Public Emergency Service Research Articles

BEST-Blockchain-Enabled Secure and Trusted Public Emergency Services for Smart Cities Environment.

In the last few years, the Internet of things (IoT) has recently gained attention in developing various smart city applications such as smart healthcare, smart supply chain, smart home, smart grid, etc. The existing literature focuses on the smart healthcare system as a public emergency service (PES) to provide timely treatment to the patient. However, little attention is given to a distributed smart fire brigade system as a PES to protect human life and properties from severe fire damage. The traditional PES are developed on a centralised system, which requires high computation and does not ensure timely service fulfilment. Furthermore, these traditional PESs suffer from a lack of trust, transparency, data integrity, and a single point of failure issue. In this context, this paper proposes a Blockchain-Enabled Secure and Trusted (BEST) framework for PES in the smart city environment. The BEST framework focuses on providing a fire brigade service as a PES to the smart home based on IoT device information to protect it from serious fire damage. Further, we used two edge computing servers, an IoT controller and a service controller. The IoT and service controller are used for local storage and to enhance the data processing speed of PES requests and PES fulfilments, respectively. The IoT controller manages an access control list to keep track of registered IoT gateways and their IoT devices, avoiding misguiding the PES department. The service controller utilised the queue model to handle the PES requests based on the minimum service queue length. Further, various smart contracts are designed on the Hyperledger Fabric platform to automatically call a PES either in the presence or absence of the smart-home owner under uncertain environmental conditions. The performance evaluation of the proposed BEST framework indicates the benefits of utilising the distributed environment and the smart contract logic. The various simulation results are evaluated in terms of service queue length, utilisation, actual arrival time, expected arrival time, number of PES departments, number of PES providers, and end-to-end delay. These simulation results show the effectiveness and feasibility of the BEST framework.

Time Series Cleaning Methods for Hospital Emergency Admissions

Due to the nature of hospital emergency services, density cannot be easily estimated. It is one of the important issues that should be planned for emergency service managers to have sufficient resources continuously in services that develop suddenly, and emergency interventions are made for human life. Effective and efficient management and planning of limited resources are important not only for hospital administrators but also for people who will receive service from emergency services. In this situation, estimating the number of people who will request service in the emergency service with the least error is of great importance in terms of resource management and the operations carried out in the emergency services. The density of patients coming to the emergency department may vary according to the season, special dates, and even time zones during the day. The aim of the study is to show that more successful results will be obtained because of processing the time series by considering the country and area-specific features instead of the traditional approach. In this paper, the patient admission dataset of the public hospital emergency service in Turkey was used. Data cleaning and arranging operations were carried out by considering the official and religious special days of Turkey and the time periods during the day. The data set is first handled holistically, and its performances are measured by making predictions with the LSTM (Long Short Term Memory) model. Then, to examine the effect of time zones, performance values were calculated separately by dividing each day into 3 equal time zones. Finally, to investigate the effect of triage areas on the total density, the model performance was measured by dividing the data forming each time zone into 3 different triage areas in 3 equal time periods. Three stages were applied both on the raw data set and on the data created by extracting the official, religious holidays, and weekend data specific to Turkey. According to the MAPE (Mean Absolute Percentage Error) and RMSE (Root Mean Square Error) results, more successful results are obtained thanks to the cleaning and editing processes. Thanks to the study, it is thought that the data sets used for demand forecasting studies in the health sector will produce results closer to reality by determining and standardizing the purification criteria in this way.

Is 24/7 remote patient management in heart failure necessary? Results of the telemedical emergency service used in the TIM-HF and in the TIM-HF2 trials.

AimsTelemedical emergency services for heart failure (HF) patients are usually provided during business hours. However, many emergencies occur outside of business hours. This study evaluates if a 24/7 telemedical emergency service is needed for the remote management of high‐risk HF patients.Methods and resultsThe study included 1119 patients merged from the TIM‐HF and TIM‐HF2 trials [age 69 ± 11, 73% male, left ventricular ejection fraction 37% ± 13, 557 New York Heart Association (NYHA) II/562 NYHA III]. Patients received a 24/7 physician‐guided emergency service provided by the telemedical centre (TMC) in addition to remote management within business hours. During emergency calls, patient status, symptoms, electronic patient record, and instant telemonitoring data were evaluated by the TMC physician. Following diagnosis, patients were referred for hospital admission or instructed to stay at home. Apart from the TMC, patients could place a call to the public emergency service at any time.Seven hundred sixty‐eight emergency calls were placed over 1383 patient years (0.56 calls/patient year). Five hundred twenty‐six calls (69%) occurred outside business hours. There were 146 (19%) emergency calls for worsening HF, 297 (39%) other cardiovascular, and 325 (42%) non‐cardiac causes, with a similar pattern inside and outside business hours. Of the 1119 patients, 417 (37%) placed at least one emergency call. Patients with NYHA Class III, higher N‐terminal prohormone of brain natriuretic peptide (>1.400 pg/mL) levels, ischaemic aetiology of HF, implanted defibrillator, and impaired renal function had a higher probability of placing emergency calls. During study follow‐up, patients who made an emergency call had a higher all‐cause mortality (22% vs. 11%, P = 0.007 in TIM‐HF; 16% vs. 4%, P < 0.001 in TIM‐HF2) and more unplanned hospitalizations (324 vs. 162, P < 0.001 in TIM‐HF; 545 vs. 180, P < 0.001 in TIM‐HF2). Of the total 1,211 unplanned hospital admissions, 492 (41%) were initiated by a patient emergency call.Three hundred seventy‐nine calls (49%) were placed to the TMC, whereas 389 calls (51%) were made to the public emergency service. Three hundred twenty‐six (84%) of the calls to the public emergency service resulted in acute hospitalizations.The TMC initiated 202 (53%) hospital admissions; 177 (47%) patients were advised to stay at home. All patients that remained at home were alive during a prespecified safety period of 7 days post‐call. Diagnoses made by the TMC physician were confirmed in 83% of cases by the hospital.ConclusionA telemedical emergency service for high‐risk HF patients is safe and should operate 24/7 to reduce unplanned hospitalizations. Emergency calls could be considered as a marker for higher morbidity and mortality.

Wiring Effects Mitigation for Through-Wall Human Motion Micro-Doppler Signatures Using a Generative Adversarial Network

Through-wall detection and recognition of human motions via radar is of great benefit to public security and emergency service applications. The micro-Doppler signatures extracted from the targets of interest in motion typically contain distinct inner-individual motion features, which is the key to human identification and motion classification. However, no research so far considered a very common application scenario, where the conductive wires buried in the wall are in a powering on mode, let alone study its potential effect on the collected signatures of motion behind wall. As it should be anticipated, strong interference components would be brought in the obtained micro-Doppler signatures, and the subsequent motion recognition would be severely affected. In this paper, we, for the first time, report the effect of the buried live wire on the micro-Doppler signatures. Specifically, a micro-Doppler signature enhancement method, named range-max time-frequency representation (R-max TFR) is utilized to obtain feature enhanced micro-Doppler signatures of behind wall human motions. And to mitigate the clutter components introduced by the buried live wire, the effect is first modeled as an impulse response with its center located at a fixed frequency instance in the R-max TFR map. Then, a novel technique based on conditional Generative Adversarial Network (cGAN), is proposed to fulfill the goal. Both numerical and experimental results, as well as comparisons with other classical de-clutter methods, demonstrate the effectiveness and superiority of the proposed de-wiring cGAN framework in suppressing the wiring effect in behind wall micro-Doppler signatures.

Submission to the Parliamentary Joint Committee on Law Enforcement Inquiry into Criminal Activity and Law Enforcement during the COVID-19 Pandemic

A wide range of likely impacts from increased risks of domestic violence due to economic stress and ‘stay at home’ public health orders, business failure, police and emergency service fatigue, higher risks of infection in prisons amongst others are some of the many challenges wrought by COVID-19. This submission focuses on two issues in relation to transnational and serious organised crime and the impact of COVID-19 on underground online illicit markets and the convergence of organised crime groups across the Indo-Pacific region.First concerns the role of illicit crypto-markets (‘darknets’) in the diversion and black market sale of medicines and products associated with the COVID-19 pandemic, and the adaption of these markets to the criminal opportunities presented by the pandemic. The second issue is the scale and acceleration of illicit drug production, notably of synthetic opioids, novel psychoactive substance (NPS) and amphetamine type stimulants (ATS) in Southeast Asia and the convergence of criminal (network) interdependencies between Chinese ‘black societies’ (triads) and their collaborators

Characterization of the consultations of the adult migrant population in a public emergency service in the northern area of Santiago Chile in 2018

International migration is increasing steadily worldwide. In Chile 4.4% of its population are migrants. Worldwide, emergency rooms are chosen by migrants to solve health problems. Characterize the adult migrant population treated in a public emergency service of the Santiago metropolitan region during 2018. Through simple descriptive statistics, the center's database is analyzed, keeping in mind ethical aspects. 13.72% of the total consultations were migrants. Of these 95.3% resided in localities assigned to the hospital; they are granted between the ages of 20 and 44 and came mainly from: Peru, Haiti, Venezuela, Colombia and Bolivia. 10.67% does not hold health coverage. Most consultations (62.33%) have a mild prognosis. The diagnoses of Chileans and foreigners within the age group of 20 to 44 years old coincide in a different order, however, migrants most frequently present respiratory, digestive and infectious / parasitic diseases. Migrant consultations reflect mild to moderate health conditions typical of healthy people, being able to talk about the "healthy migrant effect". As the diagnoses between Chileans and foreigners coincide in the age group and socioeconomic level, it can be said that they have a similar health condition. Due to most of the migrant consultations were categorized with less severity, have a mild prognosis, lower hospitalization rates and their main destination is domicile, there is evidence that they use the emergency service as the first option facing health problems.

Hierarchical siting of macro fire station and micro fire station

With the rapid increase of city building density, public emergency service system for providing fire services faces increasing challenge in reducing the loss of lives and property, especially for the reduction of massive casualties in fire accidents. For obtaining a higher benefit from public service facilities, GIS-based techniques such as location optimization are commonly used. However, as a special facility, fire emergency facilities are quite particular in siting and providing services, and they have their unique demands including specific response time, benefit maximization, workload balancing and cost minimization; traditional optimization methods for fire facility siting are difficult to account for all of these objectives. Furthermore, the public emergency services agencies in China are implementing a plan to establish a hierarchical fire service system by siting fire stations with different capacities, and under this context, the general covering models with the same level of facilities are limited in their effectiveness. Therefore, this paper proposes a hierarchical covering model which takes into account the different characteristics of different levels of fire facilities (i.e. macro fire station and micro fire station). The case study of Nanjing city proves that our model is effective in practical applications of emergency services optimization.

An Efficient Bounded Model Checking Approach for Web Service Composition

With the development of service-oriented architecture, Web service composition has become more important for mitigating potential security vulnerabilities. When the scale of services increases, it will lead to the problem of state explosion. Symbolic model checking is a common method used to alleviate the problem of state-space explosion. However, for a large Web service composition system, the number of services is large, and the corresponding state space may exceed the magnitude of the symbolic model checking that can verify it. As it alleviates the state-space explosion problem, bounded model checking was utilized in the present study to verify the properties of the service composition system. Bounded model checking searches for bounded counterexamples in a limited local space and reduces the state space. This study verifies the composition of semantic Web services described by OWL-S and proposes a timed service model (TSM) to formally model the service composition system. Furthermore, the auto-mapping relationship between the OWL-S service description and the model is established. For more efficient verification, this study uses SMT-based (SMT: satisfiability modulo theory) encoding in the TSM. Finally, a public emergency service composition system was built to verify the proposed model and the efficiency of the proposed algorithm.

An iterative solution approach to a multi-objective facility location problem

This work presents a novel methodology for solving multi-objective facility location problems (mo-FLPs) with the focus on public emergency service stations. Our study is one of a few studies incorporating the objectives of three well-known problems, viz. the p-median problem (pMP), the maximal coverage location problem (MCLP) and the p-center problem (pCP). Aiming to find a set of Pareto optimal solutions and a compromise solution for all three objectives, we have developed an algorithm which solves each individual location problem sequentially. The proposed approach is mainly based on a combination of the branch & bound and iterative goal programming techniques. The performance of the algorithm is demonstrated with numerical examples.

ICD-10 mental and behavioural disorders due to use of crack and powder cocaine as treated at a public psychiatric emergency service: An analysis of visit predictors

The present study investigated the predictors of an increased number of visits from individuals with some of the diagnoses noted in chapter F14 of ICD-10, from calls to the emergency psychiatric unit of a general hospital in São Paulo state, Brazil, in the period 2011–2012. Poisson regression models were carried out for the outcome variable, accounting for number of subsequent visits to the psychiatric emergency unit. For the analysis of this outcome we took into account the exposure time of each individual in the study. Our findings point to a population at risk for frequent psychiatric emergency service visits: individuals over 25 years. This population should be targeted for interventions on entry into public healthcare due to increased psychiatric morbidity and greater clinical morbidity already confirmed by previous studies. We discussed the need of these individuals for special attention during the clinical or psychiatric emergency consultation which, unfortunately, may be the access point for the public health system. None of the other variables were related to the outcome of interest, such as those related to the level of individual entry into the care network before and after treatment, and other variables related to medical acts during the visit.

The role of the pediatrician in the emergency service: the fear of failure and the need to be well

Introduction: medical work has undergone profound changes. The wage system, employment conditions, low wages, and loss of status have brought, among other problems, loss of autonomy, creativity, and increased workload. Given the intense contact with pain, suffering, and death it is possible to understand why these professionals are frequent sufferers of burnout and psychological distress. Objective: To understand the complaints of tiredness and exhaustion among doctors working in public hospital pediatric emergencies. Methods: Qualitative research using different techniques. 44 participants from 62 pediatricians were selected at a public emergency service. They were observed during work and answered group interviews that highlighted recurring themes considered relevant and that were further explored in group techniques. Results: The study showed that physicians experience negative feelings about their performance in pediatric emergency shifts. The highlights were the fear of failure and fear of not doing the best in the care to critically ill children and to those who died. The percep tion that they must be well in order to properly do their tasks became apparent. Conclusions: The research gave better insight into the work of the emergency pediatrician, showing that the nature of the service can lead to their feeling tired and experiencing negative feelings.

Construction of the Public Emergency Service Geographic Information Platform

Emergency geographic information service is based on all kinds of spatial information, and it is used for scientific dynamic analysis, judgment, forecast and risk assessment of emergency events. It is as the ‘console’ of the whole emergency command platform decision-making and it is also the presupposition and basis to realize the emergency management, emergency decision-making, command and space planning. This paper first analyzes the development tendency of emergency geographic information service platform at home and abroad, then introduces the software architecture and technology system of emergency geographic information service platform. It focuses on the emergency 3D moving target management, emergency information integration fusion, emergency information service management, and other key technologies.

Association of monthly frequencies of diverse diseases in the calls to the public emergency service of the city of Buenos Aires during 1999–2004 with meteorological variables and seasons

This work aims to study associations between monthly averages of meteorological variables and monthly frequencies of diverse diseases in the calls to the public ambulance emergency service of the city of Buenos Aires during the years 1999-2004. Throughout this time period no changes were made in the classification codes of the illnesses. Heart disease, arrhythmia, heart failure, cardiopulmonary arrest, angina pectoris, psychiatric diseases, stroke, transient ischemic attack, syncope and the total number of calls were analyzed against 11 weather variables and the four seasons. All illnesses exhibited some seasonal behavior, except cardiorespiratory arrest and angina pectoris. The largest frequencies of illnesses that exhibited some association with the meteorological variables used to occur in winter, except the psychiatric cases. Heart failure, stroke, psychiatric diseases and the total number of calls showed significant correlations with the 11 meteorological variables considered, and the largest indices (absolute values above 0.6) were found for the former two pathologies. On the other side, cardiorespiratory arrest and angina pectoris revealed no significant correlations and nearly null indices. Variables associated with temperature were the meteorological proxies with the largest correlations against diseases. Pressure and humidity mostly exhibited positive correlations, which is the opposite of variables related to temperature. Contrary to all other diseases, psychiatric pathologies showed a clear predominance of positive correlations. Finally, the association degree of the medical dataset with recurrent patterns was further evaluated through Fourier analysis, to assess the presence of statistically significant behavior. In the Northern Hemisphere high morbidity and mortality rates in December are usually assigned to diverse factors in relation to the holidays, but such an effect is not observed in the present analysis. There seems to be no clearly preferred meteorological proxy among the different types of temperatures used. It is shown that the amount of occurrences depends mainly on season rather on its strength quantified by temperature.

Sistematização da assistência de enfermagem: percepções de enfermeiras

The Nursing Care System (NCS) is a systematic and individualized organization of care provided to individuals. In practice, the assistance in emergencies is characterized by being prompt and efficient, where the professionals involved prioritize actions, leaving the documentary evidences for a second level. This study was undertaken to verify the perceptions of nurses about NCS and its registration. This is a qualitative study of exploratory nature, developed in a semi-intensive unit of a public emergency service, in October 2009. A questionnaire with seven open-ended questions developed by the authors was applied with the intention of interviewing nurses and faculty who conduct activities in the sector. The results showed that nurses know the importance of systematizing and believe that the nursing staff is mostly responsible for their implementation. Although they consider the instrument objective and practical, the NCS is not carried out in the sector due to the limitation of not being checked by nursing staff or doubtfully checked as mentioned by the participants. It is necessary that universities and institutions work together to find ways of making the NCS viable, thus collaborating with the scientific development and improvement of quality of care.

Sofrimento no trabalho de enfermagem: reflexos do "discurso vazio" no acolhimento com classificação de risco

Estudo que abordou o contexto laboral de trabalhadores de enfermagem que atuam no Acolhimento com Classificação de Risco em um pronto-socorro público de Porto Alegre, Rio Grande do Sul, com objetivo de conhecer suas vivências acerca desta tecnologia para o atendimento em emergência. Pesquisa qualitativa que utilizou como fonte de informações os registros institucionais, cenas de atendimentos observadas e registradas em diário de campo e entrevistas semiestruturadas com os profissionais de enfermagem. As informações foram submetidas à análise de conteúdo, e os dados revelam as características do serviço e os sentimentos da equipe de enfermagem, que apontaram a presença do sofrimento no trabalho ao perceberem seu discurso como "vazio", ou desprovido de sentido. Os achados evidenciaram a necessidade de atenção aos trabalhadores a fim de protegê-los do possível adoecimento e de sofrimento no trabalho, e convocá-los à cogestão desta tecnologia.

Intelligence-Led Mitigation

This paper explores methods for capitalizing on existing law enforcement intelligence capabilities to provide intelligence support to decision makers for a full spectrum of public safety and emergency service operations. Intelligence-led mitigation is a management philosophy and business process to proactively guide strategic, operational, and tactical decisions for mitigating the effects of intentional, accidental, and natural incidents. There is currently a gap in the intelligence products needed by public safety and emergency service organizations to support their resource decisions, and the quantity and quality of intelligence products they are receiving. This breach between producer and consumer exists across the country and at all levels of government. The intelligence-led mitigation model was designed to demonstrate how the existing principles and processes of intelligence-led policing can be applied to a broader set of incidents, incident phases, and stakeholders in order to effectively and efficiently fill this critical intelligence gap.

Knowledge and attitude regarding standard precautions in a Brazilian public emergency service: a cross-sectional study

The purpose of this study was to assess the knowledge and attitude of health care professionals regarding their use of universal precaution measures at a public emergency service. The study also aimed to assess the rates of occupational accidents involving biological substances among those workers. This study was performed with 238 workers, from June to November 2006, using univariate and multivariate analysis. The chance of not adopting precaution measures was 20.7 (95% CI: 5.68 - 75.14) times greater among drivers compared to physicians. No significant association was found between adopting universal precaution measures. The occupational accident rate was 20.6% (40.8% involving sharp-edged objects). The risk of physicians having an occupational accident was 2.7(95% CI: 1.05 -7.09) times higher than that of drivers. The fact that a staff member had adequate knowledge about universal precaution measures was insufficient to foster compatible attitudes towards reducing the risk of transmitting infectious agents and causing occupational accidents.

O trabalho dos pediatras em um serviço público de urgências: fatores intervenientes no atendimento

This qualitative empirical study discusses the material and organizational conditions of work by pediatricians in a public emergency service, with the aim of identifying factors that affect care. The work was studied using group interviews and direct observation in the emergency unit. The results were compared with statistical and historical data from documental research. Forty-four pediatricians from seven teams were interviewed, and seven of the pediatricians were observed while on duty. The precarious referral and counter-referral system was a determinant factor leading to the heavy demand on the emergency unit. Agglomeration of patients and families at the entrance to the emergency service led to time pressure and interfered directly in the pediatric care. The study identified informal strategies devised and implemented by these physicians in attempts to guarantee the quality of care in keeping with pediatric principles.

COP-2-COP Hotlines: Programs to Address the Needs of First Responders and Their Families

This article delineates the factors that have long contributed to the high rate of stress-related disorders in those frontline professionals responsible for the safety and security of the public (law enforcement officers, firefighters, and emergency service personnel). It covers the rationale for COP-2-COP, a unique program designed to address the mental health needs of a high-risk population, its history, its components, and outcomes. This state funded program is a crisis intervention helpline for first responders, and their families, providing peer support, clinical assessment, referrals to mental health practitioners with relevant experience, and Critical Incident Stress Management. We begin with two newspaper reports of actual cases and end with four fictional case studies that reflect a composite of typical symptoms experienced by clients contacting one of the COP-2-COP hotlines. These cases are presented along with the special programs that were designed to address the consequences of the terrorist attacks that occurred on September 11, 2001. Fortunately, COP-2-COP was already in place and prepared to act in response to the impact of a trauma of unprecedented magnitude.

Epidemic Asthma in Barcelona: An Evaluation of New Strategies for the Control of Soybean Dust Emission

Background: Asthma attacks and mortality due to inhalation of soybean antigens in Barcelona have been well documented. Strict protective measures in the unloading process were established in 1998 to avoid the release of soybean dust into the atmosphere. The present study was undertaken to assess the effectiveness of these latest environmental measures, and, if effective, to recommend their implementation in the many harbours where soybean is unloaded. Methods: Levels of soybean aeroallergen were analysed daily during a period of 5 years and 2 months in a total of 1,854 samples, 125 from the pre-intervention period and 1,729 from the postintervention period. Additionally, the number of asthma admissions to the emergency rooms of the city’s three largest hospitals was recorded. Asthma patients attended at home by the public home emergency service and judicial autopsies registering asthma deaths were also investigated. Results: The mean concentration of soybean aeroallergen was 159 U/m³ in the pre-intervention period and 39 U/m³ in the postintervention period (p < 0.0001). Significant differences in postintervention aeroallergen concentrations were found between days of soybean unloading (42 U/m³) and days of no unloading (33 U/m³), with p < 0.0001. No significant relationship was found between concentrations of environmental soybean aeroallergens and the number of emergency room admissions for asthma. Conclusions: Implementation of stricter protective measures in silos for the soybean unloading process has reduced the concentration of soybean dust in the atmosphere and evidences the effectiveness of the measures adopted.