people acquiring new HIV infections decreased from 120,000 in 2010 to 74,000 in 2021, and HIV-related deaths decreased from 82,000 in 2010 to 51,000 in 2021. However, the country still faces challenges such as high HIV transmission among key populations (KP) who account for 11% of new HIV infections. Over the years, the government and development partners involved in HIV response efforts in Nigeria have been establishing and scaling up access to services to help address the needs of KPs. Initially, services for KPs as with the general population in Nigeria were largely preventive. Treatment of PLHIV in Nigeria commenced in 2002 and has increased from about 15,000 to more than 1.78 million PLHIVs in 2023. Despite this progress in treatment coverage, however, KPs are not equitably covered. To address this gap, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) launched an ambitious initiative-the Key Population Investment Fund (KPIF)-to target the unaddressed HIV-related needs of key populations (KPs) who are disproportionately affected by HIV. The KPIF initiative was implemented through partner organizations such as the Society for Family Health (SFH), a KP-friendly and indigenous non-governmental organization. Earlier, the program implemented by SFH was largely an HIV prevention program. SFH's transformation, transition, and growth to a comprehensive HIV prevention, care, and treatment service provider was necessary to bridge the gap in the needed expansion of HIV services to adequately meet the care needs of KPs and scale up programs. Therefore, this paper's aim is to share experiences in the transformation of SFH into a comprehensive HIV prevention, treatment, and care service provider in the hope that it may serve as a lesson for organizations with similar objectives.

Bridging the Regulatory gap: Identifying Opportunities to Enhance Buprenorphine Access in West Virginia’s Opioid Crisis Response

Bridging the Regulatory gap: Identifying Opportunities to Enhance Buprenorphine Access in West Virginia’s Opioid Crisis Response

Contribution of the Geodiversity knowledge to social, economic, and environmental health development

With the support of this study, based on published information, this article highlights that Geosciences enable the research of methods and perspectives aimed at optimizing the management of natural resource use, aligning them with ecological limitations and incorporating environmental and social variables into the territorial planning process. Geoscientific information, knowledge, and learning establish a foundation for the supply of essential resources and provide technical and scientific support across various sectors and topics of societal interest. These include mining, where knowledge and proper utilization of essential mineral resources are crucial for human survival and quality of life; energy, which relies on petroleum, gas, coal, peat, and other minerals for nuclear energy generation, as well as for renewable energy sources like wind and solar power. Agriculture, which depends on fertilizers, soil remineralizers, conditioners, and a reliable water supply. In the field of public health, geoscientific knowledge helps ensure the quality of water, soil, and air. In urban planning, it guides land-use restrictions or expansion. In housing, the availability of construction materials is essential. In civil defense, geoscientific insights are crucial for managing landslides, floods, earthquakes, subsidence, and erosion. Regarding infrastructure, geosciences support both social (housing, sanitation, education, healthcare) and economic (energy, transportation, communications) developments. Tourism benefits from geoparks and scenic areas, while environmental studies focus on impact assessments, disaster prevention, and the rehabilitation of degraded areas. Moreover, geoscientific knowledge is indispensable for planning across various sectors of the economy, regions, and societal issues. This applies to public institutions, civil society organizations, private companies, and watershed committees, aiding in the formulation of Regional Development Plans, Ecological-Economic Zoning, Territorial Planning, and strategies for the utilization of continental shelves, coastal environments, and accident prevention. We are entirely dependent on the geological characteristics of natural environments, as they provide the raw materials—such as minerals, water, and food—necessary for our survival and socio-economic development. As geoscientific knowledge and understanding of land and environmental suitability and limitations increase, Geodiversity can play a more significant role in shaping public policies related to urban and rural land use, infrastructure, and the sustainable economic exploitation of mineral and water resources, aligning with Municipal Master Plans, State Development Plans, and the National Territorial Planning Strategy.

Slow Codes are symptomatic of ethically and legally inappropriate CPR policies.

Although cardiopulmonary resuscitation (CPR) was initially used very selectively at the discretion of clinicians, the use of CPR rapidly expanded to the point that it was required to be performed on all patients having in-hospital cardiac arrests, regardless of the underlying condition. This created problems with CPR being clearly inadvisable for many patients. Do Not Resuscitate (DNR) orders emerged as a means of providing a transparent process for making decisions in advance regarding resuscitation, initially by patients and later also by clinicians. Under hospital policies in many countries, however, CPR remains the default position for all patients having cardiac arrest in the hospital if there is no DNR order in place, regardless of whether CPR is medically indicated or in the patient's best interests. "Slow Codes" are the delayed or token efforts to provide CPR when clinicians feel CPR is futile or inappropriate. After giving a historical overview of the development and the changing use of CPR, we argue that more attention needs to be given to the cause of slow codes, namely, policies requiring CPR to be performed as the default action while simultaneously lacking implementing interventions such as advance care planning as a routine policy. This is ethically and legally inappropriate, and hospital policies should be modified to allow clinicians to consider whether CPR is appropriate at the time of arrest. Such a change requires a stronger emphasis on early recognition of patients for whom CPR is not in their best interests and to improve hospital emergency planning.

Public crisis management during COVID-19: an empirical analysis of professional and volunteer emergency responders in Germany

PurposeCrises such as the 2015–2016 European refugee crisis and the 2019 coronavirus disease (COVID-19) represent creeping crises that public organisations manage. Yet both scholars and practitioners lack insight into how well public organisations manage creeping crises that lead to a new normal and whether professionals and volunteers differ in their crisis response.Design/methodology/approachUsing survey data from 112 professional and volunteer emergency responders in Germany, this study examines how crisis-induced reforms and challenges during COVID-19 affected their crisis response. This study uses partial least squares structural equation modelling to evaluate the relationships among crisis-induced reforms and challenges and both crisis response proficiency and collaboration intention.FindingsCrisis-induced reforms support both crisis response proficiency and collaboration intention, while organisational challenges weaken response proficiency. A group comparison reveals that whereas professional responders are more likely to manage crises better than volunteer responders, volunteer responders are more predisposed to engage in future stakeholder collaboration.Practical implicationsPublic sector organisations need to embrace opportunities for better crisis response through crisis-induced reforms. Additionally, policymakers need to acknowledge the differing capabilities and support needs of both professional and volunteer emergency responders.Originality/valueThis study provides insights into creeping crisis management by analysing crisis response proficiency and collaboration for two typical crisis responders: emergency response professionals and volunteers. While demonstrating that crisis response proficiency is more realistic in a professional setting, whereas volunteers more strongly focus on collaboration, the study presents a differentiated view of public crisis responders.