A multi-organisational approach for disaster preparedness and response:the use of optimisation and GIS for facility location, stock pre-positioning, resource allocation and relief distribution

From 1992 to 2012 4.4 billion people were affected by disasters with almost 2 trillion USD in damages and 1.3 million people killed worldwide. The increasing threat of disasters stresses the need to provide solutions for the challenges faced by disaster managers, such as the logistical deployment of resources required to provide relief to victims. The location of emergency facilities, stock prepositioning, evacuation, inventory management, resource allocation, and relief distribution have been identified to directly impact the relief provided to victims during the disaster. Managing appropriately these factors is critical to reduce suffering. Disaster management commonly attracts several organisations working alongside each other and sharing resources to cope with the emergency. Coordinating these agencies is a complex task but there is little research considering multiple organisations, and none actually optimising the number of actors required to avoid shortages and convergence. The aim of the this research is to develop a system for disaster management based on a combination of optimisation techniques and geographical information systems (GIS) to aid multi-organisational decision-making. An integrated decision system was created comprising a cartographic model implemented in GIS to discard floodable facilities, combined with two models focused on optimising the decisions regarding location of emergency facilities, stock prepositioning, the allocation of resources and relief distribution, along with the number of actors required to perform these activities. Three in-depth case studies in Mexico were studied gathering information from different organisations. The cartographic model proved to reduce the risk to select unsuitable facilities. The preparedness and response models showed the capacity to optimise the decisions and the number of organisations required for logistical activities, pointing towards an excess of actors involved in all cases. The system as a whole demonstrated its capacity to provide integrated support for disaster preparedness and response, along with the existence of room for improvement for Mexican organisations in flood management.

A Markov chain location-allocation meta-model for hurricane relief

An emergency is a deviation from a planned course of events that endangers people, properties, or the environment. It can be described as an unexpected event that causes economic damage, destruction, and human suffering. When a disaster happens, Emergency Managers are expected to have a response plan to most likely disaster scenarios. Unlike earthquakes and terrorist attacks, a hurricane response plan can be activated ahead of time, since a hurricane is predicted at least five days before it makes landfall. This research looked into the logistics aspects of the problem, in an attempt to develop a hurricane relief distribution network model. We addressed the problem of how to efficiently and effectively deliver basic relief goods to victims of a hurricane disaster. Specifically, where to preposition State Staging Areas (SSA), which Points of Distributions (PODs) to activate, and the allocation of commodities to each POD. Previous research has addressed several of these issues, but not with the incorporation of the random behavior of the hurricane's intensity and path. This research presents a stochastic meta-model that deals with the location of SSAs and the allocation of commodities. The novelty of the model is that it treats the strength and path of the hurricane as stochastic processes, and models them as Discrete Markov Chains. The demand is also treated as stochastic parameter because it depends on the stochastic behavior of the hurricane. However, for the meta-model, the demand is an input that is determined using Hazards United States (HAZUS), a software developed by the Federal Emergency Management Agency (FEMA) that estimates losses due to hurricanes and floods. A solution heuristic has been developed based on simulated annealing. Since the meta-model is a multi-objective problem, the heuristic is a multi-objective simulated annealing (MOSA), in which the initial solution and the cooling rate were determined via a Design of Experiments. The experiment showed that the initial temperature (T0) is irrelevant, but temperature reduction (δ) must be very gradual. Assessment of the meta-model indicates that the Markov Chains performed as well or better than forecasts made by the National Hurricane Center (NHC). Tests of the MOSA showed that it provides solutions in an efficient manner. Thus, an illustrative example shows that the meta-model is practical.

Managua Relief

Bob del Toro, Dianne Haley and Others with Toys for Managuan Relief. On December 23, 12:29 a.m. local time in Managua, Nicaragua, a magnitude 6.2 earthquake occurred. The earth caused widespread damage among Managua, the capital city. In Managua, 5,000 residents were killed, 20,000 were injured and over 250,000 were left homeless. In Miami, residents and relief organizations focused on helping children. Wife of General Arturo Somoza pleaded on efforts on gathering sporting goods and toys for Managua’s young people. Relief committees purchased 230 dozen balls – basketball, rubber, and volley, soccer, and others. Nearly $500 came from students in Hialeah High School. Jump ropes and jacks were donated from a sorority at Florida International University. Arrangements were made to bring 44,000 pounds of baby formula and canned meat and 13,000 pounds of medicine. Many of Miami’s corporations, associations, and residents contributed to the Managuan Relief effort. Source: The Miami News, March 19, 1973 by Lynn Feigenbaum 887-3400. april 30, 1973. Cutlines: More than 350 dozens of various balls, skate boards and games were recently purchased by the Student Governance Committee of Florida International University for the young people of Managua, Nicaragua who not only do not have enough toys but are unable to attend schools which are closed. Left to right are, Bob del Toro, Dianne Haley, Chairman of the Student Governance Committee, Hialeah Councilman Jack Weaver of the Hialeah-Managua Sister City Committee, Barbara O'Nan and Margaret Klein.

Managua Relief

On December 23, 12:29 a.m. local time in Managua, Nicaragua, a magnitude 6.2 earthquake occurred. The earth caused widespread damage among Managua, the capital city. In Managua, 5,000 residents were killed, 20,000 were injured and over 250,000 were left homeless. In Miami, residents and relief organizations focused on helping children. Wife of General Arturo Somoza pleaded on efforts on gathering sporting goods and toys for Managua’s young people. Relief committees purchased 230 dozen balls – basketball, rubber, and volley, soccer, and others. Nearly $500 came from students in Hialeah High School. Jump ropes and jacks were donated from a sorority at Florida International University. Arrangements were made to bring 44,000 pounds of baby formula and canned meat and 13,000 pounds of medicine. Many of Miami’s corporations, associations, and residents contributed to the Managuan Relief effort. Source: The Miami News, March 19, 1973 by Lynn Feigenbaum From: City of Hialeah Publicity Bureu. 401 1/2 East 1st Ave. Hialeah, Fla. 887-3400. april 30, 1973. Cutlines: Florida International University students recently raised more than $ 1,000 for more than 300 dozens toys and balls for the youngsters of Managua, Nicaragua. With the balls above are shown student Committee members and oficials of the Hialeah-Managua Sister City Committee, left to rigth: Bob del Toro, Sister City Committe president Raymond R. Schultz, Student Governance Committee chairman Dianne Haley and Hialeah City councilman Jack Weaver.

Managua Relief

On December 23, 12:29 a.m. local time in Managua, Nicaragua, a magnitude 6.2 earthquake occurred. The earth caused widespread damage among Managua, the capital city. In Managua, 5,000 residents were killed, 20,000 were injured and over 250,000 were left homeless. In Miami, residents and relief organizations focused on helping children. Wife of General Arturo Somoza pleaded on efforts on gathering sporting goods and toys for Managua’s young people. Relief committees purchased 230 dozen balls – basketball, rubber, and volley, soccer, and others. Nearly $500 came from students in Hialeah High School. Jump ropes and jacks were donated from a sorority at Florida International University. Arrangements by organizations were made to bring 44,000 pounds of baby formula and canned meat and 13,000 pounds of medicine. Many of Miami’s corporations, associations, and residents contributed to the Managuan Relief effort. Source: The Miami News, March 19, 1973 by Lynn Feigenbaum From: City of Hialeah Publicity Bureu. 401 1/2 East 1st Ave. Hialeah, Fla. 887-3400. april 30, 1973. Cutlines: Skate boards, paddle balls and flying saucers were among the big shipment of toys which was recently dispatched to Managua, Nicaragua by students of Florida International University through the Hialeah-Managua Sister Committee. Examining the toys above are, left to right: Margaret Klein, Hialeah councilman Jack Weaver and Barbara O'Nan.

Managua Relief

On December 23, 12:29 a.m. local time in Managua, Nicaragua, a magnitude 6.2 earthquake occurred. The earth caused widespread damage among Managua, the capital city. In Managua, 5,000 residents were killed, 20,000 were injured and over 250,000 were left homeless. In Miami, residents and relief organizations focused on helping children. Wife of General Arturo Somoza pleaded on efforts on gathering sporting goods and toys for Managua’s young people. Relief committees purchased 230 dozen balls – basketball, rubber, and volley, soccer, and others. Nearly $500 came from students in Hialeah High School. Jump ropes and jacks were donated from a sorority at Florida International University. Arrangements were made to bring 44,000 pounds of baby formula and canned meat and 13,000 pounds of medicine. Many of Miami’s corporations, associations, and residents contributed to the Managuan Relief effort. Source: The Miami News, March 19, 1973 by Lynn Feigenbaum

Managua Relief

On December 23, 12:29 a.m. local time in Managua, Nicaragua, a magnitude 6.2 earthquake occurred. The earth caused widespread damage among Managua, the capital city. In Managua, 5,000 residents were killed, 20,000 were injured and over 250,000 were left homeless. In Miami, residents and relief organizations focused on helping children. Wife of General Arturo Somoza pleaded on efforts on gathering sporting goods and toys for Managua’s young people. Relief committees purchased 230 dozen balls – basketball, rubber, and volley, soccer, and others. Nearly $500 came from students in Hialeah High School. Jump ropes and jacks were donated from a sorority at Florida International University. Arrangements were made to bring 44,000 pounds of baby formula and canned meat and 13,000 pounds of medicine. Many of Miami’s corporations, associations, and residents contributed to the Managuan Relief effort. Source: The Miami News, March 19, 1973 by Lynn Feigenbaum

Managua Relief

On December 23, 12:29 a.m. local time in Managua, Nicaragua, a magnitude 6.2 earthquake occurred. The earth caused widespread damage among Managua, the capital city. In Managua, 5,000 residents were killed, 20,000 were injured and over 250,000 were left homeless. In Miami, residents and relief organizations focused on helping children. Wife of General Arturo Somoza pleaded on efforts on gathering sporting goods and toys for Managua’s young people. Relief committees purchased 230 dozen balls – basketball, rubber, and volley, soccer, and others. Nearly $500 came from students in Hialeah High School. Jump ropes and jacks were donated from a sorority at Florida International University. Arrangements were made to bring 44,000 pounds of baby formula and canned meat and 13,000 pounds of medicine. Many of Miami’s corporations, associations, and residents contributed to the Managuan Relief effort. Source: The Miami News, March 19, 1973 by Lynn Feigenbaum

Managua Relief

On December 23, 12:29 a.m. local time in Managua, Nicaragua, a magnitude 6.2 earthquake occurred. The earth caused widespread damage among Managua, the capital city. In Managua, 5,000 residents were killed, 20,000 were injured and over 250,000 were left homeless. In Miami, residents and relief organizations focused on helping children. Wife of General Arturo Somoza pleaded on efforts on gathering sporting goods and toys for Managua’s young people. Relief committees purchased 230 dozen balls – basketball, rubber, and volley, soccer, and others. Nearly $500 came from students in Hialeah High School. Jump ropes and jacks were donated from a sorority at Florida International University. Arrangements were made to bring 44,000 pounds of baby formula and canned meat and 13,000 pounds of medicine. Many of Miami’s corporations, associations, and residents contributed to the Managuan Relief effort. Source: The Miami News, March 19, 1973 by Lynn Feigenbaum

Managua Relief

The Miami News. Mon., March 19, 1973. Managuan Relief. Miami News Staff Photo by George Kochaniec. Raymond and Connie Schultz with toys. (Back) "Focuses on kids" article On December 23, 12:29 a.m. local time in Managua, Nicaragua, a magnitude 6.2 earthquake occurred. The earth caused widespread damage among Managua, the capital city. In Managua, 5,000 residents were killed, 20,000 were injured and over 250,000 were left homeless. In Miami, residents and relief organizations focused on helping children. Wife of General Arturo Somoza pleaded on efforts on gathering sporting goods and toys for Managua’s young people. Relief committees purchased 230 dozen balls – basketball, rubber, and volley, soccer, and others. Nearly $500 came from students in Hialeah High School. Jump ropes and jacks were donated from a sorority at Florida International University. Arrangements were made to bring 44,000 pounds of baby formula and canned meat and 13,000 pounds of medicine. Many of Miami’s corporations, associations, and residents contributed to the Managuan Relief effort. Source: The Miami News, March 19, 1973 by Lynn Feigenbaum

Atlas sculpture at Rockefeller Center

General note: Title and date provided by Bettye Lane.

Artist Lora Pennington with her bronze metal sculpture of Georgia O'Keefe

General note: Title and date provided by Bettye Lane.

Relief de Kantor

S’inspirant de la réflexion élaborée par le critique Guy Scarpetta dans « Kantor au présent », un recueil d’essais tournant autour du travail de l’homme de théâtre, artiste et peintre disparu en 1990, l’auteur interroge la question de la mémoire et de la transmission d’un art théâtral lui-même entièrement voué au travail de deuil et au recyclage des matériaux historiques, autobiographiques et culturels, un art de la mise en scène si lié à son créateur qu’il était destiné dès sa conception à disparaître avec lui. Contre la fascination pour un passé réifié ou les emprunts ludiques de la postmodernité, l’oeuvre de Kantor appelle au contraire à une réinscription critique de la mémoire, héritage qui ne va pas sans questionner en retour fortement la responsabilité du témoin-spectateur, d’autant qu’il n’aura plus accès à la représentation de ces oeuvres théâtrales.

PENTAZOCINE VERSUS PENTAZOCINE WITH RECTAL DICLOFENAC FOR POSTOPERATIVE PAIN RELIEF AFTER CESAREAN SECTION- A DOUBLE BLIND RANDOMIZED PLACEBO CONTROLLED TRIAL IN A LOW RESOURCE AREA.

BACKGROUND: The unimodal approach of using pentazocine as post-cesarean section pain relief is inadequate, hence the need for a safer, easily available and more effective multimodal approach. AIM: To evaluate the effectiveness of rectal diclofenac combined with intramuscular pentazocine for postoperative pain following cesarean section. METHODS: In this double blind clinical trial, 130 pregnant women scheduled for cesarean section under spinal anesthesia were randomly assigned to two groups. Group A received 100mg diclofenac suppository and group B received placebo suppository immediately following surgery, 12 and 24h later. Both groups also received intramuscular pentazocine 30mg immediately following surgery and 6 hourly postoperatively in the first 24 h. Postoperative pain was assessed by visual analogue scale at end of surgery and 2, 12 and 24 h after surgery. Patient satisfaction scores were also assessed. RESULTS: One hundred and sixteen patients completed the study. Combining diclofenac and pentazocine had statistically significant reduction in pain intensity at 2, 12, and 24 hours postoperatively compared to pentazocine alone (p <0.05). No significant side effects were noted in both groups. The combined group also had significantly better patient satisfaction scores. CONCLUSION: The addition of diclofenac suppository to intramuscular pentazocine provides better pain relief after cesarean section and increased patient satisfaction.