bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges in Dealing with Supervised and Institutionalized Populations in a Disaster
Authors: Mace Sharon , Doyle Connie 
Published: May 2019

Introduction:Those residing in supervised facilities including nursing homes, mental health facilities, group homes, and penal institutions for health, legal, or security reasons present unique challenges in a disaster.Methods:A review of the literature and after action reports on supervised and institutionalized populations in disasters.Results:Recommendations for supervised, institutionalized populations in a disaster include: (1.) preplanned agreements for specialized transportation if needed; (2.) reciprocal agreements between similar facilities (nursing home with another nursing home, prison with other prison, dialysis centers, etc.) for resource sharing; (3.) arrangements for sharing and emergency privileging of personnel in institutions that are not their primary workplace; (4.) just-in-time training for appropriate volunteers; and (5.) accommodations for family members if personnel are to be available during a disaster.Individuals in some institutions need a personalized disaster plan with pertinent data: next of kin with contact information, medical records, care providers and care plan to accompany a mobilized individual. Long-term care and housing may be needed if the institution is nonfunctional. Dealing with medical and behavioral issues is secondary to the disaster. Chronic issues must be considered as well.Discussion: Caring for specialized, institutional individuals is complex and difficult. Comprehensive pre-disaster planning can mitigate the effects of the disaster.
Chemical and Radiation Training for Public Health and Nursing Students: An Under-Utilized Disaster Response Demographic
Authors: Atti Sukhi , Kiernan Emily , Layer Mark , Sahin Aynur , Alotiabi Shaikhah , Als uk aiti Waleed , Shuk Sydney , Lindros Kayla , Giberson Tyler , Kazzi Ziad 
Published: May 2019

Introduction:Public health (PH) and nursing students are an underutilized demographic in disaster response. Knowledge of the disaster response phase may enhance student understanding of preparedness, and provide response capabilities.Aim:A single four-hour simulation-based training session, with toxicologists as instructors, can effectively improve PH and nursing student knowledge and skills in chemical and radiation response, despite minimal prior experience.Methods:A convenience sample was used to test PH and nursing students in a response training program. An introductory lecture and simulation training reviewed: mass casualty care, triage, personal protective equipment, decontamination, and chemical and radiation exposure toxidromes. An examination was administered pre-training, and then post-training, to evaluate relevant training, knowledge, risk perception, and comfort in response capabilities to chemical and radiation incidents.Results:Forty-two students attended the course; 39 were included in the study. Seventy-two percent (n=28) of participants had no prior disaster training. Overall, there were significant differences between the pre-test and post-test scores for all students [95% CI: 5.4 (4.7-6.1); p<0.0001, paired t-test]; maximum score 15/15. Comparing scores of nursing and PH students, despite statistical difference in pre-test scores (median, IQR: 9.0 (7.5-10±2.0); 7.0 (5.7-9.0) respectively; p=0.048, Mann Whitney U-test), there were no statistical differences in post-test scores (median, IQR: 14.0 (13.0-14.0); 13.0 (12.0-14.0), respectively, Mann Whitney U-test). All students recognized nerve agent toxidrome and performed SALT triage after the training (p <0.0001, McNemar test). Subjectively, participant comfort level in responding to a chemical or radiological incident improved (p <0.0001, McNemar test). Individual risk perception for chemical or radiological disasters did not improve after training.Discussion:Improvement of knowledge and comfort was demonstrated, irrespective of previous experience. Simulation-based training of chemical and radiation disaster preparedness, led by medical toxicologists, is an effective means of educating PH and nursing students, with minimal prior fluency.
Collaborative Relationships for Mass Gathering Events
Authors: Jones Tracie 
Published: May 2019

Introduction:Electronic Dance Music events (EDMs) are complex mass gatherings and given published rates of illnesses, injuries, and hospitalizations, these events can place an additional burden on local health care services. Accordingly, during the planning process for EDMs many stakeholders are involved; however, local hospitals, a key part of the medical safety plan, are often excluded. In this case report, it is posited that the involvement of local hospital(s) and the resulting integration of on-site and acute-care service provision during an event, ultimately reduces the burden placed on local hospitals.Methods:Case report; synthesis of published literature.Results:A 25,000 person per day, two-day mass gathering EDM event trialed a model of collaborative planning with a local community hospital. Planning included the identification of a hospital liaison, pre-event teleconferences between event staff, contracted and public medical response teams, emergency management teams, harm reduction practitioners, public health, and hospital personnel. Throughout the collaborative planning process, vital information was shared in order to optimize patient continuity of care and streamline the transition of care from site medical response to an acute care setting. Outcomes included the prevention of unnecessary transfers to the hospital; however, those patients who required transfer had their initial treatment started prior to leaving the venue. Further, collaborative planning also contributed to improved bidirectional data sharing to better understand the impact on the local hospital of the event, including transfers from the onsite medical team as well as transports from the community and self-presentations for care.Discussion:The collaboration of onsite medical and hospital teams improved the delivery of essential medical care to the patrons of the event and added a layer to the safety planning process essential to mass gathering events.
Concerns for Small Hospitals in Rationalising Trauma Services: How Do We Ensure Enhanced Patient Services in Rural Areas?
Authors: Molloy Michael , Kelly Paul , Ciottone Gregory R 
Published: May 2019

Introduction:Trauma bypass has been introduced successfully worldwide with sustained reductions in mortality/morbidity. Analyzing structure, process, and outcome individually and collectively in systems has been found to focus improvement efforts in the audit cycle. The second Irish report on Major Trauma Audit (MTA) was published in December 2017. The median age of trauma patients in Ireland was 59, indicating an aging trauma population. 28% of patients required secondary transfer to complete their care. The mortality rate for 2016 was only 4%.Aim:To determine the ability of a road-based EMS system to bring patients from areas of Wexford County to proposed receiving centers within 60-90 minutes.Methods:Analysis took population centers in Wexford County, used Google Maps to estimate travel times at 3pm on a weekday, and proposed new trauma units and centers in Dublin, Cork, and Waterford.Results:In Wexford County urban centers, >95% of patients will not reach a trauma unit in less than 60 minutes with current prehospital medical service capabilities. This even excludes response/on-scene time by prehospital practitioners in land-based EMS vehicles.Discussion:The proposed introduction of trauma bypass systems in Ireland should not disenfranchise patients with respect to the standards they are currently receiving. Gap analysis suggests considerable work is required within the ambulance service to increase critical skill levels of paramedics to support critical patients in the golden hour of their transfer. An increase in vehicles/resources will be required to ensure adequate staffing to meet Health Information and Quality Authority (HIQA) targets of 8 and 19 minutes for response acuity, and for longer durations of transport allied to dynamic resource deployment model as used by National Emergency Operations Centre (NEOC). Unintended consequences of system changes will need to be monitored carefully to avoid further adversely impacting recruitment of staff to bypassed Model 3 hospitals.
Culturally Sensitive Disaster Nursing Focusing on Pacific Rim Island Countries: First Report on Japanese Public Health Nurses
Authors: Marutani Miki , Harada Nahoko , Uebayashi Mihoko , Anzai Yukiko , Takase Kanae , Okuda Hiroko 
Published: May 2019

Introduction:Providing culturally sensitive disaster nursing is essential to enhance survivors’ resilience, especially in Pacific Rim island countries, which are home to 80% of the disaster victims of the world. Until now, most studies have focused on immigrant culture or language, and few have explored the idea of disaster nursing adjusted to the affected area’s culture.Aim:The study explores public health nurses’ (PHNs) tacit knowledge regarding culturally sensitive disaster nursing focusing on the Pacific Rim island countries. This first report is the result of the study that clarified how Japanese PHNs, as relief nurses, considered the local culture to provide care to survivors in Japan.Methods:Study participants were nine PHNs from seven prefectures, who provided care to survivors of natural disasters that occurred in 2011–2017 in Japan. Semi-structured interviews were conducted with questions such as, “Which culture did you consider while providing care to survivors in each disaster phase?” Data were analyzed qualitatively and inductively and were sorted according to the four disaster phases. The study was approved by the ethical committee at the National Institution of Public Health.Results:In the acute phase, PHNs utilized close relationships between local residents and health care providers to collect information. They balanced local habits and the prevention of secondary health damage in the subacute phase; for example, balancing sanitation habits and prevention of contaminations. Additionally, they, as strangers to the community, played a role in alleviating tensions between residents under stress. During the recovery phase, they strengthened survivors’ attachment to the area.Discussion:PHNs dispatched from the outside of the affected areas must be culturally malleable to adjust their practice to the local context. Being strangers in an affected area can be advantageous if they utilize their position effectively.
Description of Disaster Forms Usage in Health Cluster in Lombok and Palu Earthquake
Authors: Ariani Madelina , Donna Bella 
Published: May 2019

Introduction:The effort of medical and health services distribution requires data. However, the data and information were ignored in an emergency situation. For improving the distribution of data and information, the Center of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada (UGM) developed forms based on Health Crisis Response Guideline by Ministry of Health 2016 and the World Health Organization (WHO).Aim:Describing the implementation and development of forms based on Lombok and Central Sulawesi earthquake in 2018 for health cluster.Methods:The form contains (1) a volunteer registration form; (2) a monitoring potential outbreak disease form; (3) health problem in health cluster daily report form; (4) a chronological situation form. This will be implemented in health policymaking by the Sulawesi district health office (DHO) and will be regularly analyzed in every week.Results:North Lombok DHO, Central Sulawesi health office, and volunteers accepted these forms well. Periodically volunteers had reported their activity to DHO. All these reports contain many health indicators including environmental health. Reproductive health and health promotion. Implementation of this form in the other type of disaster in Indonesia is suggested.Discussion:First, these forms are important to attach to the guideline of health crisis response in order to be accessed by all DHO. Second, all forms are printed documents. It needs to develop into data input and analysis applications.
Development of an E-Learning Platform For EMTs In Ghana
Authors: Bonney Joseph , Namburete Ana I. L. , Dagadu Sesinam , Quao Nana Serwaa , Osei-Ampofo Maxwell , Awariyah Dominic , Cobbold Sonia 
Published: May 2019

Introduction:The continuous development of the knowledge and skill of the emergency medical technicians (EMTs) in Ghana is important for the success of the pre-hospital system. Due to distance and time constraints, an online e-learning platform is a good way to educate the Emergency Medicine Technicians in Ghana.Aim:The study looked at the feasibility of developing a distant learning module for the training and continuous medical education of EMTs.Methods:EMTs in the Ashanti Region were randomly selected to be part of the study. They received online lectures and notes that were accessible by their mobile phones. They all received a test at the end of each model. The study measured their willingness to participate, average attendance for each model, and the scores for each model test. The study also measured the overall feasibility of the distant learning program.Results:The study developed a training course comprised of 7 modules: trauma and surgical emergencies, obstetric emergencies, pediatric emergencies, disaster management, medical emergencies, basic ultrasound, and medical research. Tests and quizzes were electronically sent to EMTs over the course of the research period, with an average test score of 70.14% (low: 35%, high: 95%) for the cohort. Feedback from participants showed gains in knowledge and skill delivery. The average attendance for all model was 56.6% ranging from 47.37%-63.16% for the models. Challenges for attendance included internet access, heavy duties, and other personal reasons. The post-training interview showed 100% willingness to participate in future online programs with the most common reasons stated as low cost, ease of attendance for models, and reduced expense.Discussion:The study concluded that online, distant learning models can be used in Ghana for training and continuous medical education for EMTs. It is an easy and cost-effective model compared to a face-to-face model.
Development of Trauma and Disaster Response in Togo, Africa
Authors: Benin-Goren Odeda , Aviran Nimrod , Adler Iris , Zlotnik Oran , Baratz Yossi 
Published: May 2019

Introduction:The project was provided under the auspice and support of the Israel Agency for International Development Cooperation (MASHAV) at the Ministry of Foreign Affairs (MFA). Togo, one of the smallest and least developed countries in West Africa, has a population of ~7.9 million. About 65% of its population lives in rural areas. Due to the lack of medical resources, Togo suffers from health problems including those related to trauma and mass events. In May 2017, a trauma and disaster team came to Togo to train the medical team in the new trauma unit, donated and built by the MFA. The unit was built in the Atakpame Regional Hospital (ARH), located 160km north of the capital, Lomé. ARH serves one million inhabitants, mostly from rural areas.Methods:The training included lectures, simulations, drills, case studies, bedside teaching, and operation of medical technologies.Results:Following the training, it was recommended to continue the program and to move forward with advanced training. Following the team’s recommendations, MASHAV decided to expand the program and to provide a multilateral project to Togo and ten other West African countries within five months after the first training ended. Twenty participants (mostly senior doctors) were chosen from ten Western African countries and brought to Lomé. The participants joined a two-day Trauma and Disaster Preparedness seminar. Following the seminar, they were moved to Atakpame to join the local team and the facilitators, to visit the trauma unit, and to learn about it as a model for trauma care that can be modified to the capabilities of the local facility.Discussion:Lessons learned and recommendations from those two projects were brought to the MFA that will try to develop more training and cooperation models to help and establish better trauma care and disaster response, supported by the Israeli team.
Disaster Education and Drills in Turkey: Do We Prepare Ourselves for Unexpected Disasters?
Authors: Ülker Volkan , Erdoğan Özcan 
Published: May 2019

Introduction:Turkey is vulnerable to many natural hazards, including earthquakes, landslides, floods, and terrorist attacks. The 7.1 magnitude Marmara Earthquake in 1999 resulted in over 18,000 deaths and estimated losses of over $28 billion. The country’s largest city, Istanbul, is located on the North Anatolian Fault and thus highly prone to earthquakes. It is estimated more than half of the population in the country are potentially seismically vulnerable. This vulnerability makes us ready for disasters. Turkey has advanced disaster risk management through initiating reforms to better manage and reduce disaster risk and strengthening institutions.Aim:To overcome institutional fragmentation, the government established the Disaster and Emergency Management Presidency (AFAD) in 2009.Methods:Assess the 2015 government adopted Turkey National Disaster Response Plan to guide all disaster and emergency response.Results:In the last six years, Turkey has become one of the world’s largest refugee-hosting countries. As of 2018, approximately 3.5 million Syrians under temporary protection have largely been integrated into cities, towns, and villages that stressing the infrastructure and increasing potential risk exposure. This situation makes us recognize disaster protection preparedness. We have many public and civil institutions to prepare society for unexpected situations. The main institution is the Disaster and Emergency Management Presidency. AFAD has many projects for youth, school children and all age groups of society. The second organization is the Red Crescent organization of Turkey. The other organizations are mainly National Medical Rescue Teams (UMKE), some university disaster clubs, and civil institutions like Beşir NGOs.Discussion:These institutions give main disaster confidence education, main CBRN education, main fire-fighting education, camping life educations, orienteering, mobile oven, and kitchen facilities and drills. We have to raise awareness of the community about preparedness to disasters. We have to share lessons with the whole population for reducing social and economic loss.
Disaster Medical Management of Pediatric and Perinatal Disaster Medical Liaison (PPDML) for Children and Pregnant Women in Osaka, Japan
Authors: Arimoto Hideki , Furuya Shinsuke , Yamashita Kimiko , Tanaka Kazuharu , Maruyama Tomoko , Takeuchi Muneyuki , Wada Kazuko , Ogita Kazuhide , Misaki Miho , Fuke Akihiro , Rinka Hiroshi 
Published: May 2019

Introduction:Children are a vulnerable population in disasters. However, there were few pediatricians, neonatologists, and obstetricians in the Japan Disaster Medical Assistance Team (DMAT), so disaster medical headquarters had limited knowledge to solve these problems. Pediatric and perinatal disaster liaison coordinators were trained to improve disaster medical management for children and pregnant women since the 2016 Kumamoto earthquake.Aim:To analyze and report the activity of PPDML during these years in Osaka, Japan.Methods:The records of PPDML in major disasters and disaster drills from 2017 to 2018 were reviewed.Results:The DMAT had disaster drills twice a year in Osaka, and PPDML participated in the drill for the first time in July 2017. In the drill, PPDML coordinated the pediatric and perinatal issues with DMAT and Japan Ground Self-Defense Force (JGSDF) in disaster headquarters. In June 20184. months after the drill, PPDML participated for the second time in February 2018 when the North Osaka Earthquake occurred. PPDML coordinated transport of 22 children and babies with congenital heart disease from the damaged National Cerebral and Cardiovascular Center Hospital. The operation was finished within 5 hours after requested transportation.Discussion:To protect children and pregnant women, cooperation between the disaster medical network and the pediatric and perinatal network is absolutely important for any phase in disaster. Because PPDML had attended in disaster drills before, the experience could make PPDML achieve good performance in a real disaster in North Osaka Earthquake. It can be concluded that cooperation between disaster medical network and PPDML is very useful to manage the disaster issues for children and pregnant women, and the most important thing is to cooperate not only in disaster but also in ordinary days.
Discovering Best Practice Establishing Evacuation Centers for Vulnerable Populations: Findings from Australia and Japan
Authors: Kako Mayumi , Steenkamp Malinda , Ryan Benjamin , Arbon Paul , Takada Yosuke 
Published: May 2019

Introduction:Potentially vulnerable population groups in disasters include the elderly and frail, people who are isolated, and those with chronic diseases, including mental health conditions or mobility issues. The disasters such as the Queensland flood and Great East Japan Disaster in 2011, affected regions of Australia and Japan. This study is followed by two pilot studies in both countries after the disasters. While both countries have different evacuation center procedures for evacuees, the issues regarding the role and responsibility across governments involving planning, setup, and management of evacuation centers demonstrate similarities and differences.Aim:This paper will report the preliminary findings of a pilot study undertaken with local government officials and humanitarian agencies in Australia and Japan concerning their involvement in planning for, setting up, and managing evacuation centers for vulnerable populations in recent natural disasters. The objective is to illuminate the similarities and differences that officials and agencies faced, and to highlight the resolutions and lessons learned in the preparation of evacuation centers through this event.Methods:This is the final stage of the study. After completing an analysis of both phases, a comparative framework to highlight similarities and differences was developed.Results:Each government’s role in relation to the establishment of evacuation centers is legally defined in both countries. However, the degree of involvement and communication with non-governmental organizations from the planning cycle to the recovery cycle demonstrates different expectations across governments.Discussion:While the role of governments is clearly established in both countries based on the legal frameworks, the planning, set-up, and management of evacuation center differs.