bluuebunny/crossref_metadata_2025 huggingface dataset:
WHO Approach to Quality and Safety: The WHO Quality Management Programme for Blood Transfusion Services
Authors: Hafner Valentina , Dhingra Neelam , Lloyd Shan , Amin Noryati Abu , Fordham Jan
Published: May 2019

Objective:

Quality management in all areas of blood transfusion is crucial for the provision of a safe and adequate blood supply. In 2000, the World Health Organization (WHO) launched an innovative global programme, “Quality Management Programme (QMP) for Blood Transfusion Services” in order to assist and support Member States in the development of quality systems for blood transfusion services.

Methods:

The QMP has been developed as a lon- term programme in collaboration with WHO Regions, Collaborating Centres, and Experts in Transfusion Medicine. The major components of QMP are: (1) Identification and strengthening of regional quality training centers; (2) Organization of Quality Management Training (QMT) courses with a well-structured curriculum; (3) Development of advocacy, training, and learning materials to support the implementation of the programme; (4) Establishment of external quality assessment schemes (EQAS); and (5) Creation of effective quality networks. Activities in this programme have been carried-out in all of the WHO regions since 2000.

Results:

Consultations for the planning and evaluation of QMP were conducted in 2000. Global endorsement and support was obtained from the WHO Regions as well as from the experts. Implementation of QMP includes training of blood transfusion staff as quality managers with responsibility for establishing quality systems at national level. Regional quality training centres, each with dedicated QMT coordinators, have been identified as focal points for this network. Key achievements in this programme have been: (1) The conduct of 20 QMT courses in three years (2) Ttraining of 65 global and regional facilitators; (3) Training of 350 quality managers from 121 countries; (4) Introduction of the programme to 240 directors of blood transfusion services; and (5) Increased participation of centres, now 257, in WHO-EQA Schemes.

Conclusions:

The establishment and implementation of quality management systems in blood transfusion services through this collaborative programme will lead to improvements in the safety, adequacy, and quality of blood for all patients requiring blood transfusion. This will be a major step towards achieving the ultimate goal of global blood safety.
Training Australian General Surgeons for Humanitarian Emergencies: A Comparison Between Trainee Logbooks and Emergency Medical Team Caseloads
Authors: Coventry Charles , Dominquez Lynette , Read David , Trelles Miguel , Ivers Rebecca , Holland Andrew
Published: May 2019

Introduction:

Emergency medical teams (EMTs) have helped to provide surgical care in many recent sudden onset disasters (SODs), especially in low- and middle-income countries (LMICs). General surgical training in Australia has undergone considerable change in recent years, and it is not known whether the new generation of general surgeons is equipped with the broad surgical skills needed to operate as part of EMTs.

Aim:

To analyze the differences between the procedures performed by contemporary Australian general surgeons during training and the procedures performed by EMTs responding to SODs in low- and middle-income countries (LMICs).

Methods:

General surgical trainee logbooks between February 2008 and January 2017 were obtained from General Surgeons Australia. Operating theatre logs from EMTs working during the 2010 earthquake in Haiti, 2014 typhoon in the Philippines, and 2015 earthquake in Nepal were also obtained. These caseloads were collated and compared.

Results:

A total of 1,396,383 procedures were performed by Australian general surgical trainees in the study period. The most common procedure categories were abdominal wall hernia procedures (12.7%), cholecystectomy (11.7%), and specialist colorectal procedures (11.5%). Of note, Caesarean sections, hysterectomy, fracture repair, specialist neurosurgical, and specialist pediatric surgical procedures all made up <1% of procedures each. There were a total of 3,542 procedures recorded in the EMT case logs. The most common procedures were wound debridement (31.5%), other trauma (13.3%), and Caesarean section (12.5%). Specialist colorectal, hepato-pancreaticobiliary, upper gastrointestinal, urological, vascular, neurosurgical, and pediatric surgical procedures all made up <1% each.

Discussion:

Australian general surgical trainees get limited exposure to the obstetric, gynecological, and orthopedic procedures that are common during EMT responses to SODs. However, there is considerable exposure to the soft tissue wound management and abdominal procedures.
The Importance of Enforcing Road Safety Laws to Reduce Road Traffic Collision (RTC) Occurrence and Fatalities in Nigeria
Authors: Awoniyi Oluwafunbi , Molloy Michael , Hart Alexander , Voskanyan Amalia , Sarin Ritu , Ciottone Gregory
Published: May 2019

Introduction:

Road Traffic Crashes (RTC) are one of the most preventable causes of death worldwide, yet are the number one cause of death in Nigeria. In March 2010, the United Nations General Assembly launched “The Decade of Action for Road Safety (2011-2020)” to “reduce road traffic deaths and injuries by 50% by 2020.”

Aim:

To analyze trends in RTC and deaths in relation to current road safety laws in Nigeria, and possible future interventions.

Methods:

Annual reports from 2013-2017 were obtained from the Federal Road Safety Corps (FRSC) of Nigeria. These reports were analyzed for trends in RTC, deaths, and reported causes to find areas of possible improvement.

Results:

The number of RTC and deaths declined yearly from 2013-2017. Crashes decreased from 23.4% in 2013-2014 to 6.2% in 2015, to 0.4% in 2016, and then increased to 3.2% in 2017. Results showed that fatalities from RTC in 2013-2014 decreased by 8.4%, then by 9.3% in 2015, and by 7.1% in 2016, but had a 1.3% increase in fatalities from 2016-2017. Analysis showed that speed violations (SPV) were the top cause of RTC. These had a decrease in the number of crashes from 5,495 (32% of RTC) in 2013, to 3,496 (29%) in 2014, to 3,195 (26.5%) in 2015. They then increased to 3,848 (33.9%) in 2016 and to 4,840 (44.1%) in 2017. There was a decline in reports of RTC caused by driving under the influence (DAD) from 1% in 2013, to 0.8% in 2014, and 0.5% in 2015 and 2016.

Discussion:

Current road safety laws have been effective in decreasing the total number of RTC and deaths. While certain laws such as those regarding DAD have been effective, other laws such as speed limits have been less successful and may require further changes in legal codes and/or enforcement.
Hurricane Sandy - Initial Evaluation of Patient Characteristics
Authors: Rosenthal Marc , Dunne Robert
Published: May 2019

Introduction:

Disaster medical team response by governmental and non-governmental responders is highly variable and poorly characterized. Each response is unique in terms of caseload, patient demographics, and medical needs encountered. This variability increases the difficulty of determining team member composition as well as supply and equipment needs. In an effort to demonstrate this issue, we have reviewed the National Disaster Medical Response to Hurricane Sandy.

Methods:

This project was a retrospective chart review of Hurricane Sandy data abstracted from the National Disaster Medical System (NDMS) Health Information Repository (HIR) medical records from the NDMS system response, and were abstracted for data including vital signs, ages, sex, chief complaint, and final impressions. In addition, length of stay among other parameters was abstracted. The data was analyzed using Microsoft Excel and Access with descriptive statistics. In addition, the results were compared to similar indices in a community emergency department and prior NDMS responses.

Results:

The results indicate a wide range of patient ages, chief complaints, and final impressions. The vast majority of patients seen by Disaster Medical Assistance Teams (DMAT) were stable with relatively low acuity issues. The total number of charts reviewed were 7,905. Respiratory complaints were the most frequent at 845 patients followed by toxicology/injuries at 706 patients and mental health issues at 452 patients. In approximately 3,400 patients, no diagnosis was present in the chart. Length of stay averaged below 1 hour and peak patient ages were between 50-60 with a significant number of infants less than 2 years.

Discussion:

Characterization of NDMS responses by DMATs and comparison with prior events and community emergency department caseloads can provide an insight into the needs of DMATs and other response organizations in future responses.
Level of Emergency Preparedness Before and After a False Missile Alert in Hawaii
Authors: Qureshi Kristine , Glauberman Gary , Bray Michele , Gershon Robyn , Zhi Qi , Chen John , Choi So-Yung
Published: May 2019

Introduction:

On January 13, 2018, a false ballistic missile alert that lasted 38 minutes was issued across Oahu, Hawaii, United States. As a result of a system failure, an erroneous text message was sent that stated, “Ballistic missile threat inbound to Hawaii. Seek immediate shelter.”

Aim:

The research team wanted to know the degree of reported anxiety triggered by the event and if knowledge, attitudes, or behaviors for individual/family emergency preparedness (EP) changed post-event.

Methods:

A 50-question survey that asked about individual and family EP pre- and post-event, and the level of anxiety triggered by the event, was administered to a convenience sample of full-time adult residents of Oahu. The study was conducted over a 6-8 week period post-event. Statistical analysis was used to identify factors associated with an increasing level of EP post-event and reported event-triggered anxiety.

Results:

209 participants completed the survey (29% male, 71% female) with about one half living with children. One third were essential workers. Key factors that correlate with increasing various areas of EP post-event include higher educational, receipt of electronic emergency alerts, prior emergency training, and higher reported connectedness to community. Those with higher event anxiety were more likely to develop and practice an EP plan post-event, encourage EP with friends, and report a higher level of community connectedness. The elderly were more likely to have higher levels of EP before and after the event but were less likely to receive emergency alert notifications or have EP training.

Discussion:

While the event was very unfortunate, it did seem to stimulate citizen disaster EP among some groups. Additional research should explore the utility of increasing EP education for communities immediately after disasters, tailoring this education for groups, and targeting the elderly for participation in the emergency alert system.
Victorian Compendium of Community-Based Resilience Building Case Studies - Critical Success Factors Help Communities Strengthen Resilience to Disasters
Authors: Spencer Caroline , Cross Suzanne , McArdle Dudley , Archer Frank
Published: May 2019

Introduction:

Global conversations emphasize strengthening communities’ resilience to disasters. These conversations inspired the Victorian Compendium of Community-Based Resilience Building Case Studies. The Compendium motivates community members to build expertise, reduce program duplication, and save valuable resources. Case study analysis identified critical success factors. Between 2012 and 2018, community groups completed an Expression of Interest to present at the MUDRI Advancing Community Resilience Forums, which provided an opportunity to impart resilience activities and knowledge. It also solved challenges and shared unforeseen learning. Over six years, 72 groups presented. Subsequently, 35 submitted their activity for consideration into the Compendium. Of these 35, 30 were included.

Aim:

This updated research analyses critical success factors of 30 case studies. Success factors support the key tenet of the Victorian Compendium of Community-Based Resilience Building Case Studies: to promote the sharing of achievable, practical resilience building activities. The online Compendium provides free access for all communities to explore activities before, during, and after disasters.

Methods:

A thematic analysis identified critical success factors of 30 Compendium case studies.

Results:

Case studies revealed unique and valuable learning in diverse settings. The critical success factors included: (1) strong governance, Board support, leadership and trust; (2) partnerships; (3) commitment, adaptability, and stamina; and (4) community-based initiatives. Other success factors included a paid facilitator and local government support, stamina, and celebrating success.

Discussion:

The Compendium represents an Australian first and offers an innovative contribution to resilience practice and research. It enhances other Victorian initiatives such as the Rockefeller funded Resilient Melbourne Strategy, which incorporates the Compendium to bring people together from across sectors to deliver distinct, yet connected actions to strengthen resilience. The Compendium enables diverse communities to adopt or adapt proven resilience activities, thereby preserving valuable resources. It offers the opportunity to extend to a national or international Compendium.
Youth Participation in Post-Terrorist Attack Recovery: A Case Study in Southern Philippines
Authors: Ferolin Maria Cecilia , Fernandez Glenn
Published: May 2019

Introduction:

In the southern Philippines, human-induced disasters, such as terrorist attacks, have caused unprecedented damage to the economic, social, and political life of the attacked and nearby areas. More gruesome is the direct impacts to human life and wellbeing. This study focuses on the 2017 Marawi armed siege, the longest urban battle in the Philippines. The 154-day siege took a heavy toll, including 1,132 deaths among militants, soldiers, police, and civilians, and caused the displacement of some 400,000 local inhabitants. The city is in total ruins leaving its economic center as “Ground 0.” The aftermath of the siege demands major interventions to address physical and economic damages, but more importantly, to ameliorate the human impacts caused by the brutalities of war. The displaced peoples need to recover from health impacts – psychological trauma, as well as social, environmental, and cultural. The Sendai Framework for Disaster Risk Reduction (DRR) 2015-2030 states that DRR requires society-wide engagement. Everyone, regardless of their age, gender, ethnicity, religion, or socio-economic position, should be involved in thinking, planning, and deciding about DRR. Studies on youth participation in disaster recovery are still scarce.

Aim:

This current research aims to help fill this gap and to contribute to providing the much-needed evidence base for the formulation and implementation of future policies to enable and improve youth participation in post-disaster initiatives in the Philippines.

Results:

Initial findings reveal that the following are crucial factors for youth mobilization: (1.) avenues for volunteering, (2.) access to adequate resources and support including information, funds, manpower, and social capital, (3.) opportunities for the youth to participate in the form of events or activities, (4.) legal mandate for youth participation in local, national, and international policies and frameworks. The study also looked at barriers or challenges to youth participation and their motivations.
A State of Biopreparedness
Authors: Varshney Kavita , Friend Caren , Bag Shopna , Murphy Margaret , Dempsey Kathy , Clark Penelope , Ferguson Patricia
Published: May 2019

Introduction:

Westmead Hospital (WMH) recognized gaps in its preparedness to respond to the Ebola 2014 outbreak in West Africa. A fragmented system was identified. A ‘State of Bio-preparedness’ project team convened to discuss all healthcare services in the planning, training, and implementation of a biopreparedness response.

Methods:

A survey targeting the staff’s competence and confidence in biologically hazardous infection management was conducted. Semi-structured interviews explored staff members’ experiences and perspectives of biopreparedness response. The collaborative team called “State of Biopreparedness” (SOB) was assembled and a clinical practice improvement project was undertaken. To assess readiness, nine simulated Viral Haemorrhagic Fever (VHF) exercises involving staff and consumers were conducted. These exercises were debriefed by the multidisciplinary committee and themes and issues were identified. These nine simulation drills then assessed readiness and evaluated performance.

Results:

A number of consistent issues continue to emerge including:

1.

A standard communication pathway for notification was needed - use of the incident paging system (111 pages) to notify the hospital’s incident management team.

2.

A consistent and coordinated approach to the training and maintenance of standardized and high-level Personal Protective Equipment (PPE) protocols for frontline clinical and clinical staff was required.

3.

Clear delineation of roles and responsibilities and supporting these roles by translating the VHF Control Guideline and policy into task cards and checklists.

4.

Strengthening intra- and interdepartmental staff collaboration and communication.

5.

Infection control measures to be taken by staff after identifying a patient with possible VHF to reduce the risk of transmission of disease to staff, other patients, and visitors.

Discussion:

Integrating disaster management processes with clinical protocols had a positive impact on the hospital’s biopreparedness response. Simulation exercises were a vital and practical way for staff to feel confident and competent to perform their roles.
Disaster Medicine for India & Nepal: A Model for Developing Countries
Authors: Patel Peter , Kingsland James , Murray Virginia , O’Brien James , Sen Annapurna , Ramakrishnan T , Thangalvadi Tausif , Russell Robert
Published: May 2019

Introduction:

Both India and Nepal are prone to a wide range of natural and man-made disasters. Almost 85% of India’s area is vulnerable to one or more hazards, and more than 80% of the total population of Nepal is at risk of natural hazards. In terms of the number of people affected in reported disastrous events, India is in the top 10 and Nepal is in the top 20 globally. Over the last two decades, India and Nepal have taken steps to establish their respective National Disaster Management organizations, which provide essential disaster responses. However, key gaps still remain in trained clinical capacity for managing impacts from various disasters. Our review of the region has shown that large parts of the population suffer injuries, diseases, disabilities, psychosocial, and other health-related problems from disasters.

Aim:

Develop disaster medicine clinical capacity to reduce morbidities and mortalities from disasters.

Methods:

Independent published data and work undertaken by the lead author in various disasters in India and Nepal since 1993 formed the basis of establishing the Faculty of Disaster Medicine for South Asia. The Faculty of Disaster Medicine - India and Nepal (FDMIN) was launched from Pune in March 2015. This initiative is supported by the National Association of Primary Care (UK), Public Health England, Faculty of Pre-hospital Care of Royal College of Surgeons - Edinburgh and CRIMEDIM (Novara) - Italy.

Discussion:

FDMIN has international expert advisors and has outlined 16 modules training curriculum for health care professionals. FDMIN currently has partnerships for teaching disaster medicine program with 3 medical universities and 12 major health care providers. Six pilot training programmes have been conducted in Pune, Delhi, Chennai, and Kochin. Work is underway to submit an application to the Indian regulatory bodies for approval to establish a post-graduate diploma and Master’s for Disaster Medicine.
Seven First Minutes - Community Emergency Response Training
Authors: Herbst Raphael , Jaffe Eli
Published: May 2019

Introduction:

Following a mass casualty incident (MCI), it can take several minutes for emergency medical services (EMS) to arrive. The course was developed by Magen David Adom (MDA) based on unique experience in dealing with MCIs, and the time between alerting emergency services to such an incident until they arrive. The course is focused on teaching the general public to channel their desire to help in such a situation into useful skills which can potentially improve patient outcomes. The seminar focuses on key principles such as safety, calling for help, providing an accurate picture of the scene, and initiating basic treatment with an emphasis on hemorrhage control.

Aim:

MDA examined the ability of the general public with no previous medical training to perform a basic triage and treatment in an MCI situation. Additionally, the study examined the abilities of the study groups to manage a scene until the arrival of EMS based on the principles taught in the course.

Methods:

MDA has sent teams of instructors around the world to teach over 1,000 participants. Upon completing the course, the participants partake in a drill that assesses their ability to manage a scene of 20 patients. Their ability to initiate the call for help, provide an accurate picture, initiate treatment, and give an accurate report to arriving emergency responders are examined.

Results:

The average times were recorded. Within 38 seconds, dispatch was alerted to the situation. Within 2:30 minutes, treatment was initiated for all patients. Within 4:37 minutes, the scene was fully under control, and within 6:37 minutes, an accurate report was transferred to EMS on the scene.

Discussion:

The participants demonstrated an unexpected willingness to learn, practice, and partake in the drills, and the results were unexpected.
A Surprise Mass Casualty Incident Simulation: Does It Improve Knowledge or Is It Just a Bit of Fun?
Authors: Mitchell Brad , Hammad Karen , Aldwin Dana
Published: May 2019

Introduction:

We opened a national conference in Australia with a surprise mass casualty simulation scenario of a van versus multiple persons outside the conference venue. The purpose of this exercise was to increase awareness of, and preparation for, mass casualty incident (MCI) events for the conference delegates who were paramedics, emergency department nurses, and doctors.

Aim:

The aim of the research is to understand whether a surprise MCI simulation is a useful way to increase knowledge and motivate preparedness.

Methods:

A survey hosted on Qualtrics was circulated to delegates via email. The survey was designed by the research team and had 38 questions about demographics and respondents’ experience with MCIs, as well as their perceptions of the simulation exercise. The questions were a mixture of 5-point Likert scales, multiple choice, and short answers.

Results:

The majority of respondents were clinicians (n = 66, 76%) and those who worked in emergency departments or the prehospital setting (n = 75, 86%). While the majority had not responded to an MCI in the past 5 years (n = 67, 77%), more than half (n = 50, 57%) had undertaken MCI training during this time. Overall, a vast majority of respondents found the simulation to be a worthwhile exercise that increased knowledge and preparedness. An overwhelming majority also reported that the simulation was relevant to practice, of high quality, and a useful way to teach about major incidents.

Discussion:

Our surprise major incident simulation was a fun and effective way to raise awareness and increase knowledge in prehospital and emergency department clinicians about MCI response. This approach to simulation can be easily replicated at relatively low cost and is, therefore, a useful solution to training a group of multidisciplinary health professionals outside of the workplace.
Exploring the Ethical Dimensions of All-Hazards Public Health Emergency Preparedness in Canada
Authors: Caturay Alexa , O’Sullivan Tracey , Gibson Jennifer , Thompson Alison , Khan Yasmin
Published: May 2019

Introduction:

With increasing disaster risks from extreme weather, climate change, and emerging infectious diseases, the public health system plays a crucial role in community health protection. The disproportionate impacts of disaster risks demonstrate the need to consider ethics and values in public health emergency preparedness (PHEP) activities. Established PHEP frameworks from many countries do not integrate ethics into operational approaches.

Aim:

To explore the ethical dimensions of all-hazards public health emergency preparedness in Canada.

Methods:

A qualitative study design was employed to explore key questions relating to PHEP. Six focus groups, using the Structured Interview Matrix (SIM) format, were held across Canada with 130 experts from local, provincial, or federal levels, with an emphasis on local/regional public health. An inductive approach to content analysis was used to develop emergent themes, and iteratively examined based on the literature. This paper presents analyses examining the dimensions of ethics and values that emerged from the focus group discussions.

Results:

Thematic analysis resulted in the identification of four themes. The themes highlight the importance of proactive consideration of values in PHEP planning: challenges in balancing competing priorities, the need for transparency around decision-making, and consideration for how emergencies impact both individuals and communities.

Discussion:

Lack of consideration for the ethical dimensions of PHEP in operational frameworks can have important implications for communities. If decisions are made ad-hoc during an evolving emergency situation, the ethical implications may increase the risk for some populations, and lead to compromised trust in the PHEP system. The key findings from this study may be useful in influencing PHEP practice and policy to incorporate fairness and values at the core of PHEP to ensure readiness for emergencies with community health impacts.
University of Adelaide Higher Degree by Research Program Supported by an Australian Government Research Training Program Scholarship
Authors: Filmer Leighton
Published: May 2019

Introduction:

Collaboration between Foreign Medical Teams (FMT) and Host Health Personnel (HHP) is a core standard for healthcare in a medical response to disaster,1 but descriptions of its application from recipient nation HHP are rare. This paper details the findings from a qualitative study on the experience of collaboration between International Foreign Teams (IMT) and HHP in Gorkha, Nepal since the 2015 earthquake.

Aim:

To present findings from a study that explored the experience of collaboration by Nepal health workers working with IMT since the 2015 earthquake.

Methods:

A qualitative study design using semi-structured interviews regarding the experiences and perspectives on collaboration of 12 Nepali health workers was used. The interviews were transcribed, translated, and collated using Nvivo software by QSR international, and themes regarding collaboration were identified.

Results:

Data collection is not yet complete. However, preliminary results from early analysis indicate that collaborative practice is not uniformly applied by IMT. HHP Satisfaction with IMT appears highly dependent on collaboration. Emerging themes are that rigid organizational procedures, language and cultural barriers, and intimidating leadership inhibit collaboration. Objectives were assumed to align immediately post-disaster, with evidence of objectives increasingly diverging over time. IMT leadership that was experienced, responsive to suggestions, and regularly involved HHP in planning, implementing, and reviewing activities were highly appreciated.

Discussion:

Emerging themes indicate the time-critical nature of many disasters, along with cultural/institutional/administrative barriers, make the building of collaborative relationships difficult despite being foundational for successful missions. Participants in IMT must proactively involve HHP in the objectives setting, planning, implementation, and reviewing of activities. Successful IMT participation is not only clinically competent but actively seeks collaborative relationships with HHP throughout the mission.
Towards a Taxonomy of Workplace “Pressure” in Complex, Volatile, and Emergency Situations
Authors: Calahorrano Alicia Zavala , Plummer David , Day Gary
Published: May 2019

Introduction:

Pressure in the workplace has been studied in a number of settings. Many studies have examined pressure from physiological and psychological perspectives, mainly through studies on stress. Performing under pressure is a fundamentally important workplace issue, not least for complex, volatile, and emergency situations.

Aim:

This research aims to better understand performance under pressure as experienced by health and emergency staff in the workplace.

Methods:

Three basic questions underpin the work: (1) how do health and emergency workers experience and make sense of the ‘pressures’ entailed in their jobs? (2) What impacts do these pressures have on their working lives and work performance, both positively and negatively? (3) Can we develop a useful explanatory model for ‘working under pressure’ in complex, volatile, and emergency situations?

The present paper addresses the first question regarding the nature of pressure; a subsequent paper will address the question of its impact on performance. Using detailed interviews with workers in a range of roles and from diverse settings across Ecuador, this study set out to better understand the genesis of pressure, how people respond to it, and to gain insights into managing it more effectively, especially with a view to reducing workplace errors and staff burnout. Rather than imposing preformulated definitions of either ‘pressure’ or ‘performance,’ we took an emic approach to gain a fresh understanding of how workers themselves experience, describe and make sense of workplace pressure.

Results:

This paper catalogs a wide range of pressures as experienced by our participants and maps relationships between them.

Discussion:

We argue that while individuals are often held responsible for workplace errors, both ‘pressure’ and ‘performance’ are multifactorial, involving individuals, teams, case complexity, expertise, and organizational systems, and these must be taken into account in order to gain better understandings of performing under pressure.
Risk Perception of Zika Virus Infection Among Vulnerable Women in Rio de Janeiro
Authors: Miranda Elaine , Santos-Pinto Claudia , Antunes-de-Lima Clarice , Osorio-de-Castro Claudia
Published: May 2019

Introduction:

The Zika virus (ZIKV) infection outbreak in Brazil surged in late 2014, peaking in 2015. The most affected region was the northeast, but Rio de Janeiro was especially affected in poor, vulnerable, low-income communities with inadequate sanitation and water. Most cases of the ZIKV-related neurologic syndrome, microcephaly, were detected among newborns coming from this environment.

Aim:

To identify risk perception and consequences of ZIKV infection for pregnant women in a vulnerable community in Rio de Janeiro.

Methods:

Forty women who frequented a primary health care center (PHC) in a ZIKV-prone area of Rio de Janeiro were interviewed based on an open-ended questionnaire on ZIKV infection and risk. No censorship regarding age or other demographic characteristics was applied. Interviews were transcribed and analyzed according to analytical categories stemming from the literature and prior work. Preliminary analysis focused on risks for pregnant women and other groups.

Results:

Absolute number of responses reflect density of issues within all responses. Age range was 15-60 years. Several women identified microcephaly as a consequence of ZIKV infection for newborns, but many respondents did not cite any health problem associated with ZIKA in pregnancy. Although some cited pregnant women and children as most vulnerable, people living in or near insalubrious environments, such as the elderly, and those with low immunity were more cited. Information was mostly obtained from health professionals and television. Many confused origin and symptoms of ZIKV infection with other arbovirus infections.

Discussion:

This vulnerable group of women, who continuously attend a PHC in the area, have had community experience with the disease and its consequences, showed surprisingly little knowledge as to the risks of ZIKV infection for pregnant women. Results may indicate that the health system has still not achieved adequate risk communication for at-risk women for ZIKV infection in Rio de Janeiro.
Learning Lessons during Recovery from Disasters
Authors: Khan Yasmin , Tracey Shannon , Lacarte Sara , Therrien Marie-Christine , Sikora Christopher
Published: May 2019

Introduction:

The Fort McMurray Alberta wildfire was one of Canada’s largest natural disasters in history, burning 589,995 hectares of land until being controlled on July 5, 2016. In responding to the fire, Alberta Health Services (AHS) prompted a province-wide coordinated response. Through a combination of pre-emptive strategies and responsive activities, the AHS response has been considered a success. Underlying the successful response is the collective experiences and contextual knowledge of AHS staff members acquired from past events. While the frequency and severity of risks associated with extreme weather and climate change are increasing worldwide, there is a persistent knowledge gap in the evidence-base informing public health emergency preparedness. It is imperative that lessons learned from past events inform future preparedness activities. Learning lessons is a systematic implementation process that can be used to inform future responses and best practices that are transferable to similar situations.

Aim:

To describe strategies employed and challenges encountered during recovery after the Alberta wildfires.

Methods:

A single-case study approach was employed to understand the AHS method to “learning lessons,” and the process involved in translating lessons into actionable goals. Semi-structured interviews with senior leaders (n=11) were conducted and internal documents were obtained.

Results:

The analysis revealed a strategic learning process, including debriefs, staff surveys, interviews, and member validity checking. The implementation process used to translate the lessons identified included a project management framework, evaluation techniques, and the utilization of tacit and explicit knowledge. Key challenges for implementation involve clarification of processes, leadership commitment, resource and time constraints, staff turn-over, and measuring outcomes.

Discussion:

Translating the lessons from the Alberta wildfires is crucial for enhancing preparedness, and exploratory research in this area can contribute to building a program of research in evaluation during disaster recovery.
Preparedness for a Severe Rainfall: The Importance of a Timeline
Authors: Kawase Tetsunori , Nakayama Shinichi , Kai Soichiro , Kikuta Shota , Ukai Takashi
Published: May 2019

Introduction:

For recent years, we often hear the words, “never experienced before” on a weather forecast in Japan.

Aim:

To evaluate our response to “Heisei 30-year July heavy rain” in the Hyogo Emergency Medical Operations Center.

Methods:

Review our actions taken and exchanges of views with local government representatives in a time-related manner compared with public announcements of evacuation/sheltering warning.

Results:

A specialized warning of heavy rain was announced at 10:50 PM on Friday by the local meteorological observatory. At 11:50 PM, the emergency management headquarters of prefectural medical response was established in the hospital, but a connection could not be established to 10 regional health centers for the weekend. Water levels of some rivers were increasing nearly to flood levels, and an evacuation order was announced to hundreds of thousands of people. This situation continued for a few days throughout many regions. The information of flood or landslide probability was continuously monitored, but an attempt was made to decide the timing of cancellations of standby.

Discussion:

An ordinary response to disaster depends on a clear turning point, such as the occurrence time. In heavy rainfall, there are two issues. One is about actions to prevent disaster and another is a recognition of geographic points or surface. Many critiques to the response focus on the judgments and actions for prevention before a critical event. Lessons learned included the importance of preventive actions along with a timeline and the judgment of restoration.
The Effect of Natural Disasters on Cancer Care: A Systematic Review
Authors: Man Ralph Xiu-gee , Lack David , Wyatt Charlotte , Murray Virginia
Published: May 2019

Introduction:

As the incidence of cancer and the frequency of extreme weather events rise, disaster mitigation is becoming increasingly relevant to oncology care.

Aim:

To investigate the effect of natural disasters on cancer care and the associated health effects on patients with cancer through the means of a systematic review.

Methods:

Between database inception and November 12, 2016, Embase, ScienceDirect, MEDLINE, Scopus, PsycINFO, Web of Science, and CINAHL were searched for articles. Those identifying the effect of natural disasters on oncology services, or the associated health implications for patients with cancer, were included. Only articles published in English were included. Data extraction was done by two authors independently and then verified by all authors. The effects of disaster events on oncology services, survival outcomes, and psychological issues were assessed.

Results:

Natural disasters cause substantial interruption to the provision of oncology care. Of the 4,593 studies identified, only 85 articles met all the eligibility criteria. Damage to infrastructure, communication systems, medication, and medical record losses substantially disrupt oncology care. The effect of extreme weather events on survival outcomes is limited to only a small number of studies, often with inadequate follow-up periods.

Discussion:

To the best the authors’ knowledge, this is the first systematic review to assess the existing evidence base on the health effects of natural disaster events on cancer care. Disaster planning must begin to take into consideration patients with cancer.
Effect of Tornado Outbreaks on Morbidity and Mortality in Texas
Authors: Swienton A. , Goldberg Daniel , Hammond Tracy , Klein Andrew , Horney Jennifer
Published: May 2019

Introduction:

In the United States, tornadoes are the third leading cause of fatalities from natural disasters1. To aid prevention and mitigation of tornado-related morbidity and mortality, improvement in standardizing tornado specific threat analysis terminology was assessed. The largest number of tornado-related fatalities has occurred in the state of Texas for over a hundred years. The occurrence of tornadic clusters or “outbreaks” has not been formally standardized. The concept of “tornado outbreaks” is better defined and its role in fatality mitigation is addressed in this Institutional Review Board (IRB) approved study.

Aim:

To understand the role of “tornado outbreaks” related clusters in Texas in relationship to morbidity and mortality.

Methods:

This IRB approved (IRB2017- 0507) research study utilized GIS tools and statistical analysis of historical data to examine the relationship between tornado severity (based on the Fujita Scale), the number of tornadoes, and the trends in morbidity and mortality. This study was funded in part from The National Science Foundation grant (NSF Grant #1560106) in support of the CyberHealthGIS Research Experience for Undergraduates (REU).

Results:

A statistically significant difference was demonstrated between the severity of a tornado and related morbidity and mortality during “tornado outbreaks” in Texas during a defined 30-year period.

Discussion:

Understanding the role and discerning the impacts of “tornado outbreaks” as related to tornado severity has critical implications to disaster preparedness. Applications of this conclusion may improve shelter planning/preparation, timely warning, and educating the at-risk public. Subsequently, examining the likelihood and improved descriptions of “tornado outbreaks” may aid in reducing the number of tornado-related injuries and fatalities nationally.
The Pediatric Disaster Mental Health Intervention: Meeting the Primary Care Special Needs of Children in the Aftermath of Disasters
Authors: Cooper Arthur , Frogel Michael , Foltin George
Published: May 2019

Introduction:

Effects of a disaster on a community’s mental health can persist after the physical effects of the event have passed. The pediatric population is often overrepresented in disasters and prone to serious mental health disorders based on their age and parental/community response. Pediatric primary healthcare providers require the psychosocial skills necessary to work in disaster zones and to care for children in disasters.

Aim:

Pediatric Disaster Mental Health Intervention (PDMHI) was initially developed in response to Superstorm Sandy’s impact on children and their families in New York City. The objective was to develop training for primary care providers in pediatric disaster mental healthcare and to study its impact on the trainees.

Methods:

A faculty of experts in pediatric mental health, psychiatry, psychology, and disaster preparedness was convened to develop curriculum. The faculty developed a four-hour intervention to equip healthcare providers with the skills and knowledge necessary to care for pediatric patients with mental health problems stemming from a disaster via evaluation, triage, intervention, and referral.

Results:

Three PDMHI training sessions were held. A total of 67 providers were trained. Of these, there were 31 pediatricians, 18 nurses, 8 social workers, 4 psychologists, 2 psychiatrists, and 4 others. Pre- and post-tests measured knowledge before and impact 3 months post-intervention. 62.5% of responding primary care providers made changes to their practice. 92% felt better equipped to identify, treat, and refer patients. 81% would be willing to work in a disaster zone and felt prepared to treat patients with disaster mental health issues.

Discussion:

PDMHI covers psychosocial responses to disasters from normal to mental health disorders. Participants gained tools for managing pediatric mental health issues in primary care. Study data showed an increase in the participants perceived knowledge and skills about pediatric disaster mental health, and willingness to participate in future disasters.
Review of Disaster and Emergency Preparedness Among Summer Camps in the United States: Updates and Challenges
Authors: Hashikawa Andrew , Bradin Stuart , Ambrose Michael
Published: May 2019

Introduction:

More than 14 million children in the United States attend summer camps yearly, including many special medical needs children. Summer camps are at risk for multiple pediatric casualties during a disaster. The American Camp Association, in the 2017 critical issues report, identified emergency preparedness as the top critical health and safety issue. Camps, compared to school-based settings, face unique challenges when planning for disasters, but research has been challenging because of the lack of access to camp leadership and data.

Aim:

Provide a targeted up-to-date synopsis on the current state of disaster preparedness and ongoing collaborative research and technology interventions for improving preparedness among summer camps.

Methods:

Researchers partnered with a national health records system (CampDoc.com) and American Academy of Pediatrics disaster experts to review results from a national camp survey. Main themes were identified to assess gaps and develop strategies for improving disaster preparedness.

Results:

169 camps responses were received from national camp leadership. A substantial proportion of camps were missing 4 critical areas of disaster planning: 1) Most lacked online emergency plans (53%), methods to communicate information to parents (25%), or strategies to identify children for evacuation/reunification (40%); 2) Disaster plans failed to account for special/medical needs children (38%); 3) Staff training rates were low for weather (58%), evacuation (46%), and lockdown (36%); 4) Most camps (75%) did not plan with disaster organizations.

Discussion:

Collaboration with industry and disaster experts will be key to address the gaps identified. Current research and interventions include the recent release of a communication alert tool allowing camps to send mass text emergency notifications. Additionally, a recent pilot to incorporate disaster plans into the electronic health records platform emphasizing communication, evacuation, and identification of local experts has begun. Efforts to develop a unified disaster tool kit for summer camps remains a challenge.
Impact of Road Safety Laws in Colombia on Road Traffic Collision Fatalities and Injuries
Authors: Argote Killiam A. , Molloy Michael S , Hart Alexander , Voskanyan Amalia , Sarin Ritu R , Ciottone Gregory R
Published: May 2019

Introduction:

Road traffic collisions (RTC) are the leading cause of preventable death among those aged 15–29 years worldwide. More than 1.2 million lives are lost each year on roads. Ninety percent of these deaths take place in low- and middle-income countries. The General Assembly of the United Nations (UN) proclaimed the period from 2011-2020 the “Decade of Action for Road Safety,” with the objective of stabilizing and reducing the number of deaths by 50% worldwide. In this context, the government of Colombia established the National Road Safety Plan (PNSV) for the period 2011–2021 with the objective of reducing the number of fatalities by 26%. However, the effectiveness of road safety policies in Colombia is still unknown.

Aim:

To evaluate the effect of road safety laws on the incidence of RTC, deaths, and injuries in Colombia.

Methods:

RTC data and fatality numbers for the time period of January 1, 2010, to December 31, 2017, were collated from official Colombian governmental publications and analyzed for reductions and trends related to the introduction of new road safety legislation.

Results:

Data analysis are expected to be completed by January 2019.

Discussion:

RTC remains the leading preventable cause of death in Colombia despite the PNSV. Data is being mined to determine the trends of these rates of crashes and fatalities, and their relation to the introduction of national traffic laws. Overall, while the absolute numbers of RTC and deaths have been increasing, the rate of RTC per 10,000 cars has been decreasing. This suggests that although the goals of the PNSV may not be realized, some of the laws emanating from it may be beneficial, but warrant further detailed analysis.