bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Social Determinants of Health in Disaster Risk Reduction
Authors: Cuthbertson Joseph , Archer Frank , Rodriguez-llanes Jose , Robertson Andrew 
Published: May 2019

Introduction:The rationale for undertaking this study was to investigate how characteristics of population health relate to and impact disaster risk, resilience, vulnerability, impact, and recovery. The multi-disciplinary environment that contextualizes disaster practice can influence determinants of health. Robust health determinants, or lack thereof, may influence the outcomes of disaster events affecting an individual or a community.Aim:To investigate how the social determinants of health inform community perceptions of disaster risk.Methods:Community perception of disaster risk in reference to the social determinants of health was assessed in this study. Individual interviews with participants from a community were conducted, all of whom were permanent community residents. Thematic analysis was conducted using narrative inquiry to gather firsthand insights on their perceptions of how characteristics of population health relate to and impact an individual’s disaster risk.Results:Analysis demonstrated commonality between interviewees in perceptions of the influence of the social determinants of health on individual disaster risk by determinant type. Interviewees sensed a strong correlation between low community connection and disaster risk vulnerability. Specific populations thought to have low community connection were perceived to be socially isolated, resulting in low knowledge or awareness of the surrounding disaster risks, or how to prepare and respond to disasters. In addition, they had reduced access to communication and support in time of need.Discussion:The importance of a strong social community connection was a feature of this research. Further research on how health determinants can enable disaster risk awareness and disaster risk communication is warranted.
Assessing the Efficacy of a One-day Structured Induction Program in Orienting Clinical Staff to a Novel Prehospital Medical Deployment Model
Authors: Gao Crystal , Jie Lim Zheng , Yeh Sabrina , Santinon Scott , De Haas Scott , Austin Kristy 
Published: May 2019

Introduction:St. John Ambulance Victoria provides first aid and medical services at a variety of mass gathering events (MGEs) throughout Victoria. Volunteer healthcare professionals and students (termed “volunteers”) form Medical Assistance Teams (MAT) at these MGEs. MAT deployments manage a variety of patient presentations which include critically ill patients. This reduces high acuity patient transfers to the hospital and, where possible, avoid ambulance and hospital utilization.Aim:To determine the effectiveness of interdisciplinary prehospital simulation workshops in preparing volunteers for MAT deployment at MGEs.Methods:A one-day, simulation-based training session within the MAT environment was implemented to introduce volunteers to the management of various scenarios faced at MGEs. All volunteers were provided an orientation to the equipment and setting up MAT deployments at MGEs. Volunteers then participated in interdisciplinary group-based scenarios such as cardiac arrest management, drug intoxication, spinal injuries, agitated patients, and airway management. To determine the effectiveness of this training session, volunteers were invited to participate in a post-training survey, comprising of Likert scores and open-ended responses.Results:Seventeen volunteers attended the training session with 10 (58.8%) completing the post-training survey. Volunteers were satisfied with environment familiarization in the MAT (Average 4.47/5.00) and found the simulation-based training helpful (Average 3.67/4.00). The induction overall was well-received (4.60/5.00) with volunteers feeling more confident in being deployed at MGEs (4.20/5.00).Discussion:The results of the simulation-based training session were positive with volunteers receptive to the need for a training day prior to MAT deployment at MGEs. The simulation session enables volunteers to be comfortable with working in MAT and managing a diverse range of patients at MGEs. This session is likely to improve interdisciplinary communication and teamwork in the MAT. Future research is aimed at following these volunteers after several MAT deployments to improve the training session for future participants.
Blockchain Technology for Disaster and Refugee Relief Operations
Authors: McIsaac Joseph , Brulle Joseph , Burg John , Tarnacki Gregory , Sullivan Christian , Wassel Rick 
Published: May 2019

Introduction:Blockchain is a distributed ledger technology for storing and transmitting information (value) that is secure, verifiable, and auditable. Two specific use-case opportunities exist, identity management and payment systems.Aim:A secure and auditable solution for disaster refugee support.Methods:Gap analysis, literature search, and synthesis using existing technologies.Results:Strategy foundation: A blockchain identity management system that utilizes the Hyperledger Fabric framework; identification on a large scale, in a distributed model that provides immutable record capabilities to prevent fraud, with the ability to incorporate biometrics and DNA; deploy applications that will provide supply-chain capabilities; cryptocurrency for recipients and other relief functions for refugees/disaster victims; components such as consensus, membership services, and Smart Contracts; cloud-based, with redundancies in multiple vendors and additional complex government cloud requirements/certifications, leveraging NIST 800–53 by utilizing a hybrid public permissions architecture.Discussion:There are an estimated 68 million refugees worldwide at any time. Valid identification is needed by most refugees to qualify for government or international donor relief. That identification is crucial in getting refugees and victims access to the aid supply chain. Blockchain stores data on a large number of computer nodes connected over the Internet. Each node contains an identical copy that is time-stamped and protected by a cryptographic technique called hashing, and control is decentralized. This blockchain strategy will revolutionize the way the government manages the $30 billion in foreign aid to refugees. It will build upon the identities established to deploy applications that will provide supply-chain capabilities, cryptocurrency for recipients, and other relief functions for refugees/disaster victims. Stakeholders beyond government will also benefit tremendously. The distributed nature of our application will provide visibility to NGOs, nonprofits, host nation stakeholders, and other relief organizations. A single system that provides information to everyone involved will almost instantaneously change the face of relief.
Construction of an Operational Protocol for Multiple Victims and Disasters in Southern Brazil
Authors: Mara Marin Sandra , Bender Jean , Bezerra Cabral Danielle 
Published: May 2019

Introduction:Unpredictable events, such as disasters, can change the organizational configuration of health facilities. In a situation of multiple victims, this scenario modifies the flow of care to adapt to the reality that is there. In addition, emergency and emergency units provide immediate care to maintain and preserve the lives of these victims, making it a challenge for all health professionals.Aim:To construct an Operational Protocol for nursing care with multiple victims and disasters in a Hospital Emergency and Emergency Service.Methods:We used a descriptive study with a qualitative approach using the Focal Group technique (GF). The participants included nursing staff and residents who work in the emergency and emergency unit in a hospital in the south of Brazil. The topics from the GF discussion were analyzed by the scientific content of Minayo (2013).Results:The operational assistance protocol for multiple victims and disasters was planned with a redistribution of materials, equipment, human resources of the service, and physical restructuring of the service and other units with the construction of a flow chart to meet the proposed demand.Discussion:In the study, we observed the importance of discussing and planning proposals for care with multiple victims. In addition, the interest of the participants was fundamental to the success of this protocol. This protocol serves as an incentive for nursing professionals and academics for future research that evaluates the effectiveness of using nursing competencies to assist multiple victims in emergency and disaster situations.
Core Curriculum for Event Medical Leaders
Authors: Lund Adam , Munn Matthew Brendan , Ranse Jamie , Turris Sheila 
Published: May 2019

Introduction:The literature on mass gatherings has expanded over the last decade. However, no readily accessible curriculum exists to prepare and support event medical leaders. Such a curriculum has the potential to align event medical professionals on improving event safety, standardizing emergency response, and reducing community impacts.Methods:We organized collaborative expert focus groups on the proposed “core curriculum” and “electives.”Results:Key features of a mass gathering medical curriculum include operations-focused, evidence-informed, best-known practices offered via low barrier, modular, flexible formats with interactive options, and a multi-national focus.Core content proposed:
Background (Definitions, Context, Risk, Legalities)Event Medical Planning - “The Seven Steps” - (1.) Assessment and Environmental Scan - Event Emergency Action Plan, (2.) Human Resources, (3.) Equipment/Supplies, (4.) Infrastructure/Logistics, (5.) Transportation (To, On, From), (6.)Communication (Pre, During, Post), and (7.) Administration/Medical DirectionEvent After-Action ReportingCase-based ActivitiesElectives mirror Core outline and serve as expanded case-studies of specific event categories. Initially proposed electives include:
Concerts/Music FestivalsRunning EventsCycling EventsMulti-Sport EventsObstacle Adventure CoursesStaged Wilderness CoursesAmateur GamesPolitical Gatherings & OrationsReligious Gatherings & PilgrimagesCommunity Gatherings (e.g., Parades, Fireworks, etc.)Discussion:Complex team learning to standardize real-world approaches has been accomplished in other medical domains (e.g., ACLS, AHLS, ATLS, PALS, etc.). A course for event medicine should not re-teach medical content (i.e. first aid, paramedicine, nursing, medicine); it should make available a commonly understood, systematic approach to planning, execution, and post-event evaluation vis a vis health services at events. A ‘train the trainer’ model will be required, with business operations support for sustainable course delivery. The author team seeks community feedback at WCDEM 2019 in creating ‘the ACLS’ of Event Medicine.
Current Status of the Japanese Disaster Medical Record
Authors: Chishima Kayako , Toyokuni Yoshiki , Hisayoshi Kondo , Koido Yuichi , Kubo Tatsuhiko 
Published: May 2019

Introduction:There was no common medical record used in disasters in Japan. At the 2011 Great East Japan Earthquake, medical teams used their own medical records instead of a unified format and operational rules. As a result, confusion occurred at the clinical practice site. The Joint Committee on Medical Records proposed a standard format of disaster medical records in February 2015. The Ministry of Health, Labor, and Welfare has issued the notification of states’ use of a standardized medical record for disaster in 2017. It was confirmed that standardized disaster medical records were used by each organization in the 2018 Western Japan torrential rain disaster and the Hokkaido Iburi Eastern Earthquake, but the actual condition of those records was not clarified.Methods:We sent a questionnaire to the local governments where the medical team worked in 2018 Western Japan torrential rain disaster and the Hokkaido Iburi Eastern Earthquake. In the questionnaire, we asked about the operation and management of standardized disaster medical records at the time of the disaster and also questioned future management methods.Results:There was no use of other medical records. Standardized medical records were used in all records. All records were managed and operated by the disaster medical headquarters responsible for health care and welfare. Standardized disaster medical records were recorded on paper. Evacuees included patients who moved from shelter to shelter or to temporary housing to get better living conditions. That created difficulties transferring records since it was recorded on paper and stored in medical headquarters. Some returning patients were checked by several medical teams, resulting in the creation of several medical records of the same patient’s condition. Future improvements and management of the recording process and record-keeping are required.
Developing an Educational Strategy for Delivering an E-learning Disaster Medicine Course for Undergraduate Students in US Medical Schools
Authors: Molloy Michael , Power Edmond , Ciottone Gregory R. 
Published: May 2019

Introduction:Disaster Medicine (DM) is a discipline arising from the marriage of emergency medicine and disaster management. The importance of DM has recently increased, with current wildfire situations throughout the world being examples of mass scale disasters with significant human morbidity and mortality. DM deals with preparedness, mitigation, response, recovery, and prevention of disasters (1).Aim:To develop an educational strategy and reusable format for delivering undergraduate DM courses online. Man-made, weather-related, humanitarian, and technological disasters occur all around the globe annually, yet the majority of medical schools do not have an undergraduate DM program. This project developed an online course structure accessible to medical schools and students throughout the world.Methods:Learning theories and models of learning were used to construct a course layout that encouraged students to be active learners, developed long-term retention strategies, and facilitated assessment for and of learning. This was accomplished through innovative educational modalities, including novel apps and external online resources. The course focuses heavily on outcome-based education with an emphasis on the development of applicable skills. Each lecture is divided into a series of learning objectives to allow students to master concepts sequentially, followed by questions to make use of the “testing effect” (2).Results:Focused review of current medical education literature reveals that students learn best when given short, outcome-focused “mini-lectures” followed by low-stakes assessment and feedback.Discussion:Medical schools without trained DM staff now have access to expert online material developed by educationalists with a focus on skills and knowledge retention.
Development and Challenges of Japan DMORT (Disaster Mortuary Operational Response Team) Association
Authors: Kuboyama Kazutoishi , Kurokawa Kayoko , Murakami Noriko , Nagasaki Yasushi , Ukai Takashi , Yamazaki Tatsue , Yoshinaga Kazumasa 
Published: May 2019

Introduction:In 2006, Japan DMORT was established by physicians, nurses, forensic pathologists, social workers, and a journalist (inspired by a major train crash in the previous year) to provide mental support to disaster victims’ families who had not received care. However, disaster victims’ identification and care of the families were monopolized by police in Japan. Also, our ‘study group’ status confused people who were affected by disasters.Aim:To describe the development and future challenges of our association.Methods:We developed our policy to focus on mental support through various activities such as the 11 closed seminars with disaster victims’ families, 21 training courses for disaster responders, and several workshops in medical or nursing conferences. In the Christchurch Earthquake, NZ (2011), with young Japanese casualties in a collapsed building, our core member reported the needs of families’ mental support, which showed the validity of our policy.Results:In the Great East Japan Earthquake (2011), we distributed mental health care manuals for disaster responders. In the landslides in Izu Oshima Island (2013), 3 members supported victims’ families through the town office. In the Kumamoto Earthquake (2016), two members made grief work on families of 17 victims at the prefectural police academy. These activities convinced the police of the need for medical/mental support and ourselves of the necessity for legal status. In 2017, we reorganized our association into an incorporated society. We also became official members of crime/disaster victims support liaison councils of two prefectures among 47 in Japan. In 2018, official agreements were made with the Hyogo prefectural police. But in the Heavy Rains and Flooding of July and in the Hokkaido Eastern Iburi Earthquake of September, the local police did not agree to accept us.Discussion:Official collaboration with police is essential nationwide in Japan. Further relief activities are expected.
Development and Initial Validation of a Stochastic Discrete Event Simulation to Assess Disaster Preparedness
Authors: Cronqvist Mattias Lantz , Jonson Carl-Oscar , Prytz Erik 
Published: May 2019

Introduction:Assessing disaster preparedness in a given region is a complex problem. Current methods are often resource-intensive and may lack generalizability beyond a specific scenario. Computer-based stochastic simulations may be an additional method but would require systems that are valid, flexible, and easy to use. Emergo Train System (ETS) is an analog simulation system used for disaster preparedness assessments.Aim:To digitalize the ETS model and develop stochastic simulation software for improved disaster preparedness assessments.Methods:A simulation software was developed in C#. The simulation model was based on ETS. Preliminary verification and validation (V&V) tests were performed, including unit and integration testing, trace validation, and a comparison to a prior analog ETS disaster preparedness assessment exercise.Results:The software contains medically validated patients from ETS and is capable of automatically running disaster scenarios with stochastic variations in the injury panorama, available resources, geographical location, and other variables. It consists of two main programs: an editor where scenarios can be constructed and a simulation system to evaluate the outcome. Initial V&V testing showed that the software is reliable and internally consistent. The comparison to the analog exercise showed a general high agreement in terms of patient outcome. The analog exercise featured a train derailment with 397 injured, of which 45 patients suffered preventable death. In comparison, the computer simulation ran 100 iterations of the same scenario and indicated that a median of 41 patients (IQR 31 to 44) would suffer a preventable death.Discussion:Stochastic simulation methods can be a powerful complement to traditional capability assessments methods. The developed simulation software can be used for both assessing emergency preparedness with some validity and as a complement to analog capability assessment exercises, both as input and to validate results. Future work includes comparing the simulation to real disaster outcomes.
Disaster Preparedness Technician = Striking Cost Savings
Authors: Dexter Jasmine , Morrow Melanie , Fogarty Kelly , Trewin Abigail 
Published: May 2019

Introduction:The workplace holds a rapidly deployable, self-sufficient field hospital including a medicine cache valued at $80,000. The cache is rotated through the affiliated hospital pharmacy when they have less than 12 months to their expiry. Rotations are done regularly due to the short expiry dates of stock coming from suppliers. A senior pharmacy technician is employed two days per week at a cost of $13,024.80 per annum to manage this cache.Aim:To demonstrate the associated cost savings of employing a pharmacy technician to manage a medication cache.Methods:Every month, the technician extracts items with less than a year expiry from the stock control system and compares these dates with that of the stock held in the pharmacy. All items with a better expiry date are rotated as long as there is sufficient turnover to ensure use before its expiry. Automatic recording occurs of items rotated, items discarded, and their costs are used as key performance indicators (KPI).Results:Over a 12 month period, $52,803 worth of stock was rotated. On average, 48 lines and 7,619 individual items were rotated monthly with a value of $4,061.83 (range $0-$8,820 per month). During this period, there were 2 months where no rotations occurred due to staff changeover and annual leave. 10 lines of medicines at a value of $4,041 were discarded over this time period. The two main reasons for discarding were that the medicine was not a pharmacy item or was not used in a large enough quantity to allow rotation.Discussion:The equivalent of four times the technician’s wage was saved over 12 months. This illustrates striking cost savings gained by efficient, timely rotations and the cost benefits of employing a technician.
Does Medical Presence Decrease the Perceived Risk of Substance-Related Harm at Music Festivals?
Authors: Munn Matthew Brendan , White Melissa Sydney , Hutton Alison , Turris Sheila , Tabb Haddon , Lund Adam , Ranse Jamie 
Published: May 2019

Introduction:The use of recreational substances is a contributor to the risk of morbidity and mortality at music festivals. One of the aims of onsite medical services is to mitigate substance-related harms. It is known that attendees’ perceptions of risk can shape their planned substance use; however, it is unclear how attendees perceive the presence of onsite medical services in evaluating the risk associated with substance use at music festivals.Methods:A questionnaire was administered to a random sample of attendees entering a multi-day electronic dance music festival.Results:There were 630 attendees approached and 587 attendees completed the 19 item questionnaire. Many confirmed their intent to use alcohol (48%, n=280), cannabis (78%, n=453), and recreational substances other than alcohol and cannabis (93%, n=541) while attending the festival. The majority (60%, n=343) stated they would still have attended the event if there were no onsite medical services available. Some attendees agreed that the absence of medical services would have reduced their intended use of alcohol (30%, n=174) and recreational substances other than alcohol and cannabis (46%, n=266).Discussion:In the context of a music festival, plans for recreational substance use appear to be substantially altered by attendees’ knowledge about the presence or absence of onsite medical services. This contradicts our initial hypothesis that medical services are independent of planned substance use and serve solely to reduce any associated harms. Additional exploration and characterization of this phenomenon at various events would further clarify the understanding of perceived risks surrounding substance use and the presence of onsite medical services.