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Journal of Emergency Management
January/February 2006, Volume 4
, Number 1


Article
Letter to the editor. Revisting the pupose of disaster planning
David A. McEntire, PhD
January/February 2006; pages 7-8


Article
Editorial. Emergency preparedness is all local
Osman O. Aloyo, CEM, CBCP
January/February 2006; pages 11-12


Article
Perspective on people. Part 1: Social dimensions of interagency collaboration
Neil Simon, BS, MA
January/February 2006; pages 13-16


Article
Legal desk. The role of the Incident Command System
William C. Nicholson, JD
January/February 2006; pages 19-21


Article
The biological disaster challenge: Why we are least prepared for the most devastating threat and what we need to do about it
Eliot Grigg; Joseph Rosen, MD; C. Everett Koop, MD, ScD
January/February 2006; pages 23-35


Article
Community emergency response teams and community disaster planning
Frank M. Bertone
January/February 2006; pages 36-40


Article
An assessment of retention incentives for volunteer firefighters in Virginia
Steven M. De Lisi, MPSL, CFO; Gary S. Green, PhD; Peter M. Carlson, DPA ; Harry Greenlee, BA, MA, JD
January/February 2006; pages 41-50

Abstract
Volunteer firefighters provide fire protection for the majority of communities in the United States and often receive little compensation in return. In addition to the inherent hazards of firefighting, volunteers are challenged by increasing call volumes, training requirements, and demands from family and careers. As a result, fire department leaders often attempt to retain members through incentives. The opinions of 108 volunteer firefighters in Virginia about which incentives will enhance recruitment and retention efforts were investigated according to personal factors such as sex, age, and rank. The analysis looked at 12 incentives and five personal characteristics and revealed only six of the 60 possible two-variable relationships as being statistically significant. In particular, younger volunteers were more likely to name training competitions, tuition reimbursement, and the opportunity to fundraise as being important factors in their volunteerism. The most significant finding of the research, however, is that a decentralized management style—manifested in the delegation of authority and participation in decision making—is important to the vast majority of volunteers, regardless of their personal attributes. Although such emphasis on decentralization will likely require a cultural shift in many volunteer fire departments, it is cost-effective and, most importantly, will encourage the recruitment of volunteers and enhance their retention. Key words: volunteer firefighters, incentives, recruitment, retention


Article
The quinary pattern of blast injury
Yoram Kluger, MD, FACS; Adi Nimrod, MD; Philippe Biderman, MD; Ami Mayo, MD; Patric Sorkin, MD
January/February 2006; pages 51-55

Abstract
Objective: Bombing is the primary weapon of global terrorism, and it results in a complicated, multidimensional injury pattern. It induces bodily injuries through the well-documented primary, secondary, tertiary, and quaternary mechanisms of blast. Their effects dictate special medical concern and timely implementation of diagnostic and management strategies. Our objective is to report on new clinical observations of patients admitted to the Tel Aviv Medical Center following a recent terrorist bombing. Results: The explosion injured 27 patients and three died. Four survivors, who had been in close proximity to the explosion as indicated by their eardrum perforation and additional blast injuries, were exposed to the blast wave. They exhibited a unique and immediate hyperinflammatory state, two upon admission to the intensive care unit and two during surgery. This hyperinflammatory state was manifested by hyperpyrexia, sweating, low central venous pressure, and positive fluid balance. This state did not correlate with the complexity of injuries sustained by any of the 67 patients admitted to the intensive care unit after previous bombings. Conclusion: The patients’ hyperinflammatory behavior, unrelated to their injury complex and severity of trauma, indicates a new injury pattern in explosions, termed the quinary blast injury pattern. Unconventional materials used in the manufacture of the explosive can partly explain the observed early hyperinflammatory state. Medical personnel caring for blast victims should be aware of this new type of bombing injury. Key words: terrorism, blast injury, hyperinflammation


Article
Principles of ethics for emergency managers
Robert O. Schneider, PhD
January/February 2006; pages 56-62

Abstract
This article reviews several alternatives in ethical theory available as possible criteria for the development of ethical principles for the emergency management profession. It also examines the basic elements (core values) of existing codes of professional ethics for emergency managers in the context of these criteria. The developing emergency management profession, it is suggested, requires more scholarship directed to the establishment of a more complete ethical theory and a more clearly articulated set of ethical principles for emergency managers. The discussion concludes with a suggestion as to what a more comprehensive, informative, and functional statement of ethical principles for the emergency management profession might look like. But this proposed formulation, offered for discussion purposes, assumes the need for more effort at defining the moral criteria that will give these principles their ultimate meaning. Key words: ethics, administrative ethics, emergency management ethics

Journal of Emergency Management
March/April 2006, Volume 4
, Number 2


Article
Newsbriefs
March/April 2006; pages 9-9

Abstract
Effort to Improve Border Safety. H5N1 Avian Flu Virus Vaccine Induces Immune Responses in Healthy Adults.


Article
Perspective on people. Part 2: Social dimensions of interagency collaboration—team development
Neil Simon, BS, MA
March/April 2006; pages 11-16


Article
Legal desk. Incorporating volunteer resources
William C. Nicholson, JD
March/April 2006; pages 17-18


Article
Failures of technology and systems: Contributing to flawed preparedness
Saul B. Wilen, MD
March/April 2006; pages 19-23

Abstract
Preparedness has become America’s operative societal concept. We aim for educational preparedness to compete in a global economy. We invoke preparedness to deal with natural disasters. We see preparedness as the basis for security and safety of the homeland. We assume that the existing systems operating in our lives, communities, and society are solid and will not fail. We have come to believe that technology is our salvation. Systems and technologies will be explored in the context of their integral positive and negative roles in the preparedness process and continuum. Key words: preparedness, technology, systems, disasters


Article
Building internal capacity for community disaster resiliency by using a collaborative approach: A case study of the University of New Orleans Disaster Resistant University Project
John J. Kiefer, PhD; Monica T. Farris, PhD; Natalie Durel, MPA
March/April 2006; pages 24-28

Abstract
This paper describes the development of a disaster resistant community at the University of New Orleans (UNO). It includes the process for obtaining leadership support and “buy in,” for identifying specific expertise within the university community, and for enlisting and ensuring broad stakeholder support and participation in the plan. In late 2004, the author’s research team at the University of New Orleans successfully sought and was subsequently awarded a FEMA-sponsored grant to develop a Disaster Resistant University (DRU). This resulted in the formulation of a comprehensive mitigation plan aimed at identifying and reducing risks throughout UNO’s campus. Early in the planning process, the research team decided that, unlike other universities who had been awarded FEMA DRU grants, it would be important to develop local, “in-house” expertise in disaster resiliency to ensure sustainability. Rather than contracting an external agency to develop the mitigation plan, the researchers decided to leverage the disaster expertise already resident in the UNO community. At the same time, the UNO researchers considered it essential to use a methodology in developing the plan that would ensure representation from a broad range of stakeholders. To do this, the research team utilized a unique collaborative methodology in the hazard identification and mitigation process.


Article
Different modes of disaster management in response to the tsunami in Southeast Asia
Dagan Schwartz, MD; Major Adi Leiba, MD; Colonel Issac Ashkenasi, MD, MPA, MSc; Captain Guy Nakash, MD; Major Rami Pelts, MA; Colonel (res) Avishay Goldberg, PhD; Brigadier General Yeheskel Levi, MD; Colonel Yaron Bar-Dayan, MD, MHA
March/April 2006; pages 29-36

Abstract
The tsunami of December 26, 2004, can be described as one of the worst disasters medical systems have ever had to face. This paper will describe the geophysical properties of tsunamis and their disastrous impact on human beings and infrastructure. Finally, we will present three different modes of response to the tsunami that were present in different provinces in Thailand. These three modes represent different strategies of disaster management, and analyzing each will help to begin understanding how best to respond to the next large-scale natural disaster. Key words: tsunami, geophysical properties, modes of response


Article
Risk communication needs in a chemical event
Janice S. Lee, PhD, MHS; Sharon L. Lee, PhD; Scott A. Damon, MAIA, CPH; Robert Geller, MD; Erik R. Janus, MS; Chris Ottoson, CIH; Marilyn J. Scott, CSP, ARM
March/April 2006; pages 37-47

Abstract
In an effort to define the role of state and local health agencies in a chemical terrorism event and to share knowledge, materials, and resources, representatives from state, local, and federal agencies formed the Interstate Chemical Terrorism (ICT) workgroup in 2002. Working with the ICT workgroup, the Centers for Disease Control (CDC) funded a workshop effort to address the basic elements of risk communication (RC) needs in a chemical event. The primary goal of the workshop was to develop templates for chemical fact sheets destined for the general public and press, medical providers, public health officials, first responders, and impacted workers, as well as a list of core competencies and benchmarks. We summarize workshop discussion and outcomes. Key words: risk communication, chemical event, core competencies, benchmarks


Article
Disaster preparedness and response: Implications for public health nurses
Andrea Jennings-Sanders, Dr.PH, RN
March/April 2006; pages 48-51

Abstract
Disasters are becoming more of an integral aspect of life in the United States and in other countries. Public health nurses are in the forefront of providing health services to people affected by disasters. Thus, it is essential that all public health nurses have access to information that will assist them in disaster situations. The purpose of this paper is to illustrate how the Framework for Public Health Nurses: Interventions Model can be utilized for planning and responding to disasters. The interventions in the model are directly applicable to disaster situations and, in addition, raise questions on issues that need to be addressed by local, state, and federal public health officials. Key words: Public health nurses, disaster situations, disaster nursing


Article
There is no cold zone: The hazardous materials zone model and mass terrorism chemical weapon events
Scot Phelps, JD, MPH, CEM, CBCP
March/April 2006; pages 52-56

Abstract
This study examined 70 after action reports (AARs) from full-scale chemical weapons exercises held in large cities across the United States by the Office of Domestic Preparedness’ Chemical Weapons Improved Response Program (CWIRP). These exercises were held to determine that, if “hot, warm, and cold” zones were established, did victims stay in the hot zone until they could be decontaminated, and did responders observe the hot-warm-cold zone demarcations? Only 35 percent of reports indicated that responders utilized the zone concept, less than 20 percent of reports indicated that victims were compliant with the zone model, and less than 15 percent of reports indicated that responders properly observed the zones that were created. Results indicate that use of the zone model for a mass terrorism chemical weapons attack (MTCWA) is not well utilized, and that responders operating in the cold zone need personal protective equipment. Key words: chemical weapons, responders, zone model, personal protective equipment


Article
Network-centric emergency response: The challenges of training for a new command and control paradigm
Lt. Col. Mark Stanovich, USMCR
March/April 2006; pages 57-64

Abstract
The last two decades have seen technological innovations that have revolutionized the collection and transfer of information, permitting access to and dissemination of massive amounts of data with unprecedented speed and efficiency. These innovations have been incorporated into virtually every aspect of modern society, from personal communications, to commercial and business processes, to governmental function and military operations. The concept of network-centric warfare (NCW) grew out of these new capabilities and has been a prominent topic in strategic and operational discussions in the US military since the late 1990s. In recent years, the concepts behind NCW have been increasingly applied to emergency response, particularly as responders prepare for an increasingly complex threat spectrum in a post-9/11 world. As emergency responders adopt the technological innovations and organizational concepts that enable network-centric operations, attention should be paid to the lessons learned by the US armed forces in the application of the network-centric approach to war-fighting. Emergency operations centers (EOCs), incident command centers (ICCs), and field personnel will require extensive training and experimentation to sort out the impact of this new technology. They must develop protocols and procedures to leverage maximum advantage, while avoiding the undesirable and damaging effects of that technology improperly applied. Because most emergency response organizations lack the vast training resources of the US military, they must be innovative and adaptable in taking advantage of every opportunity to train their personnel in the assimilation of this new technology. Key words: network-centric, technological innovations, emergency response, emergency operations centers, incident command centers

Journal of Emergency Management
May/June 2006, Volume 4
, Number 3


Article
Editorial. FEMA: Change or die
Royce Saunders
May/June 2006; pages 6-6


Article
Perspective on people. Part 3: Social dimensions of interagency collaboration—building alliances
Neil Simon, BS, MA
May/June 2006; pages 9-13


Article
Leadership. Crisis leadership versus leadership in crisis
Saul B. Wilen, MD
May/June 2006; pages 15-20

Abstract
Effective leadership must already be in place when a crisis occurs. Leadership must be able to function during the crisis and effectively bring it to resolution so that recovery can begin and proceed as successfully as possible. The existing challenges reinforce the need for leadership that can operate on multiple planes. Competence, planning, and problem-solving abilities form the basis for determining a leader’s success. Innovation, decision making, a prevention orientation, risk taking, and risk management must all be part of the leadership skills package.


Article
Should Tamiflu™ be stockpiled locally?
Sandro Cinti, MD; Gerald Blackburn, DO
May/June 2006; pages 21-24

Abstract
The outbreak of H5N1 avian influenza in Asia raises serious concerns about an influenza pandemic of the kind seen in 1918. In addition, the recent federal response to Hurricane Katrina highlights the need for advanced local preparation for biological disasters. It is clear that there will not be enough vaccine early in an influenza pandemic. Without vaccine, the role of antivirals, especially oseltamivir (Tamiflu™), in treatment and prophylaxis becomes of paramount importance. It is unlikely that the Centers for Disease Control and Prevention (CDC) will be able to stockpile enough oseltamivir to protect every first responder in the United States. Thus, it is important that local governments and hospitals consider stockpiling oseltamivir for the treatment and/or prophylaxis of local first responders. Key words: pandemic, influenza, oseltamivir, Tamiflu™, antivirals, first responders


Article
Risk communication and message mapping: A new tool for communicating effectively in public health emergencies and disasters
Vincent T. Covello, PhD
May/June 2006; pages 25-40


Article
Trauma among emergency responders and terrorism investigators: Suggestions for conducting needed research
Thomas J. Friedman, JD
May/June 2006; pages 41-46

Abstract
This article discusses the paucity of information that exists concerning the traumas and stresses that affect emergency responders (ERs) and terrorism investigators (TIs). There has not yet been an in-depth, phenomenological, qualitative study examining the perceptions of ERs or TIs during and after emergency incidents to determine whether their experiences led to serious stress or trauma. More research is needed concerning the work experiences of these individuals, which is often dangerous, sometimes taking place in horrific settings, and often occurring in high pressure and high profile situations. We do not know why some ERs and TIs are traumatized by their experiences and others are not. We do not know why some are able to cope with their various stressors in a healthy manner when others develop symptoms clearly indicative of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). We are not certain to what degree the severity of the trauma experienced directly affects the severity of these symptoms, and we have not studied the resultant ability or inability of ERs and TIs to continue to work and interact with family and friends. By conducting additional studies on this topic, ERs and TIs can be taught better coping mechanisms, we can establish more proactive professional mental health responses, gain a more empathetic understanding of ERs and TIs, and help emergency and law enforcement organizations prepare more effective educational and training materials. Key words: emergency responders, terrorism investigators, acute stress disorder, post-traumatic stress disorder


Article
Disasters and the surge environment
David L. Glotzer, DDS; Walter J. Psoter, DDS, PhD
May/June 2006; pages 47-52

Abstract
With the recent actual, and the anticipated possible, disastrous events in this country, it is an absolute duty of responsible agencies on all levels to prepare and improve the medical response system. Past experience has shown that one critical area of preparedness that needs to be addressed is the available number of trained individuals in the public health workforce that can and will respond. We propose that the dental profession, with proper additional training and integration into an organized healthcare system, can be one additional source of this much needed manpower. Key words: disaster, surge response, dental profession


Article
The management of volunteers: Recent experience with the American Red Cross in Baton Rouge, Louisiana
Kirsten Levy, MBA
May/June 2006; pages 53-60

Abstract
Rather than simply watch horrific events unfold, many citizens do everything in their power—immediately—to help; they seek outlets for their energy. Organizations that use citizen assistance, while grateful, often find the outpouring difficult to manage. This article describes a positive experience with the American Red Cross (ARC) as a citizen-turned-volunteer. It notes observations about the organization’s management of volunteers during a two-week deployment at regional headquarters in late November 2005 in Baton Rouge, Louisiana, where disaster relief for Hurricanes Katrina and Rita, combined into one disaster relief effort, was scaling down. The volunteer experience was positive because ARC was well organized and catered to expectations. ARC proved to be the natural choice for a volunteer outlet. The ARC can be considered a giant conduit for training, turning bystanders into volunteers and deploying them quickly to disaster relief in the field at little expense.


Article
The Hospital Emergency Incident Command System— is the Army Medical Department on board?
Major John J. Casey III, USA, MSSI, MHS
May/June 2006; pages 61-64

Abstract
Catastrophic scenarios that once seemed merely theoretical have become a stark reality. Horrific natural disasters, the emergence of state-sponsored terrorism, proliferation of chemical and biological agents, availability of materials and scientific weapons expertise, and recent increases in less discriminate attacks all point toward a growing threat of mass casualty (MASCAL) events. Hospitals across America are upgrading their ability to respond to disasters and emergencies of all kinds as the nation wages its war on terror. To respond to these challenges, many civilian hospitals are relying on the Hospital Emergency Incident Command System (HEICS), an emergency management model that employs a logical management structure, detailed responsibilities, clear reporting channels, and a common nomenclature to help unify responders. Modeled after the FIRESCOPE (FIrefighting RESources of California Organized for Potential Emergencies) management system, HEICS is fast becoming a key resource in healthcare emergency management. Over the past couple of years, military hospitals have begun embracing the HEICS model as well. This article discusses the prevalence of HEICS and provides an analysis of its effectiveness within the Army Medical Department (AMEDD).

Journal of Emergency Management
July/August 2006, Volume 4
, Number 4


Article
Calendar
July/August 2006; pages 6-6


Article
Perspective on people. Part 4: Social dimensions of interagency collaboration— Joining the collaboration: Individual subscription
Neil Simon, BS, MA
July/August 2006; pages 12-16


Article
Design, creation, and deployment of a sampling kit for hazardous material investigations
Steven M. DeLisi, MS; Michael F. Martin; Timothy R. Croley, PhD
July/August 2006; pages 17-22

Abstract
Response to a hazardous material (HAZMAT) incident and/or an environmental crime often involves a legal investigation. Our laboratory, in collaboration with a number of state, local, and federal agencies, developed and deployed a sampling kit designed specifically for first responders to expedite both collection and transportation of physical evidence to the state laboratory for identification, while maintaining chain of custody. These kits have been used for sampling and transport of samples for a number of legal cases and have shown great utility in and among our local first responder community.


Article
Managing debris successfully after disasters: Considerations and recommendations for emergency managers
David A. McEntire, PhD
July/August 2006; pages 23-28


Article
Advanced IT support of crisis relief missions
Peter Sapaty, PhD; Masanori Sugisaka, PhD; Robert Finkelstein, PhD; Jose Delgado-Frias, PhD; Nikolay Mirenkov, PhD
July/August 2006; pages 29-36

Abstract
A novel distributed control ideology and technology will be described for management of advanced crisis relief missions. The approach is based on the installation of a universal “social” module in highly portable electronic devices, like laptops and mobile phones, which can collectively interpret a spatial scenario language, exchanging high-level program code (waves), data, and control with other modules in a parallel fashion. This technology can dynamically integrate any human and technical resources that were scattered postdisaster into an operable, distributed system capable of solving—autonomously—complex survivability, relief, and reconstruction problems. Key words: critical infrastructures, key resources, emergency management, emergent societies, crisis relief, information technologies, distributed control, WAVE-WP model, mobile electronic devices, mobile robotics


Article
Animals in disaster: The emergency planning process of Heartland Humane Society, Corvallis, Oregon
LTjg Christopher Dorsey, USN
July/August 2006; pages 37-41

Abstract
Animals play a major role in people’s lives. Humans interact with animals in the food chain, train them for entertainment, and often accept them as integral members of their families. Recent disasters have shown the strength of the human-animal bond; for example, a number of people have refused to leave flooded homes without their pets. Organizations that deal with animal control can play a vital role during disasters. This case study highlights the employment of emergency management principles at a community animal shelter. The study follows the project from initial assessments through the development of an initial emergency program. Key elements in this process include a realistic risk assessment, training, and available local support, as well as economic concerns. Although this does not display a finished product, it demonstrates the initial steps involved in creating an emergency management program for a small public service organization.


Article
The delivery of essential humanitarian services after the tsunami in Aceh, Indonesia
Shannon Doocy, PhD; Anita Shankar, PhD; Bahie Rassekh; Courtland Robinson, PhD; Gilbert Burnham, MD, PhD
July/August 2006; pages 43-50

Abstract
A survey of 478 Indonesian households displaced by the tsunami was conducted in two districts in Aceh Province in late March and early April 2005. Essential services (shelter, water, food, health services) were provided to approximately half of internally displaced persons (IDPs) within seven days of the tsunami, and this figure rose to around 70 percent within two weeks of the tsunami. Essential services reached significantly greater proportions of the tsunami-displaced population in Aceh Besar than Banda Aceh at both two and four weeks post-tsunami. The majority of IDPs reported satisfaction with essential services other than shelter in the first two weeks post-tsunami, and satisfaction with essential services other than food increased by four weeks after the tsunami. Of IDP households surveyed, the vast majority reported that there were services they would have liked to receive but did not, both in the month following the tsunami and at the time of the survey. Key words: tsunami, Indonesia, humanitarian assistance, beneficiary, satisfaction


Article
Product Directory
July/August 2006; pages 51-51


Article
Water, water everywhere, but not a drop to drink
Saul B. Wilen, MD
July/August 2006; pages 52-56

Abstract
Many of today’s perspectives are limited because they are based on antiquated paradigms. Preparedness (the state of readiness to perform and support) is an operational goal for realistic solutions. Planning is a critical element for creating preparedness. Effective emergency management incorporates the planning process from the outset. This allows for consideration of the spectrum of possibilities and for adjusting actions as conditions change. The planning process has universal applications, and its utilization clearly has an impact on the rate of successful outcomes. It is helpful to examine challenges faced by and responses from those involved in emergency management and disaster preparedness, including government officials. It is important to explore the forces that support solutions and those that impede them. This analysis will offer such a focus.

Journal of Emergency Management
September/October 2006, Volume 4
, Number 5


Article
Perspective on people. Part 5: Social dimensions of interagency collaboration— growing and managing the collaborative relationship
Neil Simon, BS, MA
September/October 2006; pages 13-19


Article
National Guard Civil Support Teams: Their organization and role in domestic preparedness
Edwin A. Hurston, MBA; Alvin H. Sato, CPT, PhD; Jeffrey R. Ryan, PhD
September/October 2006; pages 20-26

Abstract
Our country is adapting to better respond to terrorist attacks on our homeland. The development and funding of the Weapons of Mass Destruction-Civil Support Team (WMD-CST) concept is one such adaptation. It is unique in the history of our nation’s approach to disaster response and civil defense. This program has resourced a standing military contingent, trained and equipped to deploy rapidly for the specific missions of detecting, monitoring, and assessing hazardous materials and providing advice to civil authorities. These teams were established to assist local incident commanders in determining the nature and extent of an attack or incident, to provide expert technical advice on WMD response operations, and to help identify and support the arrival of follow-up state and federal military response assets. Accordingly, we will outline the structure and functions of WMD-CSTs and discuss the process necessary for requesting their assistance and training expertise.


Article
Management aspects of medical preparation for mass casualty incidents
Royce Moser, Jr., MD, MPH; Colleen Connelly, BSN, RN; A. Peter Catinella, MD, MPH
September/October 2006; pages 27-32

Abstract
Medical facilities may prepare for mass casualty incidents (MCIs) by stockpiling equipment, training members of response and treatment teams, and conducting limited “walk-through” exercises with small numbers of simulated patients. However, experience during actual and simulated MCIs in peacetime and in combat settings has repeatedly demonstrated the importance of the “4 Cs” (Command and Control, Communication, and Coordination) in managing an MCI response. Events such as 9/11 and Katrina have underscored the need to incorporate the 4 Cs into medical disaster response planning if the medical actions during an MCI are to be effective. This discussion considers pertinent aspects of the 4 Cs that can enhance disaster response capabilities.


Article
Obstacles to improvement in EMS systems
Stephen Dean, PhD
September/October 2006; pages 33-38

Abstract
The aim of this qualitative study was to identify obstacles to improving response times in emergency medical service (EMS) systems. The study consisted of structured interviews with policy makers, managers, and workers chosen from two EMS systems in a convenience sample, one of which has implemented two specific response time improvements and one of which has not. I asked interviewees to identify obstacles to implementing two types of strategies for response time improvement: peak load staffing and dynamic deployment. Obstacles created by internal stakeholders, including workers, managers, and unions, accounted for 77 percent of the obstacles identified. Funding obstacles were the second most frequently cited, composing 7 percent of the obstacles mentioned, while other types of obstacles, including lack of education of the public and elected officials and lack of research on improvement strategies, accounted for the remaining 16 percent of the obstacles identified. The interview results suggest that opposition by internal stakeholders is as, if not more, significant an obstacle to improving EMS response times as lack of funding. Therefore, increasing funding alone may not result in improvements to EMS systems.


Article
Social Dimensions of Disaster: A teaching resource for university faculty
Thomas E. Drabek, PhD
September/October 2006; pages 39-46

Abstract
The preparation of a faculty resource on the social dimensions of disaster was supported by the Federal Emergency Management Agency (FEMA), a unit within the Department of Homeland Security. This essay explains the origins of the project and its context within FEMA’s Higher Education Project. The essay comprises four topics: 1) the FEMA Higher Education Project; 2) a developmental history; 3) a faculty resource, i.e., a brief description of an instructor guide entitled Social Dimensions of Disaster, 2nd edition; and 4) future challenges in course implementation.


Article
Practical points of terror victims’ medical management
Shmuel C. Shapira, MD, MPH; Shmuel Penchas, MD, PhD; Shlomo Mor-Yosef, MD, MPA
September/October 2006; pages 47-50

Abstract
Terror victims’ medical management needs differs from those of victims in other trauma scenarios in terms of both demographic and epidemiological characteristics. After a terror attack, patients with widely differing personal characteristics present with a clinical picture practically constituting a terror victim syndrome: varying combinations of asymmetric projectile damage, blast, burns, and some blunt trauma, combined with acute and chronic stress disorder. Existing healthcare institutions are generally not adequately prepared to handle mass casualty events (MCEs) associated with terror. To improve their capabilities, two methodologies are recommended. The first consists of training involving medical professionals with expertise in terror or similar situations; trauma fellows and emergency medicine physicians are exposed to recurrent simulation exercises, leading to a library of institutional methodologies for the practice of large-scale terror events. The second introduces movable, temporary advanced life support (ALS) islets, the components of which are normally kept in storage but can be very quickly set up when needed. Ancillary equipment utilization is concomitant. Key words: terror, trauma, intensive care, specialists, islets, weapons of mass destruction


Article
Context-driven decision support for megadisaster relief
Alexander V. Smirnov, PhD; Tatiana Levashova; Nikolay Shilov, PhD
September/October 2006; pages 51-56

Abstract
The situation following Hurricane Katrina showed that conventional tiered response to disaster events, whereby state and local officials are responsible for coordinating efforts in the first few days, does not work well in the case of megadisasters (massive hurricanes, earthquakes, large-scale acts of terrorism, etc.). Such situations require the application of new technologies, such as scenario-based information fusion for preparing operations, context-aware interoperability of response participants, and on-the-fly decision support and assistance for officials. Here, we propose a context-driven decision-making schema based on such technologies as context-ontology management and constraint satisfaction technology.


Article
Spontaneous volunteer response to disasters: The benefits and consequences of good intentions
Lauren S. Fernandez, MS; Joseph A. Barbera, MD; Johan R. van Dorp, DSc
September/October 2006; pages 57-68

Abstract
During disasters, large numbers of citizens and nonemergency organizations converge at the site wanting to offer assistance. Most are willing to provide their services free of charge. This response brings the potential benefit of valuable assistance to the disaster site, but it is also subject to the risks associated with unmanaged personnel. Historical evidence highlights these issues and emphasizes the importance of an effective and efficient volunteer management system. Key words: disaster, spontaneous volunteer, volunteer management


Article
A model for lessening the negative impact of natural disasters and infectious disease outbreaks
Kai-Lit Phua, PhD
September/October 2006; pages 69-74

Abstract
This paper presents a model to facilitate the study of natural disasters and infectious disease outbreaks so as to lessen their negative impact. An adaptation of the Haddon matrix, this model contains innovations such as an explicit consideration of socioeconomic factors influencing the probability of the health-impacting event; factors affecting the severity, rate of spread, and extent of its immediate impact; reactions to the event; and short-term and long-term effects. Another innovation is that the “host” is widened to include affected individuals as well as family members, affected communities, and the larger society. This model can be used to develop public programs to lessen the immediate impact of natural disasters and infectious disease outbreaks and to develop better long-term programs to help victims/survivors, families, and affected communities. Key words: natural disasters, infectious disease outbreaks, Haddon matrix, agent-host-environment interactions


Article
A history of the Emergency Management Accreditation Program (EMAP)
Valerie Lucus, MS, CEM, CBCP
September/October 2006; pages 75-79

Abstract
Protecting the lives and property of citizens is a primary role of government, and institutionalized emergency management programs have been developed to fill that role. As the effects of both natural and man-made disasters have expanded, those programs are now being asked to validate their ability to provide that protection through some kind of official and recognized endorsement. The Emergency Management Accreditation Program was created to provide that assurance by accrediting state and local emergency management programs.


Article
From the First Amendment to “safety first”: Working with the media in crisis situations
Ken Lerner, JD
September/October 2006; pages 80-84

Abstract
This paper surveys the law regarding management of news media and media information in an emergency. At the scene of an incident, responders generally may make media representatives comply with the same access restrictions that are imposed on the public. However, media personnel have the right to photograph or otherwise cover the story from whatever vantage point is available. Once the media has information about an emergency, legally it is very difficult to prevent journalists from reporting it, even if doing so is perceived as complicating response efforts. In some communities, law enforcement agencies and local media have adopted a cooperative approach that allows the media to perform its job while minimizing interference with emergency management.

Journal of Emergency Management
November/December 2006, Volume 4
, Number 6


Article
Community emergency response teams and the wealth of communities in New Jersey
Scott Phelps, JD, MPH, CEM, CBCP, Paramedic
November/December 2006; pages 11-16

Abstract
This study examined median household income (MHI) of communities with community emergency response teams (CERTs). Preliminary data from New York City showed that in three of five counties, the mean MHI in CERT communities exceeded countywide MHI by up to $19,000. The research was then expanded to New Jersey, where, of 18 counties with CERTs, the mean MHI exceeded the countywide MHI in 15 counties (83 percent of the time). In counties where the mean CERT-community MHI was higher, it exceeded the county MHI by $6,060. Mean CERT-community MHI also exceeded the state’s MHI by over $5,000 ($60,745 versus $55,146). Given recent examples of the vulnerability of poor and working-class communities, emergency management agencies at all levels need to target CERT resources based on need, not on demand.


Article
The Ten CERTmandments
Earle Hartling
November/December 2006; pages 17-20


Article
Emergency logistics planning and disaster preparedness
Naim Kapucu, PhD
November/December 2006; pages 21-24

Abstract
Emergency management is often evaluated and improved after a disaster, especially in the realm of preparedness. This article discusses the importance of logistics planning and operation as it relates to preparedness. The selection of field logistics sites, such as staging areas, prior to the occurrence of a natural or man-made disaster is a crucial step in emergency management planning. Selection can be aided and kept consistent by pre-identifying state- and county-level guidelines for staging areas.


Article
Mandatory emergency response training for clinicians in New York State: Can a policy case be made?
Steven H. Silber, DO, ScM; Kristine M. Gebbie, DrPH, RN; Theodore J. Gaeta, DO, MPH
November/December 2006; pages 25-32

Abstract
There is no mandatory training for individual physicians with respect to overall emergency preparedness in New York State. This paper explores the policy implications of linking licensure and registration to mandatory competency-based educational programs on emergency preparedness response structure and high-risk biological agents. In this article, we explore the implications of mandatory registration and training with a single emergency response facility or agency, and we propose creative solutions that may make such a policy palatable to all stakeholders.


Article
Training the nation’s responders for pandemic influenza: A Department of Homeland Security planning and preparedness initiative
Jeffrey R. Ryan, PhD; Allen W. Kirchner, MD; Jan G. Glarum; Jennifer Davey; Martha Lavender, MSN, DSN; Dana George; Mandy Abernathy; Amie Knight; Heather Horn; Mick Castillo; F. Marion Cain III
November/December 2006; pages 33-40

Abstract
Communities all over the world are preparing for the next disaster. Lately, the World Health Organization has focused its attention on H5N1, a subtype of the influenza virus. H5N1, which most Americans recognize as “bird flu,” has caused massive losses in poultry production, as well as some human fatalities. Public officials have been warned that H5N1 may mutate into a strain that is not only highly pathogenic but also readily transmissible between humans. Should this occur, we might find ourselves on the verge of the next great pandemic. Because of this, community leaders, public health officials, and responders at planning and management levels face one of their most challenging problems: planning and preparing for pandemic influenza. Recently, an initiative at the Center for Domestic Preparedness was undertaken to assemble a training program for community leaders and senior responders that will address the current threat of a pandemic, outline an appropriate response to the problem, and exercise small planning teams using a tabletop model. Key words: pandemic, influenza, planning, preparedness, community response, medical surge, mass prophylaxis, genetic shift, genetic drift


Article
TOPOFF 3: Comments and recommendations from members of the New Jersey Universities Consortium for Homeland Security Research
Paul J. Lioy, PhD; Fred S. Roberts, PhD; Brendan McCluskey, JD, MPA; Mary Jean Lioy, MS; Audrey Cross, PhD, JD; Lee Clarke, PhD; Lee Louise Stanton, JD; William Tepfenhart, PhD; Mary Ellen Ferrara, MS
November/December 2006; pages 41-51

Abstract
Faculty members from the New Jersey Universities Consortium for Homeland Security Research served as observers in the TOPOFF 3 exercise in New Jersey in April 2005. The exercise involved a simulated release of pneumonic plague, with symptomatic individuals sent to hospitals and asymptomatic individuals sent to points of dispensing (PODs) to receive antibiotics. This paper summarizes Consortium members’ observations about the exercise, with emphasis on the PODs’ strategies and implementation, and on the role of communications and command centers. The future role of university collaborations with local and federal agencies in similar counter-terrorism exercises is also discussed.


Article
Emergency planning for municipalities: Emergency Planning 101
Clayton S. Scott, LTC (Ret) USA, CEM
November/December 2006; pages 52-54