Hasil untuk "Crisis management. Emergency management. Inflation"

Said Hachimi-Idrissi, V. Dobiáš, W. Hautz et al.

Acute pain management in European emergency settings faces persistent challenges, including inadequate clinical knowledge, training deficits, heightened emphasis on opioid stewardship, and concerns regarding drug-seeking behaviors. Despite previous guidelines, oligoanalgesia remains prevalent, with many patients experiencing suboptimal pain control. The evolving clinical landscape necessitated updating the 2020 European Society for Emergency Medicine (EUSEM) guidelines, considering emergent technological advances, the ongoing opioid crisis, aging populations, and continued pressure on emergency services. EUSEM launched the European Pain Initiative (EPI) to provide evidence-based recommendations for acute pain management in emergency settings and published guidelines in 2020. EPI convened a new project to review and update the previous guideline, rooted in the changing clinical landscape and experience. A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching MEDLINE, Cochrane database, Google Scholar, and EMBASE from January 2020 to May 2025. Publications were evaluated against predetermined inclusion and exclusion criteria, with evidence levels assigned to assist in developing management recommendations. The literature findings were integrated with the clinical experience of the EPI panel to reach a consensus on flexible, adaptable guidelines suitable for diverse European settings. These updated guidelines provide evidence-based recommendations for adult (≥16 years) and pediatric (≥1-≤15 years) patients in emergency and prehospital settings, promoting a multimodal approach to acute pain management. The recommendations integrate the Channels-Enzymes-Receptors Targeted Analgesia framework with WHO analgesic ladder principles and emphasize systematic pain assessment, flexible routes of administration, and patient-specific decision-making. Nonopioid and multimodal strategies are prioritized, with opioids reserved for appropriate indications.

R. Firdaus, A. Tantri, S. Manggala et al.

Purpose Crisis Resource Management (CRM) is critical in managing code trauma cases, yet remains underemphasized in many medical training programs in Indonesia. This study aimed to develop and evaluate a virtual reality (VR)-based CRM training module tailored for emergency physicians. Patients and Methods A pilot CRM module was designed through expert focused group discussions (FGDs) and refined using the Delphi method. The module included a lecture, roundtable discussion, and VR simulation. Fifteen emergency physicians participated in the training and were assessed using pre- and post-tests, a checklist based on CRM objectives, the Ottawa General Rating Scale (GRS), and a satisfaction questionnaire. Results Participants showed a significant improvement in knowledge (mean pretest 70 vs posttest 95.33; p < 0.001). Checklist completion rates had a median of 81% individually and 80% at the team level. Ottawa GRS scores indicated strong performance in leadership, problem-solving, communication, and situational awareness (overall mean score: 6.2/7). Satisfaction ratings reflected positive participant experiences with the module. Conclusion VR-based simulation is an effective, accessible tool for enhancing CRM skills in emergency settings, particularly in low-resource or remote environments. The module demonstrated high participant satisfaction and notable improvements in both individual and team performance and incorporating VR into trauma team CRM training should be considered.

A. Ripoll-Gallardo, Giacomo Oldrini, Giovanni De Luca et al.

Vishal Kashav, Chandra Prakash Garg

Purpose – The purpose of this paper is to identify key sustainability enablers that are crucial for resilient humanitarian supply chains (RHSCs) during natural calamities and pandemics. It also aims to subsequently rank them using the fuzzy analytic hierarchy process (AHP) to assess their importance. The goal is to enhance stakeholders’ understanding, enabling them to implement effective strategies to mitigate disruptions and safeguard RHSCs. Design/methodology/approach – This study applied the fuzzy AHP as part of the multicriteria decision-making (MCDM) framework to prioritize sustainability enablers that are crucial for the resilience of humanitarian supply chains (RHSCs). Findings – The research findings indicate that the operational enablers category is the most critical, followed by the infrastructural and environmental categories, which rank as the second and third most critical, respectively. Among the sub-categories, “Hyper-connectivity,” “Renewable energy sources for infrastructure” and “Sustainable procurement and sourcing practices” are identified as the top three, highlighting the urgency for immediate attention. Research limitations/implications – While this research provides valuable insights, it also presents some limitations and opens new avenues for future study. First, the study predominantly focuses on natural calamities and pandemics, potentially overlooking other catastrophic events that could jeopardize humanitarian supply chains. Second, to eliminate potential biases and develop a more robust model, it would have been beneficial to explore other modern MCDM methods. It is possible that these alternative MCDM techniques might yield better results than fuzzy AHP. Future research could explore a broader range of crises to comprehensively address the varied dynamics influencing Resilient Humanitarian Supply Chains (RHSCs) while also experimenting with different cutting-edge MCDM methods. Additionally, future research could dive deeper into the top-ranked technology enablers, particularly focusing on human-technology interactions within humanitarian supply chains, a topic that is currently being discussed among experts. Social implications – The manuscript emphasizes the importance of global preparedness and collaborative efforts among governments, nongovernmental organizations and communities. Through its discussion of social enablers, this study aims to develop RHSCs that prioritize the well-being of disaster-affected populations and individuals used in this field. Originality/value – This research offers unique insights by ranking sustainability enablers for resilient humanitarian supply chains (RHSCs) amid natural calamities and pandemics, providing novel and actionable contributions.

Yuqi Liu, Min Hua, Xuhai Pan

The syngas pipeline serves as the primary carrier for syngas exported from the coal gasification furnace, is vulnerable to corrosion and erosion from the transported medium, and is prone to leakage due to long-term high-pressure operation. Moreover, due to its compositional characteristics, syngas pose flammability, explosive, and toxicity risks, which can potentially lead to severe accidents if a leak occurs. Therefore, it is essential to conduct a risk assessment of syngas pipeline leakage. This study proposes a risk assessment approach for syngas pipeline leakage in coal gasification using Dynamic Bayesian Network (DBN). First, the risk identification model is built using Bow-Tie (BT) analysis and then mapped into DBN using a mapping algorithm. Expert evaluation, improved similarity aggregation methods, and fuzzy set theory are employed to quantify prior probabilities. To address the uncertainty of the DBN model, a Leak Noisy-or gate model is introduced. Time series are added to predict the dynamic probabilities. Nine key hazard events, six highly sensitive factors, and the maximum causal chain are identified, and predict the dynamic probability of syngas pipeline leakage and potential consequences. This study provides a theoretical basis for routine maintenance and risk assessment of syngas pipelines.

Mengwei Liu, Fei You, Qianyu Lu et al.

Tetraethoxysilane (TEOS) and γ-(methacryloyloxy) propyltrimethoxysilane (KH570) were used to prepare a single silica (SiO2) sol and a silica-5'-adenosine monophosphate (AMP, bio-based substance) hybrid sol via sol-gel processes. Then, the prepared series of sols were successively applied onto the cotton fabric (COT) surface through a dipping-baking method. Fourier infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD), scanning electron microscope (SEM), energy dispersive spectroscopy (EDX), thermogravimetric analysis (TGA), limiting oxygen index (LOI), vertical flammability test (VFT), and cone calorimetry test (CCT) were used to characterize the functional groups, surface element compositions, crystal structures, microscopic morphologies and surface element distributions, thermal stability and flame retardancy levels of original (raw), and treated cotton fabrics. Results show that the series of sols are successfully converted to gels and coated onto the cotton fabric surfaces. AMP-SiO2-KH570@COT shows the best flame retardancy with the highest char residue rate (48.7%) (6.5 times that of raw cotton fabric), and a LOI value of 27.7% (non-flammable level). It can self-extinguish with a char length of only 8.2 cm in a VFT. It shows reduced total heat release (THR) and peak heat release rate (PHRR) by 3.8% and 48.5% and has the longest ignition time (43 s) in a CCT. The SiO2 sol-converting gel modified with KH570 clearly improves the interfacial compatibility with the cotton fabric and effectively isolates heat and oxygen. Meanwhile, the AMP gel pyrolyzes the phosphate group at high temperatures to accelerate the carbonization degrees of cotton fibers. These components show good synergistic flame-retardant effects.

Anatoliy V. Rybakov, Evgeniy V. Posternak

Цель. Разработать единый интегрированный набор данных для прогнозирования ущерба от чрезвычайных ситуаций и последующего анализа необходимых сил и ресурсов. Сформировать комплексный подход, позволяющий преодолеть разрозненность исходных сведений об ущербе, антропогенных показателях и задействованных инженерно-технических мер (далее – ИТМ) (сил и средств). Методы. В работе использовалась последовательная схема агрегирования и предварительной обработки данных из различных источников, включающая фильтрацию пропусков и унификацию форматов. Для восполнения недостающих сведений и повышения репрезентативности выборки применялись алгоритмы синтетической генерации на основе вариационных автокодировщиков, копул и генеративно-состязательных сетей. На заключительном этапе введена простая нейронная сеть, которая по известному значению ущерба дополняет отсутствующие данные о силах и средствах. Результаты. Эксперименты показали, что наилучший баланс между точностью и сохранением исходного распределения признаков продемонстрировала модель CTGAN, достигшая высших показателей формы распределения столбцов и общего балла качества данных. Применение нейронного модуля с функцией активации ReLU в выходном слое позволило избежать отрицательных значений при прогнозировании сил и ресурсов. Совокупное использование синтетической генерации и нейронных предсказаний увеличило полноту итогового набора данных, сохранив статистическую согласованность признаков. Итоговый массив данных дает более детальное представление о связях между ущербом, социально-демографическими характеристиками территории и объемами ИТМ, что обеспечивает возможности для дальнейших исследований по повышению эффективности ликвидации последствий ЧС. Область применения исследований. Сформированный набор данных может быть использован в качестве обучающей базы для моделей машинного обучения, ориентированных на прогнозирование материальных потерь, а также для разработки систем поддержки принятия решений при планировании и распределении ресурсов в чрезвычайных ситуациях. Результаты исследования представляют научно-практический интерес для специалистов в области управления рисками, а также для разработчиков информационных систем, интегрирующих аналитические модули по оценке ущерба и оптимизации сил и средств.

Haopeng Wu, Shengjie Niu, Seong Soo Yum et al.

To address the challenges in observing wire icing, this study took the deep residual network ResNet34 as the baseline model and optimized it using normalization, dropout techniques, and data augmentation methods. A novel wire icing risk level identification model based on deep learning was proposed. The results demonstrated that the optimized ResNet34 model (ResNet34+) achieved an average identification accuracy of 93.3% for wire icing risk levels across different regions and wire orientations. Additionally, the identification accuracy was notably higher between 8:00−11:00 and 15:00−17:00. During a coexisting freezing rain and supercooled fog event on Lushan, the model achieved an average wire icing identification accuracy of 89.4% and 90.8% on east-west and north-south oriented wires, respectively, indicating good generalizability of the model. The application of this model provided a novel approach for identifying wire icing risk levels.

E. Benjamin

INTRODUCTION The current crisis of emergency department overcrowding demands novel approaches. Despite a growing body of patient flow literature, there is little understanding of the work of emergency nurses. This study explored how emergency nurses perform patient flow management. METHODS Constructivist grounded theory and situational analysis methodologies were used to examine the work of emergency nurses. Twenty-nine focus groups and interviews of 27 participants and 64 hours of participant observation across four emergency departments were conducted between August 2022 and February 2023. Data were analyzed using coding, constant comparative analysis, and memo-writing to identify emergent themes and develop a substantive theory. FINDINGS Patient flow management is the work of balancing department resources and patient care to promote collective patient safety. Patient safety arises when care is ethical, efficient, and appropriately weighs care timeliness and comprehensiveness. Emergency nurses use numerous patient flow management strategies that can be organized into five tasks: information gathering, continuous triage, resource management, throughput management, and care oversight. CONCLUSION Patient flow management is complex, cognitively demanding work. The central contribution of this paper is a theoretical model that reflects emergency nurses'conceptualizations, discourse, and priorities. This model lays the foundation for knowledge sharing, training, and practice improvement.

Genevieve Santillanes, Ashley A. Foster, P. Ishimine et al.

Suicide is a leading cause of death among youth, and emergency departments (EDs) play an important role in caring for youth with suicidality. Shortages in outpatient and inpatient mental and behavioral health capacity combined with a surge in ED visits for youth with suicidal ideation (SI) and self‐harm challenge many EDs in the United States. This review highlights currently identified best practices that all EDs can implement in suicide screening, assessment of youth with self‐harm and SI, care for patients awaiting inpatient psychiatric care, and discharge planning for youth determined not to require inpatient treatment. We will also highlight several controversies and challenges in implementation of these best practices in the ED. An enhanced continuum of care model recommended for youth with mental and behavioral health crises utilizes crisis lines, mobile crisis units, crisis receiving and stabilization units, and also maximizes interventions in home‐ and community‐based settings. However, while local systems work to enhance continuum capacity, EDs remain a critical part of crisis care. Currently, EDs face barriers to providing optimal treatment for youth in crisis due to inadequate resources including the ability to obtain emergent mental health consultations via on‐site professionals, telepsychiatry, and ED transfer agreements. To reduce ED utilization and better facilitate safe dispositions from EDs, the expansion of community‐ and home‐based services, pediatric‐receiving crisis stabilization units, inpatient psychiatric services, among other innovative solutions, is necessary.

Evan S. Schwarz, Ann M Dietrich, Stephen Sandelich et al.

Opioid use disorder (OUD) has emerged as a significant public health crisis affecting individuals across all age groups. However, there remains a critical gap in understanding the specific nuances and challenges associated with OUD in pediatric populations. This article provides a comprehensive review of the epidemiology, definition of OUD, screening recommendations for OUD, and evidence‐based management strategies for OUD in pediatric patients.

Ольга Владимировна Рева, Татьяна Алексеевна Говор

Цель. Разработка математической модели многофакторного процесса гидрометаллургического синтеза защитных никелевых покрытий для деталей ПАСТ из высокоскоростных кремнефтористых электролитов для определения оптимальных технологических режимов работы при варьировании ряда факторов (концентрация кремнефторида никеля в растворе, плотность катодного тока, температура раствора). Методы. В работе применены метод рандомизации, стандартные методики определения электрохимических характеристик (толщина осажденных никелевых покрытий, выход по току катодной реакции), модуль «Профили желательности» программного пакета STATISTICA, а также метод полного факторного эксперимента для получения регрессионной модели. Результаты. Проведен полный факторный эксперимент с использованием нового высокоскоростного кремнефтористого электролита никелирования на трех уровнях факторов, влияющих на скорость осаждения никелевых покрытий: молярная концентрация кремнефторида никеля (NiSiF6) в растворе с = 1; 1,25; 1,5 моль/дм3, температура раствора электролита t = 40; 50; 60 °C, плотность катодного тока i = 8; 10; 12 А/дм2. В результате анализа экспериментальных данных разработана регрессионная модель прогнозирования скорости осаждения никелевых покрытий в исследованных диапазонах изменения варьируемых факторов. Оптимальные значения варьируемых факторов: молярная концентрация NiSiF6 в растворе с = 1,2 моль/дм3; температура раствора электролита t = 53 °C; плотность катодного тока i = 11,6 А/дм2. При данных условиях достигается наибольшее значение зависимой переменной (скорость осаждения никелевого покрытия), составляющее 240,7 мкм/ч. Область применения исследований. Разработанная регрессионная модель позволяет определить оптимальный диапазон для каждого из основных параметров системы, в частности концентрации кремнефторида никеля в растворе, плотности катодного тока, температуры электролита, что дает возможность наметить пути минимизации побочных процессов (формирования на катоде оксо- и гидроксосоединений никеля и выделения водорода) для получения защитных никелевых покрытий с заданными свойствами.

Mjriam Sano', Michela Marchiori, Wilma Angela Renata Di Napoli

In Italy, over 86% of patients with mental disorders have one emergency department visit per year, with 6–9% having two visits and approximately 2% having three visits. It is not significant to include those with four or more visits in this data set. In the context of the COVID-19 pandemic, there has been a notable increase in the utilisation of emergency services for psychiatric concerns. In our emergency department (ED), we observed a 10% increase in admissions for psychiatric problems, psychomotor agitation, behavioural disorders, and drug intoxication between 2022 and 2023. We present an organisational management model that has been found to be effective for patients with minor psychiatric problems, those who repeatedly present to the emergency department, and/or those with discontinuous referrals to the relevant mental health centre or acute episodes. One possible strategy could be to consider directing psychiatric emergencies that can be deferred to territorial crisis management from the Trento emergency department to the mental health centre.

D. Đorđević

Management accounting has a wide set of various techniques for the purpose of decision-making, planning, coordination, control and motivation through performance measurement, budgeting, responsibility centers, transfer pricing, costing and cost allocation. Over the past two decades, the need to explain the mechanisms of business decision-making by expanding the focus from the internal environment to factors of the external environment such as exchange rate fluctuations, inflation, slowing down of economic activity, volatility of the stock market and others has been clearly manifested. The strategic aspect and non-financial information, as important aspects of decision-making in crisis conditions, influenced the development of new and improvement of existing management accounting techniques. In the post-corona era, the central focus of management accounting tools and techniques becomes sustainability and accelerated technology adoption, so management accounting practices must be adapted accordingly. The intention of the work is twofold. First, the work tries to point out the environmental factors and influences that are the impetus for necessary changes and adaptability of the management accounting technique in the crisis circumstances. Second, the aim of the paper is a critical review of the current literature on the issue of the use of management accounting techniques in conditions of crisis and unpredictability in various types of entities and industry sectors. Finally, the aim of the paper is to consider whether new and proactive management accounting techniques are applied in crisis conditions or whether the management's focus is on the short-term realization of income and profit.

B. Newman, R. Wilkerson

Hailemariam Gezie, A. Azazh, Birhanu Melaku et al.

Background Hypertension (HTN) is a major global health problem that affects approximately 1.13 billion people worldwide, and 1–2% of this population has hypertensive crisis. Hypertensive crisis is becoming a major health issue in low-income countries. However, few studies have been conducted in developing countries such as Ethiopia. This study aimed to assess the determinants of hypertensive crisis among patients visiting adult emergency departments of public hospitals in Addis Ababa. Method A hospital-based unmatched case–control study was conducted among 85 cases with a hypertensive crisis and 170 controls with hypertension without a hypertensive crisis in the adult emergency departments of public hospitals in Addis Ababa from March 15 to May 15, 2021. Data were collected using a structured questionnaire and analyzed using SPSS version 26. Binary logistic regression and multivariable logistic regression were performed. Finally, a statistically significant level was declared at a p value of less than 0.05. The result was summarized and presented in text, tables, and graph. Result The odds of having hypertensive crisis were 3.6 times (AOR = 3.621) higher among participants with a history of hypertension compared to those without a history of hypertension. There was also 4 times increased risk of hypertensive crisis among participants who presented with diabetes mellitus than participants who presented without it (AOR = 4.179). Similarly, participants who presented with stroke had 7 times higher odds of having hypertensive crisis (AOR = 7.174) than participants without stroke. Conclusion This study demonstrated a statistically significant association between unemployment, diabetes mellitus, stroke, heart failure, history of hypertension, family history of hypertension, and regular follow-up with a hypertensive crisis. The Ethiopian Ministry of Health, Ababa City Administration Health Bureau, and hospitals shall give due attention to the HTN crisis. Health care workers, hospital managers, and other stakeholders shall work towards the early detection and management of HTN-crisis to prevent related morbidity, disability, and mortality.

Paul Kojo Ametepe, U. Onokala

PurposeThe goal of this study is to explore the role leadership play by Singapore’s government in the handling of the Covid-19 crisis and to suggest recommendations around the leadership dynamics in solving similar challenges experienced by businesses, organizations and societies.Design/methodology/approachThis review was conducted using a case study and a desk review, a systematic review as well as a narrative method where physical books, web searches, online platforms, patterns in related occurrences and related literature were used to support the study. The review was anchored on the contingency approach and the stakeholder theory. Two hypotheses were developed and tested using qualitative comparative analysis. The study finding showed that the Singapore government used an all-inclusive functional leadership approach in curtailing the effect of the pandemic on Singaporeans. The study recommends that in decision-making, being proactive and timely is critical, and developing more conceivable and holistic crisis response plans through an integrated orientation is paramount to the successful achievement of a goal.FindingsDespite some flaws, it was found that the Singaporean government had conveniently used a contingency leadership approach through an all-inclusive functional leadership to mitigate the effect of Covid-19 through the use of social media, messaging apps and effective communication, effective pandemic control techniques, albeit in a proactive manner. As a result, Singapore's mortality rate was relatively lower than that of other nations that were adversely affected by the epidemic, earning them a prime position in the crisis response. The study, therefore, contends that their proactive response to containing the pandemic can be used as a model for people, businesses, the political system and society to lessen incidents of a similar nature in the future.Practical implicationsPolicymakers, scholars and frontline workers may have sufficient reason to devote time to developing a more viable, comprehensive crisis response plan by pursuing an integrated learning strategy, through the use of contingency approaches and drawing on past experiences in dealing with global health emergencies. Apart from this, Singapore’s experience will serve as a lesson for the management of businesses and leaders of societies to take proactive steps in dealing with challenges as soon as they arise.Originality/valueThis review showed that contingency is a reality faced by every society and organization and people’s collective responsibility is a necessity during such time. Therefore, when an organization/institution is in a familiar situation, policymakers, academics and business management/leaders need to be proactive and also reflect on past experiences to deal with current and future mistakes in the course of daily operations in an organization/society.