In this thesis, we propose an optimization model to assist the Region of Waterloo Emergency Medical Services (EMS) to meet the new provincial land ambulance response time standard. The new land standard requires multiple response time thresholds which are based on the acuity of the patient determined at the time the 911 call is made. The performance of an EMS system is affected by many factors, including the number of ambulances deployed, their locations, and the dispatching strategy that is employed. The number of ambulances available over the course of the day varies when ambulance crews start and end their shifts, and when ambulance crews are called out or return from a call. In order to maintain coverage, it is therefore desirable to locate ambulances in stations as a function of how many are available, and the geography and frequency of potential calls. This may result in relocation of ambulances whenever there is a change in the number of available vehicles. This research provides a compliance table indicating how many ambulances to locate at each station when the number of available ambulances is given. We explore two main objectives: 1) maximizing the expected coverage for all patients, and 2) maximizing the coverage for the most acutely ill patients. Constraints include the number of available ambulances, the response time requirements, and service level constraints for each acuity level. In this study, we conducted an empirical analysis of ambulance response times, travel times to a hospital, and time spend at the hospital. We used two years of EMS data from July 2006 to June 2008 for the Region of Waterloo (ROWEMS). Based on this study, we show that using the binomial distribution to represent the number of busy ambulances suggested by Gendreau et al. (2006) is only valid for low utilization rates. The problem of allocating available ambulances among candidate stations is formulated as a Mixed Integer Non-linear Problem (MINLP) model that includes the priority of calls and multiple daytime periods. Computational results using the ROWEMS data will be presented. A detailed comparison shows that the predictions obtained from our model are often as good as the Approximate Hypercube (AH) model, but with a simpler and quicker procedure. The model proposed in this thesis can also be used as a planning tool to find promising candidate locations for new ambulance stations.

As the pre-hospital emergency medical service experienced a series of interactions, so they should be well-managed to improve the needs of patients and the quality of pre-hospital EMS. Based on the approaches of service encounter, we can further understand and guide the performance of EMT and the reactions from patients. Especially besides the technical aspect, we expected that the quality of pre-hospital EMS and the evaluation made by general people will be also emphasized. We can see that partly EMS disputive events were happened because there are some communication problems between EMT and family members. And the communication problems were almost originated from the mutual mis -understanding and self-servicing biases. The anticipation and consciousness demand difference enlarges, causes to have the dispute. The research first carries on the important instance to investigate, collect 42 senior EMT from Kaohsiung city government fire department, to provide satisfaction events 31, not satisfactory events 23 carry on the nature analysis. The reasons of satisfy or dissatisfy includes: The service attitude, rescues the specialized skill, the communication ability, extra provides the service, coordinates the patient demand, rescues factor and so on equipment and rescue time. Then depends on the obtained each factor and the reference correlation literature discussion carries on the populace to ask the volume design, asks the volume revision and the test, the populace questionnaire survey and so on. Finally analyzes the populace to ask the volume adjusts the result, to have rescued the service contact experience each factor and the populace oral traditions response relations. The research arranges part-time workers carries on the street corner to ask the volume and the recycling, total sends out 1060, recycles 928, effectively asked volume 781, invalid ask volume 147. In view of 781 effectively asked the volume carries on a letter analysis using the SPSS software, the factor analysis, the t-test, variance statistical method and so on and regression analysis. Screens affects populace oral traditions to be supposed the multiple coefficient of correlation (correlative value) respectively is: Rescues the personnel the clothing correct manners discipline (0.236), the service attitude(0.254), the first aid technology (0.351), generally rescues the equipment (0.243), the specialty rescues the equipment (0.214) and the rescue time (0.261)and so on. After regression analysis, by factor forecast (first aid technology, specialized equipment, general equipment) oral traditions response result: R2¡@¡@¡×0.137, the F test reaches extremely reveals the standard. Conclusion¡GUnder the government limited expenditure, wants to enhance the populace positive oral traditions to respond that, first should strengthen rescues the personnel the first aid technology, purchases the specialized first aid equipment and the general equipment in turn.

Texte remanié de: Inaug. -Diss.--Kunstgeschichte--Ludwig-Maximilians-Universität--München, 1995. / Bibliogr. p. 257-313.

In this thesis, we propose an optimization model to assist the Region of Waterloo Emergency Medical Services (EMS) to meet the new provincial land ambulance response time standard. The new land standard requires multiple response time thresholds which are based on the acuity of the patient determined at the time the 911 call is made. The performance of an EMS system is affected by many factors, including the number of ambulances deployed, their locations, and the dispatching strategy that is employed. The number of ambulances available over the course of the day varies when ambulance crews start and end their shifts, and when ambulance crews are called out or return from a call. In order to maintain coverage, it is therefore desirable to locate ambulances in stations as a function of how many are available, and the geography and frequency of potential calls. This may result in relocation of ambulances whenever there is a change in the number of available vehicles. This research provides a compliance table indicating how many ambulances to locate at each station when the number of available ambulances is given. We explore two main objectives: 1) maximizing the expected coverage for all patients, and 2) maximizing the coverage for the most acutely ill patients. Constraints include the number of available ambulances, the response time requirements, and service level constraints for each acuity level. In this study, we conducted an empirical analysis of ambulance response times, travel times to a hospital, and time spend at the hospital. We used two years of EMS data from July 2006 to June 2008 for the Region of Waterloo (ROWEMS). Based on this study, we show that using the binomial distribution to represent the number of busy ambulances suggested by Gendreau et al. (2006) is only valid for low utilization rates. The problem of allocating available ambulances among candidate stations is formulated as a Mixed Integer Non-linear Problem (MINLP) model that includes the priority of calls and multiple daytime periods. Computational results using the ROWEMS data will be presented. A detailed comparison shows that the predictions obtained from our model are often as good as the Approximate Hypercube (AH) model, but with a simpler and quicker procedure. The model proposed in this thesis can also be used as a planning tool to find promising candidate locations for new ambulance stations.

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abstract: Emergency Medical Services (EMS) first response personnel treat urgent and immediate illnesses and injuries in prehospital settings, and transport patients to definitive care if needed. EMS originated during warfare. The practice of rescuing wounded soldiers started during the Byzantine Empire, and developed along with other medical advances to the present day. Civilian EMS in the United States grew rapidly starting in the 1960s. Following the landmark National Research Council white paper of “Accidental Death and Disability: The Neglected Disease of Modern Society”, the nation addressed the key issues and problems faced in delivering emergency medical services. Today, colleges and universities often sponsor EMS organizations to serve populations concentrated in complex campuses. These are collectively known as Collegiate-Based Emergency Medical Services (CBEMS). By September 2018, there were 252 registered CBEMS organizations in the United States. Most are affiliated with the National Collegiate Emergency Medical Services Foundation (NCEMSF), which advocates, encourages, and provides support for CBEMS organizations. A survey repeating prior work (1996 and 2005) was sent to all NCEMSF registered CBEMS organizations, and 24 responded. The survey included questions on demographics, response capacities, coverage, organization, and logistics information. Locally, Arizona State University Student Emergency Medical Services (SEMS at ASU) began as an all-student-run volunteer organization in 2008. In 2018, SEMS at ASU became ASU EMS, as an official subdivision of the ASU Environmental Health Safety (EH&S) Department. This study summarizes the history of EMS, investigates the current status of CBEMS organizations and traces the history of ASU EMS from a volunteer group to an official department. / Dissertation/Thesis / Masters Thesis Biology 2019

The thesis deals about usage standard of CSN EN ISO 14001:2005 and it implementation to the company. In the theoretical part is analyzed process of the implementation and behaviour standard CSN EN ISO 14001:2005 in the building company XYZ. The attention is mainly drawn to benefits and costs connected with the implementation. Reccomendations for system functioning EMS are presented as a conclusion.

<p>The Swedish National Rail Administration, Banverket, has the overarching sector responsibility for Swedish railways, including a responsibility for implementing and managing the government decision for an ecologically sustainable development. In support of achieving ecologically sustainable development and fulfilment of the national environmental objectives and environmental legislation, Banverket initiated the implementation of an Environmental Management System (EMS) in 1998. The overall aim of this thesis is to examine the EMS applied at Banverket with regard to the identification and monitoring of environmental aspects at the administrative Railway Regions of Banverket. The analysis is based on a qualitative approach comprising questionnaires, interviews, document analysis and participating observations.</p><p>Areas for potential improvements are identified. A more stringent use of the EMS is needed in the organisation. Furthermore, a link between activity, aspect and impact when identifying environmental aspects would improve the procedure. Like in other public organisations, the monitoring of environmental aspects at Banverket is insufficient. Introducing indicators and integrating different Government requirements for environmental monitoring into one system, using EMS as a tool would make the system more effective. In the thsesis a framework is proposed for the identification of environmental aspects pertaining to operation and maintenance at Banverket. This framework has an input–output perspective and provides a clear connection between activity, aspect and impact. Furthermore, by establishing the framework on a system used mainly for environmental performance evaluation, a better connection between the identification and monitoring of aspects is created, possibly improving both processes. The framework for the identifica-tion of environmental aspects, as proposed in the thesis, could also be modified and applied in other organisations.</p><p>A major conclusion of the study is that the EMS applied at Banverket, in its present form, is not an effective environmental management tool for achieving ecologically sustainable development within the rail sector. Adapted methods for identification and monitoring of environmental aspects for public organisations such as Banverket would facilitate the application of EMS and increase its effectiveness as an environmental tool.</p>

Emergency medical services (EMS) personnel experience direct traumatic exposure that can leave a lasting negative impact. However, little is known about the vicarious exposure that EMS personnel experience at challenging calls when family and loved ones are present at the scene. Additionally, there is minimal research that has looked at the experiences among paramedics and EMTs who arrive to mental disturbance calls or completed suicides. In order to add to the substantial body of literature on EMS personnel and traumatic exposure, this study explored their experiences of multifaceted traumatization; the lived experiences of paramedics and EMTs who have responded to completed suicides where loved ones of the deceased were present, and as a result, experienced both a negative psychological impact and posttraumatic growth. The study explored the risk factors and protective factors that paramedics and EMTs experience in their work. Additionally, this inquiry sought to explore the ways in which participants find meaning in providing emergency medical services and how they sustain their work. &lt;br&gt;This qualitative, phenomenological study was conducted through semi-structured individual interviews with 12 paramedics or EMTs who have been employed or volunteered for at least one year. Explication of data was completed using van Manen's (1990) four existential themes: spatiality, corporeality, temporality, and relationality. The results of this study identified themes that address van Manen's (1990) lived existentials, protective factors against posttraumatic symptoms through direct and vicarious traumatization, risk factors that contribute to these symptoms, and meaning making in their work. The implications of the study for the field of emergency medical services and suggestions for future research are provided. / School of Education; / Counselor Education and Supervision (ExCES) / PhD; / Dissertation;

The purpose of this study was to investigate how companies in the textile industry systematically are working with environmental issues, e.g. ISO14001. The most significant environmental aspects in the textile industry are water and chemical use. Environmental management systems are based on target management to be able to work with environmental issues in a standardized and structured way. Nevertheless, a certification do not tell if a company are sustainable or not, only that they are working with improvements. A survey was prepared and distributed by TEKO for the members within the environmental group. The same survey was also sent to a fashion store who after the survey was interviewed. The 14 responses received from the survey were further analyzed. The result showed that 57% were certified with ISO14001, 64% considered ISO14001 as relevant to the industry, 79% considered work with product labels as not enough environmental work. OEKO-TEX were the most common product label to use. Consumers can be confused by the number of different product labels that exist on the market and therefore a label that applies to all textile are requested. One company collected textile waste, moreover, the result showed no trend whether the municipality or the producers should be responsible for the collecting. To sort textile waste separately gain environmental benefits and has also become a goal set by the EU. At the same time, the demands are increasing in production countries as a result of the population becoming more aware of pollution in air and water.