bluuebunny/crossref_metadata_2025 huggingface dataset:
Morwell Coal Mine Fire as a Cascading Disaster: A Case Study
Authors: McArdle Dudley , Spencer Caroline , Archer Frank
Published: May 2019

Introduction:

Despite the influential Hyogo and Sendai Frameworks, risk remains poorly understood in the emergency preparedness sector. Hazard assessment and risk management are usually considered before events. An alternative view considers risk as a cascade of potential consequences throughout an event. The 2014 fire in the Victorian rural community of Morwell included a three-phased event: a small bush fire, from which embers ignited a persistent fire in a disused open cut brown coal mine fire. The consequent air pollution precipitated a public health emergency in the nearby community of 15,000 people.

Aim:

To examine this event as a case study to investigate concordance with accepted definitions and key elements of a cascading event.

Methods:

Selected literature informed a risk cascade definition and model as a framework to examine the key post-event public inquiries available in the public domain.

Results:

Informed by a Conceptual Framework for a Hazard Evolving into a Disaster (Birnbaum et al., 2015), Wong and colleagues promote a Core Structure of a Comprehensive Framework for Disaster Evaluation Typologies (Wong, 2017). This Core Structure provided an adequate model to examine the sequence of events in the Morwell event. Definitions of cascading effects is more complex (Zuccaro et al., 2018). Our analysis of the Morwell event used the authoritative definition of cascading disasters published by Pescaroli and Alexander (2015). Using this definition, the Morwell event increased in progression over time and generated unexpected secondary events of strong impact. The secondary events could be distinguished from the original source of disaster, and demonstrated failures of physical structures as well as inadequacy of disaster mitigation strategies, while highlighting unresolved vulnerabilities in human society.

Discussion:

The Morwell coal mine fire of 2014 reflects the key criteria of a cascading disaster and provides understandings to mitigate the consequences of similar events in the future.
Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNe) Preparedness: Perceptions of Australian Emergency Department (ED) Doctors and Nurses
Authors: Hammad Karen , Ranse Jamie , Mortelmans Luc
Published: May 2019

Introduction:

Clinicians working in emergency departments (ED) play a vital role in the healthcare response to chemical, biological, radiological, nuclear, and explosive (CBRNe) events. However, ED clinicians’ individual and workplace preparedness for CBRNe events is largely unknown.

Aim:

The aim of this research was to explore Australian ED nurses and doctors’ perceptions of individual and workplace preparedness related to CBRNe events.

Methods:

The study populations were Australian nurses and doctors who work in EDs. Data was collected via a survey with 43 questions requiring binary responses or a rating on a Likert scale. The survey consisted of questions relating to the participant’s previous disaster training, perceived likelihood of a CBRNe event impacting their ED, perceived level of knowledge, perceived personal preparedness, perception of ED preparedness, and willingness to attend their workplace. Data were analyzed using descriptive and inferential statistics.

Results:

There were 244 complete responses, 92 (37.7%) doctors and 152 (62.3%) nurses. When comparing doctors and nurses, there was a statistical difference between gender (p = < 0.001), length of employment (p = < 0.001), and role in the ED (p = < 0.001). Doctors and nurses had a similar level of previous training except for practical training in mask fitting (p = 0.033). CBRNe events were considered separately. Perceived level of knowledge, perceived personal preparedness, and perception of ED preparedness were significant predictors of willingness to work in all CBRNe event. Perceived likelihood of a CBRNe event impacting their ED was not a predictor of willingness.

Discussion:

This research contributes to an overview of the current status of Australian ED clinicians’ preparedness for CBRNe response. To increase the willingness of ED doctors and nurses attending their workplace for a CBRNe event, strategies should focus on enhancing individuals perceived level of knowledge, perceived personal preparedness, and perception of ED preparedness.
Rising Sea Level and the Growing Threat of Hazardous Material Releases: A Pilot Project in Coastal Virginia
Authors: Becker S.M.
Published: May 2019

Introduction:

Hazardous materials are widely used in modern society, including in industry, business, agriculture, research, healthcare, and other sectors. As sea levels continue to rise around the globe, locations where hazardous materials are produced, stored, transported, or utilized become increasingly vulnerable to flooding, storm surge, and other problems that can result in accidental releases. Such releases can pose threats to health, the environment, and the economic viability of communities.

Aim:

This paper reports on a new pilot project in Coastal Virginia to increase awareness, enhance safeguards, and strengthen preparedness for the growing threat of hazardous material releases posed by rising sea levels.

Methods:

Launched under the Institute for Coastal Adaptation and Resilience (ICAR) at Old Dominion University, with support from the ODU Resilience Collaborative, the project includes several components. One part identifies hazardous materials sectors that could be affected by rising seas. Another component consists of case studies of locations that have already been affected. A third component involves stakeholder workshops where participants work collaboratively to enhance safeguards and strengthen preparedness.

Results:

Designed in 2017 and 2018, the project secured initial funding early in 2018. Since then, the project has worked to identify sectors and activities that could be affected by rising seas and establish links with key stakeholder agencies, sectors, and organizations. The next steps, to be completed in 2019, involve preparation of case studies from facilities already affected by rising sea levels, and the implementation of the first in a series of stakeholder workshops.

Discussion:

As sea levels rise, more hazardous materials locations become vulnerable. Proactively addressing this threat is an essential part of sea level rise preparedness, adaptation, and resilience. The new pilot project in Coastal Virginia is intended to help address this challenge by increasing awareness and bringing stakeholders together to collaboratively identify practical steps forward.
Positively Adapting to a Changed Reality
Authors: Henderson Rose
Published: May 2019

Introduction:

Following the New Zealand November 2016 earthquake, mental health staff were deployed to assist with the immediate levels of distress in the community. The work included working with individuals, couples and families, staff wellbeing sessions, psychosocial education, and participating in outreach clinics to isolated communities.

Aim:

Aware of international evidence and the experience following the 2010/11 earthquakes, the aim was to provide mental health assistance to address issues as early as possible with the intent that this would reduce the future demands on specialist services.

Methods:

Following the response phase, a small team of mental health specialists formed the Recovery and Wellbeing Team working in the affected communities undertaking clinical, consult, advisory, and educational work as needed. The team flexed and evolved to meet the changing needs. A range of data was collected and analyzed to monitor the work and the outcomes of this team.

Findings:

With additional support provided following the earthquake, there has been a significant positive change in the numbers of referrals to secondary mental health services in Christchurch. A new model of care has now been collaboratively developed, as the mental health system positively adapted to a changed reality. This model is essentially an easily accessed, early intervention, comprehensive model of mental health service to maintain the positive gains.

Discussion:

Following a significant disaster, all involved will benefit from some form of psychosocial support. For most, this will be achieved through the person’s own networks. For some, the event will trigger responses from previous traumatic experiences and a few mental health supports will be required. Having skilled professionals with the ability to cope with the constantly changing needs, and who are available to meet people at the earliest opportunity, has enabled issues to be resolved rather than leaving these issues to escalate over time.
Association Between Vitamin A Supplementation and Mortality Among Patients with Ebola Virus Disease: An International Multisite Cohort Study
Authors: Aluisio Adam , Yam Derrick , Peters Jillian L. , Cho Daniel K. , Perera Shiromi M. , Kennedy Stephen B. , Sahr Foday , Garbern Stephanie , Liu Tao , Levine Adam C.
Published: May 2019

Introduction:

Micronutrient supplementation is recommended in Ebola Virus Disease (EVD). However, there is limited data on its therapeutic impacts. This study evaluated the association between vitamin A supplementation and mortality outcomes in EVD patients.

Methods:

This retrospective cohort study accrued patients with EVD admitted to five International Medical Corps run Ebola Treatment Units (ETU) in two countries from 2014-2015. Protocolized treatments with antimicrobials and micronutrients were used at all ETUs. However, due to resource limitations and care variations, only a subset of patients received vitamin A. Standardized data on demographics, clinical characteristics, malaria status, and Ebola virus RT-PCR cycle threshold (CT) values were collected. The outcome of interest was mortality compared between cases treated with 200,000 International Units of vitamin A on care days one and two and those not. Propensity scores (PS) based on the first 48-hours of care were derived using the covariates of age, duration of ETU function, malaria status, CT values, symptoms of confusion, hemorrhage, diarrhea, dysphagia, and dyspnea. Treated and non-treated cases were matched 1:1 based on nearest neighbors with replacement. Covariate balance met predefined thresholds. Mortality proportions between cases treated and untreated with vitamin A were compared using generalized estimating equations to calculate relative risks (RR) with associated 95% confidence intervals (CI).

Results:

There were 424 cases analyzed, with 330 (77.8%) being vitamin A-treated cases. The mean age was 30.5 years and 57.0% were female. The most common symptoms were diarrhea (86%), anorexia (81%), and vomiting (77%). Mortality proportions among cases untreated and treated with vitamin A were 71.9% and 55.0%, respectively. In a propensity-matched analysis, mortality was significantly lower among cases receiving vitamin A (RR = 0.77 95%; CI:0.59-0.99; p = 0.041).

Discussion:

Early vitamin A supplementation was associated with reduced mortality in EVD patients and should be provided routinely during future epidemics.
Patient Healthcare Following a Disaster: Guidelines for Family Doctors
Authors: Burns Penelope , Douglas Kirsty , Hu Wendy , Aitken Peter
Published: May 2019

Introduction:

Health effects of disasters are mostly consistent across hazard types. Those working in communities affected by disasters have an opportunity to provide surveillance and early management to patients affected by disaster through increased understanding of the epidemiology or health consequences in the days, weeks, months, and years after disasters. Disasters have been called a social determinant of health and population-level changes or social determinants that have been documented post-incident. Environmental and community disruption contribute to health effects. Consequent health effects are evidenced across body systems, affecting both physical and mental health.

Aim:

To develop guidelines for primary care patient review following a disaster, based on the temporal pattern of disease epidemiology.

Methods:

A systematic review of the literature was undertaken to examine the epidemiology of health consequences following disasters.

Results:

Guidelines for Family Doctors based on the literature review were developed to assist preventative care, surveillance, early identification of emerging conditions, and ongoing management of pre-existing disease.

Discussion:

Healthcare management in disasters focuses on acute healthcare in emergency departments and hospitals. However, healthcare is also being provided in primary healthcare settings during the first days to weeks of the catastrophe, with many health consequences ongoing in the weeks, months, and years after the event.
Overcoming Ambiguity: Conflict Between Emergency Warning Messages and Socio-Environmental Cues
Authors: Dootson Paula , Greer Dominique , Miller Sophie , Tippett Vivienne
Published: May 2019

Introduction:

Emergency services are not the only source of information that the public uses when considering taking action during an event. There are also environmental cues, information from the media, or actions by peers that can influence perceptions and actions. When cues from different information sources are in conflict, it can cause uncertainty about the right protective action to take.

Aim:

Our research responds to concerns that conflicting cues exacerbate community non-compliance with emergency warnings.

Methods:

The sample consisted of 2,649 participants who completed one of 32 surveys.

Results:

The findings from this project confirmed emergency services agencies’ suspicions that conflicting cues can affect information processing and risk perceptions, and therefore prevent people from taking appropriate protective action. The results were reasonably consistent across fire and flood scenarios, suggesting the problem of conflicting cues is not hazard-specific. When presented with consistent cues, participants were more likely to evacuate, perceive risk about the event, share information with friends, family, and peers, find emergency warnings to be effective, and comprehend information. When faced with conflicting cues, participants were more likely to seek out additional information. It affected their information processing and self-efficacy. The results did not change for people of different ages, native language, country of birth, or post-hazard experience. This is contrary to most emergency literature research findings, which show that individual differences play a role in impacting propensity to take protective action. However, there does appear to be a significant gender effect. These results require further exploration.

Discussion:

These findings may be used to assist emergency services agencies to tailor community warnings during time-critical situations, and develop ways to mitigate ambiguity caused by conflicting cues to encourage protective action in order to save lives and properties.
“We Just Want to Help” - Nonprofits Contributions to Community Resilience in the Disaster Space
Authors: Roberts Fiona , Archer Frank , Spencer Caroline
Published: May 2019

Introduction:

The National Strategy for Disaster Resilience (NSDR) characterizes resilient communities as having strong disaster and financial mitigation strategies, strong social capacity, networks, and self-reliance. Nonprofit organizations (NPOs) embrace many characteristics of a disaster resilient community. NPOs do not operate for the profit of individual members. Community groups like Lions and Rotary Club have long histories, and while not established to respond to disasters, they frequently have heavy involvement in preparing for or recovering from, disasters.

Aim:

The study aims to address the question, “What is the potential role of nonprofit organizations in building community resilience to disasters?”

Methods:

An applied research project was carried out, using theories of resilience, social capital, and the Sendai framework to conceptualize the frameworks and guide the process. Qualitative research methods, thematic analysis, and case studies helped identify Lions, Rotary, and Neighbourhood Houses Victoria strengths, barriers, and enablers.

Results:

Research demonstrated how NPOs made significant contributions to building communities’ resilience to disasters. NPOs facilitate three Sendai guiding principles of engaging, empowering, and enabling the community to build disaster resilience. Actions included raising awareness to disaster risk, reducing disaster risk, helping prepare for disasters, and contributing to long term disaster recovery. NPO strengths included local knowledge, community trust, and connections, which matched characteristics listed in the NSDR for a disaster resilient community. However, barriers to participation included traditional emergency services ignoring NPOs, lack of role definition, and lack of perceived legitimacy.

Discussion:

As the first Australia research to scientifically analyze the contributions of these NPOs to build community resilience, before, during and after disaster, this study enhances understanding and recognition of NPOs and assists in identifying means to facilitate their disaster resilience activities and place them more effectively within Emergency Management strategic processes. Greater utilization of such assets could lead to better community outcomes.
The Roles of ARCH Project in the Strengthening of the ASEAN Disaster Health Management
Authors: Silapunt Phumin , Wuthisuthimethawee Prasit , Promkhum Dangfun
Published: May 2019

Introduction:

The Project for Strengthening the Association of Southeast Asian Nations (ASEAN) Regional Capacity on Disaster Health Management (ARCH Project) is the project under the collaborative framework between the National Institute for Emergency Medicine, Thailand, Ministry of Public Health, and Japan International Cooperation Agency. The project aims to strengthen disaster health management focusing on the International Emergency Team (I-EMT) operation and coordination in ASEAN by using various mechanisms, for example, regional collaboration meeting, regional collaboration drill, training, etc.

Aim:

The study aims to evaluate the outcomes which ARCH Project’s activities have been facilitating to strengthen the ASEAN disaster health management.

Methods:

A comparative study is utilized to see the improvement of the ASEAN disaster health management of the current situation and the project’s outputs compared to the previous survey in 2015.

Results:

Recent ASEAN disaster health management has been strengthened in three distinctive dimensions: (1.) national capacity of each ASEAN Member States is being strengthened through the project’s training courses; (2.) the ASEAN I-EMT coordination platforms have been set up to the extent that the progress of developing the toolkits such as the Standard Operating Procedures for the Coordination of EMT in ASEAN is at its eighty percent, while the Database of the EMT and their Minimum Requirements and Qualifications are now at its ninety percent; and (3.) Standard reporting forms (medical record and health need assessment form) for all ASEAN member state (AMS) has been developed and fully completed.

Discussion:

The ARCH Project has been facilitating the strengthening of the ASEAN disaster health management through its capacity building endeavors and the creation of collaborative mechanisms for operations and coordination. These activities should be maintained either under the existing or newly created mechanisms in order to build a sustainable collaborative framework.
Point of Care Transcranial Ultrasonography to Detect Midline Shift in Neuro-Emergencies in the Emergency Department
Authors: Madhavan Gayatri , Sagar Anandha
Published: May 2019

Introduction:

Midline shift (MLS) in the brain is a life-threatening emergency, which requires immediate surgical intervention following diagnosis. Currently, CT Brain is accepted as the gold standard in detection of MLS. Unfortunately, the diagnosis may be delayed when the patient is unable to undergo a CT Brain immediately due to several reasons. This has led to a constant endeavor to identify and develop other methods for detection of MLS, among which Transcranial Sonography (TCS) is included.

Aim:

To validate point-of-care TCS for detection of MLS in neuro-emergency patients in the Emergency Department, and compare it to CT values of MLS.

Methods:

This double-blinded prospective study was conducted from March 2018 to August 2018 in the Emergency Department of VIMS Hospital, Salem. All patients above the age of 18 who required a CT Brain were included, and a TCS was performed. MLS on TCS was calculated by measuring the distance between the outer table of the skull and the third ventricle on both sides, through the temporal window using a 2.8 MHz Sector Probe. MLS on CT was defined as the difference between ideal midline and septum pellucidum.

Results:

A total of 87 patients were included in this study. The MLS (mean ± SD) was 0.21cm ± 0.31cm using TCS, and 0.20cm ± 0.34cm using CT. The Pearson’s correlation coefficient between CT and TCS was 0.97 (p < 0.01). The area under the ROC curve for detection of a significant MLS using TLS was 83.7%. Using 0.5cm as a cut-off, the sensitivity, specificity, and positive likelihood ratio were 86.7%, 98.6%, and 61.92, respectively.

Discussion:

This study concludes that Transcranial Sonography could detect Midline Shift with reasonable accuracy, and can be used as a point-of-care tool in the Emergency Department to facilitate early diagnosis of MLS and intervene accordingly in neuro-emergencies.
Conceptualizing a Gender-Based Framework for Implementing Disaster-Resilient Village Program in Aceh Province, Indonesia
Authors: Oktari Rina Suryani , Syam Fatimah , Suraiya Suraiya
Published: May 2019

Introduction:

It is critical to understand how gender relations shape women’s and men’s lives to enhance their resilience toward disaster because women and men have different roles, responsibilities, and access to resources. Unequal participation between women and men in a disaster risk reduction program will influence how each can be affected by various hazards, and how they will cope with and recover from disaster. Even though women are often considered to have incredible resilience and capacity to survive in the face of disasters, they also experience a range of gender-specific vulnerabilities.

Aim:

This study aims to evaluate women’s participation in current efforts of the Disaster-Resilient Village Program and to develop a conceptual framework for implementing gender-based a disaster resilience program at the community level.

Methods:

This study employed a mixed-method approach and adopted several major activities including literature review, interview, focus group discussion, and a questionnaire survey with a total of 300 respondents. Three selected villages in Aceh Besar District, Aceh Province, were the study area of this study.

Results:

By using descriptive and inferential statistics, this study proposed a gender-based framework for implementing Disaster-Resilient Village Program.

Discussion:

This framework contributes to the emerging literature on gender-based disaster risk reduction and may assist policymakers in formulating regulations related to the community-based disaster risk management program. On the practical front, this study provided indicators to practitioners regarding some conditions that should be taken into account when mainstreaming gender in community-based disaster risk management programs. This study offered an original contribution to the existing bodies of knowledge on gender studies in disaster risk reduction efforts.
Newborn and Child Health Care in Humanitarian Crisis Settings: Piloting of Training Package for Primary Health Care Workers in Rural Nepal
Authors: Bajracharya Sumana , Shrestha Ashis , House Rose
Published: May 2019

Introduction:

The community-based integrated management of newborn and childhood illness (CBIMNCI) training package has been widely used throughout Nepal. Adding a component of disaster response and management to this program would greatly impact the community, and could improve the knowledge and skills of community workers for the management of children during a disaster.

Aim:

Describe the development and implementation of a community-based training for children in disasters.

Methods:

Using expertise from emergency and pediatric emergency physicians, pediatricians, and psychiatrists, we developed a two-day training and facilitator manual covering topics such as trauma, resuscitation, burn, drowning, disaster, nutrition, and care of the newborn. The information and manuals were presented to the Nepal Division of Child Health for approval. Four pilot trainings were conducted in Bardia and Bardibas in Nepal in September 2017, including knowledge and skill-based sessions. Knowledge was tested pre- and post-training using multiple choice questions (MCQ) and self-reflections. Skills were evaluated by direct observation and marked using a Likert scale. Confidence was assessed using a confidence matrix before and after the course. Overall feedback was taken at the end of the session.

Results:

Of 82 participants, 74 participants from four trainings were included for analysis. Post-test Cronbach’s alpha for MCQ was 0.82 and the confidence matrix was 0.86. Mean score for the pre-test MCQ was 6.12 (SD 2.22) compared to the post-test mean of 10.97 (SD 2.97), which was a statistically significant improvement (p<0.05). Trainees reported that the trauma teaching was helpful. They felt that it improved confidence regarding trauma and disasters.

Discussion:

Adding this training to current CBIMNCI can be an effective tool to reach out to primary health care workers, and provide further knowledge and skills on care of children during a disaster or humanitarian crisis.
Towards a Better Response: Combining Pareto Ranking and Geostatistics to Model Gender-Based Vulnerability in Rohingya Refugee Settlements in Bangladesh
Authors: Nelson Erica , Saade Daniela Reyes , Greenough P. Gregg
Published: May 2019

Introduction:

The Rohingya refugee crisis in Bangladesh continues to overburden humanitarian resources and undermine the health and security of over 900,000 people. Spatial, sector-specific information is required to better understand the needs of vulnerable populations, such as women and girls, and to target interventions with improved efficiency and effectiveness.

Aim:

The aim of this study was to create a gender-based vulnerability index and explore the geospatial and thematic variations in the gender-based vulnerability of Rohingya refugees residing in Bangladesh by utilizing pre-existing, open-source data.

Methods:

Data sources included remotely-sensed REACH data on humanitarian infrastructure, UN Population Fund resource availability data, and the Needs and Population Monitoring Survey conducted by the International Organization for Migration in October 2017. Gaps in data were addressed through probabilistic interpolation. A vulnerability index was designed through a process of literature review, variable selection and thematic grouping, normalization, and scorecard creation. Pareto ranking was employed to rank sites based on vulnerability scoring. Spatial autocorrelation of vulnerability was analyzed with the Global and Anselin Local Moran’s I applied to both combined vulnerability index rank and disaggregated thematic ranking.

Results:

Twenty-four percent of settlements were ranked as most vulnerable, with 30 highly vulnerable clusters identified predominantly in the Upazila of Sadar. Five settlements in Dhokkin, Somitipara, and Pahartoli were categorized as less vulnerable outliers amongst highly vulnerable neighboring sites. Security- and health-related variables appear to be the largest drivers of gender-specific vulnerability in Cox’s Bazar. Clusters of low security and education vulnerability measures are shown near the refugee ingress point near Gundum.

Discussion:

The humanitarian space produces tremendous amounts of data that can be analyzed with spatial statistics to better target research and programmatic intervention. The critical utilization of these data and validation of vulnerability indexes is required to improve the international response to the global refugee crisis.
The Use of Evidence in Humanitarian Response Decision-Making
Authors: Saulnier Dell , Allen Claire , Eriksson Anneli , Taylor Ben Heaven
Published: May 2019

Introduction:

The need to use evidence in humanitarian settings is recognized, yet utilizing that evidence to make decisions about humanitarian response remains a challenge.

Aim:

To identify how, when, and why decision makers in humanitarian response use scientific, peer-reviewed evidence to make decisions.

Methods:

An online cross-sectional survey of fifteen open- and closed-ended questions on demographics, experience, and role in humanitarian response was developed by Evidence Aid (EA) and Karolinska Institutet (KI). The online survey was available on the EA website from August 2015 to October 2018. Participants were self-selected, recruited through social media channels and mailing lists of EA and KI. All respondents and responses were anonymized. Responses were analyzed with descriptive statistics and content analysis.

Results:

47 people responded, primarily working in Europe or North America with roles of humanitarian response director/manager, independent consultant, or policymaker. Personal assessment of the quality of information, trust in the source, and information that was contextually relevant or based on field experience were factors for deciding whether information should be considered evidence. Reasons for using evidence when making decisions included adhering to good practice to maximize impact and effectiveness of aid, reassurance that the right decisions were being made, personal or organizational values, and using evidence as a tool to protect beneficiaries and organizations from poor quality decisions and program content.

Discussion:

Using evidence for decision making was common practice during the process of designing implementing and evaluating humanitarian response content, yet reasons for use varied. The importance of evidence developed and validated from field experience and trust in the source reported by this sample suggests that strengthening collaborative efforts between decisionmakers and evidence generators could be one approach to improve evidence and evidence use in humanitarian response.
Coping With On-Call Work: Current Knowledge to Support Women in the Emergency Services
Authors: Jay Sarah M , Vincent Grace E , Roberts Bernadette , Aisbett Brad , Reynolds Amy C , Paterson Jessica L , Ferguson Sally A
Published: May 2019

Introduction:

All Fire and Emergency Services (FES) personnel must balance FES work with their other responsibilities. Given that women tend to take on a greater responsibility for management of household/domestic activities than men, the on-call component of their FES work may be associated with very different challenges. Despite this, women have rarely been the focus of on-call research.

Aim:

To explore women’s on-call experiences in the FES by examining coping styles and strategies, with the goal of helping to innovate the way women are supported in FES roles.

Methods:

Relevant findings from two studies are included. The first study involved FES personnel from two agencies in Australia (n=24) who participated in a semi-structured interview. The second study was an anonymous online survey to determine work characteristics, sleep, stress, and coping in on-call workers more broadly, with workers from all industries across Australia (n=228) invited to participate.

Results:

Interview data identified two major themes in terms of coping with on-call work. Support (from family, social, and work), planning, and preparation were identified as important in helping women cope in the context of on-call unpredictability. Results from the survey (43% women) showed that on-call workers were an engaged group in terms of their coping, with 67% classified as having a positive coping style and 58% of women indicating that they agreed/strongly agreed with the statement, “I cope well with on-call work.”

Discussion:

Taken together, these data highlight engagement with positive coping by women who do on-call work, including in the FES. Importantly, positive coping strategies, such as talking about emotions, problem-solving, and seeking support have been linked to increased shift work tolerance in other populations. Coping style and strategies represent modifiable variables which could be specifically applied to assist women to manage the unique challenges associated with on-call work in the FES.
Global Event Data Research Registry: Taking Mass Gathering Research to the Next Level
Authors: Gogaert Stefan , Scholliers Annelies , Sherman Holly , Munn Matthew Brendan , Turris Sheila , Lund Adam , Ranse Jamie
Published: May 2019

Introduction:

Research on events and mass gatherings is hampered by a lack of standardized and central reporting of event data and metrics. While there is work currently being done on report standardization, this will require a plan for recording, storing, and safeguarding a repository of event data. A global event data registry would further the work of standardized reporting by allowing for the collection and comparison of events on a larger scale.

Aim:

To characterize the considerations, challenges, and potential solutions to the implementation of a global event data registry.

Methods:

A review of the academic and grey literature on the current understanding and practical considerations in the creation of data registries, with a specific focus on an application to mass gathering events.

Results:

Findings were grouped under the following domains: (1) stakeholder identification and consultation, (2) research goals and clinical objectives, (3) technological requirements (ie hosting, format, maintenance), (4) funding (budget, affiliations, sponsorships), (5) ethics (privacy, protection, jurisdictions), (5) contribution facilitation (advertising, support), and (6) data stewardship and registry access for researchers.

Conclusion:

This work outlines key considerations for undertaking and implementing an event data registry in the mass gathering space, and compliments ongoing work on the standardization of data collected at mass gathering events. If practical and ethical considerations are appropriately identified and managed, the creation of an event data registry has the potential to make a major impact on our understanding of events and mass gatherings.
On the Way Out: An Analysis of Patient Transfers from Four, Large-Scale, North American Music Festivals Over Two Years
Authors: Callaghan Christopher , Turris Sheila , Rabb Haddon , Munn Brendan , Lund Adam
Published: May 2019

Introduction:

Music festivals are globally attended events that bring together performers and fans for a defined period of time. These festivals often have onsite medical care to help reduce the impact on local healthcare systems. Historically, the literature suggests that patient transfers offsite are frequently related to complications of substance use. However, there is a gap in understanding as to why patients are transferred to a hospital when an onsite medical team, providing a higher level of care (HLC), is present.

Aim:

To better understand the causes that necessitate patient transportation to the hospital during festivals that have onsite physician-led coverage.

Methods:

De-identified patient data from a convenience sample of four, large-scale Canadian festivals (over two years) were extracted. Patient encounters that resulted in transfers to hospital, by ambulance, non-emergency transport vehicle (NETV), or self-transportation were analyzed for this study.

Results:

Each festival had an onsite medical team that included physicians, nurses, and paramedics. During 34 event days, there were 10,406 patient encounters, resulting in 156 patients requiring transfer to a hospital. A patient presentation rate of 16.5/1,000 was observed. The ambulance transfer rate was 0.12/1,000 of attendees. The most common reason for transport was musculoskeletal injuries (54%) that required imaging.

Discussion:

The presence of onsite teams capable of treating and releasing patients impacted the case mix of patients transferred to a hospital, and may reduce the number of transfers for intoxication. Confounding preconceptions, patients in the present study were transferred largely for injuries that required imaging. Results suggest that a better understanding of the specific effects onsite medical teams have on avoiding off-site transfers will aid in improving planning for music festivals. Findings also identify areas for further improvement in care, such as onsite radiology, which could potentially further reduce the impact of music festivals on local health services.
This is Sparta - A Five-Year Obstacle Course Racing Injury Analysis
Authors: Rabb Haddon , Coleby Jillian
Published: May 2019

Introduction:

Obstacle Course Races (OCR) are mass participation sporting events, challenging participants to complete physical and mental tasks over a variety of distances and terrains. The case series studied, Spartan Race, has races occurring in urban, rural, and wilderness venues, ranging from 5 to 42 kilometers, while incorporating 20 to 60 obstacles.

Aim:

To understand the injury rates, injury and illness patterns, and transport considerations within OCRs.

Methods:

A secondary data analysis of de-identified medical charts from 56 Spartan Race events occurring in Eastern Canada from 2014 to 2018 was performed. The scope of practice was first aid from 2014 to 2017, with the addition of advanced life support onsite in 2018.

Results:

Over 5 years, 2,387 injuries occurred among 127,481 participants, creating a patient presentation rate of 18.7/1000. Although the majority of injuries (92%; n=2,204) were treated onsite, a transport to hospital rate of 1.2/1000 (n=154) occurred along with an ambulance transport rate of 0.23/1000 (n=29). Lacerations (55%) and musculoskeletal (36%) injuries were the most frequent clinical presentations observed, whereas life-threatening emergencies (affecting airway, breathing, and circulation) were infrequent (n=10). Transport to the closest local tertiary care center was on average 49.8 kilometers (25.3 kilometers) and 40.5 minutes (17.9 minutes) away from the venue.

Discussion:

These results suggest that there may be an upper limit to the injury rates within Spartan Races. The majority of patient presentations were able to be treated onsite, supporting the need for a qualified onsite medical team to mitigate the strain on local healthcare systems. Although life-threatening emergencies were uncommon, they do occur, and medical teams must be appropriately prepared. Further research is needed to understand the staffing and equipment requirements of medical teams, the demographic information of the injured, and the examination of the impact OCR events have on the local health care systems.
Assessing the Quality of Roof-Harvested Rainwater after Bushfires
Authors: Steenkamp Malinda , Ross Kirstin , Whiley Harriet , Chubaka Emmanuel , Arbon Paul
Published: May 2019

Introduction:

Roof-harvested rainwater held in domestic tanks is used for a variety of purposes in Australia, including drinking and irrigation. There is limited evidence about the quality of rainwater after bushfires. Current health guidelines can be interpreted that landholders need to drain their rainwater tanks to avoid the risk of contamination. Anecdotal reports indicate that following such advice caused additional distress to landowners affected by bushfires in South Australia. Sustainable water management is important for future resilience and more evidence on water quality following bushfires is needed.

Aim:

This project investigated whether there is contamination of roof-harvested rainwater after bushfires, and if so, whether such water was safe for various purposes.

Methods:

In 2017 we tested artificially contaminated water spiked with chemicals associated with bushfires (chromated copper arsenate-treated ash and firefighting foam) and conducted a pilot field study using two purposely built roofs during a pre-fire season burn off. A field validation is planned for the summer of 2018/19 (December 2018 - March 2019), i.e., we plan to obtain 200 samples from 50 households affected by bushfire – two samples immediately after the fire event and another two after the first rain.

Results:

The artificially created contaminated water fell within guidelines for non-potable uses such as irrigation and stock watering, but was found unsuitable for drinking even after being filtered through two commercially available water filtration systems. We also plan to present results from our field study of 50 households.

Discussion:

Contaminant concentrations, even in artificially spiked water samples, are low and acceptable for non-potable uses. Bottled water should be used for drinking. Landholders should be encouraged to use their water for recovery purposes. Such advice may assist with decreasing the stress experienced by affected landholders and help with recovery efforts through the availability of a greater body of water.
The Role of Japan DMAT in Tokyo Inland Earthquake
Authors: Koido Yuichi , Misaki Miho , Chishima Kayako , Kawashima Yuzuru , Kondo Hisayoshi , Toyokuni Yoshiki , Otomo Yasuhiro , Yoshihara Katsunori
Published: May 2019

Introduction:

An inland earthquake is expected to occur in Tokyo in the near future, and disaster preparedness and response measures have been put in place by the government of Japan and local authorities.

Methods:

Japan Disaster Medical Assistant Teams (DMATs) conducted two large-scale drills for the first time in preparation for a Tokyo inland earthquake, in collaboration with the following participants: the Tokyo Metropolitan Government, disaster base hospitals in Tokyo, three Staging Care Units (SCUs), and neighboring prefectures. One of the scenarios was a north Tokyo Bay earthquake affecting the Tokyo wards and had 142 Japan DMATs participation. Another scenario was Tama inland earthquake affected mid-west of Tokyo and 110 DMATs participated. The drill included headquarters operation, affected hospital support operation, patient transportation within the area and to the wider region, SCU operation, collaboration with associated organizations, and logistics operation.

Results:

Post-drill assessments identified the following areas that need to be addressed: review of Japan DMAT implementation strategies; improvement of SCUs; establishment of a patient air transportation framework; securing means of patient transportation; improvement of communication systems; strengthening of disaster response of all hospitals in the Tokyo Metropolis; and preparations for survival in the event of isolation caused by the disaster.
Typhoon Mangkhut Case Study: Household and Community Typhoon Preparedness in Hong Kong, a Densely Populated Urban City
Authors: Man Asta YT , Chan Emily Ying Yang , Lam Holly CY
Published: May 2019

Introduction:

As a subtropical urbanized city in Southeast Asia, Hong Kong is prone to frequent typhoons. With an increasing number of severe typhoons, usual preparedness measures should be explored to assess their adequacy to safeguard health and wellbeing. Typhoon Mangkhut (2018) serves as an example of the successes and limitations of community preparedness for a severe typhoon.

Aim:

To explore how Hong Kong residents prepared for Typhoon Mangkhut and whether their usual preparedness measures provided enough protection.

Methods:

A population-based randomized telephone survey of Hong Kong residents (n=521) was conducted soon after Typhoon Mangkhut’s landing. Only residents aged 18 or above and understood Cantonese were included. Socio-demographic factors, types of typhoon and general preparedness, risk perception, and impacts from the typhoon were asked. Descriptive characteristics and univariate analysis were used to describe the patterns and associations.

Results:

8.6% of respondents felt their home was at high risk of danger during typhoons although 33.4% reported some form of impact from Mangkhut. Over 70% reported doing at least one typhoon specific preparedness measure. Among those who practiced at least one typhoon specific preparedness measure, 37.2% (p=0.002) were affected by the typhoon.

Discussion:

Despite the high adaptation of preparedness measures, warranted by the frequent typhoons, Hong Kong residents were not adequately prepared for a severe typhoon. While the early warning system and evacuation of flood-prone areas mitigated some of the impact, unexpected effects such as flying air conditioners, roadblocks affecting employment, swaying buildings, and loss of power supply were not accounted for. Future preparedness for natural disasters which will become more extreme due to climate change and needs to account for unforeseen risks.
Application of National and Sub-National Indicators to Rank Needs of People with Life-threatening Conditions and Chronic Diseases Before, During, and After a Disaster
Authors: Ryan Benjamin , Green Joseph , Franklin Richard , Burkle Frederick
Published: May 2019

Introduction:

Disasters can damage the essential public health infrastructure and social protection systems required for vulnerable populations. This contributes to indirect mortality and morbidity as high as 70–90%, primarily due to an exacerbation of life-threatening conditions and chronic diseases. Despite this, the traditional focus of public health systems has been on communicable diseases. To address this challenge, disaster and health planners require access to repeatable and measurable methods to rank and prioritize the needs of people with life-threatening and chronic diseases before, during, and after a disaster.

Aim:

Propose a repeatable and measurable method for ranking and prioritizing the needs of people with life-threatening and chronic diseases before, during, and after a disaster.

Methods:

The research began with identifying the risk disasters pose to people with life-threatening and chronic diseases. The data gathered was then used to develop indicators and explore the use of DisasterAWARE™ (All-hazard Warnings, Analysis, and Risk Evaluation) to rank and prioritize the needs before, during, and after a disaster.

Results:

This research found people at greatest risk are those with underlying cardiovascular and respiratory diseases, unstable diabetes, renal diseases, and those undergoing cancer treatment. A sustainable method to help address this problem is to expand the use of DisasterAWARE™ (All-hazard Warnings, Analysis, and Risk Evaluation) to rank and prioritize needs at national and sub-national levels.

Discussion:

DisasterAWARE™ has been successfully applied to the assessment and prioritization of disaster risk and humanitarian assistance needs in Southeast Asia (ASEAN, Viet Nam), Central America (Guatemala, El Salvador, Honduras, Nicaragua), South America (Peru), and the Caribbean (Jamaica, Dominican Republic). Using the indicators developed through this research, this proven methodology can be seamlessly and easily translated to rank and prioritize the needs of people with life-threatening and chronic diseases before, during, and after a disaster.