On the Effectiveness of Security Countermeasures for Critical Infrastructures

A game-theoretic model is developed where an infrastructure of N targets is protected against terrorism threats. An original threat score is determined by the terrorist's threat against each target and the government's inherent protection level and original protection. The final threat score is impacted by the government's additional protection. We investigate and verify the effectiveness of countermeasures using empirical data and two methods. The first is to estimate the model's parameter values to minimize the sum of the squared differences between the government's additional resource investment predicted by the model and the empirical data. The second is to develop a multivariate regression model where the final threat score varies approximately linearly relative to the original threat score, sectors, and threat scenarios, and depends nonlinearly on the additional resource investment. The model and method are offered as tools, and as a way of thinking, to determine optimal resource investments across vulnerable targets subject to terrorism threats.

Performance of a plastic-wrapped composting system for biosecure emergency disposal of disease-related swine mortalities

A passively-ventilated plastic-wrapped composting system initially developed for biosecure disposal of poultry mortalities caused by avian influenza was adapted and tested to assess its potential as an emergency disposal option for disease-related swine mortalities. Fresh air was supplied through perforated plastic tubing routed through the base of the compost pile. The combined air inlet and top vent area is ⩽∼1% of the gas exchange surface of a conventional uncovered windrow. Parameters evaluated included: (1) spatial and temporal variations in matrix moisture content (m.c.), leachate production, and matrix O2 concentrations; (2) extent of soft tissue decomposition; and (3) internal temperature and the success rate in achieving USEPA time/temperature (T) criteria for pathogen reduction. Six envelope materials (wood shavings, corn silage, ground cornstalks, ground oat straw, ground soybean straw, or ground alfalfa hay) and two initial m.c.'s (15-30% w.b. for materials stored indoors, and 45-65% w.b. to simulate materials exposed to precipitation) were tested to determine their effect on performance parameters (1-3). Results of triple-replicated field trials showed that the composting system did not accumulate moisture despite the 150kg carcass water load (65% of 225kg total carcass mass) released during decomposition. Mean compost m.c. in the carcass layer declined by ∼7 percentage points during 8-week trials, and a leachate accumulation was rare. Matrix O2 concentrations for all materials other than silage were ⩾10% using the equivalent of 2m inlet/vent spacing. In silage O2 dropped below 5% in some cases even when 0.5m inlet/vent spacing was used. Eight week soft tissue decomposition ranged from 87% in cornstalks to 72% in silage. Success rates for achievement of USEPA Class B time/temperature criteria ranged from 91% for silage to 33-57% for other materials. Companion laboratory biodegradation studies suggest that Class B success rates can be improved by slightly increasing envelope material m.c. Moistening initially dry (15% m.c.) envelope materials to 35% m.c. nearly doubled their heat production potential, boosting it to levels ⩾silage. The 'contradictory' silage test results showing high temperatures paired with slow soft tissue degradation are likely due to this material's high density, low gas permeability and low water vapor loss. While slow decomposition typically suggests low microbial activity and heat production, it does not rule out high internal temperatures if the heat produced is conserved. Occasional short-term odor releases during the first 2weeks of composting were associated with top-to-bottom gas flow which is contrary to the typical bottom-to-top flow typically observed in conventional compost piles. In cases where biosecurity concerns are paramount, results of this study show the plastic-wrapped passively-ventilated composting method to have good potential for above-ground swine mortality disposal.

Implementing the global health security agenda: lessons from global health and security programs

The Global Health Security Agenda (GHSA) describes a vision for a world that is safe and secure from infectious disease threats; it underscores the importance of developing the international capacity to prevent, detect, and respond to pandemic agents. In February 2014, the United States committed to support the GHSA by expanding and intensifying ongoing efforts across the US government. Implementing these goals will require interagency coordination and harmonization of diverse health security elements. Lessons learned from the Global Health Initiative (GHI), the President's Emergency Program for AIDS Relief (PEPFAR), and the Cooperative Threat Reduction (CTR) program underscore that centralized political, technical, and fiscal authority will be key to developing robust, sustainable, and integrated global health security efforts across the US government. In this article, we review the strengths and challenges of GHI, PEPFAR, and CTR and develop recommendations for implementing a unified US global health security program.

Adapting healthcare security officer training to changing times

The need to conduct field training programs of new officers instead of "learning by doing" has become essential as violent incidents in hospitals keep increasing, the author says. In this article he outlines the elements of a successful field training program.

Nano/micromotors for security/defense applications. A review

The new capabilities of man-made micro/nanomotors open up considerable opportunities for diverse security and defense applications. This review highlights new micromotor-based strategies for enhanced security monitoring and detoxification of chemical and biological warfare agents (CBWA). The movement of receptor-functionalized nanomotors offers great potential for sensing and isolating target bio-threats from complex samples. New mobile reactive materials based on zeolite or activated carbon offer considerable promise for the accelerated removal of chemical warfare agents. A wide range of proof-of-concept motor-based approaches, including the detection and destruction of anthrax spores, 'on-off' nerve-agent detection or effective neutralization of chemical warfare agents have thus been demonstrated. The propulsion of micromotors and their corresponding bubble tails impart significant mixing that greatly accelerates such detoxification processes. These nanomotors will thus empower sensing and destruction where stirring large quantities of decontaminating reagents and controlled mechanical agitation are impossible or undesired. New technological breakthroughs and greater sophistication of micro/nanoscale machines will lead to rapid translation of the micromotor research activity into practical defense applications, addressing the escalating threat of CBWA.

Volunteering Internationally: Why, Where and How

Oral health volunteers have an important role in addressing oral health care shortages around the world, but to be effective they need to understand and prepare for the challenges of working overseas.

Never ever? Characteristics, outcomes and motivations of patients who abscond or escape: A 5-year review of escapes and absconds from two medium and low secure forensic units

BACKGROUND

Absconds and escapes by psychiatric patients from secure forensic psychiatric settings create public anxiety and are poorly understood.

AIMS

To describe secure hospital patients who escape from within the secure perimeter or abscond, and test for differences between these groups.

METHOD

Escapes and absconds between 2008 and 2012 from the medium and low secure forensic psychiatric inpatient units of two London National Health Service Trusts were identified through the Trusts' databases. Demographic, offending, mental health and incident data were extracted from records for each.

RESULTS

Seventy-seven incidents, involving 54 patients, were identified over the five years. These were 13 escapes involving 12 patients, representing a rate of 0.04 per 1000 bed days, and 64 absconds involving 42 patients, a rate of 0.26 per 1000 bed days; 15 (28%) patients were absent without leave more than once. Over half of the patients came back voluntarily within 24 hours of leaving. Over 50% of them had drunk alcohol or taken drugs while away from the unit. Escapees were more likely to be transferred prisoners and to have planned their escape, less likely to return to the unit voluntarily and away longer than patients who absconded. Offending was rare during unauthorised leave--just three offences among the 77 incidents; self-harm was more likely. Motives for absconding included: wanting freedom or drink or drugs, family worries and/or dissatisfaction with aspects of treatment.

CONCLUSIONS

Escapes or absconding from secure healthcare units have different characteristics, but may best be prevented by convergent strategies. Relational security is likely to be as important for foiling plans for the former as it is for reducing boredom, building strong family support and managing substance misuse in the latter.

The ABCs of the US Broad Spectrum Antimicrobials Program: Antibiotics, Biosecurity, and Congress

Antibiotic resistance has been increasing at an alarming rate in the United States and globally for decades, but the problem has only recently gained broad attention at the highest levels of the US government. More and more patients are dying of infections that do not respond to antibiotics that are currently available. Meanwhile, the antibacterial product pipeline remains fragile in part because of a lack of commercial interest from pharmaceutical companies. The Biomedical Advanced Research and Development Authority (BARDA) Broad Spectrum Antimicrobials (BSA) program leads the US government's effort to bridge this gap by advancing new antibacterials through late stages of clinical development. Other commentators have described in detail BARDA's structure, process, and role in antibacterial development. This commentary offers a public policy perspective on the emerging politics of antibiotic resistance in the context of US biosecurity politics and medical countermeasure (MCM) development. It identifies promising developments and difficult challenges that together will ultimately determine whether BARDA can become a global leader for antibiotic development.

Automatic Fall Detection System Based on the Combined Use of a Smartphone and a Smartwatch

Due to their widespread popularity, decreasing costs, built-in sensors, computing power and communication capabilities, Android-based personal devices are being seen as an appealing technology for the deployment of wearable fall detection systems. In contrast with previous solutions in the existing literature, which are based on the performance of a single element (a smartphone), this paper proposes and evaluates a fall detection system that benefits from the detection performed by two popular personal devices: a smartphone and a smartwatch (both provided with an embedded accelerometer and a gyroscope). In the proposed architecture, a specific application in each component permanently tracks and analyses the patient's movements. Diverse fall detection algorithms (commonly employed in the literature) were implemented in the developed Android apps to discriminate falls from the conventional activities of daily living of the patient. As a novelty, a fall is only assumed to have occurred if it is simultaneously and independently detected by the two Android devices (which can interact via Bluetooth communication). The system was systematically evaluated in an experimental testbed with actual test subjects simulating a set of falls and conventional movements associated with activities of daily living. The tests were repeated by varying the detection algorithm as well as the pre-defined mobility patterns executed by the subjects (i.e., the typology of the falls and non-fall movements). The proposed system was compared with the cases where only one device (the smartphone or the smartwatch) is considered to recognize and discriminate the falls. The obtained results show that the joint use of the two detection devices clearly increases the system's capability to avoid false alarms or 'false positives' (those conventional movements misidentified as falls) while maintaining the effectiveness of the detection decisions (that is to say, without increasing the ratio of 'false negatives' or actual falls that remain undetected).

Humans Are Still the Critical Factor in Aviation Security

INTRODUCTION

In Germany, the German Federal Police assess the performance of aviation security screeners on a regular basis. These so-called "reality tests" are unannounced examinations which aim to investigate whether airport screeners can detect forbidden items in hand luggage or attached to the body. Recent alarming results of such inspections showed clearly that the overall detection rate is in need of improvement. To achieve this, it is important to identify specific factors that influence general screening performance. This especially includes basic cognitive functions like visual screening, alertness, and divided attention, which have come more and more into focus in current fundamental research projects. This brief commentary points out critical factors, contributes background conditions in aviation security screening, and shows possible approaches for enhancement and optimization. Finally, the human aspect is discussed as not only being the weakest factor in security screening, but also one of major importance.

Using an alarm to improve drug trolley safety

Leaving drug trolleys unlocked and unattended during drug rounds creates opportunities for drug theft and tampering. A new device was developed by our trust to detect when an open drug trolley is left unattended; it then sounds an alarm to remind staff to return to the trolley. This article describes use of the alarm on general hospital wards in one trust in the east of England. When the alarm was installed into drug trolleys on ahospital ward, it reduced the number of times unlocked trolleys were left unattended. The drug trolley alarm successfully changed the behaviour of staff on drug rounds and, in so doing, improved patient safety.

Biopreparedness in the Age of Genetically Engineered Pathogens and Open Access Science: An Urgent Need for a Paradigm Shift

Our systems, thinking, training, legislation, and policies are lagging far behind momentous changes in science, and leaving us vulnerable in biosecurity. Synthetic viruses and genetic engineering of pathogens are a reality, with a rapid acceleration of dual-use science. The public availability of methods for dual-use genetic engineering, coupled with the insider threat, poses an unprecedented risk for biosecurity. Case studies including the 1984 Rajneesh salmonella bioterrorism attack and the controversy over engineered transmissible H5N1 influenza are analyzed. Simple probability analysis shows that the risks of dual-use research are likely to outweigh potential benefits, yet this type of analysis has not been done to date. Many bioterrorism agents may also occur naturally. Distinguishing natural from unnatural epidemics is far more difficult than other types of terrorism. Public health systems do not have mechanisms for routinely considering bioterrorism, and an organizational culture that is reluctant to consider it. A collaborative model for flagging aberrant outbreak patterns and referral from the health to security sectors is proposed. Vulnerabilities in current approaches to biosecurity need to be reviewed and strengthened collaboratively by all stakeholders. New systems, legislation, collaborative operational models, and ways of thinking are required to effectively address the threat to global biosecurity.

Primary care providers' perceptions of mobile store-and-forward teledermatology

INTRODUCTION

Although teledermatology offers promise as a tool to increase access to care, adoption has been limited. Understanding the perspectives and experiences of key stakeholders, such as primary care providers (PCPs) and patients, is important to identify opportunities to reduce barriers to adoption and to improve teledermatology programs. Although many studies have examined patients' experiences and satisfaction with teledermatology, few have examined referring PCPs' perspectives.

OBJECTIVE

To identify PCPs' perceptions on the strengths and limitations of teledermatology in order to identify opportunities to improve teledermatology programs.

METHODS

We distributed an anonymous, web-based survey to 30 PCPs involved in a two-year study evaluating a mobile app-based teledermatology platform.

RESULTS

100% (18/18) agreed or strongly agreed that teledermatology increases access to dermatologic care, improves patient care, and is acceptable to patients. 100% (18/18) agreed or strongly agreed that teledermatology provides educational benefit to the PCP. Only 6% (1/18) agreed that teledermatology increases medical liability and 11% (2/18) agreed that it increases risk of a breach in privacy or confidentiality.

CONCLUSIONS

Our findings highlight that PCPs are highly satisfied with mobile app-based, store-and-forward teledermatology and that they believe teledermatology offers synergistic educational benefit. We hope these results will help guide the development of teledermatology programs to increase access to timely, cost-effective care.

The Role of Human Factors/Ergonomics in the Science of Security: Decision Making and Action Selection in Cyberspace

OBJECTIVE

The overarching goal is to convey the concept of science of security and the contributions that a scientifically based, human factors approach can make to this interdisciplinary field.

BACKGROUND

Rather than a piecemeal approach to solving cybersecurity problems as they arise, the U.S. government is mounting a systematic effort to develop an approach grounded in science. Because humans play a central role in security measures, research on security-related decisions and actions grounded in principles of human information-processing and decision-making is crucial to this interdisciplinary effort.

METHOD

We describe the science of security and the role that human factors can play in it, and use two examples of research in cybersecurity--detection of phishing attacks and selection of mobile applications--to illustrate the contribution of a scientific, human factors approach.

RESULTS

In these research areas, we show that systematic information-processing analyses of the decisions that users make and the actions they take provide a basis for integrating the human component of security science.

CONCLUSION

Human factors specialists should utilize their foundation in the science of applied information processing and decision making to contribute to the science of cybersecurity.

Opportunity, Choice, and Burglary Victimization in Taiwan

This study examined burglary victimization in Taiwan with an application of the structure-choice model that included four theoretical dimensions: proximity to crime, exposure to crime, target attractiveness, and guardianship. Drawing on the 2000 Taiwan Areas Criminal Victimization Survey, the results of the current study showed a moderate effect of the opportunity model on Taiwan's burglary victimization. Also, this study found both consistent and conflicting findings in the current data. The null effect of motorcycles (including scooters) that represented the concept of target attractiveness in relation to burglary risk reflected a difference in population density and transportation needs between Taiwan and the West. Clearly, the role of social context needs to be understood when studies apply a Western model to a non-Western context.

Fingerprint Liveness Detection in the Presence of Capable Intruders

Fingerprint liveness detection methods have been developed as an attempt to overcome the vulnerability of fingerprint biometric systems to spoofing attacks. Traditional approaches have been quite optimistic about the behavior of the intruder assuming the use of a previously known material. This assumption has led to the use of supervised techniques to estimate the performance of the methods, using both live and spoof samples to train the predictive models and evaluate each type of fake samples individually. Additionally, the background was often included in the sample representation, completely distorting the decision process. Therefore, we propose that an automatic segmentation step should be performed to isolate the fingerprint from the background and truly decide on the liveness of the fingerprint and not on the characteristics of the background. Also, we argue that one cannot aim to model the fake samples completely since the material used by the intruder is unknown beforehand. We approach the design by modeling the distribution of the live samples and predicting as fake the samples very unlikely according to that model. Our experiments compare the performance of the supervised approaches with the semi-supervised ones that rely solely on the live samples. The results obtained differ from the ones obtained by the more standard approaches which reinforces our conviction that the results in the literature are misleadingly estimating the true vulnerability of the biometric system.

One health security: an important component of the global health security agenda

The objectives of the Global Health Security Agenda (GHSA) will require not only a "One Health" approach to counter natural disease threats against humans, animals, and the environment, but also a security focus to counter deliberate threats to human, animal, and agricultural health and to nations' economies. We have termed this merged approach "One Health Security." It will require the integration of professionals with expertise in security, law enforcement, and intelligence to join the veterinary, agricultural, environmental, and human health experts essential to One Health and the GHSA. Working across such different professions, which occasionally have conflicting aims and different professional cultures, poses multiple challenges, but a multidisciplinary and multisectoral approach is necessary to prevent disease threats; detect them as early as possible (when responses are likely to be most effective); and, in the case of deliberate threats, find who may be responsible. This article describes 2 project areas that exemplify One Health Security that were presented at a workshop in January 2014: the US government and private industry efforts to reduce vulnerabilities to foreign animal diseases, especially foot-and-mouth disease; and AniBioThreat, an EU project to counter deliberate threats to agriculture by raising awareness and implementing prevention and response policies and practices.

Regulatory underpinnings of Global Health security: FDA's roles in preventing, detecting, and responding to global health threats

In February 2014, health officials from around the world announced the Global Health Security Agenda, a critical effort to strengthen national and global systems to prevent, detect, and respond to infectious disease threats and to foster stronger collaboration across borders. With its increasing global roles and broad range of regulatory responsibilities in ensuring the availability, safety, and security of medical and food products, the US Food and Drug Administration (FDA) is engaged in a range of efforts in support of global health security. This article provides an overview of FDA's global health security roles, focusing on its responsibilities related to the development and use of medical countermeasures (MCMs) for preventing, detecting, and responding to global infectious disease and other public health emergency threats. The article also discusses several areas-antimicrobial resistance, food safety, and supply chain integrity-in which FDA's global health security roles continue to evolve and extend beyond MCMs and, in some cases, beyond traditional infectious disease threats.

Strengthening global health security by developing capacities to deploy medical countermeasures internationally

In 2014, the United States in partnership with international organizations and nearly 30 partner countries launched the Global Health Security Agenda (GHSA) to accelerate progress to improve prevention, detection, and response capabilities for infectious disease outbreaks that can cause public health emergencies. Objective 9 of the GHSA calls for improved global access to medical countermeasures and establishes as a target the development of national policy frameworks for sending and receiving medical countermeasures from and to international partners during public health emergencies. The term medical countermeasures refers to vaccines, antimicrobials, therapeutics, and diagnostics that address the public health and medical consequences of chemical, biological, radiological, and nuclear events; pandemic influenza; and emerging infectious diseases. They are stockpiled by a few countries to protect their own populations and by international organizations, such as the World Health Organization (WHO), for the international community, typically for recipients with limited resources. However, as observed during the 2009 H1N1 influenza pandemic, legal, regulatory, logistical, and funding barriers slowed the ability of WHO and countries to quickly deploy or receive vaccine. Had the 2009 H1N1 influenza pandemic been more severe, the world would have been ill prepared to cope with the global demand for rapid access to medical countermeasures. This article summarizes the US government efforts to develop a national framework to deploy medical countermeasures internationally and a number of engagements to develop regional and international mechanisms, thus increasing global capacity to respond to public health emergencies.

Leveraging the laboratory response network model for the global health security agenda

Promoting global health security as an international priority is a challenge; the US Centers for Disease Control and Prevention (CDC) in its Global Health Security Agenda has articulated the importance of accelerating progress toward a world safe and secure from infectious disease threats. The goals are to (1) prevent and reduce the likelihood of outbreaks-natural, accidental, or intentional; (2) detect threats early to save lives; and (3) respond rapidly and effectively using multisectoral, international coordination and communication. Foundational to this agenda is the World Health Organization (WHO) Revised International Health Regulations (IHR) of 2005, which provide the legal framework for countries to strengthen their health systems in order to be able to respond to any public health emergency of international concern. This article proposes leveraging the distributed structure of the US-managed Laboratory Response Network for Biological Threats Preparedness (LRN-B) to develop the core capacity of laboratory testing and to fulfill the laboratory-strengthening component of the Global Health Security Agenda. The LRN model offers an effective mechanism to detect and respond to public health emergencies of international concern.

Health inequalities and infectious disease epidemics: a challenge for global health security

In today's global society, infectious disease outbreaks can spread quickly across the world, fueled by the rapidity with which we travel across borders and continents. Historical accounts of influenza pandemics and contemporary reports on infectious diseases clearly demonstrate that poverty, inequality, and social determinants of health create conditions for the transmission of infectious diseases, and existing health disparities or inequalities can further contribute to unequal burdens of morbidity and mortality. Yet, to date, studies of influenza pandemic plans across multiple countries find little to no recognition of health inequalities or attempts to engage disadvantaged populations to explicitly address the differential impact of a pandemic on them. To meet the goals and objectives of the Global Health Security Agenda, we argue that international partners, from WHO to individual countries, must grapple with the social determinants of health and existing health inequalities and extend their vision to include these factors so that disease that may start among socially disadvantaged subpopulations does not go unnoticed and spread across borders. These efforts will require rethinking surveillance systems to include sociodemographic data; training local teams of researchers and community health workers who are able to not only analyze data to recognize risk factors for disease, but also use simulation methods to assess the impact of alternative policies on reducing disease; integrating social science disciplines to understand local context; and proactively anticipating shortfalls in availability of adequate healthcare resources, including vaccines. Without explicit attention to existing health inequalities and underlying social determinants of health, the Global Health Security Agenda is unlikely to succeed in its goals and objectives.

Global health security agenda and the international health regulations: moving forward

The launch of the Global Health Security Agenda (GHSA) in February 2014 capped over a decade of global efforts to develop new approaches to emerging and reemerging infectious diseases-part of the growing recognition that disease events, whether natural, accidental, or intentional, threaten not just public health, but national, regional, and global security interests. In 2005, the United States, along with other Member States of the World Health Organization (WHO), adopted the revised International Health Regulations [IHR (2005)]. The IHR (2005) conferred new responsibilities on WHO and the global health community to coordinate resources for capacity building and emergency response, and on the now-196 States Parties to develop the core capacities required to detect, assess, report, and respond to potential public health emergencies of international concern. Both GHSA and the IHR aim to elevate political attention and encourage participation, coordination, and collaboration by multiple stakeholders, while leveraging previously existing commitments and multilateral efforts. GHSA and the IHR (2005) are platforms for action; how efforts under each will complement each other remains unclear. Mechanisms that measure progress under these 2 overlapping frameworks will aid in focusing resources and in sustaining political momentum for IHR implementation after 2016.

Automated In-Home Fall Risk Assessment and Detection Sensor System for Elders

PURPOSE OF THE STUDY

Falls are a major problem for the elderly people leading to injury, disability, and even death. An unobtrusive, in-home sensor system that continuously monitors older adults for fall risk and detects falls could revolutionize fall prevention and care.

DESIGN AND METHODS

A fall risk and detection system was developed and installed in the apartments of 19 older adults at a senior living facility. The system includes pulse-Doppler radar, a Microsoft Kinect, and 2 web cameras. To collect data for comparison with sensor data and for algorithm development, stunt actors performed falls in participants' apartments each month for 2 years and participants completed fall risk assessments (FRAs) using clinically valid, standardized instruments. The FRAs were scored by clinicians and recorded by the sensing modalities. Participants' gait parameters were measured as they walked on a GAITRite mat. These data were used as ground truth, objective data to use in algorithm development and to compare with radar and Kinect generated variables.

RESULTS

All FRAs are highly correlated (p < .01) with the Kinect gait velocity and Kinect stride length. Radar velocity is correlated (p < .05) to all the FRAs and highly correlated (p < .01) to most. Real-time alerts of actual falls are being sent to clinicians providing faster responses to urgent situations.

IMPLICATIONS

The in-home FRA and detection system has the potential to help older adults remain independent, maintain functional ability, and live at home longer.

Biosurveillance capability requirements for the global health security agenda: lessons from the 2009 H1N1 pandemic

The biosurveillance capabilities needed to rapidly detect and characterize emerging biological threats are an essential part of the Global Health Security Agenda (GHSA). The analyses of the global public health system's functioning during the 2009 H1N1 pandemic suggest that while capacities such as those identified in the GHSA are essential building blocks, the global biosurveillance system must possess 3 critical capabilities: (1) the ability to detect outbreaks and determine whether they are of significant global concern, (2) the ability to describe the epidemiologic characteristics of the pathogen responsible, and (3) the ability to track the pathogen's spread through national populations and around the world and to measure the impact of control strategies. The GHSA capacities-laboratory and diagnostic capacity, reporting networks, and so on-were essential in 2009 and surely will be in future events. But the 2009 H1N1 experience reminds us that it is not just detection but epidemiologic characterization that is necessary. Similarly, real-time biosurveillance systems are important, but as the 2009 H1N1 experience shows, they may contain inaccurate information about epidemiologic risks. Rather, the ability of scientists in Mexico, the United States, and other countries to make sense of the emerging laboratory and epidemiologic information that was critical-an example of global social capital-enabled an effective global response. Thus, to ensure that it is meeting its goals, the GHSA must track capabilities as well as capacities.

Guatemala's ministry of health rapid response team manuals

The function of public health rapid response teams (RRTs) is to quickly identify, investigate, and control an outbreak before it can spread. The Central America Regional Office in Guatemala provided assistance to the Guatemalan Ministry of Health and Social Assistance (MSPAS) to develop RRT manuals at the district and regional levels. The manuals are divided into 4 sections: background, activity lists, standard operating procedures, and annexes. The manuals outline Guatemala's RRT members' responsibilities and will be tested in the near future through tabletop exercises. The development of the manuals is a concrete and significant step toward the attainment of Guatemala's IHR goals and should be integrated into a larger emergency management system to promote "a world safe and secure from global health threats posed by infectious diseases."

Individual differences in the calibration of trust in automation

OBJECTIVE

The objective was to determine whether operators with an expectancy that automation is trustworthy are better at calibrating their trust to changes in the capabilities of automation, and if so, why.

BACKGROUND

Studies suggest that individual differences in automation expectancy may be able to account for why changes in the capabilities of automation lead to a substantial change in trust for some, yet only a small change for others.

METHOD

In a baggage screening task, 225 participants searched for weapons in 200 X-ray images of luggage. Participants were assisted by an automated decision aid exhibiting different levels of reliability. Measures of expectancy that automation is trustworthy were used in conjunction with subjective measures of trust and perceived reliability to identify individual differences in trust calibration.

RESULTS

Operators with high expectancy that automation is trustworthy were more sensitive to changes (both increases and decreases) in automation reliability. This difference was eliminated by manipulating the causal attribution of automation errors.

CONCLUSION

Attributing the cause of automation errors to factors external to the automation fosters an understanding of tasks and situations in which automation differs in reliability and may lead to more appropriate trust.

APPLICATION

The development of interventions can lead to calibrated trust in automation.

Video Surveillance in Mental Health Facilities: Is it Ethical?

Video surveillance is a tool for managing safety and security within public spaces. In mental health facilities, the major benefit of video surveillance is that it enables 24 hour monitoring of patients, which has the potential to reduce violent and aggressive behavior. The major disadvantage is that such observation is by nature intrusive. It diminishes privacy, a factor of huge importance for psychiatric inpatients. Thus, an ongoing debate has developed following the increasing use of cameras in this setting. This article presents the experience of a medium-large academic state hospital that uses video surveillance, and explores the various ethical and administrative aspects of video surveillance in mental health facilities.

The role of the health physicist in nuclear security

Health physics is a recognized safety function in the holistic context of the protection of workers, members of the public, and the environment against the hazardous effects of ionizing radiation, often generically designated as radiation protection. The role of the health physicist as protector dates back to the Manhattan Project. Nuclear security is the prevention and detection of, and response to, criminal or intentional unauthorized acts involving or directed at nuclear material, other radioactive material, associated facilities, or associated activities. Its importance has become more visible and pronounced in the post 9/11 environment, and it has a shared purpose with health physics in the context of protection of workers, members of the public, and the environment. However, the duties and responsibilities of the health physicist in the nuclear security domain are neither clearly defined nor recognized, while a fundamental understanding of nuclear phenomena in general, nuclear or other radioactive material specifically, and the potential hazards related to them is required for threat assessment, protection, and risk management. Furthermore, given the unique skills and attributes of professional health physicists, it is argued that the role of the health physicist should encompass all aspects of nuclear security, ranging from input in the development to implementation and execution of an efficient and effective nuclear security regime. As such, health physicists should transcend their current typical role as consultants in nuclear security issues and become fully integrated and recognized experts in the nuclear security domain and decision making process. Issues regarding the security clearances of health physics personnel and the possibility of insider threats must be addressed in the same manner as for other trusted individuals; however, the net gain from recognizing and integrating health physics expertise in all levels of a nuclear security regime far outweighs any negative aspects. In fact, it can be argued that health physics is essential in achieving an integrated approach toward nuclear safety, security, and safeguards.