There is a paucity of literature evaluating mass casualty systems and no clear 'gold standard' for measuring the efficacy of information decision support systems or triage systems that can be used in mass casualty events. The purpose of this research was the preliminary validation of a comprehensive conceptual model for a mass casualty continuum of care. This research examined key relationships among entities/factors needed to provide real-time visibility of data that track patients, personnel, resources and potential hazards that influence outcomes of care during mass casualty events.A modified Delphi technique was used to validate the proposed model using a panel of experts. The four research questions measured the extent to which experts agreed that the: 1) ten constructs represent appropriate predictors of outcomes of care during mass casualty events; 2) proposed relationships among the constructs provide valid representations of mass casualty triage; 3) proposed indicators for each construct represent appropriate measurements for the constructs; and 4) the proposed model is seen as useful to the further study of information and technology requirements during mass casualty events. The usefulness of the online Delphi process was also evaluated.A purposeful sample of 18 experts who work in the field of emergency preparedness/response was selected from across the United States. Computer, Internet and email applications were used to facilitate a modified Delphi technique through which experts provided initial validation for the proposed conceptual model. Two rounds of the Delphi process were needed to satisfy the criteria for consensus and/or stability related to the constructs, relationships and indicators in the model. Experts viewed the proposed model as relatively useful (Mean = 5.3 on a 7-point scale). Experts rated the online Delphi process favorably.Constructs, relationships and indicators presented in this model are viewed as preliminary. Future research is needed to develop the tools to measure the constructs and then test the model as a framework for studying effects and outcomes of mass casualty events. This study provides a foundation for understanding the complex context in which mass casualty events take place and the factors that influence outcomes of care.

Traumatic haemorrhage is a leading preventable cause of critical mortality in mass casualty events (MCEs). Treatment requires the rapid provision of high volumes of packed red blood cells (PRBC) to meet the surge in casualty demand these events generate. The increasing frequency of MCEs coupled with the threat of more violent mechanisms risks overwhelming hospital based transfusion systems. The overall objective of this research was to improve understanding of blood use in MCEs using a mathematical modelling approach. A computerised discrete event simulation model was designed, developed and validated using civilian and military transfusion databases, a review of historical MCEs and discussion with experts involved in all aspects of in-hospital MCE PRBC provision. The model was experimented with across increasing casualty loads to optimise event outcomes under varied conditions of: stock availability, laboratory processing procedures and individual PRBC supply. The model indicated even in events of limited size the standard on-shelf PRBC stock level was insufficient to adequately meet demand amongst bleeding casualties. Restocking during an event allowed for equivocal treatment results if performed early following an event and this would be most effective if activated by central suppliers. Modifications to transfusion laboratory processing procedures were found to be of limited benefit in improving outcomes due to the principally automated nature of the techniques they employ. Conversely, the use of restricting excessive individual provision of both overall PRBC and emergency type O PRBC to individual casualties did show potential for managing scenarios where only a finite supply of stock existed or an accurate estimation of expected casualties was available.

The subject of the study for this dissertation is the relationship between pricing and reserving risks for property-casualty insurance companies. Since the risk characteristics of insurers differ based on their structure, objectives and incentives, segmenting the insurers into subgroups would allow for a better understanding of group-specific risks. Based on this approach to analyzing insurer financial risks, we find that, in a given accident year, the pricing and reserving errors are positively correlated, especially in long-tailed lines of business. Large insurers, stock insurers, and multi-state insurers, in general, exhibit a strong correlation between accident-year price and reserve errors. However, only size of insurers appears to be a factor that influences the interaction between price changes and the calendar year loss reserve adjustments. Furthermore, we find that the pricing risk and reserving risk are marginally more homogenous within a market segment when size, type and number of states are employed as criteria for market segmentation, hence insurance regulators should consider the refined market segments for the RBC formula. The empirical results also indicate that, in general, Chain-Ladder reserving method likely contributes to loss reserve errors when there is a change in the loss development pattern and the magnitude of the errors is worse for large insurers. Finally, we find that our proposed measurement method for the product diversification benefit provides support for the notion that the diversification benefit on the incurred losses increases with the number of lines in the portfolio. Yet, the diminishing returns tend to decrease the diversification benefit on the incurred losses for insurers that write the business in more than six of the selected lines. To the contrary, our proposed measure does not provide clear evidence that writing business in many product lines increases the product diversification benefit with respect to adverse loss development. We do find that the diversification benefit for both incurred losses and loss development is higher for larger insurers. Hence, for risk management and regulatory purposes, a stronger case can be made for considering firm size than product diversification.

Thesis (M.Ed.)--Regis University, Denver, Colo., 2007. / Title from PDF title page (viewed on Oct. 30, 2007). Includes bibliographical references.

Thesis (M.S.)--School of Advanced Air and Space Studies, 2008. / "June 2008." Vita. Includes bibliographical references (p. 82-84). Also available via the Internet.

Dissertation (Ph.D.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 295 pages. Includes vita. Includes bibliographical references.

The topic of this diploma thesis was chosen with regard to the currency of this issue. There are discussed the basis of financial planning and it is accounted why the finance is important to be planned. Not insignificant part of the financial planning is insurance, which penetrates the whole financial plan. In this field I focused on, in my opinion, the most important financial security, namely income security in case its failure, which mostly accident insurance deals with. The theoretical part of the thesis is followed by a number of sample presentations of financial plans in selected insurance companies.

The need for increasing efficiencies for medical resource delivery during a mass casualty incident/event is a paramount logistical planning factor that could mean life or death to the citizens affected by a disaster. As such, Washington State has prioritized emergency management and preparedness. Using the just-in-time system by way of Baghbanian' s complex adaptive decision-making theory as the foundation, gave purpose to this qualitative study. This was accomplished by analysis of emergency management professional responses, and to what degree, improvements can be made to the medical resource delivery system during a mass casualty incident/event. Data were collected through semi structured interviews with a random sample of 12 experienced emergency professionals from the State of Washington. This study was guided by primary research questions that focused on emergency managers and their understanding and adaptability toward preparedness. Interview data were deductively coded and analyzed through a thematic analysis procedure. The key theme of this study is that participants perceived slight differences in logistical and operational approaches that vector into transportation and operational understanding as the main factors influencing medical resource delivery. The positive social change association of this study is that it provides emergency managers, first responders, and medical staff with recommendations for analysis and planning development for medical resource delivery, thereby mitigating the life and death implications for citizens in future disasters.

No description available.

In this thesis we introduces the user interface design and forensic analysis tool for DIORAMA system. With an Android device, DIORAMA provides emergency personnel the ability to collect information in real time, track the resources and manage them. It allows the responders and commanders to mange multiple incidents simultaneously. This thesis also describes the implementations of commander app and responder app, as well as two different communication strategies used in DIORAMA. Several trials and simulated mass casualty incidents were conducted to test the functionalities and performance of DIORAMA system. All responders that participated in all trials were very satisfied with it. As a result, DIORAMA system significantly reduced the evacuation time by up to 43% when compared to paper based triage systems.