special event case study

Case Studies: Successful Events Using Event Software

Introduction.

In the evolving realm of event planning, success hinges on adapting to the target audience’s demands and creating memorable experiences. This compilation of case studies uncovers the success stories of prominent organizations such as GE Healthcare, leveraging modern platforms in the information technology sector. These stories illuminate the transformative power of event software in orchestrating successful product launches, virtual and hybrid events, and esports competitions across the United States and beyond. They highlight amplified customer satisfaction, enhanced security, significant cost savings, and insightful analytics, offering valuable lessons for event planners on the path to success. Delve into these customer stories to discover how the right platform can elevate your event planning strategies.

5 Event Case Studies

Case study 1: product launch by ge healthcare.

GE Healthcare leveraged a top-tier platform in the information technology sector to successfully launch a groundbreaking product. This case study emphasizes the crucial role of analytics in understanding the target audience, leading to a memorable experience and amplified customer satisfaction.

Case Study 2: Virtual Event In The United States

As the demand for virtual events surged, a prominent firm triumphed in hosting a large-scale virtual event using advanced event software. The event offered attendees an interactive experience and demonstrated impressive cost savings, making it a success story worth noting.

Case Study 3: Hybrid Event In The Information Technology Sector

In this customer story, an IT company adeptly bridged the gap between physical and digital spaces, setting up a hybrid event that attracted a broad audience. The event showcased the platform’s security features, underscoring the importance of safety in memorable experiences.

Case Study 4: Esports Competition

This case study recounts how a leading Esports organization used an event software platform to deliver an exceptional experience for attendees, from live streaming to real-time social media integration. This success story encapsulates the power of creating memorable experiences for a specific target audience.

Case Study 5: United Nations Conference

The United Nations harnessed event software to enhance the attendee experience at a crucial conference. With robust analytics, seamless security, and improved customer satisfaction, this case study is an example of how event planners can utilize technology for successful and impactful events.

The Skift Take: These case studies demonstrate the powerful role of event software platforms in facilitating successful events, from product launches to large-scale conferences. Leveraging technology, organizations like GE Healthcare and the United Nations have improved attendee experience, enhanced security, saved costs, and gained valuable insights. These success stories serve as a testament to the transformative potential of information technology in event planning.

Why Event Badges Will Never Be The Same Again [Case Study]

The digital revolution has forever changed the face of event badges. In our case study, we delve into how technology-driven badges have enhanced the event experience, providing not just identity verification, but also serving as a tool for networking, data collection, and improving overall attendee engagement.

How To Increase Engagement With Your Event App By 350% [Case Study]

In this case study, we unravel the strategy behind a staggering 350% increase in event app engagement. Through a blend of user-friendly design, interactive features, and personalized content, the case underlines the power of a well-implemented event app in boosting attendee interaction and enhancing the overall event experience.

How To Meet Green [Case Study]

This case study explores the concept of sustainable event planning. It illustrates how a platform’s features can facilitate ‘green’ events, thereby reducing environmental impact while ensuring a memorable attendee experience. Such initiatives highlight the potential for event software to contribute meaningfully towards global sustainability goals.

How To Increase Attendance By 100+% [Case Study]

This case study explores the tactics employed by an organization which led to a remarkable doubling of event attendance. The successful campaign, powered by a robust event software platform, offered personalized communication, early bird incentives, and an appealing event agenda, demonstrating the potential of effective marketing strategies in boosting event turnout.

How This Event Boosted Their Success [Case Study]

This case study unravels the success journey of an event that significantly boosted their success using a comprehensive event software platform. The strategic use of interactive features, data insights, and exceptional planning led to a remarkable rise in attendee satisfaction and engagement, underlining the game-changing potential of technology in event management.

In the dynamic field of event planning. The power of leveraging advanced platforms in information technology, as demonstrated in the case studies, is clear. Success stories from esteemed organizations such as GE Healthcare. Underscore the invaluable role of event software in facilitating triumphant product launches, virtual and hybrid events, and even esports competitions. The benefits are manifold, including enhanced customer satisfaction, improved security, substantial cost savings, and the generation of valuable analytics to guide future strategies. These case studies serve as tangible proof that the right technology can significantly elevate the success of your event.

If these success stories inspire you to embrace the transformative power of event software. We invite you to experience the difference firsthand. Orderific is ready to demonstrate how our platform can elevate your event planning process. Book a demo with us today and begin your journey towards unprecedented event success.

What role do event case studies play in the event planning and management process?

Event case studies offer real-world examples of successful planning and management strategies, providing valuable insights and lessons.

How can event professionals benefit from studying real-world success stories in the industry?

They can gain practical knowledge, tactics, and inspiration to implement successful strategies in their own events.

What types of insights can event case studies provide for improving future events?

Event case studies provide actionable insights into effective planning strategies, attendee engagement, and ROI optimization.

Are there specific industries or event types that are commonly featured in case studies?

Yes, industries often featured include tech, healthcare, and entertainment, and event types range from corporate events to music festivals.

How can event planners effectively apply lessons learned from case studies to their own projects?

They can apply these lessons by tailoring the strategies highlighted in case studies. Which aligns with their event’s unique needs and goals.

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How to Craft a Post-Event Case Study

People say there’s no better teacher than experience, but the lesson can’t fully be understood without first putting the story into context.

Reports contain a wealth of valuable information but understanding the big picture is the job of a comprehensive after-event case study. The self-examination a case study provides helps identify the subtler trends, queues and missteps that occurred during the planning and execution of an event, allowing you to address them long before they can become problems at future events. It also provides you with the opportunity to capitalize on areas of your plan with the potential to increase your success rate and prove your success.

Of course, you want to create a case study that details the event, but you also want to create a document that engages its readers. If you are unsure how to get started telling your event’s story, don’t stress, just concentrate on these five important writing rules and you’ll create a complete accounting of your event, as well a great story.

Tell a Good Story

It’s important to identify any fault lines running through your event’s plan, but no one wants to be inundated with negativity. Create a story that allows people to get excited about the high points as they learn about any issues that arose.

Thoughtful use of phrasing is your weapon here—after all, it’s your chance to make your work look its best—but you don’t want to lie or slant the information unfairly. Always tell the tale from a place of neutral acceptance, rather than adding unnecessary dramatic flair or overenthusiastic compliments. If you load up your narrative with too much emotion it diminishes the validity of your reporting.

Three Plot Structure

Every story has a beginning, a middle and an end. Case studies are plotted the exact same way, with an overview of the event at the beginning, a step-by-step accounting of the entire process filling in the middle, and the results of your work as your conclusion.

TIP: Greater Giving Event Software will help you easily track all the details related to an event, making the creating of a great case study easier than ever before! With Greater Giving Event Software you can:

• Manage and track event sponsors
• Track registration, bidders, donors, and procurement
• Create, send and store promotional and thank-you emails
• Capture, centralize, track and manage benefit event or auction details
• Build professional-looking reports
• Track success year-to-year for improved planning over time

Begin by with an explanation of your mission statement, describe your target audience and state your goals. Next, list the strategies and tactics you based on to decide on a theme and program and provide specific information about the reason you chose your vendors. Detail the happenings at the event, with specifics on what was experienced throughout the evening, leading the reader through to the night’s conclusion, then conclude with the results, whether it be in donations, attendance or something else of importance to your organization. If you’ve proven the event was a success; declare it. If the event failed to meet your expectations, provide suggested solutions to the problems you’ve identified in your case study.

Details, Details, Details

You’ve got the basics covered, now it’s time to fill in your case study with interesting details that reveal how the whole event came together. Throughout the case study pull out specific details that aided or hindered the success of the night. Record the highs and lows experienced from set up, to tear down. Call out stand-out team players and service providers that either aided or hampered the activities. Adding as much detail as possible to your case study archives the secrets of your success for future planning.

Deepening the Sensory Experience

Incorporating audio/visual experiences into case studies saved online offers yet another view with new perspectives for future readers. Let readers experience the event through photos, recordings and videos so they can see and hear for themselves what you witnessed. This provides another layer of connection for the readers of your case study and acts as a third leg to prop up your arguments when you want to redirect your efforts or ask for a larger budget.

Instruct your team to use their mobile phones throughout the night to record everything they find interesting, difficult or exciting about the evening. When putting your case study together search for additional footage from attendees through the hashtag you generated for event night to get your attendees perspective, as well.

Seek Out Testimonials from Attendees and Sponsors

Nothing speaks louder than the accolades of your community. Ask for quotes from your sponsors and guests and add them into breakout boxes to increase visual interest in your case study. Look for quotes that back up the information you’ve gleaned from your reporting and place it in the document next to that specific information. Focus your questions on different portions of the night’s program. Ask your guests and sponsors questions such as whether the theme reflect the mission of the organization? Did the sponsors feel as though they were represented properly? Was the entertainment a compliment to the organization’s mission?

Dathan Montes

Dathan is the Digital Marketing Associate at Greater Giving where he is focused on marketing initiatives benefiting the sales and customer support departments. Prior to his current role, he spent several years working in the online search marketing industry. Outside of Greater Giving, Dathan enjoys spending time with his family, collecting and restoring vintage BMX bicycles.

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Event Management

5 Event Case Studies

Skift Meetings Studio Team

January 13th, 2017 at 10:00 AM EST

Event planners are creating effective and successful events every single day, but on the whole we could do better with sharing event data and best practice. Here are 5 event case studies we can all learn from.

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Whether it is down to time, client confidentiality or protecting our ideas and ways of working eventprofs seem to struggle with shouting about our achievements and letting others benefit from our successes (or failures).

When a project is over we brainstorm and analyze internally within our team and with our clients but very few of us publish meaningful data and outcomes from our events for others to learn from and be inspired by. Perhaps this is one of the reasons why some executives struggle to appreciate the results and return that events can bring and why we still battle to protect event budgets in times of austerity?

As an industry we should work harder to crystallize the Return on Investment and Return on Objectives so there can be no doubt about the importance and relevance of events to the marketing mix. We need to demonstrate more clearly exactly how we added or created value through our events to prove that they are essential.

These 5 case studies from 2016 focus on events that achieved their objectives and share top tips on their learnings and data.

Why Event Badges Will Never Be the Same Again [Case Study]

The 2016 Seattle GeekWire Startup Day used technology to help attendees get more from networking opportunities at the event and improve the experience. Through smart event badges they were able to create a total of 9,459 positive matches between participants with shared interests and analyze more closely the supply and demand.

How to Increase Engagement with your Event App by 350% [Case Study]

If you invest in a mobile app for your event you want to be sure that people will download and use it. This case study outlines how the MAISON&OBJET exhibition increased engagement with their event app by 350%

How To Meet Green [Case Study]

One of the objectives of the Canadian Medical Association Annual Meeting was to create the greenest event going. Focusing on three main areas, this is how they did it and the difference they made.

How to Increase Attendance by 100+% [Case Study]

Streamlining the registration process can have a big impact on workload and numbers. This case study shares how the Colorado Judicial Branch doubled the number of attendees for their largest conference and saved countless hours of administration time.

How This Event Boosted Their Success [Case Study]

Running regional events as part of a country-wide tour has plenty of challenges. This case study looks at how The Get Fit and Thick tour streamlined their processes for event success across the US.

In Conclusion

As these 5 case studies demonstrate, events can make a difference at a micro and macro level. As an industry let’s make a pledge to share our learnings, both positive and negative. By taking this bold step we can educate and support each other to run more effective events and further professionalize the event industry and spend event budget where they will yield the greatest results. We know the importance of events, and event technology , we need to do more to prove it to those that still need convincing.  

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Across the Country: How Immersive Experiences Shine Throughout the U.S.

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Virtual Event

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New Day Foundation for Families relies on fundraising events every year to support their mission. The critical work of the nonprofit organization reduces the catastrophic effects of financial toxicity for families faced with a cancer diagnosis. So, when the COVID-19 pandemic hit in 2020, canceling their annual fundraiser, the Hope Shines gala, was not an option. With less than two months until event day, New Day Foundation partnered with Special D Events to reimagine their program virtually and create the Hope Shines No Show Glow gala.

Host an entertaining event that effectively communicates the mission of the New Day Foundation for Families, while raising vital funds to support the cancer community.

The planning team met regularly to strategically design a program that was uplifting, impactful and fun. New Day Foundation was fortunate to have a great deal of video content, paired with a wide network of both celebrity and community voices to participate. The real challenge was to create a program that not only captured, but maintained, the shortened attention span of a virtual audience. The team was charged with pivoting from a three-hour live event to a one-hour virtual program, with hundreds of attendees and donors.

Special D Events worked with New Day Foundation to create a production show flow that integrated with their auction website, ClickBid. The team brought in a production partner that featured several studios, allowing the event to feature different scenarios throughout the evening. The end result featured 11 prerecorded videos, two stages, one emcee, two musicians, two presenters, a live cocktail-making segment, one Livestream phone-in guest and a silent auction.

In addition, the Special D Events team ensured rigorous safety protocols were in effect on rehearsal and event day, including temperature checks, masks and, of course, social distancing for the limited, in-person gala presenters.

The event raised more than $23,000 in direct donations and attracted more than 500 users on the auction website, about 100 more people than the number of attendees at past live events. New Day staff described the virtual event as “our best yet in terms of net total!”

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Watching It All Come Together: Case Studies Report on Special Event Planning and Management

Counties and municipalities throughout the United States host numerous national and regional planned special events including parades, festivals, and demonstrations, as well as many local events such as block parties and neighborhood festivals. Special Events is also the term given to unplanned, unwanted situations such as weather-related and other types of emergencies. Whether planned or unplanned, local jurisdictions need to be ready to mobilize and respond by collaborating and planning together. Attention is always focused on how the transportation system is performing as a jurisdiction hosts a fair, golf tournament, national political convention or other major events. This case studies report is designed to help the reader learn from others across the country. Useful strategies include cross boundary leadership needed to direct transportation, law enforcement, emergency management and agency professionals who might be unfamiliar with these ideas or have a difficult time working together. This report is designed to help those individuals who may be involved in planning, managing or operating a planned or unplanned event. The case study format offers an in-depth perspective of the different types of strategies currently used for particular special events across the U.S. Each example explores the challenges posed by the event, agencies involved, pre-event planning, day-of-event operations and management, the effect on neighborhoods and the relationship to other transportation needs.

• Record URL: https://rosap.ntl.bts.gov/view/dot/50030

Public Technology, Incorporated

Federal Highway Administration

• Publication Date: 2004-8
• Media Type: Print
• Features: Bibliography; Photos; Tables;
• Pagination: 84p

Subject/Index Terms

• TRT Terms: Case studies ; Cooperation ; Disaster preparedness ; Disasters and emergency operations ; Emergency management ; Highway travel ; Interagency relations ; Law enforcement ; Management ; Neighborhoods ; Planning ; Public transit ; Regional planning ; Special events ; Strategic planning ; Transportation operations ; Transportation planning
• Uncontrolled Terms: Block parties ; Demonstrations ; Festivals ; Golf tournaments ; Jurisdictions ; Parades ; Political conventions
• Geographic Terms: United States
• Subject Areas: Administration and Management; Geotechnology; Highways; Planning and Forecasting; Public Transportation; Security and Emergencies; Society; I72: Traffic and Transport Planning;

Filing Info

• Accession Number: 01019080
• Record Type: Publication
• Report/Paper Numbers: FHWA-HOP-04-029
• Contract Numbers: DTFH61-00-X-0016
• Files: NTL, TRIS, USDOT
• Created Date: Feb 27 2006 8:54AM

How to Write Case Studies About Your Events

Although they are understated and often underused as a business resource, sovaldi sale case studies can serve as an excellent marketing tool for your company to engage both existing and potential customers.The challenge is crafting a well-written case study that people actively want to read.

#1 Tell a good story

Above all else, only write case studies about your best work. Humans love good stories, therefore a genuinely interesting event will have a natural hook and motivate readers to finish. Mediocre case studies will dilute the impact of better ones.

The Chillisauce team  organise thousands of events a year, but their portfolio of case studies only includes the most-interesting stories for the various types of events that they organise:

Team building days: teams enter the Big Brother House

PR activities: assembled Britain’s first ever team for the Naked Sledding World Championship in Germany

The key to a successful and engaging case study is the development of a narrative.

Inspire, impress and inform…

Rather than using the page solely to promote or sell your services, a good case study should inspire, impress and inform readers. And like all the best stories, case studies should comprise of three parts: a beginning, middle and end. For our industry the following structure works well: –

• Beginning: why there was a demand for the event (e.g. business challenges) • Middle: paint the focal points of the event • End: results with bloody good testimonials

Case studies by wedding and proposal planners do this really well, following the entire journey from how the couple met to the end results. They often get clients to  write their own case study .

#3 Bring your story to life: the finer details

Armed with an overarching structure and narrative for your case study, the next step is to bring your story to life through the content. To achieve this, you will need to focus on the finer details maximise reader engagement. Consider the following: –

Write a catchy title:

This is one of the most important aspects of your content to grab readers’ attention in the first place. As a general rule, it is better to craft a descriptive headline akin to something that you would see in a tabloid newspaper rather than simply using a generic article title.

Include interesting visuals and engaging videos

While the use of descriptive text can clearly articulate the purpose of your event and its cultivation, for example, images and videos can help bring the page to life, reinforce your point and drive higher levels of engagement.

The use of photography is particularly important when narrating your specific event in pictures, as real-time action shots will have a far greater impact than generic imagery of crowded meeting rooms or grouped individuals.

#4 Create natural and customer-focused testimonials

This is arguably the most crucial element of your case study, as this will be entirely customer-focused and determine whether or not your event has achieved its objectives.

As a starting point, you should not be afraid to coach your clients into providing a unique and innovative testimonial, as this will help you to transcend generic compliments and meaningless platitudes. This also enables you to create a series of natural and organic testimonials, which reflect the detail of the event and the emotive response that it triggered. It is crucial that viewers connect with the individuals and identify with what they are saying, so it also worth while conducting video testimonials and sharing these online. This allows the people at the heart of your event to talk openly and express a genuine sense of enjoyment, and with a minimal amount of coaching and carefully shot footage you drive an excellent representation of your hard work.

#5 Publish online

We are living in the age of content marketing where search engines, like Google, reward websites that engage users with relevant, unique and engaging copy. Once you have created great case studies, publish them online to maximise opportunities.

In conclusion

By following this process, you can craft a unique and well-presented case study that captures the purpose of your event and its impact on attendees. From creating a basic structure for your content to creating multimedia copy that narrates an engaging story, the tips included here should help you to develop great case studies in the future.

This article is copied from  http://eventjuice.co.uk and is written by  L ewis Humphreys

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Chapter: chapter 5 - case studies: special-event management.

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C H A P T E R 5 Case Studies: Special-Event ManagementSpecial events present a unique case of demand fluctuation that causes traffic flow in the vicinity of the event to be radically dif- ferent from typical patterns. Special events can severely affect reliability of the transportation network, but because the events are often scheduled months or even years in advance, they offer an opportunity for planning to mitigate the impacts. Because large-scale events are recurring at event venues, it gives an opportunity for agencies to continually evaluate and refine strategies, impacts, and overall process improvements over time. In this section, case studies are presented that examine the processes developed for special-event management at the Kansas Speedway in Kansas City, Kans., and the Palace of Auburn Hills near Detroit, Mich. Kansas: Kansas Speedway In 2001, the Kansas Speedway opened for its first major NASCAR race. With attendance exceeding 110,000 people, it set a record as the largest single-day sporting event in the his- tory of Kansas. Attendance has continued to grow and now exceeds 135,000 for most major races. The traffic control strategies that were put into place to handle these major events were the result of years of planning between the Kansas Speed- way, Kansas Highway Patrol (KHP), Kansas Department of Transportation (KDOT), and the Kansas City Police Depart- ment. The process was successful in part because of the clear lines of responsibility that were defined for each agency and the strong spirit of cooperation and trust that was established before the first race was held. In preparation for this case study, representatives from KHP and KDOT were interviewed. Lt. Brian Basore and Lt. Paul Behm represented the KHP Troop A and were able to share their experience from many years of actively managing special events at the Kansas Speedway. The primary responsibilities of KHP are to operate the KHP Command Center that was estab- lished for the Kansas Speedway race events and to manage 45traffic on the freeways around the event. Representatives of KDOT who were interviewed included Leslie Spencer Fowler, ITS program manager, and Mick Halter, PE, who was formerly with KDOT as the District One metro engineer during the design and implementation of the Kansas Speedway. Fowler and Halter provided an excellent history of the development of the project, as well as a description of KDOT’s current opera- tional procedures used during races at the Kansas Speedway. KDOT maintains the CCTV cameras and portable DMS around the Speedway and assists KHP with traffic control on the freeways. Description This case study examines the development of the special-event management procedures for races at the Kansas Speedway. Par- ticular focus is given to the roles and responsibilities of the KHP and KDOT in developing the initial infrastructure and strate- gies that led to a successful special-event management process that has been used and refined for 8 years. One of the strongest recurring themes in development of this case study was the out- standing cooperation and partnerships that were developed between the agencies involved. Each agency has clearly defined responsibilities before and on race day, though no agency is considered in charge. They cooperate to safely and efficiently move vehicles from the freeways to city streets to the Kansas Speedway parking lots and then do the same process in reverse. Background of Agency The Kansas Speedway is a 1.5-mi oval race track suitable for many types of races, including Indy and NASCAR. Seating capacity is currently being expanded to 150,000 people, and parking capacity allows for 65,000 vehicles. The Speedway is located approximately 15 mi west of downtown Kansas City, near the intersection of I-70 and I-435, which serve as the pri- mary routes used by spectators attending the races. Events are

46held throughout the year, and there are typically two major race events each year when crowds reach capacity. The major- ity of parking is on Kansas Speedway property and is free for spectators. The Kansas Speedway provides attendants and directs vehicles into the parking areas. The primary agencies involved in traffic management for the Kansas Speedway include KHP Troop A in Kansas City, KDOT District One, and the Kansas City Police Department. KHP is responsible for traffic management on the freeways and for operation of the KHP Command Center, which is activated several days before major events and serves as the central com- munications center for all public agencies on race day. The full resources of Troop A (over 40 troopers) are used on race day, along with over 20 other troopers from around the state. KHP also deploys a helicopter to monitor traffic from the air and roving motorcycle units on race day. KDOT District One is responsible for maintaining five CCTV cameras and deploy- ing 12 portable DMSs on roads used to access the Speedway. The Kansas City Police Department provides officers for the city street network that links the freeways to the Kansas Speedway (1). Other participants in the process include Wyandotte County and the Kansas Turnpike Authority (KTA). Wyandotte County currently owns the WebEOC software used by all participat- ing agencies to share information and request assistance on race day (2). The KTA maintains I-70 near the Speedway. It is responsible for such maintenance tasks on this section of I-70 as snow and ice removal, guardrail, and signing and striping, although the section is not tolled. Process Development The Kansas Speedway opened for its first major event in sum- mer 2001. However, development of the process for special- event traffic management began long before Kansas City was even selected as the site for the racetrack. In the early 1990s the International Speedway Corpora- tion was searching for a new location for a race track in the Midwest. The track was expected to host several large events per year, including at least one to two major races that were expected to attract more than 100,000 people. Given the poten- tial positive economic benefit that such a facility could bring to an area, the International Speedway Corporation solicited pro- posal packages from several sites under consideration. Propos- als needed to address criteria established by the International Speedway Corporation for site selection, including accessibil- ity of the site to attendees. The effort to bring the race track to Kansas was led by Kansas City, with strong support from the governor and lieutenant governor of Kansas. Understanding the importance of accessibility, the governor directed KDOT to develop a plan and provide funding to make the necessary infrastructure improvements to handle race traffic for theSpeedway. The priority placed on this project by the governor’s office served as the first enabler to implementing the traffic management process. KDOT developed an extensive plan to accommodate the large number of vehicles expected to attend events at the Kansas Speedway. I-70 needed to be widened and a new inter- change was needed at 110th Street. US-24, which went through the proposed site of the track, needed to be completely realigned. Although not part of the original planning, CCTV cameras and portable DMS were also required to assist with traffic management. KDOT identified funding for each of their proposed infrastructure projects, and these projects were included in the package that was submitted to the International Speedway Corporation. More than a year before the first race event at the Kansas Speedway, all the agencies involved in traffic management began planning for the event. Agencies that participated in the planning included KHP, KDOT, KTA, Kansas City Police, Wyandotte County, and the Kansas Speedway. The Missouri DOT and Missouri Highway Patrol were also initially involved because there was concern that traffic could be affected east of the track into Missouri. (Once the Speedway opened, it turned out that this concern was unfounded as race traffic had only minor impacts on I-70 near the Speedway and did not affect traffic on I-70 in Missouri.) To facilitate traffic management planning, a consultant also was brought on-board early in the process. The success of the planning for traffic management was attributed to two primary factors. The first was the importance that the governor and Kansas City placed on the success of hosting major races at the Kansas Speedway. Millions of dol- lars were invested by the state and city to bring the race track to Kansas, and to recoup their investment they needed to suc- cessfully host large races. The visibility and importance of the first successful event was a great motivator for every agency involved. The second factor to which success was attributed was the personalities involved. Several of those interviewed for this case study noted that there were no egos in the room that got in the way. A sense of mutual respect among the agencies and for their work was a consistent factor in planning for traffic management. No single agency was designated as “in charge”; rather, each agency took responsibility for its piece and worked well with the other agencies to ensure overall success. The result of the planning efforts was a multilayered traffic plan with different agencies leading the layers. The first layer dealt with interstate traffic, which was KHP’s responsibility. The second layer dealt with traffic on local streets traveling between the interstates and the Kansas Speedway, this layer was the responsibility of the Kansas City Police Department. The third layer handled traffic entering or leaving the track property, which was the responsibility of the Kansas Speed- way. KDOT provided support to all three layers through

47deployment of CCTV cameras, DMS, and cones. Each layer was critical to successfully manage traffic for events. Detailed Process and Integration Points Figure 5.1 shows the detailed process that was developed for special-event traffic management at the Kansas Speedway. Before a major event, all four agencies that are involved in man- aging traffic on race day come together for a meeting to discuss the upcoming event and changes or special circumstances that need to be considered in their planning. These agencies have worked closely together since the first event in 2001, and there is a clear understanding of the roles and responsibilities of each agency.Figure 5.1. Detailed business process diagram of Kansas Speedway special event.are sent and portable DMS are controlled. On the day before race day, KHP conducts a briefing to review the setup and pro- cedures for race day. During the race event, KHP, Kansas City Police Department, and the Kansas Speedway manage traffic on freeways, local streets, and in the parking lots. KHP deploys a helicopter to monitor traffic from the air and roving officers on monocycles to patrol the heavily congested areas around the Speedway that cannot be easily accessed by troopers in cruisers. All agencies continue to communicate primarily through WebEOC, a system owned by Wyandotte County that lets each agency monitor messages and communicate on a web-based system. Once the race is completed, a follow-up meeting to review race day events may be held. This meeting was originally held after every event during the first few years the Kansas Speed- way was in operation, but as traffic management has become more efficient, it is now only held as warranted.In the week before race day, KHP will activate the KHP Command Center. The KHP Command Center is the commu- nications hub for the event and is where CCTV camera feeds

48Several key integration points were identified in the Kansas Speedway special-event traffic management process, including the following: • Integration between KHP and KDOT for deployment and operation of CCTV cameras and portable DMS; • Integration between KHP, KDOT, Kansas City Police Department, and Kansas Speedway to develop traffic man- agement plans for upcoming events and to discuss traffic management performance after operations; and • Integration between KHP, KDOT, Kansas City Police Department, Kansas Speedway, and Wyandotte County for sharing of information through WebEOC during the special event. Types of Agencies Involved The primary agencies that are involved in the special-event traffic management are KHP, KDOT, Kansas City Police, and the Kansas Speedway. As described earlier, a three-layered approach is set up, with KHP responsible for traffic on the free- ways, Kansas City Police responsible for traffic on local streets, and Kansas Speedway responsible for traffic in the parking areas. Numerous special teams have been established to facili- tate the special-event traffic management on race day. These include the KHP Post Commanders Team, Logistics Team, and KDOT Team. The KHP Post Commanders Team is made up of the commanders from each traffic post where KHP will be directing traffic. The post commanders attend the post com- manders briefing the evening before the race begins, direct the other troopers at their post, and communicate with the KHP Command Center. The Logistics Team is responsible for set- ting up the event, including staging and setting up of tempo- rary traffic control, providing water and tents for troopers at traffic posts, and running errands during the event. The KDOT Team is responsible for maintaining the CCTV cameras, put- ting the portable DMS boards in place and changing messages on the board if the wireless communications fail, and assisting with temporary traffic control placement. Types of Nonrecurring Congestion Addressed The process for managing the Kansas Speedway traffic deals with nonrecurring congestion due to a special event. When the Kansas Speedway first opened in 2001, KHP set up 14 inbound posts and 11 outbound posts, with troopers stationed at each post to direct traffic. Since then, KHP has increased the effi- ciency of traffic management and has been able to reduce the number of posts down to seven inbound and seven outbound. Traffic is monitored from the KHP Command Center using CCTV cameras and a helicopter that provides updates on traf- fic conditions; portable DMSs with wireless communication can assist in directing traffic. The roving motorcycle units areused around the Kansas Speedway and can assist with manag- ing any incident that blocks roadways. Over time, KHP and KDOT have refined temporary traffic control patterns and gen- eral traffic control to increase efficiency of the system as much as possible. One of the primary concerns on race day is getting traffic off I-70 without significantly affecting through traffic. Because major races are held on weekends, the overall level of traffic on I-70 is generally lighter than what is experienced on a weekday. As part of the initial package that was proposed by Kansas City to bring the Speedway to Kansas, KDOT agreed to add one more lane to I-70 to accommodate overflow traffic for major races. KHP has been able to quickly move traffic off I-70 with only minor impacts on through traffic on the interstate. KDOT has not done a study of travel times for through traffic on race day, but they estimate that at peak periods before or after a race, motorists on I-70 will only experience minor slowdowns with perhaps 5 min of delay to their total trip. Performance Measures The Kansas Speedway tracks the time it takes to clear parking lots after races and has seen improvements in clearance times since the initial race in 2001. After races, if something went wrong or clearance times exceeded normal ranges, this infor- mation is shared with KHP and an evaluation meeting with all agencies involved in the traffic management may be held to review the traffic management. However, these instances are rare and in most events the parking lot clearance times can be accurately estimated based on race attendance. KHP initially used troopers stationed at 14 inbound posts and 11 outbound posts to direct traffic. Although not a per- formance measure, the shift to seven inbound and seven outbound posts is seen by KHP as an indication of the improvement of their traffic management efficiency. Benefits The planning and cooperation between KHP, KDOT, Kansas City Police, and the Kansas Speedway allowed for efficient traf- fic management of more than 100,000 spectators from day one. The agencies involved in traffic management have been able to improve their efficiency and reduce the manpower needed to manage traffic over time and consider their traffic management effort a success from the start. The popularity of racing in the United States and the effi- cient use of the Kansas Speedway have prompted an expansion of the seating capacity of the Speedway. Current expansion work will bring the total seating capacity of the Kansas Speed- way to 150,000. Without an efficient plan to move spectators in and out of the Speedway, this expansion would not be possible.

49The traffic management process developed for the Kansas Speedway goes beyond simple convenience to spectators. By minimizing the impacts to through traffic on I-70 and I-435, KHP can reduce freeway backups and minimize the chances of secondary incidents on freeways. Efficient and effective move- ment of vehicles off the race track is also critical for evacuation. On April 25, 2009, a tornado touched down in Kansas only a few miles from the Kansas Speedway. About 30 min earlier, a race that was in progress was suspended for the day due to rain, and many of the spectators were in the process of leaving the event. The tornado did not touch down close enough to the Kansas Speedway to cause any damage, but it was an important reminder of the need to be able to efficiently move traffic out of an area, especially in Kansas, which is particularly prone to tornadoes. Lessons Learned Each agency interviewed identified the single most important factor to the success of the special-event traffic management as the cooperation among all agencies in the planning and execu- tion of traffic management. The importance placed on success- fully bringing the Speedway to Kansas by the governor and Kansas City certainly contributed to that cooperation and coordination, but the personalities of the leaders from each agency and the existing relationships that had been established were identified as even more important factors. KHP has learned that the development of a race-day proto- col is particularly important, so that procedures for handling incidents or other unexpected events are well understood. KHP has worked with their partners to develop a tow policy to address abandoned vehicles, a traffic crash policy to quickly clear incidents, and a no-patrol zone to keep troopers and police officers in cruisers from adding to the congestion around the race track by limiting patrols to troopers on motorcycles. Receiving information from the CCTV cameras and the ability to control the portable DMSs from the KHP Command Center have been valuable. However, CCTV cameras have failed in the past and communications to the portable DMSs are not always reliable, which sometimes necessitates the need for KDOT to manually change messages in the field. KHP and other agencies involved in traffic management have learned that technology is useful, but they need to be careful that they are not totally dependent on technology. Analysis and Research Observations Planning for the traffic management at the Kansas Speedway essentially began when Kansas was still being considered by the International Speedway Corporation and continued up until the first event. Political support for the Kansas Speedway gave those involved in traffic management a sense that they mustsucceed. Each agency took responsibility for their part of the plan, executed it well, and supported their partners. The sense of cooperation that started during the initial planning for traf- fic management of the race track has been carried into the con- tinued operations. It is clear that each agency felt they had an important stake in the success of the Kansas Speedway and contributed the resources and staff required for that success. One interesting note is that there are no formal agreements in place with any of the agencies regarding operations. When agencies were asked about this, they said they did not see a need to formalize what has worked well so far. There is confidence that they can continue to count on their partners, and that the strong relationships and years of experience working together will continue to add to that confidence. Michigan: The Palace of Auburn Hills The Palace of Auburn Hills (the Palace) is an arena located northwest of Detroit that hosts events such as concerts, basket- ball games, circuses, and graduations for eight months of the year. Because of the volume of traffic generated by these types of events, an increase in traffic congestion is typical in the vicin- ity of the Palace. Focused traffic management plans at these locations can help mitigate the effects of the increased conges- tion before and after the event. The Palace is located in Auburn Hills, a suburb of the greater Detroit, Michigan, area, in the north-central section of Oakland County. The Auburn Hills Police Department (AHPD) has been involved with traffic management strategies at the Palace since it opened in 1988 and has played an integral part in the development of the traf- fic management plan currently in place. To acquire details regarding the traffic management plans implemented for events hosted at the Palace, an initial inter- view was conducted with Danielle Deneau, PE, of the Road Commission for Oakland County (RCOC). After that conver- sation, a more in-depth interview was conducted with Capt. Jim Mynesberge of the Auburn Hills Police Department. Description In terms of traffic operations and management, a special event can be categorized as a scheduled interruption to normal traf- fic flow. The Palace special event case study provides an analy- sis for a multiagency, public–private partnership focused on managing traffic for planned events of varying sizes. The traf- fic management plan includes traffic control strategies man- aged through the RCOC FAST-TRAC signal system, which is programmable and detects actual traffic counts (the original timing was based on recording traffic flow as officers manually directed traffic); traffic monitoring capabilities through the MDOT CCTV cameras; and traveler information using the

50MDOT DMS and MiDrive website. The current traffic man- agement plan includes a partnership between the Palace, the Police, RCOC, and MDOT and has resulted in memoranda of understanding (MOUs) and formal agreements between some of these agencies. The plan provides a direct connection between the Police dispatch and the RCOC TOC. The effec- tiveness of the traffic management plan allows fewer officers to be used for managing traffic at special events and reduces the time required to load-in and load-out for each Palace event. Load-in and load-out are two performance measures that have been defined to measure the success of traffic control before and after events. Background of Agency The Palace is located within Auburn Hills, adjacent to I-75, and is within the jurisdiction of the AHPD. The Palace is a multipurpose arena used for concerts, sporting events, and other events such as wrestling, circuses, or graduations. The arena has been operational for over 20 years and is the perma- nent home of the Detroit Pistons (NBA) and the Detroit Shock (WNBA). The arena is recognized for its large capacity for the NBA and can accommodate over 22,000 fans for bas- ketball games and over 25,000 for concerts at center stage. The Palace also is the only arena that can hold the entire host city’s population. The AHPD provides security and traffic enforcement for the Palace during events. The Pistons typically attract a large attendance for their games, which has resulted in the arena expanding the parking capacity to keep pace with the atten- dance demands. AHPD manages the traffic before, during, and after each event, with a focus on providing efficient and safe access for motorists. Process Development The Palace partnered with AHPD and RCOC to develop a per- sonalized traffic management plan for events at the Palace. The original traffic management plan used several police officers and manual traffic control to move vehicles through several intersections in the vicinity of the Palace. The original site plan included only three driveways, which created some capacity issues for event traffic ingress and egress. The traffic manage- ment plan recommended improvements to the site that included additional lanes, modified use of the existing drive- ways, and the construction of two additional access drives. One new access drive was constructed on the north side of the site, and one on the south side. The access drive located on the south side is called Direct Drive, and when clearing the park- ing lot, only allows right turns, providing drivers with direct access to I-75. The Palace also established a MOU with MDOT to temporarily close the access road just east of Direct Driveafter events to provide exclusive use for Palace traffic when events commence. The Palace had several motivations for an improved traffic management plan. The first was happier patrons attending events. The second was monetary. Since the Palace pays for the use of AHPD officers to manage traffic at events, there was vested interest in streamlining the personnel and the time required. The larger events would require a total of 15 officers to work an event and effectively manage traffic. Each inter- section required two to three officers to safely direct traffic to and from the facility (15 officers total). With the revised plan, the larger events can be managed effectively by only one or two officers. Initially, AHPD and the Palace met regularly to discuss improvements, issues, and traffic management strategies. AHPD now has the ability to implement the Event Manager (developed by RCOC) and activate predetermined signal tim- ing plans through the RCOC TOC. With this closely integrated coordination, the issues have decreased and the coordination meetings have been reduced to only twice a year. AHPD and the Palace used two specific measures of effec- tiveness initially to determine if pre-event traffic was being managed properly. These measures allowed the two agencies to assess operations and determine the appropriate area of con- cern, namely: • If traffic was queuing on the public roadway but the Palace driveways had additional capacity, then traffic was not being managed effectively by the police. • If traffic was stopped at the driveways and vehicles were queuing on the public roads, then the Palace personnel were not effectively managing the parking operations. These observations were used to support the need to increase the access lanes and construct the additional driveway. The Palace parking process also was modified to establish longer stacking lanes approximately an hour and half before the event start time. This was necessary to accommodate the process for collecting parking fees from each vehicle. For postevent traffic, the effectiveness measure was based on all the access drives clearing at the same time. The bal- ance of exiting traffic was accomplished by sectioning the lots and directing all traffic to the specific exits. Since most events ended after 10:00 p.m., the Palace traffic could receive a higher preference in green time. It was determined that shorter cycle lengths resulted in extended clearance times for the Palace. Shorter cycle lengths create longer delays because of lost startup time and more clearance intervals per hour. In other words, the longer traffic was stopped, the longer it took to empty vehicles from the lot. The passing traf- fic was only inconvenienced by waiting through a single cycle length to accommodate the exiting Palace traffic. This impact

51was measured both visually and by using the FAST-TRAC system. Detailed Process and Integration Points Figure 5.2 shows the process used by the Palace for special-event traffic management. The traffic management plan involves revised signal timing at 19 intersections in the vicinity of the Palace. Signal timing plans were developed for small, medium, and large events. The number of intersections included in the signal timing plan provides a larger footprint than AHPD was able to manage with only police officers. The plan allows a senior AHPD officer to select the appropriate timing plan based on input from the Palace concerning the size of an event. The senior officer also has the authority to instruct the dispatcher to activate the appropriate timing plans. The dispatcher then has the ability to activate the timing plans via the Event Man- ager from the AHPD facility.Figure 5.2. Detailed business process diagram for a special event at the Palace of Auburn Hills.The Palace has access to its own CCTV cameras around the facility and to MDOT-owned CCTV cameras on the trunk routes. The MDOT cameras provide information about traf- fic conditions on the roadways approaching the Palace. The Palace personnel also use radios to communicate continuously with AHPD. The Palace documents the load-in and load-out times for each event that occurs, and has observed that the load-out time has decreased from approximately 1 h to less than 25 min with the current traffic management plan. Figure 5.3 displays the Palace and the surrounding trans- portation network for reference. I-75 runs north-south on the west side of the Palace, and M24 (Lapeer Road) runs north- south on the east side. The small connector on the south side of the Palace is the Direct Drive that is used exclusively for postevent traffic. AHPD responds to incidents in the vicinity of the Palace, including those that occur on I-75. During events, AHPD will coordinate for these incidents because they can affect traffic management at the Palace. Coordination is

52Source: © 2010 Google. Map data © 2010 Google. Source: © 2010 Google. Imagery © 2010 DigitalGlobe, USDA Farm Service Agency, Cnes/Spot Image, GeoEye, U.S. Geological Survey. Map data © 2010 Google. Figure 5.3. The Palace of Auburn Hills and surrounding transportation network.initiated by AHPD with MDOT and the Michigan Intelligent Transportation System Center (MITSC) to verify the incident, and MDOT will activate DMSs in the area to inform motorists of the incident if needed. In some cases, traffic is diverted to Opdyke Road through media and DMS communication. During an incident, the Palace monitors the CCTV cameras and communicates traffic conditions with the AHPD officers. AHPD also coordinates with RCOC to determine possible adjustments to the signal timing. After the incident has cleared, AHPD will coordinate with MDOT and RCOC to clear DMS messages and reset signal timing, respectively. Several key integration points were identified in the Palace of Auburn Hills special-event traffic management process, including the following: • Coordination between the Palace and AHPD: Based on guidelines established in the traffic management plan, the Palace determines the size of an event (small, medium, or large) and informs AHPD. • The AHPD Dispatcher has the ability to activate the pre- determined signal timing plans within FAST-TRAC. The AHPD Sergeant has the authority to select the appropriatetiming plan based on the size of the event and directs the Dispatcher as to which plan to activate. The AHPD dispatch has a direct connection with FAST-TRAC so RCOC person- nel are not required during most events. • The Palace has access to MDOT CCTV cameras so they can monitor traffic in the vicinity of the arena during an event. MDOT also monitors traffic, but the Palace’s access to sur- veillance provides the ability to focus specifically on inci- dents that can affect typical traffic during an event. • Coordination occurs via radio between Palace personnel and AHPD personnel to adjust the predetermined traffic management plan and mitigate potential impacts on traffic. The response to incidents during an event is coordinated among MDOT, the Palace, AHPD, and RCOC. Based on the impact of the incident, DMSs are activated with appropriate messages, timing plans can be adjusted, and additional resources can be implemented for modified traffic control solutions. The Palace maintains records of all events, including the load-in and load-out times. Based on this documentation, the stakeholders have identified consistent results in the current

53traffic management plan. RCOC maintains the event signal timing plans respective to each event size. These timing plans can be revisited if issues or changing traffic patterns are identi- fied. The MDOT MITS Center maintains incident records that can be referenced to determine impacts on the traffic during events. There is no central location for data related to events at the Palace, but it can be obtained from the individual partners. Types of Agencies Involved There are four main partners involved in the coordination of events at the Palace of Auburn Hills. The public–private part- nership includes AHPD, the Palace, RCOC, and MDOT. The Palace is responsible for traffic on arena property, maintaining an arena-specific traffic management plan, and coordinating with AHPD for implementation. The Palace also has access to MDOT CCTV cameras so they can monitor traffic conditions on approaching routes. AHPD is the local police department responsible for traffic control within the city, including the local interstate routes. RCOC is responsible for county road maintenance and operations of the countywide signal system. RCOC has developed and programmed event-specific timing plans relative to the three categories of event sizes and allows AHPD to activate appropriate timing plans remotely. The MDOT MITS Center is responsible for monitoring the south- eastern Michigan roadway network and uses CCTV cameras and detection for surveillance and DMS and the MiDrive web- site for sharing traveler information. Types of Nonrecurring Congestion Addressed The Palace’s traffic management plan addresses nonrecurring traffic impacts classified as special events and crashes. When the Palace opened in 1988, AHPD manually controlled traffic in and around the arena. AHPD used approximately three to four traffic control police officers per intersection at several intersections (15 officers in all). In addition, the larger events required at least an hour to move traffic in and out of the park- ing facilities. The signal timing plans available through FAST-TRAC and the agreement between RCOC and AHPD to activate signal timing plans remotely via the Event Manager make it possible to improve efficiency. The signal timing plans are predeter- mined based on the estimated level of traffic for scheduled events. The signal timing plans also incorporate additional intersections that were previously not managed during events. The revised signal timing plans allow AHPD to decrease the total number of officers required at any event to no more than two and reduced the time for emptying the lot to approxi- mately 25 min. Improved incident management is the result of an agreement between MDOT and the Palace to share camera images. The Palace personnel can access views of several cameras located onapproaching roadways. When incidents occur in Auburn Hills, even on the interstate, AHPD typically are the first responders on scene. They will respond and coordinate with the Michi- gan State Police (MSP) and MDOT on the traffic management needs at the incident. They also coordinate with the Palace on any impacts to event-related traffic. MDOT will activate mes- sage signs to warn motorists and AHPD can modify the traffic management strategy to accommodate the changes in traffic patterns. Performance Measures Because the Palace tracks the load-in and load-out times dur- ing each event, those times can be compared to ensure the traf- fic management plan is working effectively. They meet with AHPD to discuss new issues and develop strategies that can mitigate these issues at the next scheduled event. The Palace maintains constant communication with AHPD to ensure that there is efficient and safe access for motorists. AHPD also com- municates with RCOC on potential issues with the signal tim- ing plans. The improved signal timing plans have allowed AHPD to reduce the number of required traffic control police officers from 15 to no more than two officers for each event. Emptying the parking lots of the Palace can now be achieved in less than 25 min. In addition, crash rates have remained con- sistent with the implementation of the Event Manager. Benefits The traffic management program at the Palace of Auburn Hills has proven to be successful. Benefits include improved traffic control efficiency; improved travel time; higher efficiency of motorist movement; and streamlined use of police resources. These benefits are achieved through strong relationships and trust between the stakeholders. With the reduction in load-in and load-out times, the impact on motorists traveling in the vicinity of the arena also is reduced. In addition, spectators are able to reach the arena more quickly and spend more time at the event. This improved mobility translates into cost savings for the motorists by reduc- ing fuel consumption and travel. The Palace also experiences a fiscal benefit by having spectators arrive earlier at events. The improved signal timing plans allow for more intersec- tions to be managed during an event with fewer officers, which frees up more officers for responding to emergencies, inci- dents, and other situations. Fewer officers for manual traffic control also has increased safety for personnel. Directing traf- fic in the dark and during poor weather conditions often cre- ated unsafe conditions for AHPD officers. The Palace’s cost for police personnel also is reduced. The Palace indicated that the savings from the fewer officers required to control traffic can be redirected to other expenses, such as an extension of park- ing facilities or a reduction in ticket costs for events.

54Lessons Learned All the agencies involved with the special-event traffic man- agement plan have acknowledged benefits, but there are still some elements that can be improved. Some simple modifica- tions could be achieved more quickly, while others are more extensive and would require several years. The partners stated that the traffic management plan should be developed as the site is designed. This approach would identify deficiencies in driveway access and potential capacity issues related to mov- ing the maximum capacity of the parking lots. The site devel- opment also should limit the amount of traffic movement occurring closer to the buildings to minimize conflicts between vehicles and pedestrians. This additional conflict can gener- ate congestion within the parking lot. Lastly, sufficient light- ing throughout the parking lot should be implemented. Better lighting increases safety by improving visibility for drivers navigating among pedestrians, especially during inclement weather. Analysis and Research Observations The Palace traffic management plan has been developed through input from the Palace of Auburn Hills, AHPD, and RCOC and has improved the efficiency, reliability, and safety of traffic management during special events hosted by the Palace. During arena events, such as games and concerts, thetraffic flow in and out of the Palace has improved considerably while limiting the resource needs of AHPD. Coordination between the Palace and AHPD also has increased the reliabil- ity of loading and unloading the Palace parking lots. The Palace records and evaluates the load-in and load-out times to determine possible signal timing adjustments. The Palace personnel discuss improvements to the traffic manage- ment plan with AHPD on a continuous basis. The continued communication between the Palace, AHPD, and RCOC has improved operations and resulted in improved mobility for the motorists going to the Palace, as well as for motorists within the area. Agreements have been established between AHPD, the Palace, and MDOT to share CCTV camera video images for improved incident management. The police can coordinate and respond to incidents more quickly. Based on monitoring an incident, real-time information is provided and coordi- nated between all stakeholders to improve traffic coordination during and after each event. References 1. Basore, B., and P. Behm. Kansas Speedway Traffic Management. Kansas Highway Patrol, 2007. 2. TriCon Environmental, Inc. ESi WebEOC Professional Version 7. www.tricon-env.com/Product_software.php?id=webeoc. Accessed July 20, 2011.

TRB’s second Strategic Highway Research Program (SHRP 2) Report: S2-L01-RR-1: Integrating Business Processes to Improve Travel Time Reliability addresses various ways that transportation agencies can reengineer their day-to-day business practices to help improve traffic operations, address nonrecurring traffic congestion, and improve the reliability of travel times delivered to roadway system users.

The project that produced this report also produced SHRP 2 Report S2-L01-RR-2 : Guide to Integrating Business Processes to Improve Travel Time Reliability.

An e-book version of this report is available for purchase at Google , Amazon , and iTunes .

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• Corpus ID: 129247157

Festival and Special Event Management

• Johnny Allen , Robyn Stokes
• Published 26 March 1999

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How to succesfully produce an event : case study: sunset beach party 2009 -festival, the legacy-factor: towards conceptual clarification in the sport event context, bridging the academic practitioner gap in conference and events management, incorporating sustainability in meetings and event management education, modelling cultural special events, a tale of two cities : local government, community events and social capital building : a thesis presented in partial fulfilment of the requirements for the degree of master of business studies (communication) at massey university, wellington, new zealand.

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Special Events: A Framework for Efficient Management

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The biggest data breaches in 2024: 1 billion stolen records and rising

Thanks to unitedhealth, snowflake and at&t (twice).

We’re over halfway through 2024, and already this year we have seen some of the biggest, most damaging data breaches in recent history. And just when you think that some of these hacks can’t get any worse, they do.

From huge stores of customers’ personal information getting scraped, stolen and posted online, to reams of medical data covering most people in the United States getting stolen, the worst data breaches of 2024 to date have already surpassed at least 1 billion stolen records and rising. These breaches not only affect the individuals whose data was irretrievably exposed, but also embolden the criminals who profit from their malicious cyberattacks.

Travel with us to the not-so-distant past to look at how some of the biggest security incidents of 2024 went down, their impact and. in some cases, how they could have been stopped. 

AT&T’s data breaches affect “nearly all” of its customers, and many more non-customers

For AT&T, 2024 has been a very bad year for data security. The telecoms giant confirmed not one, but two separate data breaches just months apart.

In July, AT&T said cybercriminals had stolen a cache of data that contained phone numbers and call records of “nearly all” of its customers, or around 110 million people , over a six-month period in 2022 and in some cases longer. The data wasn’t stolen directly from AT&T’s systems, but from an account it had with data giant Snowflake (more on that later).

Although the stolen AT&T data isn’t public (and one report suggests AT&T paid a ransom for the hackers to delete the stolen data ) and the data itself does not contain the contents of calls or text messages, the “metadata” still reveals who called who and when, and in some cases the data can be used to infer approximate locations. Worse, the data includes phone numbers of non-customers who were called by AT&T customers during that time. That data becoming public could be dangerous for higher-risk individuals , such as domestic abuse survivors.

That was AT&T’s second data breach this year. Earlier in March, a data breach broker dumped online a full cache of 73 million customer records to a known cybercrime forum for anyone to see, some three years after a much smaller sample was teased online.

The published data included customers’ personal information, including names, phone numbers and postal addresses, with some customers confirming their data was accurate . 

But it wasn’t until a security researcher discovered that the exposed data contained encrypted passcodes used for accessing a customer’s AT&T account that the telecoms giant took action. The security researcher told TechCrunch at the time that the encrypted passcodes could be easily unscrambled, putting some 7.6 million existing AT&T customer accounts at risk of hijacks. AT&T force-reset its customers’ account passcodes after TechCrunch alerted the company to the researcher’s findings. 

One big mystery remains: AT&T still doesn’t know how the data leaked or where it came from . 

Change Healthcare hackers stole medical data on “substantial proportion” of people in America

In 2022, the U.S. Justice Department sued health insurance giant UnitedHealth Group to block its attempted acquisition of health tech giant Change Healthcare, fearing that the deal would give the healthcare conglomerate broad access to about “half of all Americans’ health insurance claims” each year. The bid to block the deal ultimately failed. Then, two years later, something far worse happened: Change Healthcare was hacked by a prolific ransomware gang; its almighty banks of sensitive health data were stolen because one of the company’s critical systems was not protected with multi-factor authentication .

The lengthy downtime caused by the cyberattack dragged on for weeks, causing widespread outages at hospitals, pharmacies and healthcare practices across the United States. But the aftermath of the data breach has yet to be fully realized, though the consequences for those affected are likely to be irreversible. UnitedHealth says the stolen data — which it paid the hackers to obtain a copy — includes the personal, medical and billing information on a “substantial proportion” of people in the United States. 

UnitedHealth has yet to attach a number to how many individuals were affected by the breach. The health giant’s chief executive, Andrew Witty, told lawmakers that the breach may affect around one-third of Americans , and potentially more. For now, it’s a question of just how many hundreds of millions of people in the U.S. are affected. 

Synnovis ransomware attack sparked widespread outages at hospitals across London 

A June cyberattack on U.K. pathology lab Synnovis — a blood and tissue testing lab for hospitals and health services across the U.K. capital — caused ongoing widespread disruption to patient services for weeks. The local National Health Service trusts that rely on the lab postponed thousands of operations and procedures following the hack, prompting the declaration of a critical incident across the U.K. health sector.

A Russia-based ransomware gang was blamed for the cyberattack, which saw the theft of data related to some 300 million patient interactions dating back a “significant number” of years. Much like the data breach at Change Healthcare, the ramifications for those affected are likely to be significant and life-lasting. 

Some of the data was already published online in an effort to extort the lab into paying a ransom. Synnovis reportedly refused to pay the hackers’ $50 million ransom , preventing the gang from profiting from the hack but leaving the U.K. government scrambling for a plan in case the hackers posted millions of health records online. 

One of the NHS trusts that runs five hospitals across London affected by the outages reportedly failed to meet the data security standards as required by the U.K. health service in the years that ran up to the June cyberattack on Synnovis.

Ticketmaster had an alleged 560 million records stolen in the Snowflake hack

A series of data thefts from cloud data giant Snowflake quickly snowballed into one of the biggest breaches of the year, thanks to the vast amounts of data stolen from its corporate customers. 

Cybercriminals swiped hundreds of millions of customer data from some of the world’s biggest companies — including an alleged 560 million records from Ticketmaster , 79 million records from Advance Auto Parts and some 30 million records from TEG — by using stolen credentials of data engineers with access to their employer’s Snowflake environments. For its part, Snowflake does not require (or enforce) its customers to use the security feature, which protects against intrusions that rely on stolen or reused passwords. 

Incident response firm Mandiant said around 165 Snowflake customers had data stolen from their accounts, in some cases a “significant volume of customer data.” Only a handful of the 165 companies have so far confirmed their environments were compromised, which also includes tens of thousands of employee records from Neiman Marcus and Santander Bank , and millions of records of students at Los Angeles Unified School District . Expect many Snowflake customers to come forward. 

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AD indicates atopic dermatitis; OCS, oral corticosteroid.

a Rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, psoriasis, Crohn disease, ulcerative colitis, Sjögren syndrome, systemic sclerosis, dermatomyositis, polymyositis, thromboangiitis obliterans, Behçet disease, sarcoidosis, pemphigus, and vitiligo.

b Patients who received a diagnosis of the outcomes of interest (osteoporosis, fracture, type 2 diabetes, hyperlipidemia, hypertension, myocardial infarction, stroke, heart failure, avascular necrosis, cataract, or glaucoma) during 1 year before or 1 year after the cohort entry date were excluded.

OR indicates odds ratio.

a Modified definition of the exposure from cumulative duration of more than 30 days per year and more than 90 days per year to a cumulative duration of more than 60 days per year.

b The long-term use of oral corticosteroids was defined as a cumulative supply of more than 30 days or more than 90 days with a greater than 5-mg daily prednisolone-equivalent dose of oral corticosteroids, which places patients at risk of systemic adverse effects, and we assessed the long-term use of oral corticosteroids annually. To exclude potential use of oral corticosteroids for conditions other than atopic dermatitis, we restricted exposure to prescriptions for patients with a diagnosis of atopic dermatitis.

c Restricted to patients who could be followed up for at least 3 years from the cohort entry date.

d Restricted to patients who could be followed up for at least 5 years from the cohort entry date.

eTable 1. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis for Composite Outcome

eTable 2. Codes Used to Define Exclusion Criteria, Exposures, Outcomes, and Covariates

eTable 3. Exposure Definition Regarding to Long-Term Oral Corticosteroid Usage in the Previous Studies

eTable 4. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis, Comparison Between Ever Long-Term Use of OCS Over 30 Days vs 90 Days

eTable 5. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Osteoporosis

eTable 6. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Fracture

eTable 7. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Type 2 Diabetes Mellitus

eTable 8. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Hyperlipidemia

eTable 9. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Hypertension

eTable 10. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Myocardial Infarction

eTable 11. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Stroke

eTable 12. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Heart Failure

eTable 13. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Avascular Necrosis

eTable 14. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Cataract

eTable 15. Demographic and Clinical Characteristics of Cases and Controls of Adult Patients (>18 Years) With Atopic Dermatitis: Glaucoma

eTable 16. E-Values for Point Estimates of Different Outcomes of Interest for Primary Exposure: >30 Days a Year

eTable 17. E-Values for Point Estimates of Different Outcomes of Interest for Primary Exposure: >90 Days a Year

eFigure 1. Overall Design of This Nested-Case Control Study

eFigure 2. Case-Control Matching Using Risk-Set Sampling Method

eFigure 3 . Explanation for the Exposure Status According to 1) Ever Long-Term OCS, 2) Cumulative No. of Years of Long-Term OCS, 3) Consecutive No. of Years of Long-Term OCS for the Primary (>30 Days) and Secondary (>90 Days) Exposure Definition

eFigure 4. Subgroup Analysis According to the Age Stratification for Evaluating the Risk of Composite Adverse Outcomes Associated With Long-Term Use of OCS

eFigure 5. Subgroup Analysis According to the Sex Stratification for Evaluating the Risk of Composite Adverse Outcomes Associated With Long-Term Use of OCS

eFigure 6. Subgroup Analysis According to the Severity of AD Stratification for Evaluating the Risk of Composite Adverse Outcomes Associated With Long-Term Use of OCS

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Jang YH , Choi E , Lee H, et al. Long-Term Use of Oral Corticosteroids and Safety Outcomes for Patients With Atopic Dermatitis. JAMA Netw Open. 2024;7(7):e2423563. doi:10.1001/jamanetworkopen.2024.23563

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Long-Term Use of Oral Corticosteroids and Safety Outcomes for Patients With Atopic Dermatitis

• 1 Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
• 2 School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
• 3 Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
• 4 Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
• 5 School of Pharmacy, Aston University, Birmingham, United Kingdom
• 6 Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
• 7 Department of Inflammation & Immunology Medical Affairs, Pfizer Pharmaceuticals Korea Ltd, Seoul, South Korea
• 8 Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
• 9 Department of Dermatology, Konkuk University School of Medicine, Seoul, South Korea

Question   What duration of oral corticosteroid use is associated with adverse effects among adult patients with atopic dermatitis?

Findings   In this nested case-control study including 1 025 270 patients with atopic dermatitis, use of oral corticosteroids for more than 90 days during 1 year was associated with a slightly increased risk of composite adverse outcomes. There was no increased risk with use of oral corticosteroids for more than 30 days.

Meaning   This study suggests that for patients with exacerbations of atopic dermatitis, limiting the duration of oral corticosteroid treatment to 90 days or less may limit adverse effects.

Importance   The use of oral corticosteroids for prolonged periods may be associated with adverse events (AEs). Nevertheless, the risk of AEs with oral corticosteroids, especially among patients with atopic dermatitis (AD), has not been comprehensively investigated and lacks evidence on duration of treatment.

Objective   To assess the association between long-term exposure to oral corticosteroids and AEs among adult patients with AD.

Design, Setting, and Participants   This nested case-control study used data from the Health Insurance Review and Assessment Service database of South Korea between January 1, 2012, and October 31, 2021, which included 1 year prior to the cohort entry date of January 1, 2013, for assessing exclusion criteria and baseline characteristics, and 1 year after the study end date of October 31, 2020, to ensure a minimum duration for assessing exposure. Among the population of adults with AD, patients diagnosed with any of 11 AEs were matched with patients who had never received a diagnosis of any of the 11 AEs.

Exposure   Long-term use of oral corticosteroids was defined as cumulative supply of more than 30 days or more than 90 days of oral corticosteroid prescription per year.

Main Outcomes and Measures   We used multivariable conditional logistic regression analyses to measure the risk of 11 individual outcomes (osteoporosis, fracture, type 2 diabetes, hyperlipidemia, hypertension, myocardial infarction, stroke, heart failure, avascular necrosis, cataract, or glaucoma) as the composite outcome, controlling for potential confounders. We further classified the composite outcome to individual outcomes to evaluate the AE-specific risk.

Results   Among 1 025 270 patients with AD between 2013 and 2020, 164 809 cases (mean [SD] age, 39.4 [14.8]; 56.9% women) were matched with 328 303 controls (mean [SD] age, 39.3 [14.7]; 56.9% women) for sex, age, cohort entry date, follow-up duration, and severity of AD, where the balance of most baseline characteristics was achieved. A total of 5533 cases (3.4%) and 10 561 controls (3.2%) were exposed to oral corticosteroids for more than 30 days, while 684 cases (0.4%) and 1153 controls (0.4%) were exposed to oral corticosteroids for more than 90 days. Overall, there was no increased risk of AEs with use of oral corticosteroids for more than 30 days (adjusted odds ratio [AOR], 1.00; 95% CI, 0.97-1.04), whereas the risk was slightly higher with use of oral corticosteroids for more than 90 days (AOR, 1.11; 95% CI, 1.01-1.23). The small elevation in experiencing an AE was observed with each cumulative or consecutive year of ever long-term use.

Conclusions and Relevance   This case-control study found a slightly increased risk of AEs associated with use of oral corticosteroids for more than 90 days per year, which warrants future research to fully elucidate the observed findings.

Atopic dermatitis (AD) is a chronic inflammatory disease that causes serious morbidity, such as pruritus, impaired quality of life, and a range of comorbidities. 1 , 2 AD is a lifelong condition that relapses chronically and needs constant care. 3 Although AD is considered primarily a pediatric disease, studies have shown high rates of AD among adults as well. 4 The prevalence of AD among adults ranged from 2.1% to 4.9% across countries, and up to 10% of adults required medication for moderate to severe AD due to inadequate response to topical therapies; the prevalence rates were higher among adult patients than among pediatric patients, of whom 1.5% required medication for moderate to severe AD. 5 - 7

As AD treatment strategies, international guidelines and expert opinions generally recommend that oral corticosteroids should generally be avoided or limited to the short term only as rescue therapy. 8 - 11 Nonetheless, given the benefits of oral corticosteroids, including their effectiveness in allergic diseases, short-term safety, and low cost, many patients with moderate to severe AD are treated with oral corticosteroids for prolonged periods, which may constitute inappropriate or excessive use. 12 , 13 However, oral corticosteroid treatment for prolonged periods could have an association with oral corticosteroid–related complications. 14 Hence, clinical evidence informing patients and practitioners regarding the management of AD exacerbations in routine clinical practice is warranted.

Although previous studies among patients with asthma or rheumatic disease have suggested associations between long-term use of oral corticosteroids and various adverse events (AEs), there are few studies of patients with AD, to our knowledge. 15 - 21 In addition, existing studies about corticosteroid use among patients with AD were conducted to evaluate the safety concerns primarily about topical corticosteroids. 22 - 29 Considering the frequent use of oral corticosteroids among adults with AD and the potential association between long-term use of oral corticosteroids and AEs, some of which are severe, there is a need to investigate the safety of the long-term use of oral corticosteroids among adults with AD. 6 , 30 , 31 Accordingly, we aimed to investigate the association between long-term use of oral corticosteroids and AEs among adult patients with AD in South Korea.

We used the nationwide Health Insurance Review and Assessment Service (HIRA) database of South Korea between January 1, 2012, and October 31, 2021, which included 1 year prior to the cohort entry date of January 1, 2013, for assessing exclusion criteria and baseline characteristics, and 1 year after the study end date of October 31, 2020, to ensure a minimum duration for assessing exposure. It encompasses comprehensive data on health care use for every resident of South Korea, ensuring that patient identifiers are anonymized. The database collects information on socioeconomic and demographic variables, diagnosis ( International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnostic code; setting of diagnosis; date of diagnosis; and others), and medications prescribed (national drug chemical code, days’ supply, dose, date of prescription, route of administration, and others) until the occurrence of emigration or death. A prior validation study examined diagnosis codes documented in the HIRA in comparison with those in electronic medical records and found an overall positive predictive value of 82.3%. 32 This study was approved by the institutional review board of Sungkyunkwan University, which waived the informed consent because only deidentified data were used in this study. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline. 33

The study cohort comprised patients who were prescribed oral corticosteroids at least once with an AD diagnosis code from January 1, 2013, to October 31, 2020. The cohort entry date was defined as the first date of the prescription of oral corticosteroids with an AD diagnosis within the study period to include the new users of oral corticosteroids. Eligible case and control groups were identified after excluding the following: (1) patients with a diagnosis of immune-mediated inflammatory diseases during a 1-year window of exclusion assessment before the cohort entry date, to evaluate the risk of AEs from oral corticosteroid use for AD; (2) patients with a diagnosis of any of 11 outcomes of interest during the exclusion assessment window of 1 year before and 1 year after the cohort entry date, to investigate the association of oral corticosteroid use with newly occurred outcomes; and (3) patients who were younger than 18 years of age on the cohort entry date, to include adult patients ( Figure 1 ).

Cases were defined as patients with AD who received a diagnosis of any of our outcomes of interest after the cohort entry date, and the index date was defined as the first date of outcome occurrence. The composite outcome of interest consisted of osteoporosis, fracture, type 2 diabetes, hyperlipidemia, hypertension, myocardial infarction, stroke, heart failure, avascular necrosis (AVN), cataract, and glaucoma. We defined controls as patients with AD who never received a diagnosis of our outcomes of interests after the cohort entry date. We matched each case with up to 2 controls without replacement, using risk-set sampling on the cohort entry date (±30 days), follow-up duration (between the cohort entry date and the index date [±30 days]), age, sex, and severity of AD. Disease severity of AD was classified as moderate to severe on the basis of the current treatment guidelines for AD. 7 Moderate to severe AD was defined as patients who were receiving at least 1 immunosuppressant, alitretinoin, intravenous immunoglobulin, dupilumab, or phototherapy during the 1 year prior to the cohort entry date. The index dates of the control group were aligned with the corresponding index date of their respective matched cases. For individual outcomes, each case was matched with up to 5 or 10 controls, using different numbers from the composite outcome for ensuring statistical power according to the size of cases for each outcome variable, using risk-set sampling as well (eFigure 2 in Supplement 1 ).

We defined the exposure ascertainment window as the period between the cohort entry date and the index date, segmenting the period into yearly intervals to assess exposure year by year to determine whether patients met the definition for long-term use of oral corticosteroids. Owing to the absence of consensus for a definition of long-term oral corticosteroid use among patients with AD, and even for other diseases, we set the classification of long-term oral corticosteroid use as follows: cumulatively more than 30 days as the primary definition for modest long-term use or more than 90 days as a secondary definition for extensive long-term use, both with greater than a 5-mg daily prednisolone-equivalent dose of oral corticosteroids per year, which places patients at risk of systemic adverse effects. 17 To exclude potential use of oral corticosteroids for related conditions other than AD, we restricted exposure to prescriptions of oral corticosteroids to patients with a diagnosis of AD. Ever long-term use was defined as patients with a history of long-term use of oral corticosteroids for at least 1 year, and all remaining patients were defined as no long-term use . Primarily, ever long-term use was defined as a binary variable using 2 thresholds (>30 days and >90 days). In addition, to examine the duration-response association with long-term use of oral corticosteroids, we used the year, which met the definition for the long-term use, as a continuous variable. We assessed the risk of each outcome associated with the number of cumulative years (considering all the intermittent years of long-term use of oral corticosteroids) throughout the exposure ascertainment period. We also evaluated the risk associated with the number of consecutive years (considering only the continuous years of long-term use of oral corticosteroids) within the exposure ascertainment period. Details of the exposure assessment are shown in eFigure 3 in Supplement 1 .

We discerned a sufficient collection of confounding variables that adequately accounted for potential biases in our analysis: demographic characteristics (eg, sex, age, and medical aid recipients), comorbidities (eg, allergic rhinitis, depression, chronic obstructive pulmonary disease, and thyroid disorders), comedications (eg, antidepressants, antibiotics, estrogens, and proton-pump inhibitors), proxies of overall health status (eg, history of hospitalization, number of outpatient visits, and Charlson Comorbidity Index score), and severity of AD. The characteristic assessment window was defined as the 1-year period before the cohort entry date (eFigure 1 in Supplement 1 ; the demographic characteristics [sex, age, insurance] were assessed on the cohort entry date and other characteristics such as comorbidities, comedications, proxies of health status, and severity of AD during the 1 year prior to cohort entry). The details of exclusion criteria, exposures, outcomes, and covariates are presented in eTable 2 in Supplement 1 .

The demographic characteristics of the cases and controls were presented as frequency (proportion) for categorical variables and as mean (SD) or median (IQR) values for continuous variables. The same analysis used to evaluate the demographic characteristics of the cases and controls of patients with AD were repeated for each of the 11 outcomes as secondary outcomes. Differences in baseline covariates between cases and controls were evaluated using the absolute standardized difference, where an absolute standardized difference greater than 0.1 indicates a statistical imbalance existing between 2 groups.

The association between long-term oral corticosteroid use and the risk of the composite and individual outcomes were investigated using multivariable conditional logistic regression analyses to estimate adjusted odds ratios (AORs) with 95% CIs, adjusting for unbalanced comorbidities, comedications, and proxies of health status after the matching. We conducted additional analyses by considering the number of cumulative or consecutive years of long-term use of oral corticosteroids throughout the entire exposure ascertainment window as continuous variables, to investigate the monotonic duration-response association.

The potential heterogeneity of long-term treatment adverse effects in selected subgroups of patients with AD was examined for the composite adverse outcomes according to age (18-39, 40-64, and ≥65 years), sex (male or female), and severity of AD (mild or moderate to severe AD). To evaluate the robustness of the main findings, sensitivity analyses were first conducted by modifying the definition of exposure from a cumulative duration of more than 30 days or more than 90 days per year to more than 60 days per year. Second, we restricted the population to patients who could be followed up for at least 3 years or 5 years from the cohort entry date. All statistical tests were 2 sided. Analyses were conducted using SAS Enterprise Guide, version 7.1 (SAS Institute Inc), provided by HIRA through a virtual access machine.

Of 1 025 270 patients with AD who had at least 1 prescription of oral corticosteroids between 2013 and 2020, we matched 164 809 cases (mean [SD] age, 39.4 [14.8]; 56.9% women and 43.1% men) with 328 303 controls (mean [SD] age, 39.3 [14.7]; 56.9% women and 43.1% men) ( Table 1 ) by 1:2 matching using risk-set sampling. Cases and controls were matched for sex, age, cohort entry date, follow-up duration, and severity of AD; balance was achieved for most covariates between the 2 groups, with an absolute standardized difference of less than 0.1 ( Table 1 ; whole baseline characteristics of cases and controls are presented in eTable 1 in Supplement 1 , individual outcomes in eTables 5-15 in Supplement 1 , and modest long-term [>30 days] vs extensive long-term [>90 days] in eTable 4 in Supplement 1 ). The most common comorbidity was allergic rhinitis (cases, 42.2%; controls, 38.7%), and the most prevalently prescribed concurrent medication was antibiotics (cases, 71.3% and controls, 66.8%). All the imbalanced variables of concurrent medication use and number of outpatient visits were additionally adjusted in the multivariable logistic regression.

Among the 164 809 cases and 328 303 controls, 5533 cases (3.4%) and 10 561 controls (3.2%) were exposed to oral corticosteroids over 30 days, and 684 cases (0.4%) and 1153 controls (0.4%) were exposed to oral corticosteroids over 90 days. Overall, the risk of AEs was not associated with use of oral corticosteroids exceeding 30 days (AOR, 1.00; 95% CI, 0.97-1.04) ( Table 2 ), while use of oral corticosteroids exceeding 90 days was associated with an 11% increased risk of the composite adverse outcome (AOR, 1.11; 95% CI, 1.01-1.23) ( Table 3 ). Each cumulative or consecutive additive year of long-term exposure (>90 days a year) was associated with a slightly increased risk of having an AE (AOR, 1.06; 95% CI, 1.00-1.13 and AOR, 1.06; 95% CI, 1.00-1.13, respectively).

In the analyses of individual outcomes, an increased risk for hypertension (AOR, 1.09; 95% CI, 1.03-1.15), AVN (AOR, 2.56; 95% CI, 1.82-3.62), and cataract (AOR, 3.22; 95% CI, 1.05-9.85) was associated with use of oral corticosteroids for more than 30 days ( Table 2 ). An increased risk for fracture (AOR, 1.22; 95% CI, 1.05-1.42), hyperlipidemia (AOR, 1.16; 95% CI, 1.03-1.30), myocardial infarction (AOR, 2.22; 95% CI, 1.17-4.22), and AVN (AOR, 6.88; 95% CI, 3.53-13.42) was associated with use of oral corticosteroids for more than 90 days ( Table 3 ). In our subgroup analysis, as compared with unexposed patients, the risk of composite AEs associated with long-term use of oral corticosteroids was generally consistent with the main analyses. No differences were observed in the stratified analyses according to the age group, sex, and severity of AD (eFigures 4-6 in Supplement 1 ). Furthermore, the results of composite outcomes demonstrated a high degree of consistency across all sensitivity analyses regarding the point estimates ( Figure 2 ).

We identified 164 809 cases and 328 303 controls of comparable patients with AD. The risk of composite adverse outcomes was not associated with with ever long-term use of oral corticosteroids exceeding 30 days, whereas the risk was slightly associated with ever long-term use exceeding 90 days. Also, the cumulative and consecutive years of ever long-term use throughout entire exposure ascertainment period was associated with a monotonic elevated risk of having an AE, although there was not a large discrepancy between the 2 distinctive analyses of additive years. Furthermore, small increased risks were identified in the examination of individual outcomes of fracture, hyperlipidemia, hypertension, myocardial infarction, AVN, and cataract. Generally consistent findings, with regard to point estimates, were observed across a range of sensitivity analyses.

Considering the overlapping pathogenetic mechanism between AD and asthma, we referred to studies of patients with asthma for comparison. One cohort study using Medicaid data found that the use of medium and high doses of systemic corticosteroids was associated with bone, cardiovascular, metabolic, and ocular AEs. 34 Another cohort study using 2000-2014 MarketScan data showed a similar increased risk of various AEs associated with the use of 1 to 3 oral corticosteroid prescriptions (AOR, 1.04; 95% CI, 1.01-1.06) and the use of 4 or more prescriptions (AOR, 1.29; 95% CI, 1.20-1.37); the cumulative burden also increased as the number of years accumulated. 20 Although previous research evaluated the frequency of oral corticosteroid use based on prescription numbers, our study provided more conclusive and valid clinical evidence by defining long-term use based on exact duration.

For individual outcomes, in line with previous studies, we also identified fracture, hypertension, hyperlipidemia, and myocardial infarction as AEs associated with long-term use of oral corticosteroids, owing to interruption of endocrine function and metabolism. 20 , 35 - 38 We observed risks of AVN and cataract with long-term oral corticosteroid use, although the risks of these 2 conditions were inconclusive in past studies. For the underlying mechanisms for AVN of the femoral head, the use of oral corticosteroids leads to intravascular coagulation that results in a inhibition of blood flow to the bones, which consequently triggers ischemic injury. 39 - 41 Although existing evidence regarding an association of AVN with duration of oral corticosteroid treatment is unclear, AVN could be induced from use of just over 30 days, and cumulative exposure is the important determining factor, as shown in our results. 39 Furthermore, although a complete elucidation remains uncertain, the mechanisms of new-onset cataract associated with modest long-term use of oral corticosteroids may be due to disturbances in osmotic equilibrium, oxidative detriment, and perturbations in lens growth factors. 42 , 43 Another potential hypothesis involves nonenzymatic Schiff base intermediates that form between the corticosteroid’s C-20 ketone group and its nucleophilic groups, undergoing Heyns rearrangement to produce stable amine-substituted adducts seen only in corticosteroid-induced posterior subcapsular cataracts. 44 , 45 No association or subtle increased hazard was observed with osteoporosis, glaucoma, stroke, or heart failure, implying that the dose and duration of corticosteroid treatment may not pose a risk for these conditions among patients with AD.

This study has some strengths. Concerns about conducting this study arose from the lack of consensus regarding the definition of long-term corticosteroid treatment, as different criteria have been used and variations have been observed (eTable 3 in Supplement 1 ). Accordingly, we combined the NICE (National Institute for Health and Care Excellence) guidelines 17 with the opinions of clinicians practicing in clinical settings. Even though evidence for a safe continuous duration of corticosteroid treatment was not available as we developed criteria for the definition of long-term treatment for the dichotomous variable, our criteria are expected to serve as a primary threshold for deciding the duration of treatment. In addition, although the long-term use of oral corticosteroids is not recommended in the guideline for treatment of AD, relatively prolonged use of oral corticosteroids is identified frequently in clinical practice. 12 Thus, this study addresses a significant gap in research by investigating the association between long-term oral corticosteroid use and a comprehensive range of AEs specifically among adults with AD. With its substantial sample size, the study provides robust statistical power to detect associations between oral corticosteroid use and relatively rare outcomes, adding to the existing evidence.

This study also has some limitations. First, disparities arose between the diagnoses recorded and the actual diseases a patient had. 46 In addition, HIRA data do not include clinical data; accordingly, the diagnostic standard criteria for AD, such as the Hanifin-Rajka criteria, 47 , 48 were infeasible. To comply with this issue, we included patients with AD who had at least 1 oral corticosteroid prescription and restricted prescriptions to patients with a diagnosis of AD. Second, due to the inbuilt characteristics of database recording drugs that are prescribed rather than drugs that are taken, the exposure measurement could be uncertain. However, we set the exposed group from the modest long term (>30 days) to the extensive long term (>90 days) and also included the numbers of cumulative or consecutive years of ever long-term use, from which the cumulative burden would be appropriately measured. Third, inhaled corticosteroids, which have some degree of systemic bioavailability, and topical and eye drop formulations of corticosteroids were not accounted for in this study. Fourth, for some of the individual study outcomes, we could not rule out the failure to detect the true effect due to the lack of statistical power; thus, future studies are warranted to corroborate these results. Fifth, due to the nature of the case-control design, it is not possible to completely exclude reverse causality. Sixth, although we considered moderate to severe AD using prescriptions of medication based on the treatment guideline, the influence of AD-related disease severity cannot be eliminated. Seventh, we addressed residual or unmeasured confounders by calculating E-values (eTables 16 and 17 in Supplement 1 ), but unmeasured confounders may be present, and the results should be interpreted with caution.

In this large population-based case-control study, we discovered that oral corticosteroid use of more than 90 days among individuals with AD was associated with a small increased risk of composite adverse outcomes. Future investigations are warranted to confirm this potential risk of AEs associated with long-term use of oral corticosteroids for patients with exacerbations of AD, and health care professionals should thoroughly weigh the benefits associated with oral corticosteroids against the observed small risk of AEs, while continuously monitoring for AEs.

Accepted for Publication: May 23, 2024.

Published: July 19, 2024. doi:10.1001/jamanetworkopen.2024.23563

Open Access: This is an open access article distributed under the terms of the CC-BY-NC-ND License . © 2024 Jang YH et al. JAMA Network Open .

Corresponding Authors: Ju-Young Shin, PhD, School of Pharmacy, Sungkyunkwan University, 2066 Saburo, Jangan-gu, Suwon, Gyeonggi-do 16419, South Korea ( [email protected] ); Yang Won Lee, MD, PhD, Department of Dermatology, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, South Korea ( [email protected] ).

Author Contributions: Drs Shin and Y. W. Lee had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Jang and Choi contributed equally to this work.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: H. Lee, Noh, Jeon, Yoo.

Drafting of the manuscript: Jang, Choi, Woo, Jeon, Yoo.

Critical review of the manuscript for important intellectual content: Jang, H. Lee, Woo, Park, Noh, Jeon, Yoo, Shin, Y. W. Lee.

Statistical analysis: Choi, H. Lee, Woo, Park.

Obtained funding: Jeon, Yoo, Shin.

Administrative, technical, or material support: Jeon, Yoo, Shin, Y. W. Lee.

Supervision: Jang, Shin.

Conflict of Interest Disclosures: Dr Park reported receiving support from the AIR@innoHK programme of the Government of Hong Kong Special Administrative Region Innovation and Technology Commission. Dr Noh reported receiving grants from the Ministry of Health and Welfare outside the submitted work. Drs Jeon and Yoo reported receiving personal fees from Pfizer Pharmaceuticals Korea Ltd outside the submitted work. Dr Shin reported receiving grants from the Ministry of Food and Drug Safety, the Ministry of Health and Welfare, the National Research Foundation of Korea, Celltrion, and SK Bioscience outside the submitted work. No other disclosures were reported.

Funding/Support: This work was supported by Pfizer Pharmaceuticals Korea Ltd.

Role of the Funder/Sponsor: Pfizer Pharmaceuticals Korea Ltd had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2 .

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Higher education event – a case study and special event approach.

Matthew J. Muldoon , University of Nevada, Las Vegas

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Professional Paper

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Master of Science in Hotel Administration

Hotel Administration

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Kathy Nelson, Chair

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The purpose of the present paper is to gain a better understanding of hospitality management literature in order to improve higher education event management strategies. The resulting professional paper intends to bring forward relevant literature and practical trends in event management. In addition, the paper intends to take a useful approach in examining the role of university conference and event standards in coordinating successful university development events. Moreover, this review expects to identify trends in higher education event programs as they relate to the hospitality industry. Events are important development initiatives and when properly planed can become a true cultivation activity (Grace, 2008). Finally, this paper serves as the impetus for a change of procedure (ex post facto) within the University of Nevada, Las Vegas Foundation.

Education; Higher; Hospitality industry – Management; Special events – Management; Special events – Planning

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Hospitality Administration and Management

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University of Nevada, Las Vegas

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Muldoon, Matthew J., "Higher education event – A case study and special event approach" (2008). UNLV Theses, Dissertations, Professional Papers, and Capstones . 624. http://dx.doi.org/10.34917/1752398

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Special event management and event marketing: A case study of TKBL All Star 2011 in Turkey

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A fresh batch of lobster at the food tent during the 2018 Maine Lobster Festival in Rockland. Ariana van den Akker/Staff Photographer

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An Assassination Attempt That Seems Likely to Tear America Further Apart

The attack on former President Donald J. Trump comes at a time when the United States is already polarized along ideological and cultural lines and is split, it often seems, into two realities.

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By Peter Baker

Peter Baker has covered the past five presidents.

• Published July 14, 2024 Updated July 15, 2024

Follow the latest news on the Trump assassination attempt.

When President Ronald Reagan was shot by an attention-seeking drifter in 1981, the country united behind its injured leader. The teary-eyed Democratic speaker of the House, Thomas P. O’Neill Jr., went to the hospital room of the Republican president, held his hands, kissed his head and got on his knees to pray for him.

But the assassination attempt against former President Donald J. Trump seems more likely to tear America further apart than to bring it together. Within minutes of the shooting, the air was filled with anger, bitterness, suspicion and recrimination. Fingers were pointed, conspiracy theories advanced and a country already bristling with animosity fractured even more.

The fact that the shooting in Butler, Pa., on Saturday night was two days before Republicans were set to gather in Milwaukee for their nominating convention inevitably put the event in a partisan context. While Democrats bemoaned political violence, which they have long faulted Mr. Trump for encouraging, Republicans instantly blamed President Biden and his allies for the attack, which they argued stemmed from incendiary language labeling the former president a proto-fascist who would destroy democracy.

Mr. Trump’s eldest son, his campaign strategist and a running mate finalist all attacked the political left within hours of the shooting even before the gunman was identified or his motive determined. “Well of course they tried to keep him off the ballot, they tried to put him in jail and now you see this,” wrote Chris LaCivita, a senior adviser to the former president.

But the Trump campaign seemed to think better of it, and the post was deleted. A memo sent out on Sunday by Mr. LaCivita and Susie Wiles, another senior adviser, instructed Trump team members not to comment on the shooting.

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