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Journal of Emergency Management
January/February 2009, Volume 7
, Number 1


Article
From the publisher
Richard A. DeVito, Jr.
January/February 2009; pages 6-6


Article
Letter to the editor
David W. Holm, MPA, JD
January/February 2009; pages 7-8


Article
Alien concept: The propriety of conducting immigration paperwork checks during evacuations
Erin Hahn, Adrian Wilairat, JD
January/February 2009; pages 13-18


Article
Long-term global threat assessment: Challenging new roles for emergency managers
Richard A. Bissell, PhD; Andrew Bumbak, MS; Matthew Levy, DO, MS; Patrick Echebi, MD, MS
January/February 2009; pages 19-37

Abstract
Based on currently available published data and literature from multiple disciplines, this article introduces medium- and long-term global developments and changes that will likely impact human society in disastrous or even catastrophic fashion, with significant impact on the roles and challenges of emergency managers. Some of the phenomena described include the following: (1) loss of fresh water, (2) significant sea level rise with resultant flooding, (3) increased heat leading to desertification and crop losses, (4) storms that are both more frequent and more violent, (5) massive food emergencies as crops fail for lack of water and/or saltwater inundation, (6) loss of the petroleum-based economy, and (7) massive population relocations on a level the world has never experienced. The perspective used is purposely global, in that the trends described do not respect political boundaries. We also recognize that mitigation and response activities may well involve many nations simultaneously. The article concludes with introductory suggestions of steps emergency management should take in preparing to serve new and more complex tasks to meet coming challenges, and a “call to action” for emergency managers to assume a more active role in confronting the risks imposed by forces that are now underway. Key words: global threat trends; risk profile; global resource depletion; emergency management; new roles


Article
Breastfeeding support in emergencies: Policy implications for humanitarian relief agencies
Michelle A. Angeletti, MSW, PhD
January/February 2009; pages 39-44

Abstract
While breastfeeding provides numerous benefits to infants and young children, these benefits are especially evident during and after emergencies. This article describes the benefits of breastfeeding in emergencies and provides guidelines that can be implemented by humanitarian relief agencies to protect, promote, and support breastfeeding. Key words: breastfeeding, lactation, infant feeding, emergency management, disasters


Article
Incorporating emergency management needs in the development of weather radar networks
Ellen J. Bass, PhD; Leigh Baumgart, MS; Brenda Philips, MBA; Kevin Kloesel, PhD; Kathleen Dougherty, MA; Havidan Rodriguez, PhD; Walter Diaz, PhD; William Donner, PhD; Jenniffer Santos, MS; Michael Zink, PhD
January/February 2009; pages 45-52

Abstract
The Center for Collaborative Adaptive Sensing of the Atmosphere (CASA) is developing networks of lowpower, low-cost radars that adaptively collect, process, and visualize high-resolution data in the lowest portion of the atmosphere. CASA researchers are working with emergency managers (EM) to ensure that the network concept is designed with EMs’ needs in mind. Interviews, surveys, analysis of product usage logs, and simulated scenarios are being used to solicit EM input. Results indicate the need for products for both high- and low-bandwidth end users, visualizations for velocity products that are more easily interpreted, and enhanced training. CASA researchers are developing interventions to address these needs. Key words: weather radar, decision making, high-resolution radar


Article
Security as subversion: Undermining access, agency, and voice through the discourse of security
Jennifer Bedford, MS; James Kendra, PhD
January/February 2009; pages 53-63

Abstract
This article describes a case in which local emergency planning was thwarted by indifference and concern about security. It argues that excessive security concerns can impede the kind of cooperation and information sharing that is widely accepted as essential to good planning and suggests that concerns about less-likely terrorist attacks undercut preparation for more-likely emergencies arising from natural or technological sources. Key words: emergency management, homeland security, preparedness


Article
H5N1 planning concerns for local governments
Robert O. Schneider, PhD
January/February 2009; pages 65-70

Abstract
The objectives of this essay are two-fold. First, it will review the very real threat an avian influenza pandemic poses to local communities. Second, it will identify several unaddressed but critical concerns that require the attention of local governments as they refine their pandemic preparedness planning. It is concluded that greater coordination with the private sector, improved public health surveillance efforts, planning for public education, and greater attention to ethical issues are essential concerns that should be on the agenda of local governments as they proceed with their preparations. Key words: avian flu, influenza pandemic, public health, emergency preparedness, mitigation, planning


Article
An introduction to netcentric operations and services-oriented architectures for emergency managers
Jeff Youmans, MSc IA, CISSP
January/February 2009; pages 71-74

Abstract
The winds of change are upon us (once again). In the computer world, it seems changes like this happen every other day. In this case, however, it really is revolutionary. The way information is passed not only within your department but also within other departments is going to move faster than ever before. It’s a wholesale architectural change that for once will not affect the computer in your car or on your desk, but will affect how the data are accessed. The objective of the services-oriented architecture is to obtain the overall goal of netcentric operations and speed the flow of data. The end goal is to resolve disastrous situations, get help to the victims, and track suspects faster than ever before. Key words: netcentric, network, services-oriented architectures, operations


Article
Planning for the last disaster: Correctional facilities and emergency preparedness
Jeffrey A. Schwartz, PhD
January/February 2009; pages 75-79

Abstract
This study uses hurricanes Katrina and Rita to illustrate the phenomenon of “planning for the last disaster,” in which public agencies become so transfixed by a profound crisis or disaster that they begin to prepare for another occurrence of the same event. In doing so, they abandon or ignore their ongoing and more generic emergency planning and deny the obvious, that the next emergency or disaster has a high probability of being a very different situation. The same counterproductive results can be obtained if an organization is swept up in media hype and public concern about an “emergency du jour,” such as Y2K or pandemic flu. Although this article examines these issues in correctional organizations, the same principles apply to almost all public agencies. Key words: corrections, emergencies, crises, disaster, jails, prisons

Journal of Emergency Management
March/April 2009, Volume 7
, Number 2


Article
Drafting, revising, and updating local emergency operations plans: The National Response Framework and the Emergency Support Function Annex model
Michael Stallings, JD; Whitney Faust, JD
March/April 2009; pages 11-18

Abstract
Lessons learned and public scrutiny resulting from the Gulf Coast hurricane disasters in 2005 led the Federal Emergency Management Agency (FEMA) to restructure its national incident response guidance. The National Response Framework (NRF) replaced the National Response Plan (NRP) in early 2008. The updated Framework has focused the attention of emergency management planning to, among other things, updating Emergency Operations Plans (EOPs) on a State and local jurisdictional level, utilizing an Emergency Support Function (ESF) model. Since 2005, compliance mandates under the National Incident Management System (NIMS) have required local government entities to revise and update emergency operations plans to incorporate NIMS components. With the introduction of the NRF in 2008, the ESF model is now the recommended standard for local government EOPs under the NIMS compliance objectives. The ESF model provides for a coordinated response effort and mutual aid options local agencies may receive from State and Federal resources in the wake of an emergency. It also works to ensure that local entities themselves have a careful accounting of all of their own resources and capabilities to avoid another slow and inadequate response that was at the heart of the Hurricanes Katrina and Rita tragedies in 2005. Key words: national response framework, emergency support function, local emergency management, emergency operations plan


Article
Distrust in emergency management: The impact of reduced information exchange
Bjørn Ivar Kruke, MSc, PhD (Candidate)
March/April 2009; pages 19-37

Abstract
Coordination of humanitarian operations in complex emergencies require joint initiatives from mutually dependent actors, such as the host government, large UN agencies, international and national nongovernmental organizations, and the population. To master the challenges of coordination, building trust relations between these actors is essential, trust relations based on the willingness to communicate, to share information, and to cooperate. However, distrust between the displaced population and host government is often seen in complex emergencies and influences the agencies coming to the emergency area. This article concludes that distrust leads to reduced information exchange and thereby increased distrust. Although distrust in the authorities is well founded in Darfur, humanitarian operations without the authorities are not possible. The right personalities in key positions and smaller forums for information exchange increase the likelihood of trust-building between individual emergency managers from the various actors; trust-building is necessary for reliable emergency management. Key words: complex emergency, trust and distrust, coordination, information exchange


Article
Using decision analysis to select alternate modes of dispensing: An example from Los Angeles County Public Health
Sinan Khan, MPH, MA; Anke Richter, PhD
March/April 2009; pages 39-51

Abstract
Objective: To comply with the Center for Disease Control’s mass prophylaxis mandates, many public health jurisdictions must supplement their existing Points of Dispensing (POD)-based system. Because of limited budgets and personnel availability, only one or two alternatives out of the many potential options can be implemented. Design: Multicriteria decision analysis is a powerful tool that allows public health officials to assess the relative effectiveness of alternate modes of dispensing while incorporating the opinions of their multidisciplinary emergency response planning teams. Setting: This process was utilized to analyze the effectiveness of alternate modes of dispensing that could be used to supplement the existing POD system within the Los Angeles County (LAC) Department of Public Health (DPH). Results: The top two options for LAC were prepositioning for civil service and partnership with a major Health Maintenance Organization. These choices were stable under a variety of sensitivity analyses, and the differences in opinion between the agencies and other stakeholders do not change them. Conclusions: The transparency of the model and analysis may allow decision makers and planners in the LAC DPH to garner support for their alternate modes of dispensing plans. By making the decision criteria clear and demonstrating the robustness of the results in the sensitivity analyses, public health partners gain a deeper understanding of the issues and their potential roles. The process can be repeated by any jurisdiction, but definition of “best” will rely on the issues and gaps that are identified with the jurisdiction’s POD plan for mass prophylaxis. Key words: bioterrorism planning, public health, decision analysis


Article
Bioterrorism and the college campus: Student perceptions of emergency preparedness
Diane L. Smith, PhD, OTR/L; Stephen J. Notaro, PhD; Stephanie A. Smith, MS
March/April 2009; pages 53-64

Abstract
Objective: The purpose of this study was to determine the current perceptions of college students in regard to the emergency management of bioterrorism. Design: University students enrolled in Community Health courses were recruited to participate in a paper or online survey to determine their perceptions regarding likelihood of a bioterrorist attack, preparedness of the university, and preparedness of the students. Participants: Of the 309 students recruited, 265 (85.9 percent) participated in the survey. Interventions: Data from the surveys were entered into an SPSS dataset for analysis. Main outcome measure: Perceived preparedness of the university for a bioterrorism emergency. Results: Students perceived that there was a low likelihood of a bioterrorist attack at the university. Only 17.6 percent of the students felt that the university was prepared for a large-scale emergency and only 24.1 percent felt that the students were prepared. One third of the students did not know that the university had policies in place for a bioterrorist attack and 88.3 percent did not know where to go for information in the event of a bioterrorist attack. Only 9.2 percent had visited the campus emergency planning Web site. Conclusions: Effort must be made by universities to determine the appropriate amount of education to the students regarding emergency preparedness based on the cost-benefit to the university and the student body. Suggestions from students included a mandatory workshop for incoming freshman, involvement of campus emergency planning with student organizations, and increased marketing of the campus emergency Web site. Key words: emergency planning, bioterrorism education, college students


Article
Situation awareness oriented user interface design for fire emergency response
Lili Yang, PhD, MSc, BSc, FBCS, CITP; Raj Prasanna, PhD candidate; Malcolm King, PhD, MA, FIMA, Cmath
March/April 2009; pages 65-74

Abstract
Emergency response management demands certain characteristics of the individuals involved. They need to act decisively on often little or incomplete information within tight time schedules, or, sometimes, with too much data from which it is difficult to extract key information. Procuring the right information at the right time, in the right format, and to get it to the right people is a challenge in any emergency response management system design; especially, as poor designs can lead to response systems that are not used, are ineffective, and in some cases dangerous to the emergency personnel. This article explores how situation awareness (SA) oriented design can be used for on-site emergency response system development. The end-user requirements are identified through extensive interviews with fire fighters and observations of fire emergency response training simulations. These requirements are calculated against the identified responsibilities of the core members in the first responder hierarchy. The on-site dynamic information which could be presented to emergency personnel is examined through the use of three SA levels to meet the various requirements of the first response party. Finally, an interface prototype of an information system for fire and rescue services is presented to illustrate the methods proposed in the article. Although our focus was on structural fire and fire fighters, the interface design for an onsite emergency response system proposed here is applicable for other emergency response situations as well, due to standard operating procedures. Key words: emergency response, fire fighter, information requirement, situation awareness oriented design, graphic user interface


Article
Equal opportunity preparedness and response: Increasing preparedness and response for citizens with visual and auditory impairment
Courtney E. Taylor, MS
March/April 2009; pages 75-79

Abstract
During the planning process for preparedness and response of disasters, people with visual and auditory disabilities are frequently and mistakenly left out. In October of 2003, a television report in San Diego, CA, failed to provide visual warnings to inform Deaf residents during coverage of local fires.1 Confusion during Hurricane Katrina resulted in numerous service animals being separated from their owners.2 Emergency workers were unprepared to assist Deaf people on the 35W bridge collapse of 2007 in Minneapolis, MN. People with visual and auditory disabilities should be aware of their own needs in the event of an emergency, and their community should be aware too. Emergency managers and first responders should take certain precautions in assisting people with disabilities. The preparedness and response stages of visually impaired, auditorily impaired, and service animals are important topics for any community. Key words: visual impairment, auditory impairment, preparedness, response

Journal of Emergency Management
May/June 2009, Volume 7
, Number 3


Article
Preparing communities: The critical integration of faith-based organizations into emergency planning and response
Jessica L. Hurst, BS, JD (Candidate, 2011); Jessica P. George, BA, JD
May/June 2009; pages 11-20

Abstract
This article discusses the paradigm shift that is taking place in emergency management planning with regard to the integration of faith-based organizations in federal, state, and local preparedness, response, and recovery efforts. In addition, this article explores potential legal issues related to government funding and support of faith-based emergency planning initiatives. Finally, the article proposes recommendations for initiating and expanding emergency planning among faith-based organizations to fully utilize the unique knowledge these groups have of the needs of their communities. Key words: faith-based organizations, emergency planning, preparedness, response, establishment clause


Article
Cleaning up New Orleans: The impact of a missing population on disaster debris removal
Timothy J. Cook, BA
May/June 2009; pages 21-31

Abstract
Public participation in a disaster debris removal process is an important component to any large-scale rebuilding effort. How, then, does such an effort progress when nearly two-thirds of the affected community’s population does not come back to participate? The City of New Orleans faced just such a situation after Hurricane Katrina and the catastrophic flooding that followed. The debris removal task is the largest in US history, and very few residents returned to participate in the cleanup. This article provides a further understanding of the impact that New Orleans’ missing population had on the city’s cleanup process. This article asserts that without this city’s residents (or first filters), the enormous debris removal effort in New Orleans was further slowed and complicated. The first two sections provide background and context, identifying the size and scope of the disaster, the low residential return rate, and the role of public participation in previous large-scale debris removal efforts. The next three sections focus on the disaster debris itself, identifying specific ways in which the missing population further complicated New Orleans’ cleanup efforts with regard to (a) the duration of the debris removal process, (b) the volume of debris, and (c) the contamination of debris.The final section considers various measures that emergency planners and managers can take to facilitate “participatory repopulation,” thus mitigating the complications of a missing population. Key words: debris removal, Hurricane Katrina, New Orleans, public participation


Article
Pandemic influenza vaccination distribution: Evaluating the policies of several large municipalities across the United States
Eric S. Raymond, Doctoral Student; P. Edward French, PhD
May/June 2009; pages 33-41

Abstract
The H5N1 influenza viral strain, or “avian flu,” has been a cause of concern for health officials at all levels of government since 2003. As it currently exhibits a 60 percent mortality rate, this strain uncomfortably resembles the H1N1 viral strain that killed more than 50 million people worldwide in the early twentieth century. Although limited worldwide vaccine-production capabilities prevent the mass distribution of vaccines in the event of a pandemic from this or any other viral strain, government officials are left with few options but to develop vaccination distribution policies for their respective communities. This research evaluates the vaccine distribution policies of eight municipalities with populations greater than 100,000 across the United States to determine the reasoning for prioritizing certain individuals over others. The authors find that each of the vaccination distribution policies follow Department of Health and Human Services guidelines with some minor modifications; however, we propose that a cost benefit analysis model which includes public participation and considers social continuance, economics, and the flexibility to adjust vaccination distribution is a more favorable approach. Key words: pandemic influenza, vaccine distribution, local government


Article
Responding to catastrophic disasters: Lessons from the World Trade Center terrorist attacks
David A. McEntire, PhD; Jill Souza, MPA
May/June 2009; pages 43-58

Abstract
The following article uses the 2001 World Trade Center Terrorist attacks as a case study to illustrate the major challenges presented to responders and emergency management officials. It examines not only the consequences of this disaster but also the immediate and long-term measures to deal with it. The article concludes with suggestions on how to prepare for such events in the future. Key words: World Trade Center attack, terrorism, response, emergency management, preparedness lessons


Article
Direct assistance to victims in rescue operations as a risk factor for post-traumatic stress disorder in police officers: The experience of the Toulouse disaster in 2001
Nelly Agrinier, MD; Artus Albessard, MD; Valerie Schwoebel, MD, PhD; Eloi Diène, MD; Thierry Lang, MD, PhD
May/June 2009; pages 59-67

Abstract
Objective: The aim of this study was to describe the prevalence of symptoms consistent with post-traumatic stress disorder (S-PTSD) in police personnel involved in rescue operations after the AZF chemical plant explosion in Toulouse, France, on September 21, 2001, and the relationship between S-PTSD and the type of rescue operation. Design: A cross-sectional survey was performed, using a mailed questionnaire. Participants: Six hundred and thirty-five out of 1,500 rescue operations police officers participated in the study. All were involved with the explosion site after the industrial disaster. Main outcome measure: The outcome variable was the presence of S-PTSD. The explanatory variables were the level of exposure during the rescue tasks. Statistics: Logistic regression was used to calculate the adjusted odds ratios (OR). Results: The prevalence of S-PTSD among policemen was 4.1 percent [95% CI: 2.1-6.2]. Policemen who had immediate health consequences (OR 4.6; [95% CI: 1.3-16.4]) and those who provided medical assistance to the victims (OR 5.7; [95% CI: 1.6-20.2]) had a higher prevalence of S-PTSD. Conclusions: Providing medical assistance to the victims was a major risk factor of S-PTSD for police officers. Training police officers to take part in medical activities at the time of the disaster might lead to a reduction of SPTSD incidence in this group. Key words: post-traumatic stress disorder, police officers, rescue workers, industrial disaster, cross-sectional study


Article
Emergency planning and people with disabilities: Massachusetts’ lessons learned
Erin McGaffigan, MSW, MS, Public Policy; Chris Oliveira, BS; Diane Enochs, BA, MA
May/June 2009; pages 68-75

Abstract
Continued challenges responding to large-scale emergencies are recognized in the aftermath of events such as Hurricanes Katrina and Rita. Elders and people with disabilities often included under the label of “vulnerable” or “special populations,” are especially hard hit given communication and accessibility barriers often faced even prior to an emergency. Approximately 15 percent of those living within our communities have disabilities, which jumps to 41 percent for those 65 years or older.1 The prevalence of functional limitations due to age or disability indicates the need for these factors to be accounted for in planning, response, recovery, and mitigation efforts at the national, state, and local level to ensure a truly effective emergency response system that meets the needs of all residents. To achieve this effort emergency management, public health, disability and elder stakeholders within Massachusetts joined together to identify the existing planning gaps and to explore potential solutions to support emergency preparedness so that emergency management systems are responsive to all individuals in the community, regardless of age or disability. The Commonwealth’s process and lessons learned are discussed later. Key words: special populations, vulnerable populations, planning, policy design, inclusion, stakeholders, disability, elderly


Article
Biological incidents: Revisiting past perspectives toward a 21st century problem
Darren K. Stocker, MS; Charles J. Kocher, MS, EdD
May/June 2009; pages 76-80

Abstract
Beginning in the 14th century, the use of biological agents as weapons created an effective methodology of killing enemy combatants and instilling fear in the populace of a community and nation. Although the deployment of these agents in various forms is in opposition to the agreements set within the rules of several weapons treaties, the use and threat of their development as a terrorist instrument has impacted societies in post-September 11th documented accounts. This article provides a chronological indication of the use of natural and synthetic biological agents as an intimidation factor and demonstrates the extent of how they have been consciously used in contemporary confrontations and how law enforcement, healthcare providers, and health organizations are engaged in the response of these biological weapons. Key words: disaster, history, emergency management, biological incidents, epidemiology

Journal of Emergency Management
July/August 2009, Volume 7
, Number 4


Article
Keeping the flu at bay: Methods for detecting and containing infectious disease
Atresha Karra, JD; Emily Cornette, JD
July/August 2009; pages 9-16

Abstract
This article focuses on the existing methods for tracking and restricting the spread of communicable diseases, both within United States borders and across nations. It will first describe the roles played by the United States’ Centers for Disease Control and Prevention and the World Health Organization and will then explore how communicable diseases across the world are identified and monitored. This will be followed by a discussion of US and world reporting requirements and methods. Finally, the article will discuss the tactics used by the United States to control the spread of disease. Key words: quarantine, communicable disease, disease detection, travel bans, H1N1


Article
Disaster mental health: A critical incident stress management program (CISM) to mitigate compassion fatigue
Norma S.C. Jones, DSW; Kamilah Majied, PhD
July/August 2009; pages 17-23

Abstract
This article presents a critical incident stress management program (CISMP) that is designed to anticipate and mitigate the emotional impact of external and internal critical incidents upon individuals and groups who deliver disaster recovery services. This comprehensive program provides for immediate and sustained responses to assist disaster workers in effectively minimizing the emotional detriment of stressful incidents, resulting from interactions with disaster victims. Disaster workers have the potential to experience compassion fatigue as they listen to the disaster survivors’ stories of pain and losses, and work long work hours over extended work periods. The program is a structured, peer-driven, clinician-guided, and supported process designed to provide interventions to address disaster-related mental health issues. Emphasis is placed on individual peer support for immediate action, and specialized individual and group support, assessment, and referral is provided by a stress management clinician. Peer partners participate in a training program, which includes: (1) an overview of stress assessment and management; (2) critical/intervention orientation; (3) identification and utilization of peer support techniques; (4) event preplanning, event briefings, defusings, and debriefings; (5) protocol for responding to an incident; and (6) basic information on workplace violence. Key words: compassion fatigue, critical incident, stress management, disaster workers


Article
Reconceptualizing household disaster readiness: The “Get Ready” Pyramid
Michele M. Wood, PhD; Megumi Kano, DrPH; Dennis S. Mileti, PhD; Linda B. Bourque, PhD
July/August 2009; pages 25-37

Abstract
The terrorist events of September 11, 2001 were followed by a dramatic increase in public education and information efforts to improve preparations for disasters across our nation. Using the State of California as a case study, this article provides an overview of existing public education campaigns intended to enhance readiness; identifies shortcomings in current approaches; and presents a comprehensive public readiness typology, the “Get Ready” Pyramid, a framework organized along a continuum of cost, intended for use by any individual or entity wishing to promote or adopt readiness actions. Future research should evaluate the framework’s utility and impact on behavior. Key words: disaster, emergency, mitigation, preparedness, readiness, information dissemination, public education, recommendations


Article
The role of the psychiatric nurse practitioner in disaster response
Brenda Marshall, EdD, MSN, PMHNP-BC
July/August 2009; pages 39-45

Abstract
Nurses have responded to, and prepared for disasters from the time of Florence Nightingale and Harriet Werley. Nurses are the largest group of professional healthcare providers in America with more than 2.4 million registered nurses, a quarter of a million of whom are Nurse Practitioners capable of diagnosing, prescribing, and treating patients. Psychiatric Nurse Practitioners are in a position to understand the unique cultural nuances and needs of a community in all phases of the disaster life cycle. Key words: mental health, PNP, CSID


Article
When disaster strikes: Bridging the hospital preparedness gap
Matthew S. Yoder, PhD; Connie L. Best, PhD; Ralph M. Shealy, MD; David R. Garr, MD; Michael G. Schmidt, PhD
July/August 2009; pages 46-50

Abstract
Bioterrorism has emerged as a serious public health threat in the United States and continues to warrant significant public health concern. In the event of a bioterrorist attack, hospitals and healthcare providers will play a primary role in the community’s response. However, recent research has suggested that hospitals are unprepared to respond to a bioterrorism event lacking personnel, equipment, knowledge, and experience. The current article highlights the gaps between need and implementation of disaster preparedness programs in healthcare settings; presents a program designed to address these limitations in a cost-effective, portable, accessible training package; and analyzes data from a basic evaluation of the program. The program is a 4.5-day training developed by the a state Area Health Education Consortium (AHEC) to help prepare hospitals for a bioterrorist attack by training personnel in the creation of a decontamination team responsible for decontaminating patients before they enter the hospital. A basic evaluation of the program found that participants who complete the training reported high ratings of competency related to decontamination procedures, their confidence in future performance, and the training overall. Results suggest that the training program holds promise in beginning to address hospital preparedness gaps. Key words: hospital preparedness, disaster, bioterrorism


Article
The hybrid exercise: Transitioning from discussion-based to operations-based exercises
Ralph Renger, PhD, MEP; Jessica Wakelee, MPH; Jillian Bradshaw, MBA, MEP
July/August 2009; pages 51-56

Abstract
HSEEP emphasizes the importance of finding the appropriate balance between challenging players while not overwhelming them. Inherent in the transition from discussion-based to operations-based exercises is increased player stress. This transition is often overwhelming. A hybrid exercise is designed to assist exercise players in building their confidence in moving from discussing plans into testing plans and carrying out operations. It combines elements of both types of exercises with the purpose of creating a smoother transition from discussion-based to operations-based exercises. The development of a hybrid exercise is illustrated by way of a real life example. It is hoped sharing the concept of the hybrid exercise will encourage other exercise planners to examine the utility of combining elements of discussion-based and operations-based exercises to create a smoother transition from one type to the other. Key words: HSEEP, exercise, planning, conduct, evaluation, hybrid


Article
Context-aware mobile coordination system for emergency response
Bill Karakostas, PhD
July/August 2009; pages 57-64

Abstract
This article proposes how context-aware Information Technologies can assist emergency response teams. Contextual information about an emergency responder’s activities such as current status and location can be automatically transmitted to other responders using criteria such as physical proximity and relevance. In this manner, ad hoc (peer-to-peer) emergency response teams can be coordinated via notifications of status updates (changes in location, task updates, personnel availability, and so on). The article argues that a peer-to-peer, context-aware coordination approach can be proved to be more effective than hierarchical command and control style of coordination in certain emergency response situations. Key words: peer-to-peer, smartphone, emergency response information systems, task context awareness, location and presence service


Article
An analysis of casualty transportation to a medical facility following the Campbelltown tornado
Bruce S. Rudy, Ded; Michele L. Shaffer, PhD; Andrea H. Horne, MA
July/August 2009; pages 65-68

Abstract
An emergency management agency is responsible for the preparation and response to a myriad of disasters. A disaster is an event that overwhelms the available resources. An analysis of tornado victims who presented to a nonurban medical center demonstrated a higher percentage of arrival by emergency vehicle when compared with other disasters that occurred in metropolitan settings. Emergency managers in nonurban settings should include plans for transportation of both critically and noncritically injured persons to a medical facility. Keywords: emergency management, disaster, triage, tornado


Article
Emergency communication: A framework for planning and targeting messages
Kenneth A. Lachlan, PhD; Patric R. Spence, PhD
July/August 2009; pages 69-72

Abstract
This article outlines a model of emergency communication for use in generating action in audience members. The model expands previous research by enlarging the framework of fear and self-efficacy. The model is first outlined explaining its theoretical dimensions and if followed by explanations of its validation. The next portion discusses its potential use for emergency practitioners. The article concludes with a description of how to use the model and where to obtain more information about the model. Key words: crisis communication, risk communication, hazard, outrage, Peter Sandman

Journal of Emergency Management
September/October 2009, Volume 7
, Number 5


Article
Editorial The deadly second wave that follows every disaster
Geoffrey Simmons, MD
September/October 2009; pages 9-10


Article
Bridge building within emergency management communities: Successes, pitfalls, and future challenges
Thomas E. Drabek, PhD
September/October 2009; pages 11-18

Abstract
Despite increased nurturing efforts, emergency management continues to reflect excessive fragmentation. Individuals remain locked within differing subcultural groups, eg, researchers vs practitioners and homeland security vs emergency management orientations. Too often they ask: “Why don’t you listen to me?” Important lessons can be learned from past bridge building efforts. The successes and failures of six specific efforts are summarized. Then, three of the most significant future challenges confronting emergency management within the United States are identified.Wisdom from the past must be applied to these challenges. Key words: emergency management cultures, bridge building, fragmentation, challenges


Article
Bringing it all back home: Continuity of government planning for local government
Robin J. Clark, JD; Adrian Wilairat, JD
September/October 2009; pages 19-31

Abstract
Continuity of government (COG) planning for local government is an important aspect of our nation's preparedness. COG plans help to prepare local government officials for emergencies in their jurisdiction by identifying legal authorities, orders of succession, and alternate facilities. This article summarizes relevant guidance, outlines key features, and provides substantive examples of the content of local government COG plans. Key words: continuity of government, order of succession, local officials, continuity planning and cgc-1


Article
Do FEMA’s, HSEEP’s, and Green’s progressively difficult emergency exercise training concepts ultimately lead to increased emergency preparedness?
Marc Glasser, MS, CPP, CEM, CHS-V, MCAS
September/October 2009; pages 33-38

Abstract
FEMA’s, HSEEP’s, and Green’s Exercise Alternates emergency exercise training approach models are built on the fundamental educational principle that progressively difficult emergency exercise training leads to the most effective learning and comprehension which ultimately increases emergency preparedness. This article addresses the merits of the “progressive” education principle in general and within the context of emergency exercise training programs. This article also briefly addresses emergency exercise planning and standardization, adult learning principles, and the theory of andragogy. This article concludes with an analysis based on a synthesis of the information reviewed, assertions and academic research results. The research material utilized was evaluated and selected based on the credibility of the source and its applicability to the subject material. Key words: emergency, exercise, training, preparedness, FEMA, Homeland Security Exercise and Evaluation Program (HSEEP), Walter Green


Article
Bringing order to chaos: How RFID can deliver business intelligence to hurricane evacuations and enhance public safety in the process
David C. Wyld, DBA
September/October 2009; pages 39-47

Abstract
In the wake of Hurricane Katrina and subsequent major hurricanes, evacuation planning and execution have taken-on a heightened level of interest from both public officials and the general public. In this article, the authors examine how radio frequency identification (RFID) can be utilized to not just facilitate mass evacuations due to hurricanes, but yield far-better, real-time information to public officials, emergency managers, and concerned family members as well. The authors begin with an overview of RFID technology. Then, the authors explore how two leading areas—the State of Texas and the City of New Orleans—have worked with private sector partners to develop, test, and actually utilize RFID-based tracking systems to be used ondemand for hurricane evacuation events. The authors then analyze the benefits of such systems for use in hurricanes and other potential mass evacuations. The authors pinpoint the public safety, operational, and business intelligence advantages of employing this new identification technology in these crisis situations. Key words: radio frequency identification, evacuation, emergency preparedness, information technology, business intelligence, planning


Article
Risk communication with nurses during infectious disease outbreaks: Learning from SARS
Eileen O’Connor, PhD; Tracey O’Sullivan, PhD; Carol Amaratunga, PhD; Patricia Thille, BSc (PT), PhD (Student); Karen P. Phillips, PhD; Michelle Carter, MSc (Candidate); Louise Lemyre, PhD, FRSC
September/October 2009; pages 48-56

Abstract
Objective: To identify gaps in risk communication during public health emergencies as identified by nurses who worked in critical and emergency care hospital units during the Severe Acute Respiratory Syndrome (SARS) outbreak in Canada. Design: This research is part of a larger multimethod study of the psychosocial impacts of the SARS outbreak in Canada for healthcare workers. For this qualitative analysis of risk communication, focus groups were conducted in four Canadian cities using purposive sampling to study perspectives of frontline critical care and emergency department nurses. Covello’s (2003) model of best practices in risk communication is applied to assess specific areas in which risk communication gaps were identified by nurses interviewed in the focus groups. Setting: Five focus groups held in four Canadian cities: Halifax, Ottawa, Toronto, Vancouver. Participant/Data: n = 100 participated in focus groups in four urban communities. Results: During the SARS outbreak in 2003, high levels of uncertainty, lack of trust, and questions about leadership credibility emerged as important risk communication challenges. Communication problems were compounded by a lack of reliable information, frequent changes in infection control guidelines and risk avoidance messages, as well as contradictory actions of management and senior leaders. Conclusions: Risk communication constitutes an important component of any emergency protocol. This study of nurses working in emergency and critical care hospital settings during the 2003 SARS outbreak indicates key areas in which risk communication could be more efficient to address nurses’ concerns related to managing uncertainty, occupational health and safety, and employee quality of life. Recommendations useful for planning of any pandemics including H1N1 are derived. Key words: risk communication, occupational support, SARS, nurses, infectious disease, emergency management, pandemic planning, disaster medicine


Article
Monitoring the early response to a humanitarian crisis: The use of an Omnibus Survey in the Solomon Islands
Reiko Miskelly, MPP; Will Parks, PhD; Nawshad Ahmed, PhD; Asenaca Vakacegu, MA; Katherine Gilbert, MPP; Tim Sutton, MA
September/October 2009; pages 57-70

Abstract
On April 2, 2007, an earthquake followed by a tsunami hit islands in Western and Choiseul Provinces of Solomon Islands. More than 36,500 people living in 304 communities were affected. Alongside other United Nations agencies, International and National Non-Government Organizations and Faith-Based Organizations, the United Nations Children’s Fund (UNICEF) has played a significant role in the emergency response. UNICEF mobilized staff and resources guided by the agency’s Core Commitment for Children in Emergencies (CCCs). Dialogue with government counterparts and partners led to an initial 6-month Emergency Management Plan (EMP) enabling coordination of UNICEF’s response to the needs of the affected population. This article describes the use of a rapid monitoring tool—the Omnibus Survey—designed to measure initial EMP targets for key child survival interventions 10 weeks after April 2. The article begins with an overview of UNICEF’s role in declared emergencies. A background to the April 2 disaster and UNICEF’s early work with partners is then provided, followed by an explanation of the Omnibus Survey. Immediate implications of the survey’s findings for UNICEF’s ongoing assistance are discussed together with broader lessons learned when preparing for and managing humanitarian crises in the Pacific. Key words: humanitarian crisis, survey, monitoring, Omnibus Survey, early response, Solomon Islands, tsunami


Article
Village-level tsunami disaster assessment: A volunteer’s perspective
Srikrishna Sulgodu Ramachandra, MBBS, MD, MPH
September/October 2009; pages 71-84

Abstract
Introduction: The Tsunami hit Indian coastal line between 8.30 and 9.30 AM Indian Standard Time (IST) on the December 26, 2004. A lot of damage to life and property—both movable and immovable—occurred to approximately 3-4 km of land adjacent to the coastal line. It mainly took away lives, shelter, fishing boats, and fishing nets of the fishermen folk. Relief in terms of money, manpower, food, water, clothing, medicines, and all other resources poured in plenty. However, any amount of relief or compensation could not match the amount of damage that had occurred. A team of 11 volunteers (two Public Health Specialists, seven Medical Interns, and two Medico Social Workers) led by the author went through ActionAid International and Community Health Cell (CHC), Bangalore, for relief work in Nagapattinam District of Tamil Nadu, which is one of the worst affected districts in India. Objectives: To conduct a rapid assessment of the amount of damage at village level to lives, social and economic losses, and damage to community resources in 15 villages of Sirkali taluk of Nagapattinam district in Tamil Nadu with an ultimate goal to provide long-term services in that community. To assess the relief needed and relief that was actually provided in these 15 villages through Government and various Non Governmental Organizations (NGOs). Methods: A 1-day (December 27, 2004) training and orientation on rapid disaster assessment, the tool to be used for the village level disaster assessment and handling relief operations in a Tsunami affected situation was given by the Country Coordinator for Disaster Management, ActionAid India, at CHC, Bangalore. Then, a 1-day (December 28, 2004) Planning and Review meeting was conducted at ActionAid Office, Chennai, to draw up an action plan for the areas to be covered and the steps to be followed during the assessment. The Survey Team was then divided into two groups of five members and six members each and set out to the villages selected for the actual data collection. The 15 villages that were part of the survey were selected by the ActionAid Chennai Office, based on the severity of destruction caused in those areas, and also since, they were the villages that ActionAid had longterm plans of adoption. A standard pretested semistructured questionnaire was provided by ActionAid and the data was collected by using participatory methods: (i) observations, (ii) key informant interviews (KIIs), and (iii) focus group discussions (FGDs). (KIIs were conducted with the Village Panchayat leaders, informal leaders, and the local residents. FGDs were conducted with the local residents. The information obtained through these participatory methods was validated against the records that were available with the local government.) Results and Discussion: An analysis of the data from the rapid assessment done in these 15 villages of Sirkali taluk are presented and discussed in this article. A discussion about some of the best practices, major pitfalls in handling certain issues, challenges faced during data collection in these disaster situations, the preparedness for this kind of a situation in India, and developing systems for warning and reporting of this kind of a disaster are also discussed. Conclusions: A disaster of this magnitude in a developing country like India clearly shows the need and commitment for Disaster Preparedness and Management. There is an urgent need to develop systems at the local, state, regional, and national levels and also ensure implementation. By doing so, although we cannot totally avoid natural disasters, we could probably be more prepared to face it and also minimize loss to lives and property to the least possible extent. Agencies involved in disaster management need to realize the ground realities of the effected area for planning a mitigation operation since each situation would be unique. Key words: disaster response, tsunami, volunteer perspective, disaster assessment

Journal of Emergency Management
November/December 2009, Volume 7
, Number 6


Article
Shooting the Moon: Should states require the H1N1 vaccine for healthcare workers?
Paris Nourmohammadi, JD; Brigid Ryan, JD
November/December 2009; pages 11-17

Abstract
On June 11, 2009, the director of the World Health Organization (WHO) raised the phase of alert in the Global Influenza Plan from level five to level six. The cause for this was the H1N1 virus which had already affected several countries. A level five alert is declared when more than one country in a single WHO geographic region is affected by the same virus. A level six declaration means that community outbreaks are occurring in at least two WHO geographic regions. Once such a declaration is made, little time remains before mitigation efforts must be planned and communicated to the public. In the wake of the WHO declaration, policy makers are clamoring for adequate disease mitigation strategies. Some health departments intend to require employees to wear personal protective equipment while on the job. Other state health departments are encouraging employees to stay home sick if they think they might have the flu. The New York State Health Department has issued an order requiring all healthcare workers to be vaccinated for H1N1 or risk being terminated. This article will explore the New York State policy and make recommendations to policy makers about how to prevent the spread of H1N1. Key words: H1N1, mandatory vaccination, employment, influenza, health care worker


Article
Challenges faced by the chronically ill and disabled in high-risk hurricane areas
Robert J. Blendon, ScD; John M. Connolly, MSEd; John M. Benson, MA; Tami Buhr, AM; William E. Pollard, PhD; Elizabeth W. Mitchell, PhD
November/December 2009; pages 19-28

Abstract
Using results from three surveys of adults in highrisk hurricane areas in eight Southern coastal states, this article examines the challenges faced by people from households where someone has a chronic illness or disability and would need help to evacuate. The analysis finds that 43 percent of people in this vulnerable group had not arranged the help they would need to evacuate. They had different reasons than other adults for why they would or might not evacuate in a future hurricane and were more likely than others (22 to 10 percent) to say they would go to an evacuation center if they did evacuate. Among those who had experience with a recent hurricane, people in this vulnerable group had encountered many more problems than others during and immediately after the storm, including more than one in four who suffered from heat exhaustion, who did not get needed prescription medicines, or who did not have enough fresh water. Key words: hurricane, disability, chronic illness, preparedness, information seeking, emergency, evacuation


Article
Emergency preparedness and vulnerable populations: Lessons learned for education and training
Richard Isralowitz, PhD; Patricia Findley, DrPH, MSW
November/December 2009; pages 29-34

Abstract
First responders, including those addressing mental health and social work needs, should be prepared and trained to respond in times of crises. However, too often such preparation is not taken until after a crisis has occurred. This article describes a cross national working exchange between United States and Israeli academic and human service personnel who engaged in a process to identify the lessons learned from disaster situations. Qualitative analysis of the focus groups identified that the most vulnerable populations, including children, immigrants, the elderly, and those with disabilities need a coordinated preparedness plan and that local efforts tend to be reactive to meet emergency needs. The need to prepare staff and volunteers for disaster response and management was also identified, including curriculum to address stress reactions. This initiative reveals the need for the development of additional education and training projects, as well as preparatory activities, to address the needs of vulnerable people including the elderly, immigrants, children and youth, underserved minority people as well as disaster relief staff and volunteers. Key words: emergency preparedness, vulnerable populations, Middle East


Article
Post-hurricane forest management responses in the southern United States
Pete Bettinger, PhD; Krista L. Merry, MS; Jeffrey Hepinstall, PhD
November/December 2009; pages 35-50

Abstract
Although people living along the southeastern and Gulf coasts of the United States may have limited experience dealing with major hurricane damage, hurricanes are imminent and pose potentially dire consequences to forest resources. In addition to understanding the physical and biological reactions of forests to extreme weather conditions, there are a number of managerial responses that should be considered based on this past experience. This article presents a summary of the more pertinent forest management responses, and where appropriate, highlights situations where these were beneficial to the overall (economic, ecological, social) recovery effort. Management responses address not only the immediate needs for clearing roads and restoring basic service needs, but also the longer-term issues related to timber salvage, reforestation, forest health, and fire danger. The damage from strong winds and storm surges may also result in serious consequences for ecological values. However, challenges and issues related to the restoration of forests and forest-related values may require several years to address. Therefore, the objective of this review article is to provide a summary of the experiences of forest land managers, researchers, and emergency planners who have directly responded to severe storms affecting the southern United States. Key words: wind damage, storm surge, windthrow, debris removal, timber supplies, wildlife and recreation impacts


Article
Steps in writing an effective Master Scenario Events List
Ralph Renger, PhD, MEP; Jessica Wakelee, MPH; Jillian Bradshaw, MBA, MEP; Lisle Hites, PhD
November/December 2009; pages 51-60

Abstract
Planning and conducting effective operations based exercises is a complex and resource intensive process. The US Department of Homeland Security Exercise and Evaluation Program (HSEEP) describes many key elements in successfully planning and conducting operations-based exercises. The Master Scenario Events List (MSEL) is integral to the successful conduct of operations-based exercises. The MSEL is the exercise blueprint, consisting of messages, or injects, designed to test exercise objectives and drive continual exercise play. Surprisingly, there is little guidance provided in the exercise development literature or by HSEEP about how to create an effective MSEL. This article discusses essential elements for a MSEL, offers recommended steps for writing a MSEL, and then illustrates these steps using an example from an operations-based exercise. Key words: master scenario events list, exercise design


Article
Effects of organization leadership behavior on learning ethics: A study of professional paramedics
David M. Sine, MA; Norvell Northcutt, PhD
November/December 2009; pages 61-70

Abstract
A review of the methods of ethics instruction reveals that demonstrated ethical behavior by leadership, although not central-most to introducing an organization’s newcomers to a normative approach to ethical decision making and behavior, is ubiquitous and highly placed in contemporary ethics pedagogy. Similarly, a review of ethics assessment tools finds that nearly all probe perceptions by group members of the ethical behavior of those who provide group supervision and leadership. This article asks if ethical behavior by senior Emergency Medical Service (EMS) leaders is of sufficient strength to convey to newcomers (in this case, newly hired fire department paramedics) the ethics of that organization. This research was conducted in an urban fire academy and compared, using a standardized assessment tool, an ethics culture survey of academy instructors, and then a class of paramedics both before and after their academy experience. The authors find that EMS newcomers do not absorb ethics osmotically and that EMS leaders must anticipate that instruction in ethics is necessary to ensure that moral actions taken by newcomers will be those desired by the organization. Key words: ethics, EMS, leadership, newcomers, ethics instruction, paramedics


Article
Understanding citizen perspectives on preparedness: A focus group study of South Carolina residents
Joseph L. Pearson, MS, DrPH; Charlotte Toole Galloway, MSPH; Sonya Forte Duhé, PhD; Nathaniel J. Patterson, MHA
November/December 2009; pages 71-79

Abstract
For emergency managers and other preparedness officials to successfully protect the public from disasters, citizen participation and cooperation are essential. Individual citizens must be aware of potential threats and take the fundamental steps needed to protect themselves and their families from disasters. In an effort to gain an understanding of citizen perspectives on preparedness, focus groups were conducted among residents of eight South Carolina counties. Participants (n = 67) responded to questions relating to aspects of disaster awareness, preparedness, and response. Participants were also queried on their sources of preparedness and response information as well as aspects of trust and credibility. Responses were coded by themes reflecting five distinct aspects of preparedness: responsibility, education and training, motivators, barriers, and community assets. Participant comments indicated a clear sense of responsibility in protecting themselves and their families from a disaster. Comments also underscored an interest in having the information and resources to overcome barriers to preparedness. Participants expressed their dependence on local leaders and institutions to gain insight on what to do in an emergency and their reliance on personal experience in guiding preparedness and response actions. These results offer an important glimpse into the mindset of citizens regarding their role in preparing themselves and their families for disasters of all types. Further, these results serve to guide the efforts of emergency managers and other preparedness officials in the process of engaging citizens in preparedness activities. Key words: citizen preparedness, disasters, emergency management