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Mimoso, J. Separation and Purification Technology. Inorganic particles increase biofilm heterogeneity and enhance permeate flux. Water research 64, , dx. Martin, K. Effect of fouling layer spatial distribution on permeate flux: A theoretical and experimental study. Journal of Membrane Science , , dx. Derlon, N. Presence of biofilms on ultrafiltration membrane surfaces increases the quality of permeate produced during ultra-low pressure gravity-driven membrane filtration.

Water Research 60, , dx. Activity of metazoa governs biofilm structure formation and enhances permeate flux during Gravity-Driven Membrane GDM filtration. Water Research 47 6 , , dx. Biofilm formation and permeate quality improvement in gravity driven membrane ultrafiltration. Water Science and Technology: Water Supply, , www.

Predation influences the structure of biofilm developed on ultrafiltration membranes. Water Research 46 10 , , dx. Boulestreau, M. Operation of gravity-driven ultrafiltration prototype for decentralised water supply. Desalination and Water Treatment 42 , , dx. Mueller, N. Nanofiltration and nanostructured membranes-Should they be considered nanotechnology or not? Journal of Hazardous Materials —, , dx. Peter-Varbanets, M. Intermittent operation of ultra-low pressure ultrafiltration for decentralized drinking water treatment. Huber, S. Characterisation of aquatic humic and non-humic matter with size-exclusion chromatography - organic carbon detection - organic nitrogen detection LC-OCD-OND.

Water Research 45 2 , , dx. Mechanisms of membrane fouling during ultra-low pressure ultrafiltration.

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Stabilization offluxduringdead-endultra-low pressure ultrafiltration. Water Research 44 12 , , dx. Larsen, T. Decision support in urban water management based on generic scenarios: The example of NoMix technology. Journal of Environmental Management 91 12 , , dx.

Jermann, D. The role of NOM fouling for the retention of estradiol and ibuprofen during ultrafiltration. Neale, P. Influence of pH on losses of analyte estradiol in sample prefiltration. Environmental Engineering Science 26 6 , , dx. Decentralized systems for potable water and the potential of membrane technology.

Water Research 43 2 , , dx. Pronk, W. Options for urine treatment in developing countries. Desalination , , dx. Neumann, M. Global sensitivity analysis for model-based prediction of oxidative micropollutant transformation during drinking water treatment. Water Research 43 4 , , dx. Dodd, M. Ozonation of source-separated urine for resource recovery and waste minimization: Process modeling, reaction chemistry, and operational considerations.

Environmental Science and Technology 42 24 , , dx. Mutual influences between natural organic matter and inorganic particles and their combined effect on ultrafiltration membrane fouling. Water Research 42 14 , , dx. Interplay of different NOM fouling mechanisms during ultrafiltration for drinking water production. Water Research 41 8 , , dx.

Meylan, S. Permeability of low molecular weight organics through nanofiltration membranes. Water Research 41 17 , , dx. Pilot experiments with electrodialysis and ozonation for the production of a fertiliser from urine. Water Science and Technology 56 5 , , dx. Steiner, M. Modelling heavy metal fluxes from traffic into the environment.

Journal of Environmental Monitoring 9 8 , , dx. Escher, B. Monitoring the removal efficiency of pharmaceuticals and hormones in different treatment processes of source-separated urine with bioassays. Environmental Science and Technology 40 16 , , dx. Maurer, M. Treatment processes for source-separated urine. Water Research 40 17 , , dx. Environmental Science and Technology 40 5 , Electrodialysis for recovering salts from a urine solution containing micropollutants. Environmental Science and Technology 40 7 , , dx.

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Treatment of source-separated urine by a combination of bipolar electrodialysis and a gas transfer membrane. Water Science and Technology 53 3 , , dx. Nanofiltration for the separation of pharmaceuticals from nutrients in source-separated urine. Water Research 40 7 , , dx. Leiknes, T. Ozone transfer and design concepts for NOM decolourization in tubular membrane contactor. Chemical Engineering Journal 1 , Phattaranawik, J.

Mass transfer studies in flat-sheet membrane contactor with ozonation. Journal of Membrane Science , Mavrocordatos, D. Analysis of environmental particles by atomic force microscopy, scanning and transmission electron microscopy. Water Science and Technology 50 12 , To protect the ecosystem and drinking water resources in Switzerland and in the countries of the downstream catchments, a new Swiss water protection act entered into force in aiming to reduce the discharge of micropollutants from wastewater treatment plants WWTPs.

As a consequence, selected WWTPs must be upgraded by an advanced treatment for micropollutant abatement with suitable and economic options such as powdered activated carbon treatment or ozonation. Differing specific ozone doses in the range of 0. Based on this assessment, a specific ozone dose of 0. After ozonation, an additional biological post-treatment is required to eliminate possible negative ecotoxicological effects generated during ozonation caused by biodegradable ozonation transformation products OTPs and oxidation by-products OBPs.

Three biological treatments sand filtration, moving bed, fixed bed and granular activated carbon GAC, fresh and pre-loaded filtration were evaluated as post-treatments after ozonation. In parallel, a fresh GAC filter directly connected to the effluent of the secondary clarifier was assessed.

Among the three purely biological post-treatments, the sand filtration performed best in terms of removal of dissolved organic carbon DOC , assimilable organic carbon AOC and total suspended solids TSS. The fresh activated carbon filtration ensured a significant additional micropollutants abatement after ozonation due to sorption. In an identical GAC filter running in parallel and being fed with the effluent of the secondary clarifier, the elimination was less efficient.

Seven primary OTPs chlorothiazide and six N -oxides formed during ozonation could be quantified thanks to available reference standards. Their concentration decreased with increasing specific ozone doses with the concomitant formation of other OTPs. The seven OTPs were found to be stable compounds and were not abated in the biological post-treatments.

They were sorbed in the fresh GAC filter, but less efficiently than the corresponding parent compounds. Habermacher, J. The effect of different aeration conditions in activated sludge - Side-stream system on sludge production, sludge degradation rates, active biomass and extracellular polymeric substances. Hubaux, N. Impact of coexistence of flocs and biofilm on performance of combined nitritation-anammox granular sludge reactors. Water Research 68, , doi. An energy-efficient membrane bioreactor for on-site treatment and recovery of wastewater.

Journal of Water, Sanitation and Hygiene for Development 5 3 , , doi. Blue Diversion: a new approach to sanitation in informal settlements. Journal of Water, Sanitation and Hygiene for Development 5 1 , , doi. Laureni, M. Activity and growth of anammox biomass on aerobically pre-treated municipal wastewater. Water Research 80, , doi. Ravndal, K. On-site treatment of used wash-water using biologically activated membrane bioreactors operated at different solids retention times.

Journal of Water Sanitation and Hygiene for Development, 9 pp, doi. Schielke-Jenni, S. Thalmann, B. Environmental Science and Technology 49 18 , , doi. Vannecke, T. Considering microbial and aggregate heterogeneity in biofilm reactor models: how far do we need to go? Water Science and Technology 72 10 , , doi. Wagner, J. Effect of particulate organic substrate on aerobic granulation and operating conditions of sequencing batch reactors. Eggen, R. Reducing the discharge of micropollutants in the aquatic environment: The benefits of upgrading wastewater treatment plants.

Environmental Science and Technology 48 14 , , dx. Abwassertrennung und Dezentralisierung. Choubert, J. Rethinking wastewater characterisation methods for activated sludge systems - A position paper. Water Science and Technology 67 11 , , dx. Growth limiting conditions and denitrification govern extent and frequency of volume detachment of biofilms.

Chemical Engineering Journal , , dx. Dynamic time warping improves sewer flow monitoring. Water research 47 11 , , dx. Micropollutant removal by attached and suspended growth in a hybrid biofilm-activated sludge process. Water Research 47 13 , , dx. Guo, B. Two-stage acidic-alkaline hydrothermal pretreatment of lignocellulose for the high recovery of cellulose and hemicellulose sugars.

Janjaroen, D. Roles of ionic strength and biofilm roughness on adhesion kinetics of Escherichia coli onto groundwater biofilm grown on PVC surfaces. Water Research 47 7 , , dx. Kim, T. General and rare bacterial taxa demonstrating different temporal dynamic patterns in an activated sludge bioreactor. Applied Microbiology and Biotechnology 97 4 , , dx. Kovalova, L. Elimination of micropollutants during post-treatment of hospital wastewater with powdered activated carbon, ozone, and UV.

Environmental Science and Technology 47 14 , , dx. Perona, P. Journal of Environmental Management , , dx. Rauch, W. Urban water management to increase sustainability of cities. Water research 47 20 , p. Stewart, T. Environmental Science and Pollution Research 20 5 , , dx. Weissbrodt, D. Assessment of bacterial and structural dynamics in aerobic granular biofilms. Frontiers in Microbiology 4 JUL , dx.

Identification of trigger factors selecting for polyphosphate- and glycogen-accumulating organisms in aerobic granular sludge sequencing batch reactors. Wunderlin, P. Isotope signatures of N2O in a mixed microbial population system: constraints on N2O producing pathways in wastewater treatment. Environmental Science and Technology 47 3 , , dx. Online N2O measurement: The next standard for controlling biological ammonia oxidation? Environmental Science and Technology 47 17 , , dx. Ye, X. Exogenous anthrahydroquinone-2,6-disulfonate specifically increases xylose utilization during mixed sugar fermentation by Clostridium beijerinckii NCIMB International Journal of Hydrogen Energy 38 6 , , dx.

Zhang, X. Interactions between Clostridium beijerinckii and Geobacter metallireducens in co-culture fermentation with anthrahydroquinone-2, 6-disulfonate AH2QDS for enhanced biohydrogen production from xylose. Biotechnology and bioengineering 1 , , dx. Lignocellulosic hydrolysates and extracellular electron shuttles for H2 production using co-culture fermentation with Clostridium beijerinckii and Geobacter metallireducens. Bioresource Technology , , dx.

Boltz, J. Method to identify potential phosphorus rate-limiting conditions in post-denitrification biofilm reactors within systems designed for simultaneous low-level effluent nitrogen and phosphorus concentrations. Water Research 46 19 , , dx. Data-driven modeling approaches to support wastewater treatment plant operation. Environmental Modelling and Software 30, , dx. Automatic reactor model synthesis with genetic programming. Water Science and Technology 65 4 , , dx. Ghasemian, M.

Anaerobic biodegradation of methyl tert-butyl ether and tert-butyl alcohol in petrochemical wastewater. Environmental Technology 33 16 , , dx. Combined biomimetic and inorganic acids hydrolysis of hemicellulose in Miscanthus for bioethanol production. Kazner, C. In: Kazner, C. Hospital wastewater treatment by membrane bioreactor: Performance and efficiency for organic micropollutant elimination. Environmental Science and Technology 46 3 , , dx. Li, X. Backwash intensity and frequency impact the microbial community structure and function in a fixed-bed biofilm reactor.

Applied Microbiology and Biotechnology 96 3 , , dx. Lotito, A. Nitrous oxide emissions from the oxidation tank of a pilot activated sludge plant. Water Research 46 11 , , dx. Rieger, L. Water Environment Research 84 2 , , dx. Schreiber, F. Nitric oxide and nitrous oxide turnover in natural and engineered microbial communities: Biological pathways, chemical reactions, and novel technologies.

Frontiers in Microbiology 3 , 24 pp, dx. Siegrist, H. Review on the fate of organic micropollutants in wastewater treatment and water reuse with membranes. Water Science and Technology 66 6 , , dx. Stasinakis, A. Review on the fate of emerging contaminants during sludge anaerobic digestion. Mechanisms of N 2O production in biological wastewater treatment under nitrifying and denitrifying conditions.

Water Research 46 4 , , dx. Anthrahydroquinone-2,6-disulfonate increases the rate of hydrogen production during Clostridium beijerinckii fermentation with glucose, xylose, and cellobiose. International Journal of Hydrogen Energy 37 16 , , dx. Systematic evaluation of biofilm models for engineering practice: Components and critical assumptions. Water Science and Technology 64 4 , , dx. Regime shift and microbial dynamics in a sequencing batch reactor for nitrification and anammox treatment of urine.

Applied and Environmental Microbiology 77 17 , , dx. Dominguez, D. Tackling uncertainties in infrastructure sectors through strategic planning: The contribution of discursive approaches in the urban water sector. Water Policy 13 3 , , dx. Identification of industrial wastewater by clustering wastewater treatment plant influent ultraviolet visible spectra. Water Science and Technology 63 6 , , dx. Gresch, M. Effects of aeration patterns on the flow field in wastewater aeration tanks.

Using reactive tracers to detect flow field anomalies in water treatment reactors. Water Research 45 5 , , dx. Gujer, W. Is modeling of biological wastewater treatment a mature technology? Water Science and Technology 63 8 , , dx. Houweling, D. N 2O emissions: Modeling the effect of process configuration and diurnal loading patterns. Water Environment Research 83 12 , , dx. Joss, A. Mikroverunreinigungen: Die Herausforderung wird angegangen. Water Research 45 18 , , dx.

Ramseier, M. Formation of assimilable organic carbon during oxidation of natural waters with ozone, chlorine dioxide, chlorine, permanganate, and ferrate. Shimada, T. Effects of the antimicrobial tylosin on the microbial community structure of an anaerobic sequencing batch reactor. Biotechnology and bioengineering 2 , , dx. Syntrophic acetate oxidation in two-phase acid—methane anaerobic digesters.

Water Science and Technology 64 9 , , dx. Velten, S. Characterization of natural organic matter adsorption in granular activated carbon adsorbers. Water Research 45 13 , , dx. Anthrahydroquinone-2,6,-disulfonate AH2QDS increases hydrogen molar yield and xylose utilization in growing cultures of Clostridium beijerinckii. Applied Microbiology and Biotechnology 4 , , dx. Zimmermann, S. Kinetic assessment and modeling of an ozonation step for full-scale municipal wastewater treatment: Micropollutant oxidation, by-product formation and disinfection.

Abegglen, C. Ozonung von gereinigtem Abwasser zur Elimination von organischen Spurenstoffen. KA Korrespondenz Abwasser, Abfall 57 2 , , dx. In: Krause, T. Liquid Treatment Processes. McGraw Hill, New York, Mathematical modelling of biofilms and biofilm reactors for engineering design.

Water Science and Technology 62 8 , , dx. Bradac, P. Cadmium speciation and accumulation in periphyton in a small stream with dynamic concentration variations. Environmental Pollution 3 , , dx. Brockmann, D. Evaluating operating conditions for outcompeting nitrite oxidizers and maintaining partial nitrification in biofilm systems using biofilm modeling and Monte Carlo filtering. Water Research 44 6 , , dx. Burkhardt, M. Umweltwissenschaften und Schadstoff-Forschung 22 5 , , dx. Beurteilung weitergehender Abwasserreinigungsverfahren anhand Indikatorsubstanzen.

The role of the flow pattern in wastewater aeration tanks. Water Science and Technology 62 2 , , dx. Leemann, A. Influence of water hardness on concrete surface deterioration caused by nitrifying biofilms in wastewater treatment plants. International Biodeterioration and Biodegradation, Article in press 10 pp , dx.

Changes in the structure and function of microbial communities in drinking water treatment bioreactors upon addition of phosphorus. Applied and Environmental Microbiology 76 22 , , dx. Menniti, A. Mechanisms of SMP production in membrane bioreactors: Choosing an appropriate mathematical model structure. Water Research 44 18 , , dx. The influence of aeration intensity on predation and EPS production in membrane bioreactors.

Water Research 44 8 , , dx. Ort, C. Sampling for pharmaceuticals and personal care products PPCPs and illicit drugs in wastewater systems: Are your conclusions valid? A critical review. Environmental Science and Technology 44 16 , , dx. Rieckermann, J. Bayesian experimental design of tracer studies to monitor wastewater leakage from sewer networks. Water Resources Research 46 8 , W 14 pp , dx.

Data reconciliation for wastewater treatment plant simulation studies-planning for high-quality data and typical sources of errors. Water Environment Research 82 5 , , dx. Worms, I. Uptake of Cd II and Pb II by microalgae in presence of colloidal organic matter from wastewater treatment plant effluents. Environmental Pollution 2 , , dx. The fate of selected micropollutants in a single-house MBR.

Water Research 43 7 , , dx. Closing the capability Gap: Strategic planning for the infrastructure sector. California Management Review 51 2 , Compartmental models for continuous flow reactors derived from CFD simulations. Environmental Science and Technology 43 7 , , dx.

Hollender, J. Elimination of organic micropollutants in a municipal wastewater treatment Plant upgraded with a full-scale post-ozonation followed by sand filtration. Environmental Science and Technology 43 20 , , dx. Hug, T. Wastewater treatment models in teaching and training: The mismatch between education and requirements for jobs. Water Science and Technology 59 4 , , dx. Full-scale nitrogen removal from digester liquid with partial nitritation and anammox in one SBR. Environmental Science and Technology 43 14 , , dx. Kaelin, D. Extension of ASM3 for two-step nitrification and denitrification and its calibration and validation with batch tests and pilot scale data.

Water Research 43 6 , , dx. Influence of shear on the production of extracellular polymeric substances in membrane bioreactors. Water Research 43 17 , , dx. Milferstedt, K. Analyzing characteristic length scales in biofilm structures. Biotechnology and Bioengineering 2 , , dx.

Morgenroth, E. Biofilm engineering: Linking biofilm development at different length and time scales. Reviews in Environmental Science and Biotechnology 8 3 , , dx. Model-based evaluation of reduction strategies for micropollutants from wastewater treatment plants in complex river networks. Environmental Science and Technology 43 9 , , dx.

Assessing wastewater dilution in small rivers with high resolution conductivity probes. Water Science and Technology 59 8 , , dx. Pons, M. Biofilm monitoring on rotating discs by image analysis. Biotechnology and Bioengineering 1 , , dx. Sin, G. Water Research 43 11 , , dx. Wick, A. Fate of beta blockers and psycho-active drugs in conventional wastewater treatment. Biological nutrient removal in a small-scale MBR treating household wastewater. Water Research 42 , , dx. Borsuk, M. Charting a path for innovative toilet technology using multicriteria decision analysis.

Environmental Science and Technology 42 6 , , dx. Braun, D. Reactive tracers reveal hydraulic and control instabilities in full-scale activated sludge plant. Water Science and Technology 57 7 , , dx. Clauwaert, P. Combining biocatalyzed electrolysis with anaerobic digestion. Water Science and Technology 57 4 , , dx. Ertefai, T. Vertical distribution of microbial lipids and functional genes in chemically distinct layers of a highly polluted meromictic lake.

Organic Geochemistry 39 11 , , dx. Are we about to upgrade wastewater treatment for removing organic micropollutants? Water Science and Technology 57 2 , , dx. Potential of in-situ sensors with ion-selective electrodes for aeration control at wastewater treatment plants.

There is a general feeling that there is better information out there that they have not accessed, information that would enable them to do better plans, improve training, and maker better decisions. A range of tactics to find useful, relevant material were reported, including restriction of inputs to limited sources with good filters; using material that has been vetted by trusted sources; relying on individual contacts; developing classification structures; and seeking specific types of information such as after action reports, reports of best practices, and specific plans.

Trust in sources and lack of cooperation or collaboration between different organizations or levels of government were reported as underlying problems. Many different sources are attempting to become the one source that everyone should go to for disaster information, and some respondents felt that this was not a worthy goal given the diversity of topics and problems that are involved. Regarding ways to better organize resources to reduce the time needed to find useful new material, suggestions included having information specialists retrieve and synthesize relevant information, establishing integrative portals to quality sites for each type of disaster, expanded indexing, and classification systems with expert input, and community-based approaches to organizing material, including use of social tagging to create taxonomies.

Respondents were also asked about what they would like to see represented in an index or ontology of disaster preparedness and response. Ideas about various approaches to organization were offered, but the emphasis was less on the specific content, and more on the need for input from experts including experienced emergency management practitioners and for dynamic systems that can evolve to meet changing knowledge and needs. When asked about current or potential roles of libraries, librarians, and information specialists, there was considerable support for the idea that librarians must become an integral part of the nation's emergency preparedness and response team.

Among the suggestions for librarian roles were:. Study participants were also asked about international considerations relevant for NLM. Cultural and language diversity were cited in the context of not relying solely on high tech solutions and the need for culturally appropriate information. Creating an international network that allowed librarians and archivists in developed countries to share expertise with those in developing countries was also suggested. The need for a central point of decision support information was cited, much of which is currently obtained in an ad hoc fashion from various international organizations when a disaster strikes.

Examples of ways in which such a resource could facilitate international disaster relief included more targeted intervention; effective stockpiling; geographical pre-positioning; better strategic decision making by senior managers, and improved targeting of rapid health assessments. By providing an example of open document collection, it was observed that NLM could work with other institutions in these countries to encourage and help them to share more widely, thus building recognition for their contributions.

Additional specific suggestions included analysis of UN data on medical and public health impacts of disasters, and providing expertise on how to respond when high tech solutions involving use of internet and advanced medical technology fail due to emergency conditions. Many had praise for NLM's current services, yet others had limited experience, especially among the emergency practitioners. One reason suggested for their more limited use was the lack of information for immediate practical use in emergency response. In addition to the structured questions, respondents were given the opportunity to provide additional information or comments not addressed by the study instrument.

Responses primarily dealt with major process issues that, at least indirectly, lead to problems in the information functions that are necessary to carry out various phases of emergency preparedness and management. These include lack of communication and information exchange between the medical and the community service operations; unclear roles and responsibilities of the federal, state, and local agencies with respect to degree of aid and recovery of the public; the need for improved cooperation and coordination among the various agencies; and more explicit treatment of ethical issues.

Though the focus of this needs assessment was in the areas of emergency medical response and public health, the investigators also emphasize that the health and medical areas integrate with a great many other aspects of a disaster, making it difficult to consider issues in isolation from other concerns like infrastructure, living necessities, transportation, and logistics. At least half of the 34 respondents were involved in other areas of emergency preparedness and management. The overall goal of this study is to aid in determining the views of potential users about the most significant knowledge, information, and services they are seeking, some of which might be incorporated into the development of the Disaster Information Management Research Center DIMRC planned by the National Library of Medicine or into other related efforts.

We were asked to: "assist NLM in determining the current information seeking behavior, existing preferred sources of information, and unmet information needs of people researchers, practitioners, volunteers, non-profit organizations, local communities, and local, state, and federal government agencies involved with emergency planning, preparedness and response to disasters with potential or actual medical and public health consequences. After describing the methodology, the respondents are all briefly described, so that the reader may understand the qualifications of the emergency response professionals who provided the information.

Then responses to each of the questions we asked are summarized. Appendix C includes the full set of responses by each of the 34 respondents. This is a long appendix; however we encourage the reader to skim this and to read carefully any of the answers to particular questions that most concern them. Our summaries in the body of this report cannot convey the richness of the ideas and viewpoints and the diversity of interests and concerns in this area of emergency preparedness and management. For anyone seeking to set specific requirements or objectives the actual responses are necessary reading.

For those seeking added sources of useful information there is a tremendous list of websites scattered throughout the comments. In addition one of the appendices D is a list of well described international websites. A number of the respondents contributed information on actual activities they are involved with to help handle the information overload problem in this field.

A number of these represent grassroots volunteer efforts to aid their fellow professionals in finding useful information. We have specifically included some of these as examples Appendix A to illustrate what is taking place. We summarize these Section 5 after we provide an overview of the individual responses. One of our respondents Marv Birnbaum, Professor at the University of Wisconsin , provides us with a set of slides he produced for a presentation at WHO World Health Orientation and we have incorporated these in the first of the examples section Appendix A with his permission.

They focus on data which illustrates two important points that support empirically many of the views of the respondents:. The categories that emerged through discussion with NLM and some initial participants in the study are:. Emergency Response Managers with some experience dealing with actual emergencies with public health components.

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Medical professionals generally doctors with some experience with large scale emergency medicine. Academics and librarians working in the area of health-related issues in emergency response and the information systems to support this response. International professionals in any of the above categories or Americans focused on international activities. An initial list of identified experts to be invited was developed by NLM supplying some names, mainly of medical professionals and librarians, and by our using our contacts through ISCRAM Information Systems for Crisis Response and Management and research in the field mainly for categories a and d above.

Invitations were sent by email, often followed up by telephone. This type of "snowball" sampling works very well in obtaining the cooperation of busy experts and increasing the response effort and rate. A total of approximately experts were contacted over the period of September through December of As of this report, we have 34 complete responses. A description of the participants follows. Most of them agreed to inclusion of their name and brief information about their relevant experiences in this report, while a few wish to remain completely anonymous.

However, when we administered the first three interviews face to face, we discovered problems with this procedure. First of all, it took almost a full day to travel to the location of the experts, and administer the interview, which took approximately 1 to 1. Secondly, transcription of these long interviews was a problem, taking about a day. But most importantly, the interview process did not obtain the detailed information about specifics of their information seeking behavior that we needed. And, the personal interview, while it developed rapport, tended to lead to stories of experiences during emergencies that were interesting and informative, but not really the topic of the inquiry.

Thus, we modified the interview guide slightly and turned it into a self report. The self report form for this guided inquiry is attached as Appendix B. Questions were dealt with through many email messages and phone calls. When a response was promised but not received within approximately a month, reminders were sent by email. We obtained much richer and more relevant information from this process than from the personal interviews, and the respondents actually took less time, most completing in under an hour.

The information supplied was already in the form of Word or HTML documents and required no transcribing. First, it used computer networks to gather the responses. Second, the sampling method took advantage of the professional social networks of the initially identified experts to obtain additional participants. The logical next step in this process would be to take the numerous needs and requirements developed in this document to a larger group of respondents for evaluation with respect to relative value to the practitioner community.

This would result in a full scale Delphi exercise. Norman Dalkey's early Delphi experiments at RAND showed that three to five experts in a very specific area usually were sufficient to cover the range of qualitative insights about a given issue or topic within their specialty. More experts in the same effort usually led to duplication of insights rather than generating new insights.

Our major categories of participants in this qualitative inquiry did satisfy those requirements:. Emergency Practitioners and Coordinators 7. The remainder of the body of this report summarizes the responses to the questions asked, in the order in which they were asked. Appendix C gives the complete set of responses to each question, broken down by category of respondent Emergency response managers, medical personnel, librarians, academic researchers, and international practitioners.

List of respondents. For the purposes of this summary we have divided the respondents into four categories. Emergency Practitioners and Coordinators. Those actively working in the field and involved in dealing directly with emergencies. Health Related Professionals. Those working as professionals in the health and medical fields who have had some responsibilities and experiences in any phase of emergency preparedness and management. Who are or have been working on topics related to emergency planning, management or response with medical or health concerns, but clearly the other two categories are not their primary function.

They may also have done some work in either or both of the first two categories. We have noted two sub-categories: Librarians and Academics. International professionals. This includes both citizens of foreign countries and Americans who are involved in international emergency management activities, who may fit in any of the above 3 categories.

For each question we have grouped the answers to a given question into one of the categories. This may provide some insight into some of the responses but there are cases of overlap between points made among the four groups. In some cases anonymity has been preserved due to a request from the contributor. There are two parts of the job. Curtin started working for the Red Cross 35 years ago at disaster sites, for 17 years total. Five or 6 years for FEMA. Erik R. He assisted with technical aspects of long-term recovery phase response to the attack on the Pentagon.

From he was a Toxicologist with the Michigan Department of Community Health, where he assisted in preparation of agency response plans, including risk communication materials for chemical events. He coordinates all hazard mitigation related activities for the Port Authority. Websites: www.

Ann E. Prior to that he was Assistant Commissioner for the same role and prior to that Executive Director. And then prior to that he was with the Navy working with chemical, biological warfare and intelligence related to this area. Eric K. Noji, M. Three years, participation in at least 6 national emergencies and exercises. Peter G. Goldschmidt is an expert in public health systems and policies. He has been responsible for a significant number of major policy studies in Healthcare.

Responsible for Disaster Planning for the Library. John R. Editor of a Journal in Emergency Management and many years of research in the area. Irene Jillson, Ph. Teaches complex emergencies with a focus on international emergencies and the roles and responsibilities of public and private sector entities in situ as well as international, regional and bilateral donors and relief agencies. Julie Dugdale, Ph. Specializes in simulation and emergency management. For over 15 years he has specialized in the application of remote sensing and GIS, primarily within the fields of disaster risk reduction and humanitarian assistance.

Between , Dr. Anonymous, many years of practical experience in the management and design of Humanitarian Information Systems. Previously served as:. International Emergency Management and Disaster Relief, till present, with emergencies including:. Began a global campaign to mobilize support for Telemedicine in Disaster Management in with a paper at the 6 th International Conference on Medical Applications of Telemedicine at Uppsala University , Sweden.

What sources do you currently consider as highly useful and important for emergency preparedness or response missions with medical or public health implications e. The diversity of sources listed is very great, with some respondents sending us lists or links to hundreds of sources.

The only sources that are mentioned by a substantial number of respondents are web sites. Figure 1 profiles the leading three websites, mentioned by at least four of the respondents. The CDC website is by far the most frequently mentioned 11 times, explicitly. The third most frequently mentioned, especially by international professionals, is Relief Web.

Thus, the types of journals and other non-web sites mentioned are especially diverse. We encourage the reader to at least skim the richness and diversity of the answers to this question in Appendix B. The fact that the most frequent website is only mentioned 11 times out of the 35 respondents is further testimony to this. Figure 1. This is part of the CDC site devoted to all kinds of emergency medicine information, as shown below in the main page.

Bioterrorism Emergencies. Mass Casualties. Preparedness Tools. Chemical Emergencies. Nerve Agents. Toxic Alcohols. Winter Weather. Radiation Emergencies. Acute Radiation Syndrome. Dirty Bombs. Nuclear Blast. Bridge Collapse. A notable feature is that it has separate pages for the general public and for the medical professional, e.

Lessons Learned Information Sharing System www. The central component of LLIS. It also serves as a central repository of relevant government homeland security documents and events. The system is frequently updated with new reports and publications intended for homeland security personnel.

ReliefWeb www. This is the global hub for time-critical humanitarian information on Complex Emergencies and Natural Disasters. The first part of this question asked was about general needs:. The practitioners were especially dissatisfied with their ability to get the current information they need, when they need it.

A web search on any given topic will likely turn up multiple resources. Unfortunately, we are still depending on traditional read: antiquated means of communication. There is a lot of clinical information, much of which is redundant, and not enough logistics and management info by comparison. Needs to be made intellectually accessible to those without radiation expertise. Using multimedia helps as this area is very technical. For instance, one notes:. It would be ideal if there were similar one-stop-shopping sites for other threats.

They would need a point person or two to communicate with experts to update the latest information and delete outdated recommendations. Psychosocial Assessment tools. Post Disaster Response Assessment instruments. A centralized data repository with raw data published or research in progress. NLM could input national resources and local projects could input regional data. It often contains the most up-to date and most relevant content. Specific examples were then requested as follows:. Can you give one or two specific examples of emergency situations or preparedness phases in which information was needed but was difficult to obtain?

Two practitioners referred to missing information after Online templates and related information could be provided to help to put together that information for any specific disaster. The second referred to wading through inches of ash two days later and thinking it was probably toxic, that people should have respirators on, but nobody had issued bulletins about this. Pediatricians were caring for senior citizens; psychiatrists were caring for gynecology patients. No one had their medical records, or prescription records with them. Access to quality information at a previously unauthorized site Astrodome, George R.

Brown Convention Center was needed immediately. In other words, what is missing in specific situations is up to date information and action advice about that specific emergency and locale. Need to improve rapid assessment of needs data for decision making, actionable threat awareness. What sort of methods or methodologies e. Clearly information overload is a problem faced by just about everyone in this field. This emphasizes the need for …"peer-reviewed materials that do not necessarily have to be present in a journal form peer-reviewed web sites may do fine e.

We have drawn a number of examples in Appendix A of this report that include some grassroots examples. While many are coping with the problem and have established a workable approach for their situation, it is clear they are suffering the stress produced by the "opportunity costs" they are encountering.

There is a general feeling that there is better information out there but they are not aware of where the specific things they need or should need are or what they are and how they can find them when their responsibilities and duties leave them little extra time. Can one do better plans, improve training, and choose better actions or decisions based upon some information or wisdom that is somewhere but which they have not accessed? Trust in sources and things like the lack of cooperation or collaboration between different organizations or levels of government is also an underlying problem.

When organizations do not feel, for whatever reason, they can expose their mistakes and seek to eliminate them through integrated efforts then there is no way the improvements can be made to create an HRO High Reliability Organization among all the diverse groups that must be involved in the integrated planning, training, responsiveness, or recovery processes of an emergency or disaster situation. A lot of different sources are attempting to become the one source that everyone should go to for disaster information, and this is not a worthy goal given the diversity of topics and problems that are involved.

Or, what would you like to see done to cut down the time to find useful new material? Using the SNS Strategic National Stockpile of medical resources list serve as an example, there are so many submissions that it is tempting to read none. Somehow they need to be categorized, and it needs to be possible to unsubscribe to portions of a list serve or to filter in what you would like to receive. It is clear they feel the need for experts that are devoted to the information classification problem that goes beyond the abilities of a general reference librarian.

It would seem to say that librarians need to develop systems where the expert-users can make recommendations on the quality and content of the items be covered if in fact one is going into the gray literature.

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Clearly a lot of what actual practitioners want is the gray literature. Even the professional vetted journal literature differs considerably in the relevance to a particular situation and this is important to many of those in positions of management or practitioner experts. Clearly there is no time to hunt down needed materials in the actual disaster phase.

Will also need an expert such as an epidemiologist to consolidate data from a variety of sources, formats etc There seems to be a feeling that in some ways too much guidance on what to do and not enough focused help is being generated on how to do it. Universities, Institutes and the Federal Government need to provide consulting services often referred to as technical assistance to Grant Awardees and other governmental and Private Sector Healthcare entities. We need less guidance and much more hands on assistance. There are repeated assertions elsewhere that the official documents often have no common internal framework relevant to the emergency community and this makes it difficult in dealing even with the official material.

Considering the wide range of agencies and contractors involved this has a ring of truth to it. However, in some areas, like dealing with emergencies like pandemics, we have not had much experience with it might be too soon to try to impose such standards. Setting up a separate integrative portal for each type of disaster was suggested and might be a worthy goal if it truly allowed cooperation and collaboration among different vetted professionals and organizations in compiling and judging the quality of the material. Note that users seem to want a much more hands on collaboration for contributing and evaluating material.

One on the Information Revolution and the other on Web 2. From the examples we have collected via our participants it is clear the users are anxious to help one another as a community of practice and in the emergency field this trend is going to continue unless they are brought in as an active part of the formal systems that seek to support them. Once again, a lot of the examples in Section 5 and Appendix A are free and based upon efforts of unpaid volunteers.

Are there any other specific medical, health care, public health disaster plans or training materials or web based resources that you consider outstanding examples of such material? Online training materials and courses are mentioned, as well as Wikipedia, as being very useful for volunteers fire departments and other community service organizations and for local communities that do not have the funds or access for more costly sources of material.

Question 5. The diversity of responses is similar to that for the first part of question 5. Some specifics that seem notable include:. Vital baseline health data e. This will require the identification of potential risk areas around the world for disasters, vulnerable populations, mass population movements, and to target these countries for contingency planning and advance health information gathering.

Specific compilations of local "best practices," actual plans for organizations such as hospitals and community service organizations, schools, local agencies so that practitioners can compare and evolve improvements in these areas relevant to their localities. More online training for health related problems in disasters, aimed at potential first responders and others likely to be on site.

This is where I see a major role for Go Local. Are there other particular services a local or specialized library should or could provide? One emergency practitioner gave a very complete set of special requirements for such crisis situations, including:. Particularly, "human generated" events Chemical, blast, technological, transportation, radiological, nuclear emergencies etc would require very specialized information requirements… including baseline health indices, diseases, in-country capacity such as the following:.

Health data such as:. Basic ethnographic data on populations at risk of adverse health consequences from disasters. This could include some medical anthropology data so that health programs and interventions could be made more culturally acceptable. Database of in-country NGOs, UN agencies, and their resources this may include many development organizations, but many of these may also have emergency relief capabilities. Ideally, this would include list of key individuals and points of contact information but such information may change too often to be readily kept up to date.

Description of the country's disaster plan, if any. Specifically, this would include what ministries, etc. Organization of health professional training in the country of origin. Local and regional laboratory capabilities for identification of causative organisms and antibiotic sensitivity testing, drug resistance e. If not available in-country, should note guidelines for transport. In-country production capacity for and availability of drugs, jerry cans, cooking kits, etc. In-country availability of food stocks.

This type of information simply is not available now. If we lose Internet, how to disseminate information? If schools are closed, librarians with families are not available to fulfill their roles, unless library planning incorporates school planning. Is there hazard pay for staying in an area deemed at risk? In terms of creating an index general ontology out of a sample document database that can then be used to automatically classify new information as it occurs, what would you want included in such a database and what specific topic areas would you want to see in the resulting index or ontology?

This is a question that may be very difficult to answer based upon cognitive differences. Those who are able to deal with abstraction usually have a better chance of conceptualizing a more complete specification of terms as opposed to those who deal better with data specifics and are very oriented to specifics.

Both types of problem solving processes are represented. We had a wide range of responses from one single term to thirty eight terms in a two level hierarchy. A significant variety of types of emergencies are represented. There is recognition that the dimension of terrorism introduces the possibility of risks that create medical problems that are the common ones that medical and health care professionals may be familiar with in a given locality.

Hence the need, as expressed, elsewhere for very selective retrieval capabilities.

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The need for great precision in finding material is quite clear in an emergency situation. Over time changes have occurred and every large scale disaster introduces new problems we did not think about before, with Katrina and being prime examples. The emergency of the pandemic as a new risk requires not only new terms to represent new problems to be addressed but also the necessity of integration of other dimensions of concern over extended periods of time. All the supporting infrastructure and logistic maintenance of normal consumable resources cannot be separated from the medical situation.

This is evident for a short time scale of weeks in Katrina but in a true pandemic this might be years, both for the disaster phase and the recovery phase of an emergency. This need for dynamic changes in the indexing of information is evident in the following quote from the contributions:. One only has to observe that of all the ontologies created by librarians to date, why are none of them used by any of the popular Web search engines??? The above change in terms due to a better understanding over the long term is further complicated by the change in the required information over the phases of emergency preparedness and management.

That which is useful for education, clinical care, research, recovery, reconstruction etc. Whatever the process there has to be allowance for change and knowledge structures that can evolve to meet changing needs. In terms of current technologies this means some combination of automation and direct involvement of the expert users themselves to be the source of new classification requirements.

Question: The national Library of Medicine has an important role in aiding other countries in the accumulation and dissemination of medical information and knowledge. What specific contributions in the above disaster information areas might be important for NLM to provide internationally? Cultural and language diversity were noted by several contributors, e. A lot of care would also be needed to make it culturally appropriate. Last, but in many ways first, it would need to entail a dialogue with stakeholders to see what — if anything — they would like from such a resource.

If NLM can more or less provide such a service, international disaster relief may become more effective because we would be able to achieve the following:. By facilitating more efficient targeting of response, NLM will contribute to more efficient use of shrinking funds for international humanitarian assistance. What contributions from other countries could be made to NLM in the disaster information area?

This could include important information sources in other countries not traditionally used in the U. There is a lot of material in other countries — local contingency plans, lessons learned, case studies, etc — but it is difficult to access as many of these documents are either not in digital form or are held locally. By providing an example of open document collection, NLM could work with other institutions in these countries to encourage and help them to share more widely, thus building recognition for their contributions.

One of the great things developing countries could teach us is how to respond if all our high tech solutions internet, advanced medical technology fail such as if there were large blackouts or in events like a large earthquake, etc. If so characterize your experience and reaction. The gold standard. There is very little information related to public health management or public health emergency management. My experience has been similar with PubMed. It is clear there is a general feeling of information overload among those in this field and the possibilities of improved library oriented professional help would be welcome.

Please add any other information or comments that you think we should have asked for or any questions that should be added to the response guide. This turned out to mostly attract major issues which at least indirectly do lead to problems in the information process necessary to carry out various phases of emergency preparedness and management. These in summary form are:. Lack of communication and information exchange between the medical and the community service operations in emergencies and in particular after the immediate response is over.

Not clear from the legislation and policies what the goals and responsibilities are of the federal, state, and local agencies with respect to degree of aid and recovery of the public. Defining roles: beneficiaries, information suppliers, information users, target audience, stakeholders, investors, etc. Better working definitions of various concepts such as scope of an emergency, coherent conceptual models, degree of quality improvement, measures of the threat.

In the process of obtaining this material we encountered from the respondents and from our activities in searching for respondents many examples of either the documentation of the plethora of sources, that creates overload, or efforts to create aids for the reduction of information overload among practitioners.

Many of these can be considered as "grass roots" efforts in that a single individual or a small team of individuals concerned with some area of emergency management and response banned together to supply an information service. Many of those involved are practitioners in the field and the problems they had over the years in sorting out relevant information from the volume of information being generated led them to track and document their success as well as making it available to other practitioners. But we only consider situations that were free to practitioners and largely publicly available on the Web with one exception.

The examples, which are described, are included in appendix A to this report. They are:. There are numerous observations made throughout the document both in the summaries and in the detailed compilations of the viewpoints of the respondents, who are emergency response practitioners and experts, broadly defined. Here we first restate and summarize what seem to be the most important unmet needs related to medically-related emergency preparedness and response, affecting the ultimate choice of options for NLM's efforts in this area.

Then we also provide a list of some summarized observations from the data. A recommender system for expert communities communities of practice is one possible approach to this problem. Experts in specific areas expressed the need to be able to nominate and evaluate specific gray literature documents and view the collective results of this for their given peer group. In addition, they want to be able to link this material to tags appropriate for their specialty group.

One can expect software to do this to evolve in the growing effort to provide tools for communities of practice and a growing effort internationally to provide open source software for international humanitarian efforts. Another aspect is the frequently expressed need for more complete indexing of terms for health-related emergency response information resources. Useful indexes would cover all kinds of health-related emergencies and also be tied to region-specific information. They would be usable by emergency planners and responders as well as by physicians. We also offer the following observations to keep in mind in thinking about services that could be provided by DIMRC, each arising from several mentions, but not meant to be rank ordered:.

Will this trend continue in the years ahead? The question is difficult to answer precisely, because the factors shaping international migration flows are tremendously complex and hard to predict, as are changes in the migration policies of receiving countries. Yet clearly decision makers in government, business and society at large would be better equipped to address the opportunities and risks if they had a better understanding of the developments likely to influence global migration over the longer term.

This book explores the social, economic and environmental forces that may combine to attract migrants of various types and backgrounds to OECD countries, as well as those that may persuade migrants to leave their countries or to stay at home. By analysing different pull and push factors and constructing five different scenarios of migration in the future, this volume endeavours to cast light on a range of key questions.

Which factors will be major determinants of global migration flows?