Every year, conflicts and natural disasters affect millions of people worldwide. However, the resources to assist those affected are perpetually insufficient. When emergencies strike, assistance organizations must decide where to prioritize their limited resources to reduce as much mortality and suffering as possible. At the start of their emergency response activities, organizations typically make three key decisions: 1) determine if they will respond 2) prioritize/triage the needs of the affected population; and 3) choose first response programs to implement. Many studies and authors note that these decisions are often based on insufficient evidence and personal judgement. This dissertation argues that we, as emergency responders, can do better. Epidemiologic methods can empower us to make better decisions based on better measurement, analysis, and evidence – improving outcomes for emergency affected persons, globally. This dissertation provides three examples of epidemiologic methods being used to inform critical emergency response decision points. Aim 1 addresses the first emergency response decision: prioritizing the most severe emergencies for response programing. Aim 2 focuses on the second emergency response decision: how can responders most accurately prioritize the needs of affected persons by using needs surveys, given the potential that needs vary by gender or age. Aim 3 examines the third decision: which response programs to implement, by summarizing the evidence base for the effectiveness of standard emergency programs. Methods In aim 1 I facilitated a panel of outbreak specialists from a leading emergency response organization to develop, test, and validate a new measure for the classification of outbreaks. I used classical scale development methods, including both qualitative and quantitative procedures. In aim 2 I used data from 12 emergency needs surveys to examine a common assumption that reported needs and experiences vary based on the gender and/or age of the respondent. I conducted both individual analyses of each study as well as a set of meta-analyses examining the prevalence differences found between gender and age sub-groups. In aim 3 I conducted a systematic scoping review of the evidence of what programs are effective in acute emergency settings. I searched six academic databases as well as eight sector-relevant grey literature databases -focusing on evidence for standard emergency interventions. Results In aim 1, a new outbreak classification measure was successfully developed based on inputs from the expert panel and a compiled dataset of indicators in global outbreak emergencies. The measure allows for the immediate (within two hours) classification of outbreaks. The expert panel participated in qualitative exercises where they developed a construct of ‘scale and severity of outbreak emergencies.’ This construct had four sub-dimensions, and a scale was developed to measure each sub-dimension, and then combined into a single measure. The content validity, criterion validity, construct validity, and reliability were examined for the measure. Criterion validity was based on a strong (0.87) correlation between the new outbreak measure and a ‘gold standard’ ranking of outbreak emergencies created by a group of emergency decision-makers (‘judges’). Similarly, construct validity was based on the measure performing as predicted when compared to measures of a similar/dissimilar construct, (convergent and divergent validity). The case for reliability was made using intraclass correlations between the new outbreak measure and the ‘gold standard’ measure (a robust result of a 0.87 using an ICC 3, 1), as well as comparing how well the outbreak measure worked alongside the conflict and natural disaster measures (another robust finding of 0.91 using an ICC 3, 1). In aim 2, I found that emergency affected persons of various gender or age groups very rarely differ in their responses to needs and experience questions in emergency surveys. When searching for differences in how gender or age groups report their households’ top three needs, meaningful differences in individual studies were found 6% of the time. When a meta-analysis of the same data was conducted across all needs questions in all 12 surveys, no meaningful differences were found between how either men or women report needs, or how different age groups report needs. Responses to questions about experiences (rather than needs) in emergencies were slightly more likely to vary by gender or age group. The meta-analysis of experience questions showed that across the 12 assessments differences in how gender or age groups experience emergencies were extremely rare (less than 4% of questions showed a meaningful summary prevalence difference). In aim 3 I identified 43 programs that are commonly implemented in acute emergency response. My scoping review searched for any studies that rigorously evaluated the impact of one or more of these programs. My search identified 4,005 unique studies; I screened them all for eligibility, resulting in only four studies that met all inclusion criteria. Thus 39 of the pre-identified, common emergency programs have no published evidence of their effectiveness in acute emergencies. The remaining four, each have one study in one context that demonstrates at least one positive effect of the program. Conclusion This dissertation provided evidence that epidemiologic methods can help solve problems, answer questions, and improve the allocation of resources in acute emergencies. While each aim focused on a unique decision point within acute emergency responses, they all contended with similar difficulties, such as incomplete and poor-quality data and a lack of shared definitions for what data points are relevant in decision-making. Yet in all three aims I found other similarities as well: there are relevant data available; and there are effective methods available that can answer many of our questions.

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Meta-synthesis is an approach to synthesize qualitative research results. Originally proposed in the medical field and in education, this approach helps to advance current knowledge by generating a new interpretive synthesis. Since current research practices and knowledge development in emergency management is excessively divergent, there has been a need for a synthesis of knowledge from practice and research. One of the main arguments of this study is that the need is met by this study of a meta-synthesis. In this research, I suggested that many research results dealing with the issue of how to improve the performance of emergency management can be integrated into strategies for network management in emergencies. I used the term strategies in a much more generalized way to capture the idea of managerial/behavioral skills, plans, and insights for emergency management. The meta-synthesis was conducted from a keyword search, surveys, and expert interviews, which identified representative studies in emergency response. The review process of the representative studies is captured in a two-by-two matrix (intervention point axis and planning-improvisation axis) as a way of presenting the meta-synthesis results. This study then, turned to an analysis of reports of the Hurricane Katrina response using the meta-synthesis results. Qualitative content analysis was used as a method for the analysis. Reports from the White House, the House of Representatives, and the Senate are the target documents of the analysis. While conducting the analysis, I argued that the attempt of interpreting the failures of Katrina response into the failures of network management strategies provides clearer understandings regarding what went wrong and what was lacking. Furthermore, I argued that the way of thinking attempted in the analysis is a constructive one in that it provides an instructive action agenda for future disasters by connecting lessons learned to the strategies for emergency management. / Ph. D.

Although emergency management is established for the purpose of addressing disasters and other major emergencies, I have found that it can be purposefully engineered to also be an assist leader to other agencies and entities during nonemergency periods because the key element of synchrony that enables emergency managers to be effective during an emergency can also be employed during nonemergency periods to assist other departments in a manner that not only delivers a direct benefit to the department but also enhances the emergency preparedness, mitigation, and resiliency efforts of the jurisdiction. Emergency managers can create this performance-enhancing synchrony using boundary spanning functions that bridge the divide that separates stakeholders. Emergency management practitioners are steadfast in their pursuit of methods and practices by which they can be more effective. The recent increase in the frequency and severity of natural disasters is only one example of the ever-growing demands placed upon these professionals. Compounding this development is the fact that the occurrences of natural disasters have outpaced research and theory development regarding how emergency management professionals should prepare for and respond to these events. This research study envisions, proposes, and outlines a framework in which emergency managers function in a broader capacity that could elevate their overall performance and importance to a higher plane than the one on which perhaps most currently operate. / Business Administration/Strategic Management

This research examines the media characterization of the conflict, regime, survivors, and rebels in the aftermath of the 2023 Syrian Earthquake which occurred during the Syrian Civil War. Investigating the effect of these media characterizations on governmental legitimacy. Using a sample of 143 articles from the BBC, DW, NPR, and Al-Jazeera published within the one year of the earthquake, articles were coded as positive, negative, or neutral regarding the conflict, regime, survivors and rebels. The research found media characterization of the conflict, regime, and survivors to be largely negative, while the rebels were characterized as neutral largely because most of the sample articles did not provide details on the rebel groups. This research indicates media characterizations can shape public perception in the aftermath of a disaster which in turn affects governmental legitimacy.

Disaster debris cleanup operations are commonly organized into two phases. During the first phase, the objective is to clear debris from evacuation and other important pathways to ensure access to the disaster-affected area. Practically, Phase 1 activities largely consist of pushing fallen trees, vehicles, and other debris blocking streets and highways to the curb. These activities begin immediately once the disaster has passed, with the goal of completion usually within 24 to 72 hours. In Phase 2 of debris removal, which is the focus of this study, completion can take months or years. Activities in this phase include organizing and managing curbside debris collection, reduction, recycling, and disposal operations (FEMA 2007). This dissertation research investigates methods for improving post-disaster debris cleanup operations—one of the most important and costly aspects of the least researched area of disaster operations management (Altay and Green 2006). The first objective is to identify the unique nature of the disaster debris cleanup problem and the important decisions faced by disaster debris coordinators. The second goal is to present three research projects that develop methods for assisting disaster management coordinators with debris cleanup operations. In the first project, which is the topic of Chapter 3, a facility location model is developed for addressing the problem of opening temporary disposal and storage reduction facilities, which are needed to ensure efficient and effective cleanup operations. In the second project, which is the topic of Chapter 4, a multiple objective mixed-integer linear programming model is developed to address the problem of assigning debris cleanup resources across the disaster-affected area at the onset of debris cleanup operations. The third project and the focus of Chapter 5 addresses the problem of equitably controlling ongoing cleanup operations in real-time. A self-balancing CUSUM statistical process control chart is developed to assist disaster management coordinators with equitably allocating cleanup resources as information becomes available in real-time. All of the models in this dissertation are evaluated using data from debris cleanup operations in Chesapeake, Virginia, completed after Hurricane Isabel in 2003. / Ph. D.

This dissertation examines the extent to which social vulnerability, as studied by researchers across multiple disciplines, has influenced the practice of emergency management at the local level. This study addresses two major research questions to accomplish this goal. First, how do local emergency managers perceive and define social vulnerability? Second, what strategies do local emergency managers employ to reach and meet the needs of socially vulnerable populations? Semi-structured interviews were conducted in person or by phone with a sample of local emergency managers, city managers, and American Red Cross personnel from the Houston - Galveston and the South East Texas regions as defined by the respective Councils of Government. A modified grounded theory approach was used with a constant comparative method to identify themes for each research question. Triangulation was accomplished through secondary census data and supplemental interviews. The interview data reveal that social vulnerability research has had an indirect influence on the practice of emergency management at the local level. This influence is facilitated through state and federal policy, training, and plans development. Based on the interview data, four themes were identified that capture the various ways in which local emergency management officials perceive and define social vulnerability. These include vulnerability as poverty and culture, vulnerability as a lack of security, vulnerability as a moral imperative, and vulnerability as a lack of awareness and knowledge. In terms of strategies employed to address social vulnerability, the data suggest four themes: leaving it to the professionals, bringing in volunteers, leveraging protocols to build buy-in, and fostering flexibility. The findings reveal the importance in closing the knowledge gap between research and practice, because increased damage, harm, and death can occur when the social inequalities of everyday life are not addressed in the planning process by emergency managers. The findings also reveal that state and federal policy, training, and plans development are the most trusted sources by emergency managers to transfer knowledge to practice. Additionally, with the proliferation of emergency management degree programs at the undergraduate and graduate levels, higher education can potentially play a more active and visible role in bridging the gap between research and practice, particularly as it relates to social vulnerability.

Biological emergency response planning plays a critical role in protecting the public from possible devastating results of sudden disease outbreaks. These plans describe the distribution of medical countermeasures across a region using limited resources within a restricted time window. Thus, the ability to determine that such a plan will be feasible, i.e. successfully provide service to affected populations within the time limit, is crucial. Many of the current efforts to validate plans are in the form of live drills and training, but those may not test plan activation at the appropriate scale or with sufficient numbers of participants. Thus, this necessitates the use of computational resources to aid emergency managers and planners in developing and evaluating plans before they must be used. Current emergency response plan generation software packages such as RE-PLAN or RealOpt, provide rate-based validation analyses. However, these types of analysis may neglect details of real-world traffic dynamics. Therefore, this dissertation presents Validating Emergency Response Plan Execution Through Simulation (VERPETS), a novel, computational system for the agent-based simulation of biological emergency response plan activation. This system converts raw road network, population distribution, and emergency response plan data into a format suitable for simulation, and then performs these simulations using SUMO, or Simulations of Urban Mobility, to simulate realistic traffic dynamics. Additionally, high performance computing methodologies were utilized to decrease agent load on simulations and improve performance. Further strategies, such as use of agent scaling and a time limit on simulation execution, were also examined. Experimental results indicate that the time to plan completion, i.e. the time when all individuals of the population have received medication, determined by VERPETS aligned well with current alternate methodologies. It was determined that the dynamic of traffic congestion at the POD itself was one of the major factors affecting the completion time of the plan, and thus allowed for more rapid calculations of plan completion time. Thus, this system provides not only a novel methodology to validate emergency response plans, but also a validation of other current strategies of emergency response plan validation.

By conducting a field survey to collect and investigate the attributes and behaviour patterns of participants in the case event, the proposed model and simulation system were implemented. Three scenarios of different populations of involved agents were simulated on the finished system according to the sample data. Simulation results were analyzed and compared to the observed data. The simulation system was found to be capable of reproducing compatible dynamics of pedestrian flows. / Finally the conclusions of this thesis study were presented. / In order to implement the model, the layered behavioural simulation model was proposed for putting the decisions made from the behaviour model into action. By identifying the three layers sustaining the routing procedure at their respective levels, the evacuation route was finally converted to selecting stepping cells from adjacent neighbours. In this way a quick way-finding process can be achieved toward the ultimate destination, so that the global objectives are coordinated with local action decisions on the cell scale. With this simulation model, the framework of the geo-referenced agent-based system was proposed with technical details presented. This system was built directly on a GIS base and thus was able to conduct simulation in a real space environment and perform advanced GIS analysis inside the simulation. / In reviewing the existing evacuation models and simulation systems, it was found that although there have been remarkable advances in reproducing and analyzing many phenomena and the dynamics of pedestrian flow in evacuations, social psychological factors were not well considered. Theories and research in the social psychological field have indicated that these factors are essential in evacuation behaviour. Therefore the author examined the socio-economic factors relating to psychological responses through a literature review and explored the potential for integrating such factors into the agent based modelling approach. / Inspired by such concerns, the author proposed the individual cognitive behaviour model consisting of the Personalized Spatial Cognitive Road Network, which represents the diverse individual spatial knowledge of recognizable roads, and the Multiple Routing Strategies which incorporated individual preferences in selecting routing strategy. The proposed model follows the principle that pedestrians are considered to be composed of heterogeneous individuals, thus each pedestrian could have his or her own knowledge base and rules of behaviour. Two steps in constructing each component were presented respectively, with an integrated framework presented in the context of agent based modelling. / Public safety has become more and more important nowadays as tragic incidents, such as the 9/11 World Trading Centre attack, have caused a large number of causalities. It is critical to improve the capability of the security department for safely managing the crowd in response to an emergency. Conventional techniques investigating evacuation dynamics, such as the sand-box game utilized by Hong Kong police department preparing evacuation plans for the case event, are generally inadequate for providing sufficient support to crowd management. Enhancing the management practice by computer based simulation techniques has been attracting an increasing amount of research interests recently, as it can offer timely decision making assistance in changing situations compared to the conventional approaches. / Wu, Lei. / Advisers: Hui Lin; Bo Huang; Yee Leung. / Source: Dissertation Abstracts International, Volume: 73-06, Section: A, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 249-273). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.