bluuebunny/crossref_metadata_2025_split 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.