Factors that influence aggressive behaviour in acute care settings

Patients with critical illness or severe trauma may feel fear, anxiety and powerlessness, which can lead to aggressive behaviour. This article examines factors that contribute to patient aggression in acute care areas and identifies how these incidents can be minimised.

Estimating the flow rate capacity of an overturned rail carriage end exit in the presence of smoke

While incidents requiring the rapid egress of passengers from trains are infrequent, perhaps the most challenging scenario for passengers involves the evacuation from an overturned carriage subjected to fire. In this paper we attempt to estimate the flow rate capacity of an overturned rail carriage end exit. This was achieved through two full-scale evacuation experiments, in one of which the participants were subjected to non-toxic smoke. The experiments were conducted as part of a pilot study into evacuation from rail carriages. In reviewing the experimental results, it should be noted that only a single run of each trial was undertaken with a limited — though varied — population. As a result it is not possible to test the statistical significance of the evacuation times quoted and so the results should be treated as indicative rather than definitive. The carriage used in the experiments was a standard class Mark IID which, while an old carriage design, shares many features with those carriages commonly found on the British rail network. In the evacuation involving smoke, the carriage end exit was found to achieve an average flow rate capacity of approximately 5.0 persons/min. The average flow rate capacity of the exit without smoke was found to be approximately 9.2 persons/min. It was noted that the presence of smoke tended to reduce significantly the exit flow rate. Due to the nature of the experimental conditions, these flow rates are considered optimistic. Finally, the authors make several recommendations for improving survivability in rail accidents. Copyright © 2000 John Wiley & Sons, Ltd.

Modelling occupant interaction with fire conditions using the buildingEXODUS evacuation model

When evacuating through fire environments, the presence of smoke may not only have a physiological impact on the evacuees but may also lead occupants to adapt their evacuation strategy through the adoption of another exit. This paper attempts to introduce this type of adaptive behaviour within the buildingEXODUS evacuation model through enabling occupants to make decisions concerning the selection of the most viable available exit during an evacuation involving fire. The development of this adaptive behaviour requires the introduction of several new capabilities namely, the representation of the occupants’ familiarity with the structure, the behaviour of an occupant that is engulfed in smoke and the behaviour of an occupant that is faced with a smoke barrier. The appropriateness of the redirection decision is dependent upon behavioural data gathered from real fire incidents (in the UK and USA) that is used to construct the redirection probabilities. The implementation is shown to provide a more complex and arguably more realistic representation of this behaviour than that provided previously.

The AASK Database V3.0: a database of human experience during aircraft evacuation incidents

This paper describes recent developments with the Aircraft Accident Statistics and Knowledge (AASK) database. The AASK database is a repository of survivor accounts from aviation accidents developed by the Fire Safety Engineering Group of the University of Greenwich with support from the UK CAA. Its main purpose is to store observational and anecdotal data from the actual interviews of the occupants involved in aircraft accidents. Access to the latest version of the database (AASK V3.0) is available over the Internet. AASK consists of information derived from both passenger and cabin crew interviews, information concerning fatalities and basic accident details. Also provided with AASK is the Seat Plan Viewer that graphically displays the starting locations of all the passengers - both survivors and fatalities - as well as the exits used by the survivors. Data entered into the AASK database is extracted from the transcripts supplied by the National Transportation Safety Board in the US and the Air Accident Investigation Branch in the UK. The quality and quantity of the data was very variable ranging from short summary reports of the accidents to boxes of individual accounts from passengers, crew and investigators. Data imported into AASK V3.0 includes information from 55 accidents and individual accounts from 1295 passengers and 110 crew.

The collection of pre-evacuation times from evacuation trials involving a Hospital Outpatient area and a University Library facility

This paper presents data relating to occupant pre-evacuation times from a university and a hospital outpatient facility. Although the two structures are entirely different they do employ relatively similar procedures: members of staff sweeping areas of the structure to encourage individuals to evacuate. However, the manner in which the dependent population reacts to these procedures is quite different. In the hospital case the patients only evacuated once a member of the nursing staff had instructed them to do so while in the university evacuation the students were less dependent upon the actions of the staff with over 50% of them evacuating with no prior prompting. Although this data may be useful in a variety of areas, it was collected primarily for use within evacuation models.

Thinking inside the box: the World Bank position on the private and public sector

An analysis of how the World Bank has maintained a position supportive of mutlinational strategies for privatisation of water. (Brief version).

Thinking inside the box: why the World Bank is not learning

An analysis of how the World Bank has maintained a position supportive of multinational strategies for privatisation of water.