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Influenza pandemica: situazione e sfide

"Il mio compito è di dirvi cose che non volete sentire, chiedervi di spendere denaro che non avete, per qualcosa che non credete accadrà."
Dr Ziad Abdeen, the Palestinian Health Authority

"For the first time in human history, we can prepare for a pandemic in advance of his arrival. E 'then the world community must now be devoted to action."
Dr Margaret Chan, Director - Communicable Diseases Section, WHO

"We do not know when a pandemic may come. However, two things are certain: anything that will first appear alarmist, and everything after that will seem insufficient. This is our dilemma, but it should not prevent us to prepare. We must reach everyone with words that inform and not fiery. We must encourage all to prepare and maybe not to panic. "
Michael Leavitt, U.S. Department of Health and Human Services, 2007

As you can imagine from these observations, some experts argue that a new influenza pandemic is inevitable. If this happens, the ' impact could be catastrophic as a whole, and most importantly, it is not easy to prepare medically, socially and economically for the event.
This essay deals with four sides of the issue: the medical and epidemiological prediction based on modeling and construction equipment; already social and economic impacts, and emergency planning.

medical aspects and epidemiological

Influence can occur in three forms. That is rather predictable seasonal and occurs mainly in winter. It can be transmitted from person to person, but most of the victims have some immunity. In addition, a vaccine is available and on the whole, the impact on society is less.
Avian Influenza (H5N1) broke out in East Asia in 2004-5. Its potential as a source of disaster is high because people have no natural immunity. Currently, a vaccine is not commercially available. However, it is likely that the virus passes from birds to humans.
Pandemic flu like 'A' is a new virus easily trasmissibilità tra gli esseri umani, i quali non dispongono di immunità naturale. Quindi, essa ha un'ottima propensione di provocare malattie gravi. Si divide in due tipi: Hemagglutinin (H) è composta di 16 sottotipi e agisce per attaccamento e penetrazione; Neuraminidase (NA) dispone di 9 sottotipi di 8 geni virali e cresce in assemblea per replicazione. E' bene notare che l'influenza pandemica non è uguale all'influenza stagionale, alla SARS o all'aviaria. Comunque, importanti lezioni vengono fornite da ciascuno di questi altri fenomeni.
L'influenza viene trasmessa per via respiratoria tramite gocce e aerosol prodotte quando una persona infetta parla, tossisce o starnutisce, o quando ella tocca una persona or an infected area, including contact between contaminated hands and your face.
Pandemics vary in severity, and then the U.S. Federal Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, authoritative institution epidemiological study, launched an index of severity of the pandemic, such as to help predict the severity and design mitigation strategies. The index is based on the case fatality ratio (the number of deaths per 100 cases of established disease) and five categories, as follows:
Case fatality ratio
Category 1: <0.1 ovvero 1 in 1000
Category 2: 0.1 - <0.5 ovvero 1 in 1000 - 1 in 200
Category 3 : 0.5 - <1.0 ovvero 1 in 200 - 1 in 100
Category 4: 1.0 - <2.0 ovvero 1 in 100 - 2 in 100
Category 5: 2.0 - or 2 in 100 + In addition, the preparation of scenarios
insists on a model of the stages of disease progression in society.

Period interpandemic
Step 1. No new influenza virus subtype has been found in humans, although one may be present in animals (but with low-risk persons).
Step 2. No new influenza virus subtype has been found in humans. However, a subtype of the virus circulating in animals and poses a substantial risk to humans.
Period of pandemic alert
Step 3. A new subtype is causing infections in people, but without significant diffusion. Step 4. transmission from one person to another is limited and localized: the virus is not well adapted to human umanil
Step 5. interpersonal transmission occurs more indicative of a better adaptation of the virus human host, without, however, full transferability (the phase indicates a substantial pandemic risk).
period of the pandemic
Step 6. It happens increased and sustained transmission of the disease in the general population.
post-pandemic period
You return to the inter-pandemic period, which therefore provides an opportunity to launch well-targeted mitigation strategies.

tools to combat the risk of pandemic flu are vaccines (which will probably not be generally available in the first wave), antivirals (probably of limited supply), interventions on transmission, infection control measures, and protocols of social isolation is of sick people than healthy ones.
There are four types of antiviral drugs, reported here with the common trade names of the product in parentheses: Amatadine (Symmetrel), rimantadine (Flumadine), Zanamivir (Relenza) and oseltamivir (better known as Tamiflu). If antivirals are taken within 48 hours of the beginning of the sick, they can help prevent clinical complications. However, questi farmaci potrebbero non funzionare contro un virus influenzale pandemico di tipo nuovamente evoluto. In ogni caso, la loro distribuzione dovrà avvenire secondo una certa priorità premeditata e, si spera, trasparente e eticamente giustificabile. All'inizio dell'ondata di influenza gli antivirali verranno usati, molto probabilmente, per cure, anziché per profilassi.
Un'altra linea di attacco e la riduzione dell'entità delle infezioni (cioè, gli interventi sulla trasmissione della malattia). Si tratta di incoraggiare tutta la popolazione a lavarsi le mani bene e spesso con sapone, di coprire la faccia in caso di tossi e starnuti, di non sputare e, quando occorre, di portare una mascherina sulla faccia.
Infine, isolation techniques can be divided into two: the quarantine infected people, and social distancing to uninfected persons, which, as far as possible, you should get rid of the company. In the latter tactic, it is increasing the space between people and decrease the frequency of social contacts, with targeted interventions, particularly on schools and workplaces.

Forecasting, modeling and scenarios

Worldwide, influenza pandemics are recurring such as to be inevitable. They are cyclic intervals (rather irregular) of 30-40 years. In the recent past, the ranges were as follows: 1847-89 (42 years), 1889-1918 (29 years), 1918-57 (39 years) and 1957-68 (11 years). It did not happen for an influenza pandemic for over 35 years and then it is assumed that one may be imminent.
As regards the consequences, the influence of so-called "English flu" of 1918 (H1N1, is, however, was born in China) has hit 25-30% of the world population became ill and 11% of these people are dead . The economic impact was profound: for example, U.S. GDP fell by 5%. The influence called "Hong Kong" in 1968 caused 34,000 deaths in East Asia and Canada. SARS in East Asia in 2003 caused 800 deaths and a fall in GDP in the region of 2%. Finally, the bird flu in East Asia in 2004-5, it has caused 112 people, of whom 57 died (52%).
Based on the analysis of these events, the forecast for the next time you indicate, globally, a mortality rate between 2.0 and 7.4 million people. The people will be hospitalized at least 135 million. World GDP will drop by $ 3 trillion. In the U.S. there will be a 15% increase in the demand for medical services, accompanied by a drop of 80% in demand for recreational facilities and 10% of demand for each kind of product.
A simulation developed for the catchment area of \u200b\u200bCareggi Hospital in Florence, using generally accepted parametric models, indicates a maximum of 5,600 hospitalizations and 1,240 deaths in a wave of influence of duration of 50 days.
generally outweigh the impact on the health system, it can be assumed that, despite the lack of health personnel, equipment and drugs and beds in medical centers, the demand for health services will exceed supply for several months. The vaccine will be available only between 6 and 8 months after the start of the crisis. Given the limited availability of care and the very high demand, most of the wards will be spent at home. The conceivable scenario
medical / health event indicates that in all probability the production and distribution of vaccines will have priority over other health insurance. In addition, to ensure an ongoing and increasingly to the task, some Private services will be controlled or nationalized by the government.
E 'Remember that you may experience, not a single pandemic, but a series of waves of illness of the total length to about two years. The impacts can be divided into those immediately (days to weeks) and long-term (weeks to months). Apart from the purely medical impact, there would be a long line of other effects, as described in the next section.

social and economic impact

In summary, the impacts of pandemic influenza can be divided between those medical and health, socio-economic and psychological ones about politics, the governance and public administration, and those on the world of commerce and business.
The preparation can not eliminate all elements of uncertainty, unpredictability, fear of the future, sense of loss, psychological trauma, bereavement, disruption of society and need to make difficult decisions. In fact, some experts argue that the psychosocial impact can be much larger than the physical. Given the high probability of becoming ill and even die, the psychological effects that could not be more profound. The fear is mixed with the decline in confidence in the ability of authorities to solve problems and bring security to the company.
The scenario is that individuals and families will devote themselves to amassing food, drugs and money. The closest social relationships will be enhanced, such as between relatives, but less important ones will be neglected. As far as the closest ever, there will be a falling birth rate that will last throughout the period of the pandemic and beyond. At the same time, respect the community, will be the cancellation of many mass meetings, accompanied by a dispersal of population away from urban centers, a phenomenon that recalls Boccaccio's Decameron and the shadow of the plague in medieval times. Under these circumstances it will be difficult to solve the problem of how to provide services to groups of people particularly vulnerable as the handicapped and the elderly.
Services basic (such as water, electricity and gas, telecommunications, procurement of food and fuel, waste collection) will be plagued by absenteeism and frequent interruptions. In addition, people who continue to work could be carriers of infection and speakers. To avoid this, schools and universities, for example, would be closed for long periods, giving students the problems of continuity of the study. Because of absenteeism and coupler of the general trade, all the major distributions will be declined.
Due to the vast expansion occurred in the international dependency, globalization will increase the risk of transmission is that the effects of the pandemic. To restrict migration carrier pandemic, borders, airports and stations will be closed to the public for long periods.
about products and services, absenteeism will be accompanied by a drop in productivity that will result in, among other things, a lack of inventory in factories and the disruption of supply chains. Consequently, there will be a reduction in the quality and availability of products, and then a food rationing and various other essential products.
As in industry, agriculture will be a decrease in the production and distribution of its products. If the transmission of the disease affects animals, there will be a great slaughter of chickens, and perhaps other types of livestock. Come risultato di tutto questo, si verificheranno grandissimi aumenti nel costo dei prodotti alimentari.
Insieme al calo nella produzione, per motivi sanitari, economici e sociali, ci sarà un calo della domanda per prodotti e servizi. Questo è stato stimato dell'entità di 10% in genere e fino all'80% per servizi come il turismo, l'aviazione e la ristorazione. In compenso, ci sarà un massiccio aumento della domanda per pubblica sicurezza, servizi di evacuazione, e assistenza medica con associati servizi di trasporto.
Per quanto riguarda il governance , ci sarà una riduzione del numero di riunioni amministrative e politiche, con appositi rallentamenti dei processi decisionali. Contemporaneamente ci saranno increases in demand for law and security, with equally large increases in public expenditure on health, safety, welfare and support of business, countered by strong lowering spending on functions not directly involved in the crisis.
In the financial sector, is expected to lower tax revenue decline for the economy. With high demand for liquidity, expects a significant increase in the supply of money and a marked decrease in the value of its currency. The circulation of money will be lowered, as will the value of the shares and thus stock prices.
The crisis will be marked by massive increases in insurance payments accompanied by the failure of some insurance companies. Major health problems will occur in prisons and there will be a decrease in the activity of courts and legal services, then the efficiency of the justice system. Finally, in the field of information, for fear of contamination is the most read newspaper and magazine paper, which will be replaced by electronic means. However, the public will remain intensely interested in news, although given the expected decline in the production and circulation of newspapers of all kinds will be difficult to maintain quality and accuracy of journalism.

Emergency preparedness

The problem of the pandemic is considered so serious and urgent that in parts of northern Europe, the planners are devoting up to three quarters of their business to prepare for such an event. Contingency planning should consider some specific aspects, such as:
- the massive increase in demand for healthcare products and services
- the need for ethics and transparency of decisions
- the public reaction to risk, and the event authorities' response
- education, training and information on the crisis for all sectors of society
- the closure of schools, businesses, shops and public places
- the lack of communication, electricity, gas, water, waste disposal waste, telephone service, distribution fuel production and distribution of food
- security and public order
- and the imposition of quarantine restrictions on the movement of the population
- how to communicate with the public and the media.
The objectives that a planner who is interested in this field must keep in mind there are four: how to limit the number of sick and dead, how to maintain the continuity of basic services, how to minimize the disruption of society and the economic losses, and how enhance the appropriate health services.
strategies can be summarized in so-called "three 'P': people, plans, products and practices. Pandemic contingency plans are needed at all levels of government and in other places such as factories, universities and offices. E 'need to create an integrated monitoring and control healthcare. We must develop a capacity to give effective and decisive action, distinguished by transparency and good communication and the extensive involvement of all sectors of the public.

Conclusions

While the likelihood of being faced with a pandemic may seem very remote to many emergency planners, it is not so unlikely. If this happens as described in this article, the consequences could be very deep and the whole "landscape of risk ', and therefore the view of civil protection, would suffer a change net in no time. The priorities would be sharply rearrangement.
will blow out some hot issues related to ethics of the choices made, and the availability and cost of remedies to the problems occurred. In this context, public health is a "power of public policy", or police. In this form, it could infringe the freedom of the individual, but at the same time you must defend the rights of the few efforts were made to protect the safety of all. Choices are difficult but you should start studying now, in "peacetime", instead of having to deal with it for the first time the height of the crisis.

Thanks
I thank Prof. Ziad Abdeen
of Al Quds University, Palestine, and Dr.. William Hancock of Texas A & M University for their valuable notes, on which this essay is based.

Twilight Digital Copy

Italia happy-go-lucky, ovvero la futura strage degli innocenti

I learn from the news today, October 20, 2008, the Italian Government, through the law 'Gelmini' (DL137 conversion of 09/01/2008) recently approved, has allocated the sum of € 20 million for structural measures on schools in the Bel Paese. Great!

In Italy there are 57,000 schools, 42,000 public school system. 70% of the population lives in seismically active zones, and 40% in areas at high risk from earthquakes. A third of schools are at risk of earthquakes and at least one third of these are at high risk. A total of 22,800 schools are not in accordance with seismic. Of 6,000 schools that are most in need of structural earthquake-resistant, were selected from 2,000 high priority - but where are the funds?

In Italy, the last earthquake with an epicenter in the immediate vicinity of a large urban center was to Avezzano back in 1915. Died 90% of the population of 11,000 inhabitants. It 'good to remember that the average interval between an earthquake damaging (or lethal) and the next is less than 60 months. And not only occur in open country.

Worldwide, there are different earthquakes nei tempi recenti che hanno distrutto le scuole en masse . Ad esempio, 103 scuole sono crollate interamente e 2813 sono state gravemente danneggiate nel terremoto di Boumerdes in Algeria, 2003. Nel terremoto di Kashmir, nel 2005, 10.000 scuole sono crollate, ammazzando 17.000 bambini (dati incredibili, ma confermati dall'ONU e dall'OMS). Nell'evento sismico in Sichuan, Cina, maggio 2008, centinai di scuole sono diventate macerie, e in un sol complesso scolastico ben 500 ragazzi sono morti.

Alcuni anni fa sono andato a visitare una scuola, elementare e media insieme, in una zona montuosa dell'Italia centrale. L'edificio, in cemento armato anni 1950, era tremendamente fatiscente. La zona è in attesa di uno sostanzioso deadly earthquake. In 50 years had never practiced an evacuation of the school, and, judging from the cracked and rusty, even an intervention of structural adjustment. A local policeman told me, with evident satisfaction, that the structure was perfectly earthquake, based on what evidence I do not know.

Twenty million euro are probably sufficient to bring between 10 and 20 schools out of 6,000. The consequences of inaction could be like in San Giuliano di Puglia in 2002, but a much larger scale.

I feel a deep sense of fatigue, as a parent who has struggled against the bad education of her son throughout the day. Sooner or later it will be another major seismic event. If it happens when schools are not in use, will be a problem to find classrooms in post-emergency phase. If, however, happens when students are in school ... Potentially, expect a massacre of the innocents, followed by a period of agonizing moans, cries tearing, anger, accusations, cancellations, those defense, who resigned (after a decent interval, to reappear as if nothing had happened), etc.. Etc. . etc. So I'm tired.

Moreover, it is better that there be a national debate on these things. In certain areas of the peninsula, the level of fear and stress should be the stars. Better, perhaps, to put faith in a figure in robe, sitting on a cloud, extending the arms Heaven protects and who goes to school with his piety. [1] Or we can take refuge in the world smiles and songs of television.

If the National Government does not allocate funds (and I do not think that regions are able to do so), maybe you could have recourse to the four mafias? If it is true, as they say the media, which have a much greater turnover of large multinational domestic industry, would be easily able to do something. And when the mafia lords are not killing people, are known for their piety.

To have recourse to irony in this way means that I have been overwhelmed by anger and frustration. But it seems to me, in front of this carelessness, the school has taught (For young people, parents and older) only amnesia.

Postscript, NOVEMBER 25. 2008: The collapse of a ceiling to a school in Rivoli, near Turin, has killed a 17 year old boy and seriously injured some of his classmates. Apparently 7.5% of the funds needed for the adjustment of public schools (maybe not only concerns the seismic) are available, though the figure would be 12.5% \u200b\u200bif it were not for the bureaucracy associated with the delivery of funds . As in the case of San Giuliano di Puglia, only the death of the boys stimulates the arrival of the funds (with low winds), and attention to the problem. Meanwhile, reports from all parts of Italy published its The Republic Corriere della Sera and indicate a widespread lack of emergency planning, structural adjustment and interest by the authorities. This is a massive violation of the right of the child (or girl) to an education in safety, as outlined by the Coalition for Global School Safety, COGSS.

[1] A problem of the immediate result of Italian earthquakes, especially in the South, is that people unharmed runs to church to pray, while the churches are among the buildings under earthquake resistance. In a seismic event in eastern Sicily in the '90s, the villagers ran to the statue of the Madonna in the church. The building has barely survived the aftershocks, la la statua e l'altare sono crollati sui fedeli raggruppati sotto.

Articoli da leggere:-

Augenti, N, E. Cosenza, M. Dolce, G. Manfredi, A. Masi and L. Samela 2004. Performance of school buildings during the 2002 Molise, Italy, earthquake. Earthquake Spectra 20(S1): S257-S270.

Grant, D.N., J.J. Bommer, R. Pinho, G.M. Calvi, A. Goretti and F. Meroni 2007. A prioritization scheme for seismic intervention in school buildings in Italy. Earthquake Spectra 23(2): 291-314.

Sito da visitare:-

Coalition for Global School Safety, www.interragate.info/cogss

I Like Touching My Moms Boobs

Il ruolo della formazione nella gestione delle emergenze


Fig 1. Forms of planning for relief operations.

Figure 2. A training course in civil defense.

The management of rescue operations following disasters, crises and emergencies is a relatively new field, but, nevertheless, may draw on a tradition of study and research which dates originally from the year 1920 (Prince 1920, Barrows 1923) and that is strong and supported from 1950 onwards. While the field is sometimes included in the science programs of management, in reality it is a discipline in itself, fondata su diverse basi. I suoi obiettivi fondamentali sono quattro (Waugh e Tierney 2007):

- in situazioni di crisi, abbinare le risorse a disposizione con il fabbisogno urgente;

- permettere diversi enti ed organizzazioni di lavorare insieme in modo efficace sotto condizioni difficili e probabilmente insolite;

- comunicare con unità operative e centri operativi in modo tale da mantenere il livello di comando e controllo delle situazioni di crisi;

- applicare i provvedimenti del piano di emergenza, insieme a rilevanti protocolli operativi e patti di assistenza mutua, secondo le esigenze del disastro.

Questi processi richiedono una conoscenza di come lavorano le diverse organizzazioni and various specialists in the rescue. Therefore, the management of emergencies (emergency management ) is a cross-discipline (Phillips 2005), which must develop a language and a culture shared by at least 35 professions and disciplines involved in one way or another, in the 'disaster cycle' (mitigation, preparedness, response, recovery and reconstruction). The complex process of coordinating emergency work requires the ability to understand and work with representatives of various disciplines, in fact, to "speak their language in order to understand their views and help them cope with the emergency effectively (Alexander 2002).

La gestione delle emergenze è una disciplina olistica, concreta e dedicata alla soluzione di problemi pratici (McEntire 2003). Essa è fortemente legata alla pianificazione d'emergenza, alla gestione della continuità degli affari aziendali (business continuity management, BCM; Elliott et alii 2001), alla risposta medica all'emergenza ed ad altri campi di natura altamente pratica. Gli imperativi sono di salvare le vite umane, aiutare a coordinare il soccorso delle vittime, contenere e ridurre i danni, e assicurare un rapido ritorno ad accettabili condizioni normali.

Nel mondo moderno, ci sono numerose associazioni alle quali i coordinatori di emergenza possono aderire. L'Istituto di Protezione Civile e Gestione delle Emergenze (ICPEM, already Institute of Civil Defense and Disaster Studio) was founded in the United Kingdom in 1937 and is a company filled with academic titles, the oldest in the world. The UK Emergency Planning Society (EPS) has 3000 members, while the International Society of Emergency Coordinators (IAEM) has 4500. The latter offers a professional qualification of global validity, the examination for Certified Emergency Manager (CEM). Throughout the world, IAEM vigorously promotes eight principles of emergency management (see Table 1). From these it is clear that emergency management requires skills such as leadership, the ability to coordinate, plus a strong knowledge of emergency (Haddow and Bullock 2003).

Worldwide, there are at least 400 books on the market (in English) relevant to emergency management. Since 1950 in this field and related subjects at least 19,000 books and scholarly articles have been published, also in English and worldwide. When teaching emergency management, it is important to use the fruits of research (Coppola 2008) and combine theory with experience derived from managing the events of the past (Alexander 2000). Both of these aspects are essential. The theory provides a kind of "road map" of the chaotic emergency situations (Drabek 2006). Using the theoretical concepts as a guide, the people trained in this field should understand highly complex processes. Included in the list command and control, evacuation, vulnerability analysis (social, economic and physical), communication (again with physical and social components), notice, search and rescue, and medical and health response to emergencies.

An emergency coordinator must be able to create, disseminate, maintain, enforce and update contingency plans for three types (Fig. 1). First there is the permanent plan that has the resources in a crisis. This requires the formulation (with great precision) of scenarios depicting the impact and dynamic response, the study of the available resources and procedures to be applied. Secondly, there contingency planning will be the pre-impact and then, thirdly, the short-term strategic planning to make during the emergency phase. The plans of all types must be compatible with different levels of government, different areas and jurisdictions, and emergency services. There is also an international dimension that includes the European Union and the Organization of the United Nations, for example in respect of the International Strategy for Disaster Reduction (UN-ISDR) and the Office for the Coordination of Humanitarian Affairs (OCHA). The work of coordination of emergency response can be local, inter-regional (in the case of national emergency) or European (in the case of an event affects more than one country or that it be so great as to require the input of resources from abroad). It may be of interest to developing countries, as in the case of humanitarian missions. In any case, for planning and managing these contingencies standardized methods exist and should be taught (ISDR 2005).

In terms of threats and scenarios, the modern emergency coordinator must understand and respond to a wide range of risks and events. Natural disasters such as floods and earthquakes are a category. Technological risks such as collisions and transport toxic rain is another. A third is made up of social risks such as rallies and mass protests, and the fourth category is the risk of intentional acts, terrorism, which also includes the collection of intelligence and military intervention and civil defense. In addition there are emerging risks (Schieb 2006). Of these pandemics are generally considered the most pressing, followed by the effects of climate change and the disruption of basic services, or impairment of the food chain. Based on these risks, the landscape of civil protection could change radically in just a few months, so flexibility is a vital quality to teach the coordinator of emergency operations (see table 1).

the coordination of emergency is a revolution taking place di tecnologia di comunicazione ed informazione. Questa ha avuto effetti profondi sulla risposta a disastri e crisi (Marincioni 2007). Quindi, è importante insegnare sia gli aspetti tecnici che il lato umano della comunicazione, compresa l'apposita ricerca in sociologia, psicologia e percezione. Dato che circa l'80% della pianificazione di emergenza costituisca un problema geografico e territoriale, i sistemi di informazione georeferenziata (GIS) sono un arnese essenziale (Dubois et alii 2006). Questi servizi ed attività saranno probabilmente concentrati nel centro operativo e il coordinatore di emergenza deve acquisire una piena conoscenza del suo potenziale e delle sue funzioni.

Recentemente è successa un'enorme crescita nella gestione continuity of business enterprise (BCM - see above). This new framework has been applied to both the public and the private economy. Its main objective is to make companies and governments resistant to disasters and crises, and enable it to overcome the hardships without going bankrupt, which is a very strong risk for companies not prepared. For the public sector in times of disaster is to prevent substantial disruptions to their services. In promoting preparations, the emergency coordinator plays a key role (Halliwell 2008).

In summary, the emergency coordinator must help to create resilience. This term comes from the rheology, the science materials, and is rapidly becoming a distinct philosophy of the organization against threats, risks, crises and disasters (Batabyal 1998). In creating resilience, the challenge is to ensure the professionalization of emergency coordinators through the rigorous application of training and the creation of recognized and respected. It 'also important to ensure that the work of emergency management in the hands of well trained professionals, in other words there is an institutional role for graduates in this field. Great progress is made in some countries, notably the United Kingdom, the United States, Canada, Australia, New Zealand, Sweden and India (Berkes 2007). It 'important that Italy will not be left back.

If education is the engine of the professionalization of the role of coordinator of emergency, which is the best way to organize it? Despite the attractions of the basic degree course in civil defense, a clear consensus that the best solution is that of higher degree. A basic degree in another field (sociology, architecture, engineering, geology, psychology or any discipline pertaining to the work of disaster reduction) can serve as a preparation on which to lay deep and solid work experience and training in civil protection transverse (ie, interdisciplinary), offered as a degree of specialization (Fig. 2). In the latter, the student, studies already mature, learning to coordinate, manage, and interviews with various specialists in order to create the 'common culture' in the civil protection has strong need (Neal 2000). The product of a process like this should be someone with flexibility and adaptability, two qualities are essential in emergency situations and risk.

Citations

Alexander, DE 2000. Scenario methodology for teaching Principles of Emergency Management. Disaster Prevention and Management 9 (2): 89-97.

Alexander, DE 2002. Principles of Emergency Planning and Management . Terra Publishing, Harpenden, UK; Oxford University Press, New York, 340 pp.

Barrows, H.H. 1923. Geography as human ecology. Annals of the Association of American Geographers 13: 1-14.

Batabyal, A.A. 1998. The concept of resilience: retrospect and prospect. Environment and Development Economics 3(2): 235-239.

Berkes, F. 2007. Understanding uncertainty and reducing vulnerability: lessons from resilience thinking. Natural Hazards 41(2): 283-295.

Coppola , D.P. 2008. The importance of international disaster management studies in the field of emergency management. In Emergency Management in Higher Education: Current Practices and Conversations . Public Entity Research Institute, Fairfax, Virginia (Capitolo 5).

Drabek, T.E. 2006. Social Dimensions of Disaster: a teaching resource for university faculty. Journal of Emergency Management 4(5): 39-46.

Dubois, G., E.J. Pebesma e P. Bossew 2006. Automatic mapping in emergency: a geostatistical perspective. International Journal of Emergency Management 4(3): 455-467.

Elliott, D., E. Swartz e B. Herbane (curatori) 2001. Business Continuity Management: A Crisis Management Approach . Routledge, Londra, 206 pp.

Haddow, G.D. e J.A. Bullock. 2003. Introduction to Emergency Management . Butterworth-Heinemann, Londra, 272 pp.

Halliwell, P. 2008. How to distinguish between 'business as usual' and 'significant business disruptions' and plan accordingly. Journal of Business Continuity and Emergency Planning 2(2): 118-127.

ISDR Secretariat 2005. Know Risk . Tudor Rose, Londra, 376 pp.

Marincioni, F. 2007. Information technologies and the sharing of disaster knowledge: the critical role of professional culture. Disasters 31(4): 459-476.

McEntire, D.A. 2003. Searching for a holistic paradigm and policy guide: a proposal for the future of emergency management. International Journal of Emergency Management 1(3): 298-308.

Neal, D.M. 2000. Developing degree programs in disaster management: some reflections and observations. International Journal of Mass Emergencies and Disasters 18(3): 417-438.

Phillips, B.D. 2005. Disaster as a discipline. International Journal of Mass Emergencies and Disasters 23(1): 111-140.

Prince, S. 1920. Catastrophe and Social Change: Based Upon a Sociological Study of the Halifax Disaster . Studies in History, Economics and Public Law no. 94. Colombia University Press, New York, 151 pp.

Schieb, P-A. 2006. Emerging risks and risk management policies in selected OECD countries. In W.J. Ammann, S. Dannenmann e L. Vulliet (curatori) Risk 21: Coping with Risks Due to Natural Hazards in the 21st Century . A.A. Balkema, Taylor &amp; Francis, Londra: 31-40.

Waugh, W.L. Jr e K. Tierney 2007. Emergency Management: Principles and Practice for Local Government (2a edizione). ICMA Press, International City Management Association, Washington, D.C., 366 pp.

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Tabella n. 1. I principi IAEM della gestione dell'emergenza

1. Comprensiva : per quanto riguarda i disastri, i coordinatori di emergenza dovrebbero prendere in considerazione tutti i rischi, tutte le fasi, tutti gli impatti e tutti gli interessati.

2. Progressive: emergency coordinators should anticipate future disasters and take preventive and preparatory measures to create disaster-resistant and resilient communities.

3. Risk Management: to coordinate the priorities and resources, emergency coordinators should use the principles of good risk management, based on the identification of hazards and an analysis of risks and impacts.

4. Integrated: emergency coordinators should ensure a degree of unity among all levels of government and all elements of the community.

5. Collaborative : coordinators emergenza dovrebbero creare e mantenere rapporti larghi e sinceri tra persone ed organizzazioni atti ad incoraggiare fiducia, promuovere un'atmosfera da squadra, creare consenso e facilitare comunicazione.

6. Coordinata : per arrivare ad obiettivi comuni, i coordinatori di emergenza dovrebbero sincronizzare le attività di tutti gli interessati.

7. Flessibile : quando si tratta di affrontare la sfida dei disastri, i coordinatori di emergenza dovrebbero utilizzare approcci creativi e innovativi.

8. Professionale : i coordinatori di emergenza dovrebbero utilizzare un approccio basato su principi scientifici, radicati nella conoscenza accademica della materia, con ampio riferimento alla formazione, l'addestramento, l'etica, il servizio pubblico e il costante miglioramento.

NB: Questo principi costituiscono la base della definizione del profilo professionale del coordinatore di emergenza, come utilizzato nell'esame del CEM – Certified Emergency Manager .
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Rapid Heart Beat, Left Arm Numbness

L'esercito sulle strade delle città italiane

Lo spiegamento delle truppe sulle strade delle principali città italiane nell'estate del 2008 ha sollecitato molti commenti dal resto del mondo. In realtà non è una mossa particolarmente insolita. La stessa cosa è successa in India e Cina contemporaneamente. Moreover, the army has been used in several Italian crisis, most recently in early 2008 to remove the rubbish from the streets of Campania. Foreign commentators have asked, in various ways, whether the appearance of armed troops on the streets of Rome and Milan mean the return of fascism, or rather want to know if it's just a sign of the inability of the Italian police forces to fight a ' wave of criminal activity. Finally, ask whether, given the government's concern with the issue of immigrants in Italy, the presence of troops is a sign of xenophobia. This last question is favored by the various pronouncements of the center-right government than the presence of foreigners, which, in spite of the statistics, water, the fear of strangers expressed by some citizens.

consider the role of troops in the streets of Italian cities and try to derive some lessons of general application without reference to particular country. First, there is a wave of criminal activity on the streets of Italy, which remain safe at par with the best urban environments in other parts of Europe. In any case, the emergency services and civil protection are not necessarily completely demilitarized. The police have a police force and a branch of the army, with full military organization. In different parts of Italy they are guardians of public order more visible police force, though no longer visible in the ubiquitous urban police. Second, the State Police and the National Corps of Firemen depend on the Ministry of the Interior, a fact that makes them the central Italian Army. The third consideration is that, as in many other countries, fire brigades are organized on a paramilitary base on the grounds of professionalism, discipline and efficiency at work. In some parts of Italy even hunters are organized on a military features, although the objective is to acquire the raw material of hams, sausages and steaks of wild boar. In other words, there is reason to be especially anxious because of the military organization.

Nevertheless, I have written repeatedly in the past [1] that the measure of the evolution of a civil protection system remains in its degree of demilitarization. In a well-developed service, lack of military organization makes it free from authoritarianism, with a flexible and responsive to the needs for security of the civilian population.

In contrast, civil defense is virtually reborn in 2000, the new age of international terrorism. Paradoxically, after the attacks of 11 September 2001, the decentralization of the response to the crisis has been sharply reversed. In many countries, the central state have launched renewed forms costly, ambitious and often draconian defense civile sotto il titolo di "homeland security" (e in un certo senso è bene che non ci sia una facile traduzione del termine in italiano) o qualsiasi sia il termine di applicazione locale. I "guerrieri freddi" sono tornati in trionfo, contenti di avere un bersaglio, un nemico di nuovo nella personificazione del male, Osama Bin-Laden (il quale, naturalmente, è in gran parte una creazione delle paure e degli interessi dell'Occidente e non è esattamente ben messo per fungere come il nonno del terrorismo moderno come viene caratteristicamente dipinto dai media).

Quando, pochi anni fa, soldati e carri armati sono stati inviati a presiedere sull'Aeroporto di Heathrow a Londra fu detto che l' intelligence militare had identified a specific threat. Maybe, but it was clear that the military forces on the ground would not have prevented the killing of a civilian plane with a missile fired from a house in the districts of West London. Instead, the functions of the troops were tied to their encrypted communications and the visible presence, considered reassuring, armed men in uniform. In any case, it was left to the intelligence services to gather intelligence and police to shadow the infrastructure of terrorism and its lines of command. About

troops on the streets, you have to worry about the cities of the world where they are for years, a permanent presence - or Yangon Harare, perhaps - and what they do when montano le pattuglie. In una società democratica, il personale dell'esercito può fare ben poco per ridurre l'incidenza dell'attività criminale, soprattutto se manca il potere dell'arresto dei sospettati. Tranquilli ambienti urbani non possono essere trattati come se fossero campi di battaglia, oppure ci sarebbero costanti violazioni di diritti civili ed umani. Inoltre, le truppe non sono state formate e addestrate nella prevenzione dei crimini in aree urbane. Le loro uniche doti sono il fattore dell'intimidazione e le armi che sarebbero malavvisati ad usare in qualsiasi circostanza che non fosse una vera e propria emergenza.

Una tregua infelice e non dichiarata esiste tra protezione civile e difesa civile. La prima ha radici locali, è decentrata e esiste con lo scopo di affrontare tanti tipi di contingenza, da caimani nei torrenti a terremoti all'influsso dei pellegrini per il funerale del Santo Padre. Il secondo è controllato dal governo centrale e esiste per proteggere la popolazione civile (oppure i sui rappresentanti ) contro attacco armato. I due sistemi non sono necessariamente distinti, l'uno dall'altro, dai loro nomi, ne ugualmente sviluppati. In Italia, la protezione civile è un fenomeno altamente visibile con basi dovunque nella nazione e migliaia di volontari vestiti in divise colorate. La difesa civile è un servizio molto più riservato, e le suo funzioni vengono discusse molto poco, tranne in prefettura, forse.

La tendenza nella rivalry between defense and civil protection is inherent in the policy of subsidiarity and centrism. The Italian government has put troops on the street is very busy with the subsidiarity, since half of the Council of Ministers talk constantly leave the provincial boundaries by the interference of Rome. However, in this there is an element of deception. Politicians who work at the center in a national government are not particularly inclined to give local government the power to ease, at least so they can not preside over a substantial network decentralization and regionalization of power. So the deployment of troops, solid evidence of the central power.

In operational terms, the deployment of soldiers to stand guard over the strategically important sites is of little importance. It 's very likely not have the necessary education and training in the tactics of counter-urban terrorism, and are not equipped with the appropriate access to intelligence. E 'instead of a visible indication of a more profound and complex linked to the inner workings of government, indeed, the governance. Once, I was part of the mechanism explained by a high-level policy on the table in a restaurant in Lombardy, but I fear it is a bundle of relationships too complex to be understood by as my feeble intellect. In any case, the march of events (SARS, avian flu, earthquakes, chissache?) will change the process and determine, as they do political alliances, what is the possible balance between defense and civil protection. The only certainty is that, with regard to crisis management, the politicians keep a preference for populist decisions, and then are attached to short-termism. At worst, the results are seen in spontaneous reactions to events and ill-considered, as is the deployment of troops on the streets, while at best I am afraid that this is a span of attention to the problem of emergency that remains limited and sporadic.



Note [1] Alexander, D. 2002. From civil defense to civil protection - and back again. Disaster Prevention and Management 11 (3): 209-213.