Natural hazard risk analysis in the framework of water safety plans.

The available literature on natural hazard risk analysis focused on the implementation of water safety plans (WSPs) is surprisingly quite poor, despite the significant increase in the number and severity of disasters and adverse effects on drinking water supply systems generated by natural hazards. At the same time, WSPs that conveniently account for natural hazards with a comprehensive approach 'from source to tap' are still scarce as they typically occur at larger spatial scales and adequate prevention, mitigation and adaptation require efficient inter-institutional collaborations. The aim of this paper is to highlight the main bottlenecks for water utilities to include natural hazards in the development of their WSPs. The research adopted a stakeholders-oriented approach, involving a considerable number of water utilities (168), water sectoral agencies (15) and institutions (68) across the Adriatic-Ionian Region through a stepwise process that generated joint SWOT analysis, the development of a decision support system (DSS) focused on WSPs procedures and tabletop exercises. The final outcomes generated strategic documents (REWAS - Adrion Road map for resilient water supply) that highlighted the necessity for efficient cross-sectoral and inter-institutional cooperation in the development of well-founded and robust WSPs to address natural hazard risk analysis for water supply systems (DWSS).

Incredible Women: Legal Systems Abuse, Coercive Control, and the Credibility of Victim-Survivors.

Research has long demonstrated that victim-survivors of intimate partner violence face barriers to being believed when they seek help via the legal system and are simultaneously at risk of their abuser weaponizing the legal system against them. This article draws on the experiences of 54 women victim-survivors of coercive control in Australia who had experienced legal systems abuse within criminal and civil protection order systems. Drawing on feminist legal theory, we highlight that the legal system continues to disbelieve women and validate abusers. These experiences hold implications for victim-survivor views on the merits and risks of criminalizing coercive control.

Reducing the negative impact of accidents associated with the release of dangerous substances to environment.

Background: The article is concerned with an evaluation of the current state of emergency readiness of industrial companies in the event of dangerous substance leakage and with a presentation of textile sorbents used for the purposes of capturing an escaped substance. Methods: A part of the article is concerned with the experimental designation of sorption capacity of hydrophobic, chemical, and universal sorption mats for chosen polar (water and alcohol) and non-polar (oil and gasoline) liquids. Experiments were realized according to Standard Test Method for Sorbent Performance of Adsorbents for use on Crude Oil and Related Spills, American Society for Testing and Materials (ASTM F726-17), type I. and Test methods for non-woven fabrics, European Union International Organization for Standardization (EN ISO 9073-6:2004). The aim of the article is an experimental designation of sorption capacity of textile sorption mats using two different methods, a comparison of the acquired results and a comparison of the acquired data with the data given by the manufacturer. Results: Textile sorbents, which can, owing to their sorption ability, allow the elimination or mitigation of a negative impact of a possible accident in the company connected with an escape of a liquid dangerous substance were tested and compared with the established values. Based on the obtained results it is possible to state that sorption capacities of the chemical and universal mat for the substrate water are equal and consistent with the data given by the manufacturer. Textile sorption mats also have a comparable sorption capacity. The sorption capacity on the substrate gasoline is the same in all textile sorbents. The adsorption capacity per unit mass all type's sorbents was similar for non-polar liquids (gasoline was values from 6.41 to 6.57 and oil was values from 9.54 to 10.24). Conclusion: The acquired results confirmed the universality of textile sorption mats for gasoline. Sorption capacities of the chemical and universal mat for the substrate water are equal and match the data given by the manufacturer. Textile sorption mats have a maximum sorption output up to 60 s, afterwards the sorption capacity values remain unchanged.

Living labs for civic technologies: a case study. Community infrastructuring for a volunteer firefighting service.

Digital technologies are increasingly adopted and developed in living labs, to support and enable co-production processes around wellbeing related public services. This research report presents the case of one of the local laboratories established by the European project NLAB4CIT, in the city of Kaisariani, Greece. In order to enhance community engagement, participatory design methods are applied under an "infrastructuring" notion; the living lab model is reapproached as community infrastructure; and digital tools are understood as civic technologies. The article reports on the initial co-design phases, in order to provide other living labs on digital co-production with an overview on the socio-technical challenges encountered. These challenges concern how community actors can engage in the process of co-production of public services, and how digital technologies can be introduced to this purpose. Strength factors emerge such as the existence of an already active community, the creation of an enduring space of collaboration between researchers and citizens, and a civic approach to technology that makes them accessible and tailored. Open challenges concern the role of the public administration, the extent to which technologies are actually co-designed and co-developed, and some technical issues such as internet accessibility.

[Medical civil protection in Germany-a Greek tragedy?] / Medizinischer Bevölkerungsschutz in Deutschland ­ eine griechische Tragödie?

In terms of civil protection, there is nothing against self-critical reflection of events, such as the coronavirus disease 2019 pandemic, and learning lessons from them. In the past, however, this has often not led to anticipating future situations, their consequences, and better preparation. To some extent, this seems like a Greek tragedy: conscious disregard-except that this must not be fate. In addition to pandemics, important scenarios for which civil protection in Germany is inadequately prepared, according to the author's assessment, include attacks and accidents involving CBRN (chemical, biological, radiological, nuclear) hazardous substances, mass casualties in the event of a terror attack with hospitals or rescue services as the target of the attacks, as well as prolonged power or drinking water failures, and disruptions in information and communication structures following cyberattacks. There is an urgent need to identify existing problems and demand functional concepts for hospitals, rescue services, and rapid response teams. Responsible authorities, in turn, must develop, finance, and implement concepts.

Three Nordic countries responding to COVID-19 - Eldercare perspectives.

Comparative international studies show that about half of the deceased in the COVID-19 pandemic were persons living in institutional and residential eldercare. As seniors are the most affected age group, we aim to study if and to what extent the eldercare services were included in the National Pandemic Plans, and how they were included in the response during the first phase of the pandemic in Finland, Iceland, and Sweden. We use the CRISMART approach to crisis documentation and analysis in comparing national response to the pandemic for the eldercare sector. The method enables comparison of extraordinary crisis situations from the decision-making and policy-making perspective. We found that there were both similarities and differences in the preparedness of the three Nordic countries, as well as in how they responded to the pandemic. In all three countries the focus of the national responses framed the problem as a health and healthcare services' problem. We also found value conflicts in the response between the value of protection versus social contact and self-determination and hence relating to the quality of eldercare. Keeping in mind the proportional increase of elderly people, care challenges, and future crises, we must strengthen the position of local social services within the emergency management systems to enhance disaster resilience and sustainability of our societies.

[Further developments in disaster control: goal, strategy and tactic using the example of the 2021 flood disaster in the Ahr valley]. / Weiterentwicklung im Katastrophenschutz: Ziel, Strategie und Taktik am Beispiel der Hochwasserkatastrophe 2021 im Ahrtal: "Lessons learned" aus Sicht der Medizinischen Task Force 47 (Unterfranken).

Objectives: In July 2021, the Medical Task Force 47 was deployed to the flood disaster in western Germany as part of the cross-regional disaster relief system. With the aim of deriving possible improvements in disaster management, it was scientifically evaluated. The focus of this study was the strategy to build up and to maintain a responsive and efficient rescue system. Materials and methods: After defining an evaluation process, an interdisciplinary panel of experts reviewed operational documents and relevant concepts of the Bavarian Red Cross. Based on these, strategies and tactics were developed to achieve predefined goals. Results: The performance of the emergency units could be increased by modern vehicles and equipment (eBikes, drones, all-terrain vehicles). To improve the response capability, new rapid response groups could be required that can take over the function of an advance command and can process mission assignments in impassable terrain autonomously. These could be integrated and synchronized into regional and cross-regional disaster relief. Conclusion: In future, it could be difficult for Germany's largely volunteer-organised disaster management to safely deploy the multitude of possible state-of-the-art resources in the highly complex environment of a disaster. Partial professionalization by full-time command and control staff could be one solution for this problem.

Usage of sorbents for diminishing the negative impact of substances leaking into the environment in car accidents.

Background: Car accidents are often accompanied by dangerous substances leaking into the environment. A proper reaction to the leaking substances, utilizing appropriate sorbents, is necessary for diminishing the negative impact of such events. Sorbents as substances of initial intervention in car accidents (as well as industrial and ecological accidents) are a crucial tool for solving crises connected with dangerous substances escaping into the environment. The risk resulting from the given realities is described in detail in the introduction of the article. The goal: The goal is describing elements of crisis management in dangerous substance leakage and an analysis of sorption resources for quick and efficient interception of leaking substances, water, ethanol, oil, and gasoline in particular, as a reaction to such events. Methods: The quality of a sorption resource is determined by a parameter called the sorption capacity, which has been established according to the ASTM F716-18 standard. Loose nature-based sorbents (peat) and synthetic silicate-based SiO2, Al2O3, Fe2O3, and polypropylene-based ones were observed. The research has been realized on a water, oil, gasoline, and ethanol sorbate. Each experiment was repeated three times. The results: The results attest to the diversity of sorption capacity in comparing nature-based, silicate-based, and polypropylene-based sorption materials. The highest sorption capacity values were reached with the Sorb 4 sample, which is based on 66% of silica and 18% of alumina. The stated ratio is important, because the Sorb 3 sample contains 85% of silica and 6% of alumina and its absorption capacity values are significantly lower.

[Situational Awareness of Public Response for effective crisis management]. / Lagebild Bevölkerungsverhalten für ein effektives Krisenmanagement.

The Coronavirus pandemic, in which public response was and still is central to damage control, has demonstrated how significant psychological and social science insights are for crisis management. Currently, knowledge of public response is often not incorporated into situational reports and, therefore, cannot be sufficiently considered by crisis management teams.With the intent of supporting change, the project "Situational Awareness of Public Response", conducted by the Division of Psychosocial Crisis Management within the Federal Office of Civil Protection and Disaster Assistance, is currently designing a framework for including public response knowledge in crisis management decision-making. The main focus of this paper is this project. A strategic objective is to integrate public response knowledge more strongly into governmental crisis management. On the basis of evidence-based assessments, the needs and demands of the population can be identified and coping capacities can be better supported by crisis management measures.Several BBK-funded research projects are affiliated to the aforementioned main project, with the objective of strengthening human-centric civil protection. In a test phase, the situational picture of public response was compiled every two weeks on the basis of data and findings from publicly available studies and made available to various stakeholders.

Near-Real-Time Strong Motion Acquisition at National Scale and Automatic Analysis.

A strong motion monitoring network records data that provide an excellent way to study how source, path, and site effects influence the ground motion, specifically in the near-source area. Such data are essential for updating seismic hazard maps and consequently building codes and earthquake-resistant design. This paper aims to present the Italian Strong Motion Network (RAN), describing its current status, employment, and further developments. It has 648 stations and is the result of a fruitful co-operation between the Italian government, regions, and local authorities. In fact, the network can be divided into three sub-networks: the Friuli Venezia Giulia Accelerometric Network, the Irpinia Seismic Network, and all the other stations. The Antelope software automatically collects, processes, and archives data in the data acquisition centre in Rome (Italy). The efficiency of the network on a daily basis is today more than 97%. The automatic and fast procedures that run in Antelope for the real-time strong motion data analysis are continuously improved at the University of Trieste: a large set of strong motion parameters and correspondent Ground Motion Prediction Equations allow ground shaking intensity maps to be provided for moderate to strong earthquakes occurring within the Italian territory. These maps and strong motion parameters are included in automatic reports generated for civil protection purposes.

Assessment of community-based flood early warning system in Malawi.

One of the major natural hazards the world is facing these days are floods. Malawi has not been spared. Floods have affected the countries' socio-economic developmental plans. River gauges have been installed along major rivers to monitor water levels in a bid to warn communities of imminent flooding. In Malawi, ever since the installation of river gauges no study has been done to assess their effectiveness. This study examines the effectiveness of these river gauges as part of community-based early warning system. The research employs both qualitative and quantitative approach. Questionnaires, interviews, group discussions, document analysis were all used in order to understand the behavioural aspect of communities under study. The current community-based early warning system practices were benchmarked against the following elements: risk knowledge, technical monitoring and warning services, dissemination and communication of warnings and response capability. The study revealed that Malawi has two distinct systems in place: at national level (managed by several government departments) and at community level [managed by Civil Protection Committees (CPCs)]. These systems were installed by non-governmental organisations (NGOs) and faith-based organisations. Apparently, no direct link exists between the two. Operational bureaucracy affects the speedy presentation of warning messages at national level. Lack of capacity and necessities affects the operation of the community-based system. Despite the efforts to develop the early warning systems, the failures outweigh the successes. Government needs to provide enough funding for systems sustainability, build capacity of CPCs and install more technologically advanced systems.

From food to cash assistance: rethinking humanitarian aid in Yemen.

Humanitarian aid (HA) is needed in Yemen to cope with the worst humanitarian crisis in the world. However, current practices of distributing aid in the form of food have not had the desired effect; conflict has continued, and war economies are thriving as a result. Thus, this paper proposes the idea of cash assistance as an alternative form of HA. Our empirical analysis of HA in Yemen shows that cash assistance is a more effective and efficient way of distributing aid in comparison to food aid. This is due to food aid being vulnerable to looting by the conflicting factions, enabling funds to be inadvertently captured into the highly problematic war economy dynamic. In comparison, cash assistance targets a wider scope of peoples' necessities, in a more efficient and effective delivery approach that can be easily tracked by the donors. Cash aid can either be unrestricted, restricted, or conditional. The former allows cash transfer, the second enables vulnerable people to purchase items depending on their needs with vouchers, and the latter links the money distributed with performing a certain task. This allows communities to improve and develop, and it enables individuals to build up their skill sets and have a source of income. This is particularly important for NGOs who are unable to provide the conditions needed to bear their success. The Yemeni people have lost trust in the warring factions, as well as local and international NGOs, due to the lack of effectiveness of current methods of HA distributions due to looting and the risks associated with reaching vulnerable people. Therefore, it has become imperative to restore donor direct HA delivery by providing cash aid as a superior means of food aid in Yemen, to ensure the effectiveness of HA and to improve the lives of those who are suffering, in the long term (This article builds on previous scholarship; see Elayah, M., & Fenttiman, M. (2021). Humanitarian Aid and War Economies: The Case of Yemen. The Economics of Peace and Security Journal, 16(1). This article provides a nuanced and high-quality examination of the conduct of armed groups in Yemen. The analysis of HA in this article "supports the view that it is a significant source of funding for armed groups and consequently that it plays a huge part in allowing the war economy in Yemen to thrive". Warring groups are often looting HA to distribute it based on partisanship and to sell it on the black market to finance the war effort. They have also attempted to block HA to try and gain control over the humanitarian campaign and receive a cut of the billions of dollars given in foreign assistance. In many cases, HA is distributed through local NGOs that were established by the groups to attract international funds. Others were pre-politicized NGOs that channeled funds to specific regions or particular groups for political and military advantage. It is clear from our analysis that the ability of NGOs to use HA effectively and deliver it to those who deserve it is very limited. NGO's actions can end up expanding the war economy rather than reducing the effects of war on the poor. Distrust in international bodies and in local and international NGOs has become extremely high among those affected by the war" (Elayah, M., & Fenttiman, M. (2021: p 59)).

A mass casualty incident of infectious diseases at the port of Hamburg: an analysis of organizational structures and emergency concepts.

BACKGROUND: The project "ARMIHN" (Adaptive Resiliency Management in Port) focuses on strengthening the capability to act in a mass casualty incident (MCI) due to an outbreak of infectious diseases (MCI-ID). In addition to the current threat from the COVID-19 pandemic and associated outbreaks on cruise ships, previous MCI-ID were especially caused by pathogens such as Influenza virus or Norovirus. The first step was, to get an overview of processes and resources using the example of the Port of Hamburg, and to show the associated interaction of involved parties. This will serve as a basis for developing an operational strategy and offers the opportunity to optimize current work processes. METHODS: A selective literature research using specified key words was performed and existing MCI concepts were received from local authorities. Identified structures and processes were analyzed in a multiple step process and also brought together through discussions in workshops with involved organizations and other experts. Additionally, the distances between the nearest rescue stations and selected hospitals from the Port of Hamburg were analyzed. RESULTS: The current available concepts are proven, but an adaptation to an MCI-ID shows opportunities for a further cross-organizational development. The organizational structure of an MCI-ID in the Port of Hamburg was described, including a large number of involved organizations (n = 18). There are 17 involved fire and rescue stations and the port can be reached from these locations within 6 to 35 min. Based on their specialist expertise, 14 of the 31 listed clinics were selected. CONCLUSION: The purpose of the study was to provide an analysis of the current situation and show how involved parties would cope an MCI. A description of processes and resources at the Port of Hamburg will be used when designing a management plan for responding to an MCI-ID.

"Hang in There!": Mental Health in a Sample of the Italian Civil Protection Volunteers during the COVID-19 Health Emergency.

Few studies have been conducted on civil volunteers and their emotional conditions concerning the current COVID-19 pandemic. The present study aimed to evaluate the impact of the COVID-19 emergency on the mental health (general well-being, depression level, and post-traumatic distress), coping strategies, and training needs in an Italian sample of 331 Civil Protection volunteers of the L'Aquila province, during the first nationwide "lockdown" (8 March-3 June 2020). The rate of respondents to the online survey was limited (11.5%), presumably because displaying distress would be considered a sign of "weakness", making volunteers unable to do their jobs. More than 90% of the volunteers showed good mental health conditions and a wide utilization of positive coping strategies, with the less experienced displaying better emotional conditions compared to colleagues with 10 or more years of experience. The type of emergency, the relatively few cases of contagion and mortality in the territory compared to the rest of Italy, and the sense of helping the community, together with the awareness of their group identity, could have contributed to the reported well-being. These results may help to identify the needs of volunteers related to this new "urban" emergency to improve both their technical and emotional skills.

MECHANISM OF STATE REGULATION OF MEDICAL RESPONSE TO EMERGENCIES AS AN ELEMENT OF THE CIVIL PROTECTION SYSTEM.

OBJECTIVE: The aim: Conducting a comprehensive analysis on ensuring the mechanism of state regulation of the development of medical emergency response as an element of the civil protection system of Ukraine in the context of dynamic changes of external and internal factors of its functioning. PATIENTS AND METHODS: Materials and methods: The data of the state statistical reporting for the period 2010-2019 and the legislative acts of Ukraine on medical emergency response were used as the materials of study. Bibiliosemantic and statistical method and the method of structural-and-logical analysis were applied in the course of study. CONCLUSION: Conclusions: The sustainable socio-economic development of Ukraine should be accompanied by the formation of a safe environment for the society and each individual, guaranteeing an acceptable level of risk and a modern security system based on the principles of international law. The high degree of the Ukrainian industry concentration is currently in a conflict with the low technological discipline of production, which creates objective preconditions for the growth of man-made and technologically-environmental disasters, catastrophes, and other emergencies. Outbreaks of particularly dangerous and infectious diseases, which are of concern not only because of their prevalence but also because of the potential danger to the health of the nation, its economy and international reputation of the state can pose a significant threat to the socio-political and socioeconomic stability of the state. Ukraine is a potentially vulnerable area for epidemics due to a number of natural, geographical and geopolitical factors. Therefore, the health consequences (real and potential) of any emergency are certainly a threat to the national security of Ukraine both directly and due to the extremely negative impact on the socio-economic, socio-political and psychological conditions of the population. Increasing the level of public administration for medical emergency response will increase the effectiveness of emergency response measures.

Preparação e resposta a desastres do Brasil na pandemia da COVID-19 / Preparación y respuesta a desastres de Brasil en la pandemia de COVID-19 / Disaster preparedness and response in Brazil in the face of the COVID-19 pandemic

Resumo Como a crise em saúde pública causada pela pandemia da COVID-19 ajuda a compreender o funcionamento do Sistema Nacional de Proteção e Defesa Civil (SINPDEC) nas fases de preparação e resposta a desastres em saúde no Brasil? A resposta a essa pergunta se dará por meio do seguinte objetivo geral: compreender o funcionamento do SINPDEC no enfrentamento à COVID-19, com ênfase na atuação do Ministério da Saúde (MS), órgão gestor de combate às ameaças em saúde. Para tanto, três objetivos específicos serão explorados: caracterizar a (doença) COVID-19 como evento em saúde pública com potencial causador de desastre, situar os conceitos de preparação e resposta na literatura de governança de desastres e identificar previsões legais e funcionamento da gestão de desastres no Brasil. A despeito das tensões decisórias no âmbito político, a burocracia profissional brasileira conseguiu garantir a ativação do sistema de governança de desastres relativa às fases de preparação e resposta. Contudo, sua ativação não foi suficiente para aplacar a crise, cujo agravamento expõe falhas nas fases de prevenção e mitigação de desastres, bem como a falta de uma resposta ao desastre em âmbito federativo.

Resumen ¿Cómo la crisis de salud pública causada por la pandemia de COVID-19 ayuda a comprender el funcionamiento del Sistema Nacional de Protección y Defensa Civil (SINPDEC) en las fases de preparación y respuesta a desastres de salud en Brasil? La respuesta a esta pregunta se dará mediante el siguiente objetivo general de investigación: comprender el funcionamiento del SINPDEC en el afrontamiento a la COVID-19, con énfasis en el trabajo del Ministerio de Salud, organismo gestor del combate contra las amenazas a la salud. Con este fin, se explorarán tres objetivos específicos: caracterizar la COVID-19 como un evento de salud pública con el potencial de causar un desastre; situar los conceptos de preparación y respuesta en la literatura sobre gestión de desastres; e identificar las predicciones legales y el funcionamiento de la gestión de desastres en Brasil. Se argumenta que, a pesar de las tensiones políticas en la toma de decisiones, la burocracia profesional brasileña logró garantizar la activación del sistema de gestión de desastres relacionado con las fases de preparación y respuesta. Sin embargo, su activación no fue suficiente para aplacar la crisis, cuyo empeoramiento expone fallas en las fases de prevención y mitigación de desastres, así como la falta ‒e importancia‒ de una respuesta al desastre en ámbito federativo.

Abstract This article aims to understand how the National System of Protection and Civil Defense functions in response to COVID-19, with emphasis on the work of the Ministry of Health, which is the body responsible for tackling health threats. Three specific objectives were used: the first characterizes COVID-19 as a public health event that can represent a disaster; the second situates the concepts of preparedness and response in the disaster governance literature; the third identifies the jurisprudence and the functioning of disaster management in Brazil. The findings show that, despite the political decision-making tensions, the Brazilian professional bureaucracy managed to guarantee the activation of the disaster governance system related to the preparation and response phases. However, its activation was not enough to allay the crisis. The severity of the pandemic exposed flaws in the phases of disaster prevention and mitigation, as well as the lack of coordinated government response.

Variation in State Laws on Access to Civil Protection Orders for Adolescents Experiencing Intimate Partner Violence.

PURPOSE: Intimate partner violence (IPV) is prevalent among adolescents. Civil protection orders (CPOs) are the most common legal remedy used by individuals experiencing IPV to prevent recurrence. However, laws on whether adolescents can access CPOs vary by state. We assessed the landscape of state legislation regarding adolescents' access to CPOs for IPV. METHODS: We systematically assessed statutes across all 50 U.S. states and the District of Columbia for 5 indicators: whether minors can be granted CPOs, whether minors can file on their own behalf, whether dating relationships are eligible, definitions of abuse qualifying for CPOs, and whether a CPO prohibits firearm possession and requires surrender of firearms. RESULTS: A total of 48 states (94%) explicitly allow minors to obtain CPOs. Fourteen states (27%) explicitly allow minors to file for a CPO on their own behalf. Forty-four states (86%) recognize dating relationships as qualifying relationships for a CPO. A CPO may be issued for physical violence in all 51 states (100%), sexual violence in 46 states (90%), threats of physical or sexual violence in 47 states (92%), stalking in 44 states (86%), and psychological/emotional violence in 28 states (55%). In 22 states (43%), an individual subject to a CPO is prohibited from possessing firearms and is required to surrender firearms they already have. CONCLUSIONS: There is a significant variation in states' CPO statutes related to adolescent IPV. Improvements in legislation that reduce the barriers to legal relief for those experiencing violence can be an important part of a comprehensive solution to reducing IPV among adolescents.

[Advanced medical post within hospitals as possible tactical instrument for handling mass casualty incidents]. / Der Behandlungsplatz innerhalb eines Krankenhauses als mögliches taktisches Werkzeug zur Bewältigung eines Massenanfalls von Patienten.

BACKGROUND: An important instrument for handling mass casualty incidents in preclinical settings is the use of an advanced medical post. In certain circumstances, however, the establishment of such an advanced medical post on or close to the incident site is impossible. Terrorist attacks are a prime example for this. The highest priority for hospitals during mass casualty incidents is to adjust the treatment capacity to the acute rise in demand and to sustain its functionality throughout the duration of the incident. By establishing an advanced medical post within hospitals during certain types of mass casualty incidents these aims could potentially be accomplished. AIMS: The aims of this pilot study were to test the practicability of the establishment of an advanced medical post within a university hospital and to identify potential problems. The results provide the foundation of a generalized concept, which will then be integrated into the hospital emergency plans. METHODS: After the formation of a multiprofessional expert committee, different areas within the hospital were evaluated based on spatial and tactical considerations. Predefined questions were assessed and harmonized with respect to organization, vehicle management, communication, leadership and patient transport through the means of a practice run. RESULTS: The establishment and operation of an advanced medical post within the hospital were easily possible. The consequent deployment of section leaders enabled the smooth coordination of transport and an unobstructed simulated patient flow. The management of the treatment area by a senior emergency physician and a senior emergency medical service officer in close cooperation with the operational hospital lead proved to be a useful concept. Technical problems with communication within the hospital were resolved by using wireless phones and the installation of a digital radio repeater. DISCUSSION: During acute scenarios with only short prior notice, the authors prefer concepts that supplement the normal hospital operation through additional staff and material. In circumstances with prior notice of more than 60 min an advanced intrahospital advanced medical post, staffed by civil protection units, could be a concept that enables the absorption of the first patient arrivals within the first hour of a mass casualty incident without disturbing the functionality of hospitals to any great extent. Further practice runs are, however, necessary to further develop and adjust this concept to real-life circumstances.

Preparedness against mobility disruption by floods.

Civil responders currently have limited information available to them to support flood incident planning. A new generation of tools are emerging that produce more detailed understanding of flood impacts on people and accessibility during floods. These are typically applied in isolation, proving only a partial assessment of impacts. This paper integrates analysis of flood hydraulics, transport accessibility and human safety to explore the impact of flooding on pedestrians and drivers, and its implications on emergency routes and service areas. A reference scenario, developed and used by the local Civil Protection Agency, is applied to Galluzzo in Florence (Italy). Results shows that 37% of inhabitants live close to roads where they can be swept away, and 78% live in locations where parked vehicles can be transported by floodwaters. Furthermore, at its worst 22.5% of road extension is inaccessible; and all hospitals, fire and police stations cannot be reached, highlighting the need to take preventative action from the outset of an event that is predicted to lead to substantial inundation. Integration of multiple indicators of flood impacts, especially those most relevant to human safety, is fundamental to civil responders if they are to successfully planning and implement emergency response operations in urban environments.

Requisitos para la apertura de un consultorio odontológico en México / Requirements for the opening of a dental office in Mexico

La apertura de un consultorio privado es de interés para muchos profesionistas odontólogos. Más allá de las cuestiones económicas o de habilidad técnica, una limitante importante para llevarlo a cabo es el desconocimiento de los trámites administrativos necesarios para ello. Es común que muchos odontólogos se atrevan a mantener en uso un negocio que, la mayoría de las veces, no cumple con este tipo de aspectos, lo que conlleva a ser susceptible a diversas sanciones. El objetivo de este trabajo es enunciar y describir los requisitos básicos para la apertura de un consultorio de prestación de servicios profesionales odontológicos dentro del territorio mexicano. Posterior a una revisión de la legislación y normatividad vigentes en la República Mexicana, se enlistan los trámites realizados ante cuatro dependencias públicas: Servicio de Administración Tributaria (SAT), regulación sanitaria, protección civil y gobierno local. Cabe resaltar que esta información se ofrece bajo ciertas consideraciones, ya que puede existir variación de acuerdo con los lineamientos establecidos por los gobiernos locales de cada entidad federativa. Se concluye que dar cumplimiento con estos requisitos es el primer paso para el adecuado funcionamiento de nuestro negocio, lo cual ayuda a evitar las sanciones correspondientes y el desprestigio del consultorio (AU)

Opening a private dental offi ce is of interest for many dentists. Beyond economic issues or technical ability, an important limitation to carry this out is the unawareness of administrative procedures necessary for it. Commonly, many dentists dare to keep into the business despite not complying with all the necessary procedures, which makes them susceptible to administrative sanctions. The objective of this work is to enunciate and describe the basic requirements for opening a dental service offi ce within Mexican territory. After a review of current legislation and regulation in the Mexican Republic, the procedures performed in four public agencies are listed: The Tax Administration Service (SAT), health regulation, civil protection, and local government. It should be noted that this information is off ered under certain considerations, highlighting that data presented is done in a generic way, since this may vary according to guidelines from local government of each federative entity. It is concluded that compliance with these requirements is the fi rst step for the proper functioning of our business, which helps avoid the corresponding sanctions and disrepute of the private practice (AU)