Search results

Untimely responses to emergency situations in urban areas contribute to a rising mortality rate and impact society's primary capital. The efficient dispatch and relocation of ambulances pose operational and momentary challenges, necessitating an optimal policy based on the system's real-time status. While previous studies have addressed these concerns, limited attention has been given to the optimal allocation of technicians to respond to emergency situation and minimize overall system costs.

In this paper, a bi-objective mathematical model is proposed to maximize system coverage and enable flexible movement across bases for location, dispatch and relocation of ambulances. Ambulances relocation involves two key decisions: (1) allocating ambulances to bases after completing services and (2) deciding to change the current ambulance location among existing bases to potentially improve response times to future emergencies. The model also considers the varying capabilities of technicians for proper allocation in emergency situations.

The Augmented Epsilon-Constrained (AEC) method is employed to solve the proposed model for small-sized problem. Due to the NP-Hardness of the model, the NSGA-II and MOPSO metaheuristic algorithms are utilized to obtain efficient solutions for large-sized problems. The findings demonstrate the superiority of the MOPSO algorithm.

This study can be useful for emergency medical centers and healthcare companies in providing more effective responses to emergency situations by sending technicians and ambulances.

In this study, a two-objective mathematical model is developed for ambulance location and dispatch and solved by using the AEC method as well as the NSGA-II and MOPSO metaheuristic algorithms. The mathematical model encompasses three primary types of decision-making: (1) Allocating ambulances to bases after completing their service, (2) deciding to relocate the current ambulance among existing bases to potentially enhance response times to future emergencies and (3) considering the diverse abilities of technicians for accurate allocation to emergency situations.

Public safety (communicators; e.g. 9-1-1, police, fire and ambulance call-takers and dispatchers), like many other public safety personnel (e.g. police, paramedics), (re)suffer operational stress injuries (OSIs) that are too often hidden and at a prevalence higher than the general population. Unfortunately, there are very little data for OSI rates in Canadian communicators. To the authors’ knowledge, this is the only pan-Canadian study focusing on organizational culture, and its potential influence on OSIs, within the communicator context.

The authors conducted a 179-item online survey of Canadian communicators comprising 17 validated screenings for occupational stress injuries and symptoms and four open-ended questions relating to their agency's organizational culture. The authors thematically analysed participants' open-ended responses and their screening scores.

A semi-grounded thematic approach revealed that managers and supervisors were significant contributors to negative perceptions (n = 165) of organizational culture, potentially resulting in or worsening existing OSIs. Specifically, leadership was viewed as ineffective, inconsistent, unsupportive, abusive and toxic, with limited understanding of communicator roles. Communicators described feeling devalued, particularly when leaders fail to recognize communicator OSIs, which can perpetuate stigma. Conversely, positive leaders (n = 24) were described as supportive, communicative and encouraging.

The findings suggest that while leadership behaviours are a key factor in employee well-being, it varies considerably across agencies, impacting treatment-seeking behaviours. The authors’ new understandings of leaders' roles in OSIs may help reduce the frequency and severity of communicator OSIs, helping ensure that emergency services are delivered to Canadians.

Overcrowding continues to afflict emergency departments (EDs), and its attendant consequences are becoming increasingly severe. The burden of the COVID-19 pandemic is further escalating the situation worldwide. One of the most critical questions is how to adequately quantify what constitutes overcrowding and determine implications for operations management in improving service efficiency. This paper aims to discuss the aforementioned.

The authors propose the time and class complexity measures for ED service systems, taking into account important patient-level and system characteristics. Using an extensive data set from a Canadian ED, the authors investigate the performance of complexity-based measures in predicting service delays.

The authors find that the complexity measure is potentially more important than some well-known crowding metrics. In particular, EDs can improve service efficiency by managing the level of complexity within a desirable interval. Furthermore, complexity exposes how the interplay between demand-side behavioral changes and supply-side responses affects operational performance. Moreover, the results suggest that arrival patterns—the number of patients of each class arriving per time and times between events (arrivals and service completions)—increase the risk of service delays more than the demand volume.

This paper is the first to provide an extensive investigation into the application of the complexity-based measure for ED crowding. The study demonstrates potential values to be gained in ED service systems if complexity measure is incorporated into their operations management decisions.

Paramedics became nationally registered in 2018 in Australia. Prior to this, there was no central regulation of the profession with reliance on organisational regulation through employers. As paramedics expanded their scope, role and range of employers, especially outside statutory agencies, there was increasing need to engage in professional regulation. Regulation is more than a legal and bureaucratic framework. The purpose of the paper states that the way paramedics interact with their new regulatory environment impacts and is influenced by the professionalisation of the discipline. Regulation also redefines their positionality within the profession.

Two mixed-method surveys were undertaken. A pre-registration survey occurred in the month prior to regulation commencing (N = 419) followed by the second survey 31 months later (N = 407). This paper reports the analysis of qualitative data from the post-registration survey and provides comparison to the pre-registration survey which has been previously reported. Analysis was undertaken using interpretive phenomenological analysis (IPA).

Themes from the pre-registration survey continued however became more nuanced. Participants broadly supported registration and saw it as empowering to the profession. Some supported registration but were disappointed by its outcome, others rejected registration and saw it as divisive and oppressive.

Paramedics are beginning to come to terms with increasing professionalisation, of which regulation is one component. Changes can be seen in professional identity and engagement with professional practice; however, this is nascent and is deserving of additional research to track the profession as it continues to evolve.

In Trinidad and Tobago, there is significant reliance on the traditional and centralized police service to engage in crime response and suppression in urban and rural areas. In this regard, policing scholarship has largely focused on the impact of policing within urban areas, producing a gap in knowledge on what policing rural spaces entails. Despite this, there is some understanding that policing rural spaces can engender diverse challenges and calls for variability in policing strategies. The current study examines the lived experiences of police officers stationed in rural communities in Trinidad and Tobago.

Using the descriptive phenomenological approach, semi-structured interviews were conducted with eleven police officers stationed in rural communities throughout the country.

Interviewees narrated the importance of community dynamics and community-specific needs in shaping their roles and functions when operating in and serving these communities. Three major themes were identified: (1) network activity in policing; (2) engagement in localistic and service-oriented approaches and (3) community-specific challenges.

The findings suggest that while there is an emphasis on traditional law enforcement responsibilities, in the rural context, police responsibilities and duties are constantly being redefined, reframed and broadened to meet the contextual community and geographic-specific diversities and demands.

This paper aims to present a literature review of remote monitoring systems for water infrastructure in the Global South.

Following initial scoping searches, further examination was made of key remote monitoring technologies for water infrastructure in the Global South. A standard literature search methodology was adopted to examine these monitoring technologies and their respective deployments. This hierarchical approach prioritised “peer-reviewed” articles, followed by “scholarly” publications, then “credible” information sources and, finally, “other” relevant materials. The first two search phases were conducted using academic search services (e.g. Scopus and Google Scholar). In the third and fourth phases, Web searches were carried out on various stakeholders, including manufacturers, governmental agencies and non-governmental organisations/charities associated with Water, Sanitation and Hygiene (WASH) in the Global South.

This exercise expands the number of monitoring technologies considered in comparison to earlier review publications. Similarly, preceding reviews have largely focused upon monitoring applications in sub-Saharan Africa (SSA). This paper explores opportunities in other geographical regions and highlights India as a significant potential market for these tools.

This review predominantly focuses upon information/data currently available in the public domain.

Remote monitoring technologies enable the rapid detection of broken water pumps. Broken water infrastructure significantly impacts many vulnerable communities, often leading to the use of less protected water sources and increased exposure to water-related diseases. Further to these public health impacts, there are additional economic disadvantages for these user communities.

This literature review has sought to address some key technological omissions and to widen the geographical scope associated with previous investigations.

This performance autoethnography may or may not be interpreted as a continuation of a conversation regarding the experiences of those with devalued statuses in academic settings. The authors rely on “strange accounting” to consider their experiences in the academy from various standpoints: before and after promotion, before and after leaving academia. While reflecting on our past experiences, we introduce the concept of “everyday precariousness” as a way of explaining the normalization of instability, insecurity, and negative affect that is part of everyday life for those with devalued statuses in academic settings and beyond. Everyday precariousness is an embodied experience for those in vulnerable positions. Normalized exposure to risks, such as discrimination, harassment, bullying, or structural instability, produces an undercurrent of threat that permeates academic culture. Our stories of everyday precariousness span race, ethnicity, class, academic roles, and gender boundaries (among many others). Analyzing these experiences furthers previous work on the uses of strange accounting as well as the dynamics of status silencing. In the final analysis, unresisted and unabated, everyday precariousness and status silencing can lead to institutional failure and resonance disasters.

Estimation of (in)efficiency became a popular practice that witnessed applications in virtually any sector of the economy over the last few decades. Many different models were deployed for such endeavors, with Stochastic Frontier Analysis (SFA) models dominating the econometric literature. Among the most popular variants of SFA are Aigner, Lovell, and Schmidt (1977), which launched the literature, and Kumbhakar, Ghosh, and McGuckin (1991), which pioneered the branch taking account of the (in)efficiency term via the so-called environmental variables or determinants of inefficiency. Focusing on these two prominent approaches in SFA, the goal of this chapter is to try to understand the production inefficiency of public hospitals in Queensland. While doing so, a recognized yet often overlooked phenomenon emerges where possible dramatic differences (and consequently very different policy implications) can be derived from different models, even within one paradigm of SFA models. This emphasizes the importance of exploring many alternative models, and scrutinizing their assumptions, before drawing policy implications, especially when such implications may substantially affect people’s lives, as is the case in the hospital sector.