bluuebunny/crossref_metadata_2025_split huggingface dataset:
Newborn and Child Health Care in Humanitarian Crisis Settings: Piloting of Training Package for Primary Health Care Workers in Rural Nepal
Authors: Bajracharya Sumana , Shrestha Ashis , House Rose 
Published: May 2019

Introduction:The community-based integrated management of newborn and childhood illness (CBIMNCI) training package has been widely used throughout Nepal. Adding a component of disaster response and management to this program would greatly impact the community, and could improve the knowledge and skills of community workers for the management of children during a disaster.Aim:Describe the development and implementation of a community-based training for children in disasters.Methods:Using expertise from emergency and pediatric emergency physicians, pediatricians, and psychiatrists, we developed a two-day training and facilitator manual covering topics such as trauma, resuscitation, burn, drowning, disaster, nutrition, and care of the newborn. The information and manuals were presented to the Nepal Division of Child Health for approval. Four pilot trainings were conducted in Bardia and Bardibas in Nepal in September 2017, including knowledge and skill-based sessions. Knowledge was tested pre- and post-training using multiple choice questions (MCQ) and self-reflections. Skills were evaluated by direct observation and marked using a Likert scale. Confidence was assessed using a confidence matrix before and after the course. Overall feedback was taken at the end of the session.Results:Of 82 participants, 74 participants from four trainings were included for analysis. Post-test Cronbach’s alpha for MCQ was 0.82 and the confidence matrix was 0.86. Mean score for the pre-test MCQ was 6.12 (SD 2.22) compared to the post-test mean of 10.97 (SD 2.97), which was a statistically significant improvement (p<0.05). Trainees reported that the trauma teaching was helpful. They felt that it improved confidence regarding trauma and disasters.Discussion:Adding this training to current CBIMNCI can be an effective tool to reach out to primary health care workers, and provide further knowledge and skills on care of children during a disaster or humanitarian crisis.
Towards a Better Response: Combining Pareto Ranking and Geostatistics to Model Gender-Based Vulnerability in Rohingya Refugee Settlements in Bangladesh
Authors: Nelson Erica , Saade Daniela Reyes , Greenough P. Gregg 
Published: May 2019

Introduction:The Rohingya refugee crisis in Bangladesh continues to overburden humanitarian resources and undermine the health and security of over 900,000 people. Spatial, sector-specific information is required to better understand the needs of vulnerable populations, such as women and girls, and to target interventions with improved efficiency and effectiveness.Aim:The aim of this study was to create a gender-based vulnerability index and explore the geospatial and thematic variations in the gender-based vulnerability of Rohingya refugees residing in Bangladesh by utilizing pre-existing, open-source data.Methods:Data sources included remotely-sensed REACH data on humanitarian infrastructure, UN Population Fund resource availability data, and the Needs and Population Monitoring Survey conducted by the International Organization for Migration in October 2017. Gaps in data were addressed through probabilistic interpolation. A vulnerability index was designed through a process of literature review, variable selection and thematic grouping, normalization, and scorecard creation. Pareto ranking was employed to rank sites based on vulnerability scoring. Spatial autocorrelation of vulnerability was analyzed with the Global and Anselin Local Moran’s I applied to both combined vulnerability index rank and disaggregated thematic ranking.Results:Twenty-four percent of settlements were ranked as most vulnerable, with 30 highly vulnerable clusters identified predominantly in the Upazila of Sadar. Five settlements in Dhokkin, Somitipara, and Pahartoli were categorized as less vulnerable outliers amongst highly vulnerable neighboring sites. Security- and health-related variables appear to be the largest drivers of gender-specific vulnerability in Cox’s Bazar. Clusters of low security and education vulnerability measures are shown near the refugee ingress point near Gundum.Discussion:The humanitarian space produces tremendous amounts of data that can be analyzed with spatial statistics to better target research and programmatic intervention. The critical utilization of these data and validation of vulnerability indexes is required to improve the international response to the global refugee crisis.
The Use of Evidence in Humanitarian Response Decision-Making
Authors: Saulnier Dell , Allen Claire , Eriksson Anneli , Taylor Ben Heaven 
Published: May 2019

Introduction:The need to use evidence in humanitarian settings is recognized, yet utilizing that evidence to make decisions about humanitarian response remains a challenge.Aim:To identify how, when, and why decision makers in humanitarian response use scientific, peer-reviewed evidence to make decisions.Methods:An online cross-sectional survey of fifteen open- and closed-ended questions on demographics, experience, and role in humanitarian response was developed by Evidence Aid (EA) and Karolinska Institutet (KI). The online survey was available on the EA website from August 2015 to October 2018. Participants were self-selected, recruited through social media channels and mailing lists of EA and KI. All respondents and responses were anonymized. Responses were analyzed with descriptive statistics and content analysis.Results:47 people responded, primarily working in Europe or North America with roles of humanitarian response director/manager, independent consultant, or policymaker. Personal assessment of the quality of information, trust in the source, and information that was contextually relevant or based on field experience were factors for deciding whether information should be considered evidence. Reasons for using evidence when making decisions included adhering to good practice to maximize impact and effectiveness of aid, reassurance that the right decisions were being made, personal or organizational values, and using evidence as a tool to protect beneficiaries and organizations from poor quality decisions and program content.Discussion:Using evidence for decision making was common practice during the process of designing implementing and evaluating humanitarian response content, yet reasons for use varied. The importance of evidence developed and validated from field experience and trust in the source reported by this sample suggests that strengthening collaborative efforts between decisionmakers and evidence generators could be one approach to improve evidence and evidence use in humanitarian response.
Coping With On-Call Work: Current Knowledge to Support Women in the Emergency Services
Authors: Jay Sarah M , Vincent Grace E , Roberts Bernadette , Aisbett Brad , Reynolds Amy C , Paterson Jessica L , Ferguson Sally A 
Published: May 2019

Introduction:All Fire and Emergency Services (FES) personnel must balance FES work with their other responsibilities. Given that women tend to take on a greater responsibility for management of household/domestic activities than men, the on-call component of their FES work may be associated with very different challenges. Despite this, women have rarely been the focus of on-call research.Aim:To explore women’s on-call experiences in the FES by examining coping styles and strategies, with the goal of helping to innovate the way women are supported in FES roles.Methods:Relevant findings from two studies are included. The first study involved FES personnel from two agencies in Australia (n=24) who participated in a semi-structured interview. The second study was an anonymous online survey to determine work characteristics, sleep, stress, and coping in on-call workers more broadly, with workers from all industries across Australia (n=228) invited to participate.Results:Interview data identified two major themes in terms of coping with on-call work. Support (from family, social, and work), planning, and preparation were identified as important in helping women cope in the context of on-call unpredictability. Results from the survey (43% women) showed that on-call workers were an engaged group in terms of their coping, with 67% classified as having a positive coping style and 58% of women indicating that they agreed/strongly agreed with the statement, “I cope well with on-call work.”Discussion:Taken together, these data highlight engagement with positive coping by women who do on-call work, including in the FES. Importantly, positive coping strategies, such as talking about emotions, problem-solving, and seeking support have been linked to increased shift work tolerance in other populations. Coping style and strategies represent modifiable variables which could be specifically applied to assist women to manage the unique challenges associated with on-call work in the FES.
Global Event Data Research Registry: Taking Mass Gathering Research to the Next Level
Authors: Gogaert Stefan , Scholliers Annelies , Sherman Holly , Munn Matthew Brendan , Turris Sheila , Lund Adam , Ranse Jamie 
Published: May 2019

Introduction:Research on events and mass gatherings is hampered by a lack of standardized and central reporting of event data and metrics. While there is work currently being done on report standardization, this will require a plan for recording, storing, and safeguarding a repository of event data. A global event data registry would further the work of standardized reporting by allowing for the collection and comparison of events on a larger scale.Aim:To characterize the considerations, challenges, and potential solutions to the implementation of a global event data registry.Methods:A review of the academic and grey literature on the current understanding and practical considerations in the creation of data registries, with a specific focus on an application to mass gathering events.Results:Findings were grouped under the following domains: (1) stakeholder identification and consultation, (2) research goals and clinical objectives, (3) technological requirements (ie hosting, format, maintenance), (4) funding (budget, affiliations, sponsorships), (5) ethics (privacy, protection, jurisdictions), (5) contribution facilitation (advertising, support), and (6) data stewardship and registry access for researchers.Conclusion:This work outlines key considerations for undertaking and implementing an event data registry in the mass gathering space, and compliments ongoing work on the standardization of data collected at mass gathering events. If practical and ethical considerations are appropriately identified and managed, the creation of an event data registry has the potential to make a major impact on our understanding of events and mass gatherings.
On the Way Out: An Analysis of Patient Transfers from Four, Large-Scale, North American Music Festivals Over Two Years
Authors: Callaghan Christopher , Turris Sheila , Rabb Haddon , Munn Brendan , Lund Adam 
Published: May 2019

Introduction:Music festivals are globally attended events that bring together performers and fans for a defined period of time. These festivals often have onsite medical care to help reduce the impact on local healthcare systems. Historically, the literature suggests that patient transfers offsite are frequently related to complications of substance use. However, there is a gap in understanding as to why patients are transferred to a hospital when an onsite medical team, providing a higher level of care (HLC), is present.Aim:To better understand the causes that necessitate patient transportation to the hospital during festivals that have onsite physician-led coverage.Methods:De-identified patient data from a convenience sample of four, large-scale Canadian festivals (over two years) were extracted. Patient encounters that resulted in transfers to hospital, by ambulance, non-emergency transport vehicle (NETV), or self-transportation were analyzed for this study.Results:Each festival had an onsite medical team that included physicians, nurses, and paramedics. During 34 event days, there were 10,406 patient encounters, resulting in 156 patients requiring transfer to a hospital. A patient presentation rate of 16.5/1,000 was observed. The ambulance transfer rate was 0.12/1,000 of attendees. The most common reason for transport was musculoskeletal injuries (54%) that required imaging.Discussion:The presence of onsite teams capable of treating and releasing patients impacted the case mix of patients transferred to a hospital, and may reduce the number of transfers for intoxication. Confounding preconceptions, patients in the present study were transferred largely for injuries that required imaging. Results suggest that a better understanding of the specific effects onsite medical teams have on avoiding off-site transfers will aid in improving planning for music festivals. Findings also identify areas for further improvement in care, such as onsite radiology, which could potentially further reduce the impact of music festivals on local health services.
This is Sparta - A Five-Year Obstacle Course Racing Injury Analysis
Authors: Rabb Haddon , Coleby Jillian 
Published: May 2019

Introduction:Obstacle Course Races (OCR) are mass participation sporting events, challenging participants to complete physical and mental tasks over a variety of distances and terrains. The case series studied, Spartan Race, has races occurring in urban, rural, and wilderness venues, ranging from 5 to 42 kilometers, while incorporating 20 to 60 obstacles.Aim:To understand the injury rates, injury and illness patterns, and transport considerations within OCRs.Methods:A secondary data analysis of de-identified medical charts from 56 Spartan Race events occurring in Eastern Canada from 2014 to 2018 was performed. The scope of practice was first aid from 2014 to 2017, with the addition of advanced life support onsite in 2018.Results:Over 5 years, 2,387 injuries occurred among 127,481 participants, creating a patient presentation rate of 18.7/1000. Although the majority of injuries (92%; n=2,204) were treated onsite, a transport to hospital rate of 1.2/1000 (n=154) occurred along with an ambulance transport rate of 0.23/1000 (n=29). Lacerations (55%) and musculoskeletal (36%) injuries were the most frequent clinical presentations observed, whereas life-threatening emergencies (affecting airway, breathing, and circulation) were infrequent (n=10). Transport to the closest local tertiary care center was on average 49.8 kilometers (25.3 kilometers) and 40.5 minutes (17.9 minutes) away from the venue.Discussion:These results suggest that there may be an upper limit to the injury rates within Spartan Races. The majority of patient presentations were able to be treated onsite, supporting the need for a qualified onsite medical team to mitigate the strain on local healthcare systems. Although life-threatening emergencies were uncommon, they do occur, and medical teams must be appropriately prepared. Further research is needed to understand the staffing and equipment requirements of medical teams, the demographic information of the injured, and the examination of the impact OCR events have on the local health care systems.
Assessing the Quality of Roof-Harvested Rainwater after Bushfires
Authors: Steenkamp Malinda , Ross Kirstin , Whiley Harriet , Chubaka Emmanuel , Arbon Paul 
Published: May 2019

Introduction:Roof-harvested rainwater held in domestic tanks is used for a variety of purposes in Australia, including drinking and irrigation. There is limited evidence about the quality of rainwater after bushfires. Current health guidelines can be interpreted that landholders need to drain their rainwater tanks to avoid the risk of contamination. Anecdotal reports indicate that following such advice caused additional distress to landowners affected by bushfires in South Australia. Sustainable water management is important for future resilience and more evidence on water quality following bushfires is needed.Aim:This project investigated whether there is contamination of roof-harvested rainwater after bushfires, and if so, whether such water was safe for various purposes.Methods:In 2017 we tested artificially contaminated water spiked with chemicals associated with bushfires (chromated copper arsenate-treated ash and firefighting foam) and conducted a pilot field study using two purposely built roofs during a pre-fire season burn off. A field validation is planned for the summer of 2018/19 (December 2018 - March 2019), i.e., we plan to obtain 200 samples from 50 households affected by bushfire – two samples immediately after the fire event and another two after the first rain.Results:The artificially created contaminated water fell within guidelines for non-potable uses such as irrigation and stock watering, but was found unsuitable for drinking even after being filtered through two commercially available water filtration systems. We also plan to present results from our field study of 50 households.Discussion:Contaminant concentrations, even in artificially spiked water samples, are low and acceptable for non-potable uses. Bottled water should be used for drinking. Landholders should be encouraged to use their water for recovery purposes. Such advice may assist with decreasing the stress experienced by affected landholders and help with recovery efforts through the availability of a greater body of water.
The Role of Japan DMAT in Tokyo Inland Earthquake
Authors: Koido Yuichi , Misaki Miho , Chishima Kayako , Kawashima Yuzuru , Kondo Hisayoshi , Toyokuni Yoshiki , Otomo Yasuhiro , Yoshihara Katsunori 
Published: May 2019

Introduction:An inland earthquake is expected to occur in Tokyo in the near future, and disaster preparedness and response measures have been put in place by the government of Japan and local authorities.Methods:Japan Disaster Medical Assistant Teams (DMATs) conducted two large-scale drills for the first time in preparation for a Tokyo inland earthquake, in collaboration with the following participants: the Tokyo Metropolitan Government, disaster base hospitals in Tokyo, three Staging Care Units (SCUs), and neighboring prefectures. One of the scenarios was a north Tokyo Bay earthquake affecting the Tokyo wards and had 142 Japan DMATs participation. Another scenario was Tama inland earthquake affected mid-west of Tokyo and 110 DMATs participated. The drill included headquarters operation, affected hospital support operation, patient transportation within the area and to the wider region, SCU operation, collaboration with associated organizations, and logistics operation.Results:Post-drill assessments identified the following areas that need to be addressed: review of Japan DMAT implementation strategies; improvement of SCUs; establishment of a patient air transportation framework; securing means of patient transportation; improvement of communication systems; strengthening of disaster response of all hospitals in the Tokyo Metropolis; and preparations for survival in the event of isolation caused by the disaster.
Typhoon Mangkhut Case Study: Household and Community Typhoon Preparedness in Hong Kong, a Densely Populated Urban City
Authors: Man Asta YT , Chan Emily Ying Yang , Lam Holly CY 
Published: May 2019

Introduction:As a subtropical urbanized city in Southeast Asia, Hong Kong is prone to frequent typhoons. With an increasing number of severe typhoons, usual preparedness measures should be explored to assess their adequacy to safeguard health and wellbeing. Typhoon Mangkhut (2018) serves as an example of the successes and limitations of community preparedness for a severe typhoon.Aim:To explore how Hong Kong residents prepared for Typhoon Mangkhut and whether their usual preparedness measures provided enough protection.Methods:A population-based randomized telephone survey of Hong Kong residents (n=521) was conducted soon after Typhoon Mangkhut’s landing. Only residents aged 18 or above and understood Cantonese were included. Socio-demographic factors, types of typhoon and general preparedness, risk perception, and impacts from the typhoon were asked. Descriptive characteristics and univariate analysis were used to describe the patterns and associations.Results:8.6% of respondents felt their home was at high risk of danger during typhoons although 33.4% reported some form of impact from Mangkhut. Over 70% reported doing at least one typhoon specific preparedness measure. Among those who practiced at least one typhoon specific preparedness measure, 37.2% (p=0.002) were affected by the typhoon.Discussion:Despite the high adaptation of preparedness measures, warranted by the frequent typhoons, Hong Kong residents were not adequately prepared for a severe typhoon. While the early warning system and evacuation of flood-prone areas mitigated some of the impact, unexpected effects such as flying air conditioners, roadblocks affecting employment, swaying buildings, and loss of power supply were not accounted for. Future preparedness for natural disasters which will become more extreme due to climate change and needs to account for unforeseen risks.
Application of National and Sub-National Indicators to Rank Needs of People with Life-threatening Conditions and Chronic Diseases Before, During, and After a Disaster
Authors: Ryan Benjamin , Green Joseph , Franklin Richard , Burkle Frederick 
Published: May 2019

Introduction:Disasters can damage the essential public health infrastructure and social protection systems required for vulnerable populations. This contributes to indirect mortality and morbidity as high as 70–90%, primarily due to an exacerbation of life-threatening conditions and chronic diseases. Despite this, the traditional focus of public health systems has been on communicable diseases. To address this challenge, disaster and health planners require access to repeatable and measurable methods to rank and prioritize the needs of people with life-threatening and chronic diseases before, during, and after a disaster.Aim:Propose a repeatable and measurable method for ranking and prioritizing the needs of people with life-threatening and chronic diseases before, during, and after a disaster.Methods:The research began with identifying the risk disasters pose to people with life-threatening and chronic diseases. The data gathered was then used to develop indicators and explore the use of DisasterAWARE™ (All-hazard Warnings, Analysis, and Risk Evaluation) to rank and prioritize the needs before, during, and after a disaster.Results:This research found people at greatest risk are those with underlying cardiovascular and respiratory diseases, unstable diabetes, renal diseases, and those undergoing cancer treatment. A sustainable method to help address this problem is to expand the use of DisasterAWARE™ (All-hazard Warnings, Analysis, and Risk Evaluation) to rank and prioritize needs at national and sub-national levels.Discussion:DisasterAWARE™ has been successfully applied to the assessment and prioritization of disaster risk and humanitarian assistance needs in Southeast Asia (ASEAN, Viet Nam), Central America (Guatemala, El Salvador, Honduras, Nicaragua), South America (Peru), and the Caribbean (Jamaica, Dominican Republic). Using the indicators developed through this research, this proven methodology can be seamlessly and easily translated to rank and prioritize the needs of people with life-threatening and chronic diseases before, during, and after a disaster.