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Status–authority asymmetry in the workplace emerges when lower-status professionals are ascribed with the functional authority to oversee higher-status professionals and elicit compliance from them on specific processes or tasks. Eliciting such compliance is ridden with challenges. How and when can lower-status professionals with functional authority elicit compliance from higher-status professionals? To examine this question, I conducted a 24-month ethnography of 911 emergency coordination to understand how 911 dispatchers (lower-status professionals with functional authority) can elicit compliance from police officers (higher-status professionals). I identify a set of relational styles—entailing interactional practices and communication media—enacted by the dispatchers. My findings suggest that dispatchers whose relational styles involved customizing the workflow via private communications with police officers or privately escalating cases of officers' noncompliance to supervisors did not elicit greater compliance. In contrast, dispatchers who did elicit compliance used a peer publicizing relational style: they shared news of the noncompliant behavior—generally in a bantering, humorous manner—with an officer's immediate peers using a communication medium that all officers in the police unit could hear. Publicizing noncompliant behavior among the immediate peers triggered the officer to self-discipline, as that noncompliant officer's trustworthiness was on the line in front of the peer group. More generally, through enrolling an alter's peers in the compliance process, the lower-status professionals with functional authority could generate second-degree influence and elicit compliance from the higher-status professionals. [ABSTRACT FROM AUTHOR]

Emergency communication operators (ECOs) are routinely exposed to duty-related trauma and tasked with obtaining pertinent information to identify the nature of the emergency, allocate necessary resources and provide critical details to those responding to the crisis. Stress associated with responding to a difficult call places ECOs at an increased risk for mental health problems. This paper presents results of the National Wellness Survey for Public Safety Personnel, concerning the impact of occupational stressors ECOs experience. Findings indicate high prevalence rates of occupational and personal stressors, as well as diagnostic impressions of ECOs. The findings revealed that more than one-third of ECOs are experiencing clinically significant levels of anxiety, depression, and PTSD. Consistent with research, ECOs endorsed being negatively affected by their job, yet were reluctant to seek help. Implications of the findings for assisting ECOs in alleviating stress are considered. Suggestions for future directions in this area are offered. [ABSTRACT FROM AUTHOR]

Despite the crucial role they play in keeping our communities safe, 9-1-1 dispatchers (formally known as public safety telecommunicators) lack the same legal classification as police officers, firefighters, and other public safety professionals. Although public safety telecommunicators are the first point of contact for individuals in crisis, the United States Office of Management and Budget officially classifies them as clerical workers--the same category as secretaries and office clerks--instead of public safety professionals. As the first public safety telecommunicator to serve in Congress, I know firsthand the challenges telecommunicators face and the importance of recognizing their selfless commitment to protecting our communities. I have introduced bipartisan legislation, the "9-1-1 SAVES Act," to officially reclassify public safety telecommunicators as public safety professionals and bring the profession one step closer to the respect, resources, and support it deserves. In this essay, I discuss the evolution of the public safety telecommunicator profession, the challenges telecommunicators face, and the road to occupational reclassification. Finally, I draw from data, my own lived experience, and the experiences of current public safety telecommunicators to make the case for reclassification as an avenue toward strengthening our public safety system by building and retaining a more robust telecommunicator workforce. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to investigate the relationship between alexithymia, two types of ruminations (intrusive and deliberate) and post-traumatic stress disorder (PTSD) symptoms for two groups of emergency workers working in Poland: paramedics and emergency call centre operators. Material and methods: The research project was conducted the Wielkopolskie voivodship in Poland. The participants were paramedics (n = 72; 54 men, 18 women) and dispatchers (n = 66; 35 men, 31 women). The following Polish versions of standardized tools were used: the Impact of Event Scale-Revised (IES-R), Toronto Alexithymia Scale-20 (TAS-20), and the Event Related Rumination Inventory (ERRI). Results: Analysis of the correlation with Spearman's test demonstrated a statistically significant relationship in both groups between the symptoms of PTSD and ruminations and alexithymia and intrusive ruminations. The correlation between intrusive ruminations and PTSD was stronger for the paramedic group. Also, in the paramedic group, ruminations acted as a mediator for the relation of alexithymia and the intensity of post-traumatic stress. Conclusions: The results of the study provide some evidence that paramedics present more PTSD symptoms than emergency call centre operators. The important individual features which increase PTSD are emotional-cognitive aspects of mental processing: ruminations and alexithymia. The paramedics' direct participation in traumatic events is more overloading for them than the indirect participation in traumatic events for dispatchers. [ABSTRACT FROM AUTHOR]

In the conditions of effective training in aviation for dispatchers and pilots, it requires the use of infocommunication systems capable of working under conditions of fuzzy uncertainty in real time. The functioning of such systems is based on fuzzy inference systems. However, the development and implementation of these systems requires the creation of fuzzy knowledge bases. Therefore, special attention in this study is paid to the creation of a system of fuzzy inferences and the formation of a fuzzy knowledge base of this system. The result is a lozenge-type fuzzy inference system. The fuzzy knowledge base of the system contains the rules according to which, based on the results of test computer game problems of varying complexity, a conclusion is formed about the applicant's ability to acquire knowledge and skills in a certain specialty. When developing the rules, both the results of passing different levels of professionally oriented computer test games were taken into account, and the interest of dispatchers and pilots was taken into account. Therefore, the proposed fuzzy rules of the knowledge base of the fuzzy inference system make it possible to assess not only the ability of the controller or pilot to solve certain problems. This dependence of the input dataset on time allows the implementation of a fuzzy inference system of the Sugeno type, using clear input data in the formation of inferences. [ABSTRACT FROM AUTHOR]

Psychological First Aid (PFA) is a promising early intervention for managing mental health symptoms and providing psychosocial support after exposure to a traumatic event (TE) among high-risk organizations such as Emergency Medical Service (EMS). However, recipients' experience with PFA remains understudied. This study aimed to explore the perception of EMS workers (n = 13) who received PFA administered by a peer helper using a qualitative inductive approach. Findings from a thematic analysis indicated that the PFA intervention addresses EMS workers' immediate needs in congruence with Hobfoll's five essential principles to enhance coping and recovery after a TE. Specific components of the intervention, such as its time-sensitive nature and the closeness with peers, were especially appreciated by EMS workers. The PFA intervention appeared to have a beneficial impact on recipients, regarding the reduction of stigma, the increase of help-seeking behaviors, and the decrease of organizational difficulties. In conclusion, the PFA intervention offered by peer helpers is appreciated by recipients and is a beneficial first step toward supporting EMS workers in the aftermath of workplace trauma. These qualitative findings contribute to the current literature by informing further research about PFA intervention in other high-risk organizations and quantitative studies aiming to test PFA's efficacy in such settings. [ABSTRACT FROM AUTHOR]

Callers making an emergency phone call can exhibit emotional displays about a current situation characterized by different forms of conduct such as shouting, howling each spoken word, speech distortion, crying, pleas for help, expressions such as "Oh God" (Whalen and Zimmerman, 1998). Since emotional outbursts can derail the call's progress, emotional callers are considered 'non-compliant' with the primary task, and dispatchers face practical challenges with caller management. Findings show how using a modal verb format can redirect callers to focus on a patient's care. Using conversation analysis, this article illustrates dispatchers' methods for redirecting an emotional caller's attention to complete a task, which works to calm callers and sustain their attention for the call's duration. • Dispatchers manage caller's emotions by redesigning protocol questions using a modal verb format. • Patient-focused directives work to calm callers and enlist their cooperation. • The analysis contributes to conversation analysis's theoretical foundation by expanding work on action design. [ABSTRACT FROM AUTHOR]

Objective: To determine the effects of the implementation of the telephone cardiopulmonary resuscitation (T-CPR) program on the outcomes of out-of-hospital cardiac arrest (OHCA).Methods: In this prospective study, Emergency Medical Service (EMS) dispatchers and all bystanders attending to patients with OHCA were included. The consensus sampling was carried out based on inclusion and exclusion criteria. The data collection tool was consisted of a demographic questionnaire for patients and bystanders accompanied by a checklist for CPR outcomes. Data were collected 6 months before and after the implementation of the T-CPR program and analyzed using SPSS version 18.Results: The results revealed that the percentages of successful and unsuccessful CPR cases before the implementation of the T-CPR program were 28.1% and 71.9%, respectively. However, in total, 32% and 67.8% of the CPR cases were successful and unsuccessful, respectively, after the implementation of the mentioned program. The survival rate increased from 56.5% in the pre-intervention phase to 72.4% in the post-intervention one. In terms of the outcomes, brain complications decreased from 40% in the pre-intervention phase to 32.1% in the post-intervention one; however, the Chi-square test showed no significant difference in terms of CPR outcomes in the two time periods (p=0.797).Conclusion: According to the results, it is recommended that T-CPR programs be developed and dispatchers be trained in the area of this research. The results could be regarded as a guide to EMS managers, healthcare professionals, and the basis for further studies on this subject.

Care for patients who experience out-of-hospital cardiac arrest (OHCA) has rapidly evolved in the past decade. Increased sophistication of care in the community, emergency medical services (EMS) and hospital setting is associated with improved patient-centred outcomes. Notably, Utstein survival doubled from 11.6% to 23.1% between 2011 and 2016. These achievements involved collaboration between policymakers, clinicians and researchers, and were made possible by a strategic interplay of policy, research and implementation. We review the development and current state of OHCA in Singapore using primary population-based data from the Pan-Asian Resuscitation Outcomes Study and an unstructured search of research databases. We discuss the roles of important milestones in policy, community, dispatch, EMS and hospital interventions. Finally, we relate these interventions to relevant processes and outcomes, such as the relationship between the strategic implementation of bystander cardiopulmonary resuscitation and placement of automated external defibrillator with return of spontaneous circulation, survival to discharge and survival with favourable neurological outcomes. [ABSTRACT FROM AUTHOR]

This study examines the gatekeeping role that public safety communication specialists (911 calltakers and dispatchers) play in the criminal justice footprint using systematic observations of one of the largest public communication centers in the U.S. Findings indicate that public safety communications professionals can play a significant role in initially shaping the criminal justice footprint, and can help to prevent that footprint from growing. However, organizational constraints, liabilities, and rules, as well as the expectations and beliefs of citizens and activities of police officers, can also inhibit this gatekeeping function. Recent assertions that citizen calls for public safety services might be easily diverted or prevented to reduce this footprint rely on significant changes to several policies, practices, and assumptions that have yet to be easily realized. [ABSTRACT FROM AUTHOR]

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Background: Emergency call-takers and dispatchers (ECDs) field emergency calls and dispatch the appropriate emergency services. Exposure to the callers' traumatic experiences can lead to psychological stress and even to secondary traumatic stress (STS). In addition, previous studies suggest that ECDs may also suffer from posttraumatic stress disorder (PTSD), depression and anxiety disorders. Objectives: To investigate the prevalence of STS and to screen for PTSD, depression and anxiety disorders in ECDs. We further aimed to identify sociodemographic variables and attachment styles as possible risk factors for higher STS symptom load in ECDs. Methods: STS and PTSD regarding lifetime traumatic events, as well as depression and anxiety disorders, were investigated in N = 71 ECDs. Multiple regression analysis was performed to identify possible risk factors for higher STS symptom load. Results: The analysis determined a prevalence of 8.5% for moderate STS and 2.8% for severe STS. A total of 11.3% of the ECDs screened positive for PTSD, 15.5% for depression and 7.0% for anxiety disorders. A higher number of children and the absence of a secure attachment style were identified to be significantly associated with higher STS symptom load. Conclusions: STS resulting from exposure to traumatic emergency caller content is a common phenomenon among ECDs. Specific sociodemographic variables and the attachment style are significant risk factors of STS symptom load. ECDs should receive regular psychoeducational interventions and supervision to identify and mitigate mental distress at an early stage. [ABSTRACT FROM AUTHOR]

The taxi-passenger problem is more and more prominent in terminal stations; passengers usually wait in a long queue for taking a taxi in rush hour, and otherwise taxis wait in a queue for passengers. Nevertheless, there are few ways for dispatchers handling taxis' and passengers' queues to save time. In this paper, we build a new taxi-passenger dispatching model to solve this problem. The model contains four parts: information collection, passenger dispatching model with dispatcher control, taxi dispatching model, and emergency dispatching strategies. Different from traditional thought in the problem of double-ended queue theory, it is an analytical model with a simulation method. The numerical result of the passenger and taxi dispatching model can be used in station engineering and management. The method is based on queue theory, the simulation model, and technologies on the sensors and wireless communication. From the passenger dispatching results, we obtain the optimal release curve to direct the optimal number of passengers to be released in different arrival rates. The taxi dispatching results shows the strategy point of dispatching taxis. And the simulation results with the dispatching model perform much better than the traditional method in four scenarios. Sensitivity analysis is conducted that shows the different pattern of optimal release curve in variable conditions. [ABSTRACT FROM AUTHOR]

Although they are technically the first responders on most critical incidents, emergency dispatchers have received a modicum of attention from researchers and clinicians. The purpose of the present study was to evaluate job-related stress, psychological distress, posttraumatic stress disorder (PTSD), stress resiliency, and posttraumatic growth in this high-risk group. These areas were evaluated via an assessment battery administered to 90 emergency dispatchers working in a law enforcement agency. Results showed that dispatchers experienced an average amount of occupational stress, with 24% of the current sample reporting significant job stress. Between 13.34 and 15.56% reported symptoms consistent with a PTSD diagnosis, and 16.67% indicated sub-threshold PTSD symptomatology. The findings revealed that, overall, dispatchers experience occupational stress, psychological distress, and sub-threshold PTSD at similar or higher rates compared to police officers. Further, dispatchers reported posttraumatic growth at an average rate, also similar to that reported by police officers. Clinical implications of the results are discussed. Suggestions for directions that future research might take are offered. [ABSTRACT FROM AUTHOR]

Abstract Posttraumatic stress disorder (PTSD) may develop after exposure to an event in which death, severe physical harm, or violence occurred or was threatened. First responders, including police, fire rescue personnel, and emergency dispatchers, have been viewed as populations at high risk for developing PTSD symptoms. Indeed, over 80% of first responders report experiencing traumatic events on the job, and it is estimated that 10–15% have been diagnosed with PTSD. However, to date, limited research has reviewed the impact and services available following these traumatic events across first responders. This review examines research regarding PTSD in police officers, firefighters, and emergency dispatchers with particular attention to the prevalence, comorbid diagnoses, risk and protective factors, and resources available to each group. A discussion of limitations of the available research in this area, and suggestions for directions that future work might take, are offered. [ABSTRACT FROM AUTHOR]

Out-of-hospital cardiac arrest (OHCA) is recognized as a global mortality challenge, and digital strategies could contribute to increase the chance of survival. In this paper, we investigate if cardiopulmonary resuscitation (CPR) quality measurement using smartphone video analysis in real-time is feasible for a range of conditions. With the use of a web-connected smartphone application which utilizes the smartphone camera, we detect inactivity and chest compressions and measure chest compression rate with real-time feedback to both the caller who performs chest compressions and over the web to the dispatcher who coaches the caller on chest compressions. The application estimates compression rate with 0.5 s update interval, time to first stable compression rate (TFSCR), active compression time (TC), hands-off time (TWC), average compression rate (ACR), and total number of compressions (NC). Four experiments were performed to test the accuracy of the calculated chest compression rate under different conditions, and a fifth experiment was done to test the accuracy of the CPR summary parameters TFSCR, TC, TWC, ACR, and NC. Average compression rate detection error was 2.7 compressions per minute (±5.0 cpm), the calculated chest compression rate was within ±10 cpm in 98% (±5.5) of the time, and the average error of the summary CPR parameters was 4.5% (±3.6). The results show that real-time chest compression quality measurement by smartphone camera in simulated cardiac arrest is feasible under the conditions tested. [ABSTRACT FROM AUTHOR]

The analysis in this article considers how dispatchers in a 911 wireless call center direct callers’ orientations from one possible trajectory of action (e.g. moving to close) to keeping the caller engaged and prepared to speak with a second dispatcher. We describe how dispatchers deploy two distinct actions, a directing action and an informing action, timed at a precise moment to execute successful transfers. The analysis presents largely unexplored features of the call transfer environment, including dispatchers’ management of callers’ expectations and how the transfer phase contributes to a reshaping of the overall structural organization of a 911 call. [ABSTRACT FROM AUTHOR]

Introduction Understanding regional variation in bystander cardiopulmonary resuscitation (CPR) is important to improving out-of-hospital cardiac arrest (OHCA) survival. In this study we aimed to identify barriers to providing bystander CPR in regions with low rates of bystander CPR and where OHCA was recognised in the emergency call. Methods We retrospectively reviewed emergency calls for adults in regions of low bystander CPR in the Australian state of Victoria. Included calls were those where OHCA was identified during the call but no bystander CPR was given. A thematic content analysis was independently conducted by two investigators. Results Saturation of themes was reached after listening to 139 calls. Calls progressed to the point of compression instructions before EMS arrival in only 26 (18.7%) of cases. Three types of barriers were identified: procedural barriers (time lost due to language barriers and communication issues; telephone problems), CPR knowledge (skill deficits; perceived benefit) and personal factors (physical frailty or disability; patient position; emotional factors). Conclusion A range of factors are associated with barriers to delivering bystander CPR even in the presence of dispatcher instructions – some of which are modifiable. To overcome these barriers in high-risk regions, targeted public education needs to provide information about what occurs in an emergency call, how to recognise an OHCA and to improve CPR knowledge and skills. [ABSTRACT FROM AUTHOR]

purpose of this study was to explore the contributors to appropriate and prompt decision-making among dispatchers. Methods: A qualitative study through thematic analysis was designed. Data were collected using observation and semistructured interviews with 16 authorities and dispatchers in seven EMDs across Iran. Results: The study found “responsiveness” as the main category contributing to improved decision-making in EMD. The components introduced in this study for dispatchers’ responsiveness consisted of two categories. The first was “personal values” including faith and belief, eagerness to help, service excellence, altruism, respect, and impartiality in clinical judgment. The second was “professional attitudes” resulting from education and experience, including the recognition of emergency as a threat to health, sensitivity in triage, response to all requests for help, care for early warnings, commitment to organizational goals and standards, attention to the emergency medical service social support responsibility, and professional temperance. Conclusion: In this study, responsiveness was identified as a main category in improving the decision-making process among dispatchers. To attain responsiveness, institutionalization of its values and establishment of EMD-specific professional attitudes in dispatchers should be taken into consideration. [ABSTRACT FROM AUTHOR]

BACKGROUND: To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation (CPR) guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation. METHODS: It was a prospective, blind, randomised controlled study involving 109 medical students without previous CPR training. In a standardized mannequin scenario, after the step of dispatcher-assisted cardiac arrest recognition, the participants performed compression-only resuscitation guided over the telephone by either: (1) the pre-recorded instructional audio (n=57); or (2) verbal dispatcher assistance (n=52). The simulation video records were reviewed to assess the CPR performance using a 13-item checklist. The interval from call reception to the fi rst compression, total number and rate of compressions, total number and duration of pauses after the first compression were also recorded. RESULTS: There were no significant differences between the recording-assisted and dispatcher-assisted groups based on the overall performance score (5.6±2.2 vs. 5.1±1.9, P>0.05) or individual criteria of the CPR performance checklist. The recording-assisted group demonstrated significantly shorter time interval from call receipt to the fi rst compression (86.0±14.3 vs. 91.2±14.2 s, P<0.05), higher compression rate (94.9±26.4 vs. 89.1±32.8 min-1) and number of compressions provided (170.2±48.0 vs. 156.2±60.7). CONCLUSION: When provided by untrained persons in the simulated settings, the compression-only resuscitation guided by the pre-recorded instructional audio is no less efficient than dispatcher-assisted CPR. Future studies are warranted to further assess feasibility of using instructional audio aid as a potential alternative to dispatcher assistance. [ABSTRACT FROM AUTHOR]

The article focuses on the evaluation of workload allocation among train dispatchers in Europe.

This article explores the role of embodied, sensible knowledge in practice-based learning. Despite recent efforts to conceptualize how practitioners become skillful through corporeal and sensible learning, it still seems under-theorized and hard to understand what this exactly entails. The aim of this article is to account for the inherently embodied and sensible nature of knowledge by drawing on a 2-year ethnographic study of train dispatchers in a railway control room. Embodied and sensible knowledge is developed through the work of Merleau-Ponty and Heidegger, as phenomenology is a way to theorize the body beyond being an object to, instead, account for embodiment as lived and experienced. The data show that such knowledge can be understood as a matter of ‘attunement’: dispatchers become progressively skillful in bringing their bodies and senses in tune with practical situations and perturbations in the environment. The article contributes to a richer understanding of embodiment, especially in the relation between knowledge and practices, in organization studies and management learning. [ABSTRACT FROM AUTHOR]

Background: Canadian public safety personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police officers) are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and severities for Canadian PSP.Methods: An online survey was made available in English or French from September 2016 to January 2017. The survey assessed current symptoms, and participation was solicited from national PSP agencies and advocacy groups. Estimates were derived using well-validated screening measures.Results: There were 5813 participants (32.5% women) who were grouped into 6 categories (i.e., call center operators/dispatchers, correctional workers, firefighters, municipal/provincial police, paramedics, Royal Canadian Mounted Police). Substantial proportions of participants reported current symptoms consistent with 1 (i.e., 15.1%) or more (i.e., 26.7%) mental disorders based on the screening measures. There were significant differences across PSP categories with respect to proportions screening positive based on each measure.Interpretation: The estimated proportion of PSP reporting current symptom clusters consistent with 1 or more mental disorders appears higher than previously published estimates for the general population; however, direct comparisons are impossible because of methodological differences. The available data suggest that Canadian PSP experience substantial and heterogeneous difficulties with mental health and underscore the need for a rigorous epidemiologic study and category-specific solutions. [ABSTRACT FROM AUTHOR]

On the basis of case records from Xinjiang and Shanghai between 2013 and 2016, this article examines how dispatch work law has changed in practice and in theory during that period. It demonstrates that in using dispatch agencies as legal “protective shields” to dispose of obligations to workers, the state-owned enterprises (SOEs) have behaved much as what the case records from 2012 used in my earlier study (Part I) showed. What has changed is that public institutions and large private enterprises have followed the example of the SOEs to reduce old personnel as well as to hire new personnel through dispatch work. The new cases also show that, within that overall trend, the courts have tried to tighten their regulation of dispatch agencies, especially with respect to obligations for social insurance and compensation for unilateral dismissal of workers. At the same time, dispatch agencies (along with enterprises) have adopted some countermeasures to deal with the new pressures, especially by signing only short-term contracts and rotating a worker among different agencies. Even so, as far as the “black hole” in legal theory and practice is concerned—of an artificially constructed separation of the worker’s person from his or her work—managerial abuses, especially with respect to overtime and vacation work and unilateral termination of workers by enterprises, have continued apace with little restraint from the courts. The situation cries out for stronger reform. [ABSTRACT FROM AUTHOR]

Train dispatching is vital for the punctuality of train services, which is critical for a train operating company (TOC) to maintain its competitiveness. Due to the introduction of competition in the railway transport market, the issue of discrimination is attracting more and more attention. This paper focuses on delivering non-discriminatory train dispatching solutions while multiple TOCs are competing in a rail transport market, and investigating impacting factors of the inequity of train dispatching solutions. A mixed integer linear programming (MILP) model is first proposed, in which the inequity of competitors (i.e., trains and TOCs) is formalized by a set of constraints. In order to provide a more flexible framework, a model is further reformulated where the inequity of competitors is formalized as the maximum individual deviation of competitors’ delay cost from average delay cost in the objective function. Complex infrastructure capacity constraints are considered and modelled through a big M -based approach. The proposed models are solved by a standard MILP solver. A set of comprehensive experiments is conducted on a real-world dataset adapted from the Dutch railway network to test the efficiency, effectiveness, and applicability of the proposed models, as well as determine the trade-off between train delays and delay equity. [ABSTRACT FROM AUTHOR]

Emergency telecommunications personnel (ETCP) form the hub of police agencies and persistently deal with distressing situations on a daily basis, making them highly susceptible to psychological and physiological ailments. To date, few studies have examined the necessity or feasibility of implementing a resilience training intervention for ETCP. In this study, the authors assessed baseline psychological data from the ETCP of a large police department to determine the differences in baseline measures for ETCP and police officers. Participants included ETCP ages 29 to 64 years (n = 19). Results showed that ETCP self-reported greater levels of psychological stress compared with police officers (p < .05) for the majority of measures; ETCP experience excessive levels of stress and greater prevalence of chronic disease. Consideration should be given to piloting resilience interventions within this group to manage stress; improve health, performance, and decision making; and decrease the prevalence of chronic disease. [ABSTRACT FROM AUTHOR]

Flying used to be a phenomenon of big airliners. It is now an ever-growing reality to see air carriers operating small aircraft too. Business jets are today frequent visitors to worldwide airspaces and airports. By gradual upgrades of the equipment (both aircraft and infrastructure) the character of business aviation changes significantly its nature. From the perspective of flight preparation and flight planning these flights range between the most complicated ones. In the business aviation community little attention is often paid to the importance of dimensioning their operation control centers (OCC). This paper shows typical capacity issues and available solutions to help optimize the OCCs capacity setup. [ABSTRACT FROM AUTHOR]

Aim: Explore, understand and address issues that impact upon timely and adequate allocation of prehospital medical assistance and resources to out-of-hospital cardiac arrest (OHCA) patients.Methods: Mixed-methods design obtaining data for one year in three emergency medical communication centres (EMCC); Oslo-Akershus (OA), Vestfold-Telemark (VT) and Østfold (Ø). Data collection included quantitative data from analysis of dispatch logs, ambulance records and audio files. Qualitative data were collected through in-depth interviews and non-participant observations.Results: OA-, VT- and Ø-EMCC responded to 1095 OHCAs and 579 of these calls were included for further analysis (333, 143 and 103, respectively). There were significant site differences in their recognition of OHCA (89, 94 and 78%, respectively, p<0.001), provision of CPR instructions (83, 83 and 61%, respectively, p<0.001), time from call answered to initial CPR instructions (1.4min (1.2, 1.6), 1.1min (0,9, 1.2) and 1.3 (1.2, 1.7) respectively, p=0.002). The most frequent reason for delayed or failed recognition of OHCA was misinterpretation of agonal breathing. Interviews and observations revealed individual differences in protocol use, interrogation strategy and assessment of breathing. Use of protocol was only part of decision making, dispatchers trusted their own clinical experience and intuition, and used assumptions about the patient and the situation as part of decision making.Conclusion: Agonal breathing continues to be the main barrier to recognition of cardiac arrest. Individual differences among dispatchers' strategies can directly impact on performance, mainly due to the wide definition of cardiac arrest and lack of uniform tools for assessment of breathing. [ABSTRACT FROM AUTHOR]

Train movements on railway lines are generally controlled by human dispatchers. Because disruptions often occur, dispatchers make real-time scheduling and routing decisions in an attempt to minimize deviations from the official timetable. This optimization problem is called train dispatching. We represent it as a mixed integer linear programming model, and solve it with a Benders'-like decomposition within a suitable master/slave scheme. Interestingly, the master and the slave problems correspond to a macroscopic and microscopic representation of the railway, recently exploited in heuristic approaches to the problem. The decomposition, along with some new modeling ideas, allowed us to solve real-life instances of practical interest to optimality. Automatic dispatching systems based on our macro/micro decomposition-in which both master and slave are solved heuristically-have been in operation in several Italian lines since 2011. The exact approach described in this paper outperforms such systems on our test bed of real-life instances. Furthermore, a system based on another version of the exact decomposition approach has been in operation since February 2014 on a line in Norway. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic factors of a community are associated with bystander cardiopulmonary resuscitation (BCPR) rates and outcomes of out-of-hospital cardiac arrest (OHCA). This study aimed to test whether dispatcher-provided CPR instruction modifies the association between education level of a community and provision of BCPR. Methods: A population-based observational study was conducted with OHCAs of cardiac etiology who were witnessed by laypersons between 2012 and 2013. Exposure variable was the proportion of highly-educated residents (high school graduates and higher) in a community categorized into quartile groups. Endpoints were provision of BCPR and early chest compression (≤4min of collapse, ECC). Multivariable logistic regression analysis was performed. A final model with an interaction term was evaluated to test interactive effects of community education level with dispatcher-provided CPR instruction. Results: A total of 10,694 OHCAs were analyzed. BCPR was performed in 5112 (47.8%), and early CPR was done in 3080 (28.8%). Compared with the highest educated communities, AORs (95%CIs) for BCPR were 0.84 (0.74-0.95) in higher, 0.78 (0.66-0.92) in lower, and 0.71 (0.60-0.85) in the lowest educated communities. For ECC, AORs (95%CIs) were 0.81 (0.66-0.99) in lower and 0.62 (0.50-0.76) in the lowest. In an interaction model of 4122 OHCA patients who received dispatcher-provided CPR instruction, OHCAs occurring in higher (AOR: 0.80 (0.67-0.96)), lower (AOR: 0.67 (0.52-0.87)), and the lowest (AOR: 0.59 (0.43-0.82)) were less likely to receive BCPR compared with the highest educated communities. Conclusion: OHCA patients in communities with a higher proportion of highly-educated residents were more likely to receive BCPR, and the disparity was more prominent in the group that received dispatcher-provided CPR instruction. [ABSTRACT FROM AUTHOR]

This paper introduces the concept of information entropy in studying mental workloads to predict the mental workload of an urban railway dispatcher and thereby ensure safe rail system operation. This study combines factors that can influence mental workload, including visual behaviors required for dispatchers to obtain information, information display duration, and the amount of information in order to establish a comprehensive mental workload prediction model. Experimental monitoring tasks were carried out on a simulation dispatch interface platform to verify the model’s validity. Three assessment methods (task performance assessment, subjective assessment, and physiological assessment) were adopted to measure the mental workload levels of dispatchers under different task conditions. The results demonstrate that the model’s theoretical prediction value significantly correlates with the various experimental results, thereby verifying the model validity and indicating that it can be used to predict the mental workload for different dispatch tasks, to provide a reference for work performance evaluation, and in designing optimized dispatch display interfaces. [ABSTRACT FROM PUBLISHER]

Background: A preceding randomized controlled trial demonstrated that chest compression-only cardiopulmonary resuscitation (CPR) instruction by dispatcher was more effective to increase bystander CPR than conventional CPR instruction. However, the actual condition of implementation of each type of dispatcher instruction (chest compression-only CPR [CCCPR] or conventional CPR with rescue breathing) and provision of bystander CPR in real prehospital settings has not been sufficiently investigated.Methods: This registry prospectively enrolled patients aged =>18 years suffering an out-of-hospital cardiac arrest (OHCA) of non-traumatic causes before emergency-medical-service (EMS) arrival, who were considered as target subjects of dispatcher instruction, resuscitated by EMS personnel, and transported to medical institutions in Osaka, Japan from January 2005 through December 2012. The primary outcome measure was provision of CPR by a bystander. Multiple logistic regression analysis was used to assess factors that were potentially associated with provision of bystander CPR.Results: Among 37,283 target subjects of dispatcher instruction, 5743 received CCCPR instruction and 13,926 received conventional CPR instruction. The proportion of CCCPR instruction increased from 5.7% in 2005 to 25.6% in 2012 (p for trend <0.001). The CCCPR instruction group received bystander CPR more frequently than conventional CPR instruction group (70.0% versus 62.1%, p<0.001). In the multivariable analysis, CCCPR dispatcher instruction was significantly associated with provision of bystander CPR compared with conventional CPR instruction (adjusted odds ratio 1.44, 95% CI 1.34-1.55).Conclusions: CCCPR dispatcher instruction among adult OHCA patients significantly increased the actual provision of bystander CPR. [ABSTRACT FROM AUTHOR]

Unlabelled: The aim of this study was to explore challenges in recognition and initial treatment of out-of-hospital cardiac arrest (OHCA) by using closed-circuit television (CCTV) recordings combined with audio recordings from emergency medical calls.Method: All OHCA captured by CCTV in the Capital Region of Denmark, 15 June 2013-14 June 2014, were included. Using a qualitative approach based on thematic analysis, we focused on the interval from the victim's collapse to the arrival of the ambulance.Results: Based on the 21 CCTV recordings collected, the main challenges in OHCA seemed to be situation awareness, communication and attitude/approach. Situation awareness among bystanders and the emergency medical dispatchers (dispatcher) differed. CCTV showed that bystanders other than the caller, were often physically closer to the victim and initiated cardiopulmonary resuscitation (CPR). Hence, information from the dispatcher had to pass through the caller to the other bystanders. Many bystanders passed by or left, leaving the resuscitation to only a few. In addition, we observed that the callers did not delegate tasks that could have been performed more effectively by other bystanders, for example, receiving the ambulance or retrieving an Automated External Defibrillator (AED).Conclusion: CCTV combined with audio recordings from emergency calls can provide unique insights into the challenges of recognition and initial treatment of OHCA and can improve understanding of the situation. The main barriers to effective intervention were situation awareness, communication and attitude/approach. Potentially, some of these challenges could be minimized if the dispatcher was able to see the victim and the bystanders at the scene. A team approach, with the dispatcher responsible for the role as team leader of a remote resuscitation team of a caller and bystanders, may potentially improve treatment of OHCA. [ABSTRACT FROM AUTHOR]

Introduction We sought to determine the ability of 9-1-1 dispatchers to accurately determine the presence of out-of-hospital cardiac arrest (OOHCA) over the telephone, and to determine the frequency with which CPR instructions are initiated and chest compressions delivered in patients not in cardiac arrest. Methods We conducted a multi-center, prospective cohort study of adult OOHCA patients not witnessed by EMS for which resuscitation was attempted. Dispatchers were not health care professionals and received 6 weeks of training followed by a 6-month preceptorship. We reviewed 9-1-1 call digital recordings for all unconscious patients for which the possibility of cardiac arrest was considered using a piloted standardized data collection sheet. Results We reviewed 2260 recordings occurring between January 2008 and October 2009. Among those, 1536 were confirmed OOHCA, and 724 were not. Among the 1536 confirmed OOHCA cases, 1012 were recognized by dispatchers and 524 were not. Among the 724 cases not in cardiac arrest, dispatchers suspected cardiac arrest was present in 490 and absent in 234. OOHCA diagnostic accuracy characteristics were: sensitivity 65.9% (95%CI 63.5–68.2%), specificity 32.3% (95%CI 29.0–35.9%), PPV 67.4%, and NPV 30.9%. Dispatchers believed that OOHCA was present in 490/2260 (21.7%) cases when it was not, resulting in 54/490 (11.0%) patients inappropriately receiving chest compressions, or 54/2260 (2.4%) of the whole cohort. Conclusions Dispatchers had a fair sensitivity and modest specificity for the recognition of OOHCA. We found a very small number of patients receiving CPR when not in cardiac arrest, supporting the current use of dispatch-assisted CPR instructions. [ABSTRACT FROM AUTHOR]

Aims Survival from out-of-hospital cardiac arrest is increased by bystander cardiopulmonary resuscitation (CPR). Bystander performance can be improved when CPR instructions are delivered by a calltaker at the Emergency Communications Centre. Little is known about a young person's ability to understand these instructions and perform CPR correctly. We assessed the ability of a group of untrained young people to effectively apply these directions to an adult resuscitation manikin. Methods 87 youngsters aged 7–15 years with no previous training in CPR were separately equipped with a mobile phone and an adult assessment manikin. They phoned the emergency number (111) and were automatically diverted to a senior emergency medical dispatcher (EMD). The EMD delivered resuscitation instructions which complied fully with Medical Priority Dispatch System (version 12.1). Performance was monitored using a Laerdal Computerised Skill Reporting System. Results Average compression depth increased with age from 10.3 mm to 30 mm for 8 and 15 year olds respectively. 100 compressions per minute was achieved in youngsters aged 10 years and older but the rate fatigued over time and improved after interruption for two ventilations. Those aged 11 years and older consistently compressed the chest from 31 mm to 50 mm. Only one participant could successfully ventilate the manikin by mouth-to-mouth. Conclusion This study demonstrates that untrained youngsters should perform compression-only CPR. From 11 years of age, they can effectively perform dispatcher-directed CPR by compressing the chest at an appropriate rate and depth. However, their technique benefits from formal training. [ABSTRACT FROM AUTHOR]

Traditionally, classroom instruction has been the primary solution utilized by airlines to train Flight Dispatchers. Recently, airlines have been looking for more efficient and effective methods for training. One such strategy has been to replace classroom programmes with on-line delivered computer-based training. Facing new training strategic orientation and the pressing need for airlines to adapt to economic environments and regulatory frameworks, this paper reports the analysis of Flight Dispatchers' perspectives on what is effective Flight Dispatch training. The survey results indicate that the current Flight Dispatch training programme is effective; they do not fully support the findings from the literature that most adults prefer self-directed learning. This paper argues that Flight Dispatch computer-based training is, in certain circumstances, unable to replace Flight Dispatch classroom training. On the other hand, the literature review aligns with the research finding that computer-based training is of value toflight Dispatch trainees when it is used to complement other traditional delivery methods in Flight Dispatch training. [ABSTRACT FROM AUTHOR]

China's Labor Contract Law ("LCL") came into force on January 1, 2008. The first major piece of labor legislation since the 1994 Labor Law, the Labor Contract Law expanded legal protection for workers by mandating that labor contracts be in writing and delivered to all workers. Employers, predicting that the law would effectively raise the cost of employing full-time, long-term workers, sought methods of "creative compliance" with the law. One avenue for creative compliance emerged through the loophole in the LCL for so-called "dispatch workers." Dispatch workers are formally employed by third-party dispatch service agencies and thus not covered by employment contracts with the firms where they perform their job ("accepting entities"). In the first five years following the LCL's enactment, dispatch workers grew from a negligible share of China's labor force into a pervasive phenomenon. The dispatch worker exception began to swallow the rule, eroding the intended labor protections of the LCL. In response, the Standing Committee of the National People's Congress amended the LCL, effective July 1, 2013. These amendments drastically reduced the permissible scale and purpose of dispatch labor and augured tighter regulation for the dispatch industry. Following a period of public comment, the Ministry of Human Resources and Social Services provided specific departmental rules regarding the licensing of dispatch agencies and standard industry-wide practices, effective March 1, 2014. The new regulations restricted enterprises from hiring more than ten percent of their workers as dispatch workers and clarified the obligations of dispatching agencies as employers. With reports of abuse of dispatch workers continuing to surface, the effects of the amendments and the provisions on labor remain unclear. This comment addresses China's effort to intervene in employment arrangements via legislation. It first surveys the background of labor legislation in China from the Mao era, through reform, and into the twenty-first century. It then examines the interaction of the labor market and labor legislation, as employers respond to changes in China's labor regime through the introduction of Amendments to the LCL. Finally, this comment suggests that reform in labor legislation based on individual contract should be secondary to expanding collective labor rights. [ABSTRACT FROM AUTHOR]

Background Our aim was to assess psychomental stress and strain among dispatchers in fire departments, particularly during emergency instructions by phone and to evaluate their work ability. Methods 27 dispatchers and 20 controls were examined. In a protocol, participants recorded 1. phone instructions causing mental stress (event) 2.working time without phone instructions (non-event) 3. breaks. Continuous heart rate (variability), urine catecholamine, salivary cortisol and lymphocytes were measured. To assess the job-related burden, the Work Ability Index (WAI) was applied. Results Dispatchers demonstrated significantly higher heart rates and reduced standard deviation of all NN (heartbeat-to-heartbeat) intervals (SDNN) than the controls in all phases.WAI of dispatchers was significantly lower than that of the controls. Within the dispatchers, there was a significantly higher rate of inability to work during the past year. Conclusions The increased heart rate and reduced SDNN of examined dispatchers indicate chronic stress effects as a possible preliminary stage of a health disorder. In respect of the reduced work ability among dispatchers preventive measures are required to reduce the stress situation during their job-performance. [ABSTRACT FROM AUTHOR]

Introduction Dispatcher-assisted CPR (DA-CPR) can increase rates of bystander CPR, survival, and quality of life following cardiac arrest. Dispatcher protocols designed to improve rapid recognition of arrest and coach CPR may increase survival by (1) reducing preventable time delays to start of chest compressions and (2) improving the quality of bystander CPR. Methods We conducted a randomized controlled trial comparing a simplified DA CPR script to a conventional DA CPR script in a manikin cardiac arrest simulation with lay participants. The primary outcomes measured were the time interval from call receipt to the first chest compression and the core metrics of chest compression (depth, rate, release, and compression fraction). CPR was measured using a recording manikin for the first 3 min of participant CPR. Results Of the 75 participants, 39 were randomized to the simplified instructions and 36 were randomized to the conventional instructions. The interval from call receipt to first compression was 99 s using the simplified script and 124 s using the conventional script for a difference of 24 s (p < 0.01). Although hand position was judged to be correct more often in the conventional instruction group (88% versus 63%, p < 0.01), compression depth was an average 7 mm deeper among those receiving the simplified CPR script (32 mm versus 25 mm, p < 0.05). No statistically significant differences were detected between the two instruction groups for compression rate, complete release, number of hands-off periods, or compression fraction. Discussion Simplified DA-CPR instructions to lay callers in simulated cardiac arrest settings resulted in significant reductions in time to first compression and improvements in compression depth. These results suggest an important opportunity to improve DA CPR instructions to reduce delays and improve CPR quality. [ABSTRACT FROM AUTHOR]

The basic design of successful organized electricity markets is built on the principles of bid-based, security-constrained economic dispatch. However, the real electricity system involves features that are difficult or impossible to fully reconcile within this core model. This calls for an application of the principles of dispatched-based pricing to move as far as possible to achieving the ideal of efficient pricing and minimizing the need for additional payments through uplift and other interventions to maintain reliability. Motivated by issues under review in New England, a summary of the basic principles and illustrative applications provides examples of seeking the first-best efficient prices to mitigate the unintended consequences of second-best out-of-market payments. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Bystander-initiated cardiopulmonary resuscitation (CPR) has been reported to increase the possibility of survival in patients with out-of-hospital cardiopulmonary arrest (OHCA). We evaluated the effects of CPR instructions by emergency medical dispatchers on the frequency of bystander CPR and outcomes, and whether these effects differed between family and non-family bystanders. Methods: We conducted a retrospective cohort study, using Utstein-style records of OHCA taken in a rural area of Japan between January 2004 and December 2009. Results: Of the 559 patients with non-traumatic OHCA witnessed by laypeople, 231 (41.3%) were given bystander CPR. More OHCA patients received resuscitation when the OHCA was witnessed by non-family bystanders than when it was witnessed by family members (61.4% vs. 34.2%). The patients with non-family-witnessed OHCA were more likely to be given conventional CPR (chest compression plus rescue breathing) or defibrillation with an AED than were those with family-witnessed OHCA. Dispatcher instructions significantly increased the provision of bystander CPR regardless of who the witnesses were. Neurologically favorable survival was increased by CPR in non-family-witnessed, but not in family-witnessed, OHCA patients. No difference in survival rate was observed between the cases provided with dispatcher instructions and those not provided with the instructions. Conclusions: Dispatcher instructions increased the frequency of bystander CPR, but did not improve the rate of neurologically favorable survival in patients with witnessed OHCA. Efforts to enhance the frequency and quality of resuscitation, especially by family members, are required for dispatcher-assisted CPR. [Copyright &y& Elsevier]