Results

Strengths:1. The capacities, organization (High Commands) and military experience that make NATO the most effective organization that has existed in the last half century; 2. A good part of that efficacy is due to the participation of three of the major military powers in the world which, besides, benefit from a combination of conventional and nuclear means; 3. That has given NATO not only an incredible and effective dissuasive ability, but also a proven capacity of power projection at regional and world levels.Weaknesses1. The military hegemony historically held by the United States, which has hindered the development of military capacities of European allies and their political will to assume the roles imposed by regional and world defence, at a time when Washington increasingly shifts its strategic priorities towards the Pacific, not towards the Euro- Atlantic region; 2. The insufficient institutional development of the Alliance's political structure in relation to its military structure, which has continuously incapacitated NATO to take on and adapt to the new world strategic and diplomatic situations; 3. The increasing discrepancy of geo-strategic interests among the allies which, together with the system of decision by consensus, is creating an internal political blockade which will become even more complex with the adherence of new members, such as the Ukraine or Georgia.

In general, the results confirmed the findings from a previous study that a short, 3-hr interactive exercise is sufficient for improving physicians’ knowledge about bioterrorism preparedness. Many of the students found the exercise fun and eye opening. Some students were clearly frustrated. Unexpected student leaders emerged when faced with a novel set of challenges, including students who supported their classmates by simplifying access to the prereading material and one group that, during the exercise, answered its discussion questions by calling the administrator at the local medical center for real-time information.

 The core elements of emergency preparation with regard to inpatient services include identifying and staffing critical positions, motivating residents to consider the needs of the group over those of the individual, providing for basic needs, and planning activities in order to preserve team morale and facilitate recovery.The authors outline a four-step process in preparing a residency program for an anticipated short-term weather emergency. An example worksheet for emergency planning is included

Ability to track all units/groups participating in operation (belonging to different services and structures) and visualise their location on satellite map greatly enhances situational awareness. Ability to access exactly the same data indifferent locations results in a common operational picture for all actors involved both different services and authorities supervising them. Both above-mentioned factors allow for significantly better coordination of common operations. Automatic transmission of status information together with position information may provide for much clearer situational picture. Satellite support team physically present in headquarter is a very effective method to ensure efficient use of available space technologies. Geospatial products (satellite maps and analytical products) should use standardised marking (e.g. NATO standard symbols) to make them easily readable for users. Standards for such products made available electronically are also necessary. Users (commanding officers) require certain time (several hours) to get accustomed to new capabilities, understand them and use effectively. Operational demonstration is a very effective method to validate crisis management systems' concepts and to convince users about their usefulness.

The emergency preparedness training improved the knowledge levels and increased attitudinal and behavioural intention scores for emergency preparedness. The results at follow-up showed that the knowledge levels and attitudinal/behavioural intention scores of participants decreased slightly (P40.05) compared with levels immediately after training (Po0.01). However, there was a significant increase compared with before training (Po0.01). Moreover, more than 80% of participants reported that the training process and resources were scientific and feasible.

The results of the experiments revealed that the agent played at least as well as, and in the case of one of the two roles, significantly better than a human player. Pg 16

Three general themes emerged: (a) the need for previously prepared practical protocols, (b) the need for qualified and real team working in the situation, and (c) the need to establish periodic comprehensive training programs in disaster relief nursing.

Virtual globes can provide the geographic–social context that facilitates geo collaboration—or collaborative processes that are conducted and mediated through geographic information and knowledge.In addition to situation awareness of real world events, participants in any type of group work need to maintain awareness of collaborative activity. Examples of activity awareness include but are not limited to (a) a sense that other collaborators are ‘‘there’’ (social awareness) and (b) what relevant information is known by other collaborators. Activity awareness is important for overall situation awareness as it can influence the activity of collaborators in a given situation.Maps play a critical role as visual mediums to support development of situation awareness in humans. Virtual globes, as a next generation of mapping technology, provide an exciting new direction for supporting situation awareness in disaster management. In particular, virtual globes offer powerful visualization methods, interactivity, geographical context and ease of use that can be utilized for informed decision making tasks critical to effective disaster management. Results of these evaluations indicate the approaches presented offer a promising new direction on the use of virtual globes for situation awareness, disaster management and related research at the intersection of geographic information science and information retrieval.

The result is that timely and accurate response from the regional medical command together with timely response from a national coordination function most likely had a positive impact on patient outcome in simulation II. In addition, the results indicate that a more precise distribution of casualties over short distances to regional hospitals and long distance with HEMS to university hospitals and burn centres can be an advantage. Thus, by timely and specific referrals, the on-scene time was also reduced. Second simulation has better outcome due to three reasons. First, despite the long transport distances, the early mobilization of resources from both the Swedish and Norwegian side of the border made it possible to start transportation to the nearest regional hospitals by ambulances after 45 min. Second, the early mobilization of ambulance helicopters from Norway with both anesthesia physicians and nurses was a factor that probably contributed to these results due to the possibility of performing life-saving airway interventions after 1 h. Third, measurable performance indicators used in simulation II were found by the participants to be applicable and probably stimulated the participants to perform more timely and effective management in simulation IIHowever, despite correct triage at the scene, four patients with blunt head trauma causing expanding intracranial hematoma were identified in the system as risk for preventable death in both simulations. These cases were prioritized as immediate  but did not receive airway intervention within the stipulated period of 1 h. To address this issue, it is important to note that it was the burn perspective that governed much of the simulation and burns were to some extent prioritized for long-distance helicopter transport to the burn centres. Furthermore, the present disaster scenario occurred in a rural area where the early medical needs exceeded the response capabilities. Under such circumstances, without aggressive treatment, severe head injuries can have a poor prognosis. Nevertheless, these patients were never triaged as expectants  and could perhaps have survived in the simulation if they had received a higher priority leading to early transportation by helicopter to a university hospital for neurosurgeryThe result of this study shows that a large part of the Swedish health care system would be involved in this type of event, which might have displacement effects on regular health care in the long term. Furthermore, lessons learned from other burn disasters are that the national specialized intensive care resources can quickly become saturated for a long period. Therefore, the need for additional use of burn beds in Europe would probably arise in the longer term. National planning in case of such needs is called for.In these two simulations, we found that, in rural areas of Sweden, the major challenge in coping with a mass casualty incident with many burn cases is due to the long distances to specialized trauma and burn care units. A significant limitation in these settings is the possibility of achieving rapid patient evacuation based on the accessibility of transport resources (e.g. ambulances and helicopters). During these simulations, the extent of air transportation and coordination of helicopters were shown to be a bottleneck and were identified as significant risk factors for an unfavourable outcome. The absence of predefined organization and coordination routines concerning air transport in a mass casualty event must be addressed further at the national level. Unfortunately, it was not possible to fully test this function during these simulations.The rapid establishment of cooperation between the two county councils where the two national burn centres are located was of importance for the timely response seen in the simulations. This national coordinating function for burn care was established early and in accordance with the proposed national burn response plan. Furthermore, it was operational at an early stage and provided support to the regional management group by developing strategies for the distribution of burns.

The assistive search technologies all contributed to more effective search. The synergy with canine search proved to give more accurate results with respect to certainty of presence, location accuracy, and situation awareness. The assistive IT-system enabling digital communication of messages proved to be a valuable tool. It not only enhanced the message volume and detail sent by on-site rescuers improving the collective situational awareness, but also enabled the decision-makers in the Emergency Operation Center to focus on other tasks such as surveillance by disburdening them from the logging task.