bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determining Key Influences on Patient Ability to Successfully Manage Noncommunicable Disease After Natural Disaster
Authors: Ryan Benjamin , Franklin Richard , Burkle Frederick , Smith Erin , Aitken Peter , Leggat Peter 
Published: May 2019

Introduction:Natural disasters often damage the public health infrastructure required to maintain the wellbeing of people with noncommunicable diseases. This increases the risk of an acute exacerbation or complications, potentially leading to a worse long-term prognosis or even death. Disaster-related exacerbations of noncommunicable diseases will continue, if not increase, due to an increasing disease prevalence, sustained rise in the frequency and intensity of disasters, and rapid unsustainable urbanization in disaster-prone areas. However, the traditional focus of public health and disaster systems remains on communicable diseases, despite a low risk. There is now an urgent need to expand the public health response to include noncommunicable diseases.Aim:To explore the key influences on patient ability to successfully manage their noncommunicable disease after a natural disaster.Methods:A survey of people with noncommunicable diseases in Queensland, Australia, collected data on demographics, disease/condition, disaster experience, and primary concern post-disaster. Descriptive statistics and chi-square tests with Bonferroni-adjustment were used to analyze data.Results:There were 118 responses to the survey. Key influences on the ability to self-manage post-disaster were access to medication, medical services, water, treatment and care, power, and food. Managing disease-specific symptoms associated with cardiovascular disease, diabetes, mental health, and respiratory diseases were primary concerns following a disaster. Stress and anxiety, loss of sleep, weakness or fatigue and shortness of breath were common concerns for all noncommunicable diseases. Those dependent on care from others were most worried about shortness of breath and slow healing sores. Accessing medication and medical services were priorities for all patients post-disaster.Discussion:The key influences on successful self-management post disaster for people with noncommunicable diseases must be reflected in disaster plans and strategies. Achieving this will reduce exacerbations or complications of disease and decrease demand for emergency health care post-disaster.
Disaster Risk Reduction and Health: The Potential of Health Registers for Public Health Monitoring
Authors: Dückers Michel , Arnberg Filip , Baliatsas Christos , Reifels Lennart , Stene Lise , Yzermans Joris 
Published: May 2019

Introduction:The Sendai Framework seeks to substantially reduce disaster risk and losses in lives, livelihoods, health, and other assets including persons, communities, and countries. The framework focuses on reducing mortality while increasing population wellbeing, early warning, and promotion of health systems resilience. The use of scientific evidence to inform policy and formulate effective initiatives and interventions is crucial to disaster risk reduction within health. Different instruments and methodologies are available to guide policy and operations. The potential value of routinely collected patient data from health registers is that they can provide pre-event health and comparison group data without burdening affected populations.Aim:The current contribution aims to illustrate how health registers can help monitor the health impact of natural and human-made disasters.Methods:Patient data from health registers of general practitioners and other health professionals, sometimes combined with other registers and data sources, have been utilized to monitor the health impact of disasters and environmental hazards in the Netherlands, Norway, and Sweden since 2000.Results:Health registers allowed monitoring of mental health problems, medically unexplained symptoms, chronic health problems, and social problems. These were compared to groups not directly exposed. The health impact and care utilization was tracked after the fireworks explosion in Enschede affecting inhabitants of the neighborhood (2000; data range 1999-2005), children and parents after the Volendam café fire (2001; data range 2000-2006), Swedish survivors of the Tsunami in Southeast Asia (2004; data range 2004-2010), and parents of children affected by the terrorist attack on Utøya (2011; data range 2008-2014).Discussion:Health systems with registers have an important advantage when it comes to the potential for monitoring population health, and perhaps offer early warnings of pandemics. However, data generation should be closely connected to policy-making before and during the planning and evaluation of public health intervention.
Is There Calm After the Storm? A General Practice Registry-based Study Following the Case of a Severe Hailstorm in the Netherlands
Authors: Baliatsas Christos , Yzermans Joris , Nielen Mark , Dückers Michel 
Published: May 2019

Introduction:On June 23 and 24, 2016, a heavy hailstorm in the south of the Netherlands destroyed farms, greenhouses, and crops, and caused severe damage to many residences and cars in multiple communities. The size of the massive hailstones ranged from 3 to 5 centimeters in diameter. The farm damages alone were estimated to be 100 million euros, while total insurance industry losses were expected to exceed half a billion euros. In addition to the storm, the affected region also had its first tropical day of the year, with temperatures reaching 32 degrees Celsius. To date, the psychosocial impact and possible adverse health effects caused by the storm have not been thoroughly investigated.Aim:To explore whether the occurrence of chronic and acute health problems in the affected region increased after the hailstorm compared to “control” areas.Methods:Health data for the time period before (2013-2015) and immediately after the hailstorm (2016-2018) will be collected based on electronic health records (morbidity, psychosocial problems, and prescribed medication) from general practices (GP) located in the affected municipalities. For the same period, health problems in the affected region will also be compared with GP-registered data from different Dutch municipalities with similar urbanization levels, which will be used as a control group. The combination with external datasets (e.g. socioeconomic status, environmental exposures) will also be considered.Results:Multilevel regression analyses will be carried out to test the health impact of this sudden, onset event. The current study is a work in progress. Final results are expected in February 2019 and are presented during the conference.Discussion:The present study illustrates how routinely collected patient health records, recorded by GPs, can be used for epidemiological research in the aftermath of a disaster within the context of climate and weather extremes in Europe.
Earthquake, Tsunami, and Liquefaction in Central Sulawesi, Indonesia: How Far is Our Disaster Health Management Progress?
Authors: Donna Bella , Ariani Madelina 
Published: May 2019

Introduction:Located in the Pacific Ring of Fire, Indonesia is prone to natural hazards, such as earthquakes, tsunamis, floods, and volcanic activity. Management in the health sector is a necessary foundation for dealing with a disaster. Management lessons and essential experiences identified from disasters are often forgotten. The faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada has been developing disaster health management since 2009 after Padang Earthquake, followed by Merapi Volcano Eruption (2009), Pidie Jaya Earthquake (2016), and Lombok Earthquake (2018). The latest series of earthquakes that struck Central Sulawesi has revealed management problems with respect to the communication process, the development of coordination, and information and data synchronization.Aim:To show the importance of effective management in a health cluster, including what went well, what went poorly, and what will happen from the acute phase until the transition phase.Methods:Disaster health management implementation was compared from Padang to the Central Sulawesi’ earthquake. Then health cluster management was compared in Lombok and Central Sulawesi. Indicators were coordination, communication, data information, and organization.Discussion:There has been good progress for disaster health management in Indonesia. The health cluster approach makes coordination, data collected, and communication much easier. However, it also needs to focus on disaster planning, training, or simulation for the district health office while enhancing district response capacity. Although the challenges have changed in the last few decades, additional research is planned to limit management difficulties in the health cluster.
A Comprehensive Coalition Based Regional Approach to Pediatric Disaster Planning
Authors: Frogel Michael , Cooper Arthur , Foltin George 
Published: May 2019

Introduction:Children, who comprise 25% of the US population, are frequently victims of disasters and have special needs during these events.Aim:To prepare NYC for a large-scale pediatric disaster, NYCPDC has worked with an increasing number of providers that initially included a small number of hospitals and agencies. Through a cooperative team approach, stakeholders now include public health, emergency management, and emergency medical services, 28 hospitals, community-based providers, and the Medical Reserve Corps.Methods:The NYCPDC utilized an inclusive iterative process model whereby a desired plan was achieved by stakeholders reviewing the literature and current practice through discussion and consensus building. NYCPDC used this model in developing a comprehensive regional pediatric disaster plan.Results:The Plan included disaster scene triage (adapted for pediatric use) to transport (with prioritization) to surge and evacuation. Additionally, site-specific plans utilizing Guidelines and Templates now include Pediatric Long-Term Care Facilities, Hospital Pediatric Departments, Pediatric and Ob/Newborn/Neonatal Intensive Care Services and Outpatient/Urgent Care Centers. A force multiplier course in critical care for non-intensivists is provided. An extensive Pediatric Exercise program has been used to develop, operationalize and revise plans based on lessons learned. This includes pediatric tabletop, functional and full-scale exercises at individual hospitals leading to citywide exercises at 13 and subsequently all 28 hospitals caring for children.Discussion:The NYCPDC has comprehensively planned for the special needs of children during disasters utilizing a pediatric coalition based regional approach that matches pediatric resources to needs to provide best outcomes.The NYCPDC has responded to real-time events (H1N1, Haiti Earthquake, Superstorm Sandy, Ebola), and participated in local (NYC boroughs and executive leadership) and nationwide coalitions (National Pediatric Disaster Coalition). The NYCPDC has had the opportunity to present their Pediatric Disaster Planning and Response efforts at local, national and International conferences.
The Illinois EMSC Pediatric Preparedness Checklist - An Innovative Approach to Improving Pediatric Disaster Planning and Preparedness in Chicago
Authors: Severin Paul , Lyons Evelyn , Weber Elisabeth 
Published: May 2019

Introduction:The Illinois EMSC Pediatric Facility Recognition Program was implemented in 1998. The objective was to identify the capability of a hospital to provide optimal pediatric emergency and critical care. Beginning in 2004, steps were taken to integrate pediatric disaster preparedness into the facility recognition process.Aim:The goal of this study was to identify strengths and areas for improvement in pediatric disaster preparedness in participating Chicago hospitals.Methods:The impact of the EMSC Pediatric Preparedness Checklist was assessed during the 2016 Pediatric Facility Recognition hospital site surveys. The following components were surveyed as they relate to pediatrics: Overall Emergency Operations Plan (EOP), Surge Capacity, Decontamination, Reunification/Patient Tracking, Security, Evacuation, Mass Casualty Triage/JumpSTART, Children with Special Health Care Needs/Children with Functional Access Needs, Pharmaceutical Preparedness, Recovery, Exercise/Drills/Trainings. All survey items were extracted, collated, and reviewed.Results:Fourteen Chicago hospitals participated in the survey. Almost all hospitals (93%) surveyed indicated that they consult staff with pediatric expertise when updating their EOP, incorporate pediatric trained mental health professionals into their disaster call lists (93%), and integrate staff with pediatric focus into their incident command system/emergency operation center during a disaster (79%). Almost all of the hospitals (93%) had an infant/child abduction plan and all hospitals (100%) were testing the process at least once per year. Finally, almost all of the hospitals (93%) had incorporated a patient connection program into their tracking and reunification plan. However, not all hospitals included drills for pediatric surge, decontamination, and evacuation. Less than one-third of the hospitals had pediatric components in their alternate treatment site plans. Half of the hospitals did not have pediatric components incorporated into their decontamination plans.Discussion:Integrating the EMSC Pediatric Preparedness Checklist surveys into the recognition process is an innovative approach to improve pediatric disaster planning and preparedness in hospitals.
Validation of the Pediatric Physiological and Anatomical Triage Score in Pediatric Patients with Burn Injuries
Authors: Toida Chiaki , Muguruma Takashi , Takeuchi Ichiro , Morimura Naoto 
Published: May 2019

Introduction:Triaging plays an important role in providing suitable care to the largest number of casualties in a disaster setting. We developed the Pediatric Physiological and Anatomical Triage score (PPATS) as a new secondary triage method.Aim:This study was performed to validate the accuracy of the PPATS in pediatric patients with burn injuries.Methods:A retrospective review of pediatric patients with burn injuries younger than 15 years old registered in the Japan Trauma Databank from 2004 to 2016 was conducted. The PPATS, which was assigned scores from 0 to 22, was calculated based on vital signs, anatomical abnormalities, and need for life-saving intervention. The PPATS categorized the patients by their priority and defined the intensive care unit (ICU)-indicated patients as those with PPARSs more than 6. This study compared the accuracy of prediction of ICU-indicated patients between the PPATS and Triage Revised Trauma Score (TRTS).Results:Among 87 pediatric patients, 62 (71%) were admitted to the ICU. The median age was 3 years (interquartile range: 1 to 9 years old). The sensitivity and specificity of the PPATS were 74% and 36%, respectively. The area under the receiver-operating characteristic curve was not different between the PPTAS [0.51 (95% confidence interval: -0.51–1.48) and the TRTS [0.51 (-1.17–1.62), p=0.57]. Regression analysis showed a significant association between the PPATS and the Injury Severity Score (ISS) (r2=0.39, p<0.01). On the other hand, there is no association between the TRTS and the ISS (r2=0.00, p=0.79).Discussion:The accuracy of the PPATS was not superior to that of current secondary-triage methods. However, the PPATS had the advantage of objectively determining the triage priority ranking based on the severity of the pediatric patients with burn injuries.
Developing Sustainable Prehospital Care for NCD Emergencies in Rwanda: A Collaboration between EMS, Ministry of Health of Rwanda, and Virginia Commonwealth University
Authors: Uwitonze Jean Marie , Asay Basil , Kabagema Ignace , Louka Stephanie , Wolfe Luke , Rosenberg Ashley , Dushime Theophile , Jayaraman Sudha 
Published: May 2019

Introduction:Every year, 71% of all deaths globally are due to NCDs. Over 85% of these deaths occur in low- and middle-income countries (LMICs), with 36% of all reported deaths in Rwanda attributed to NCDs. Approximately 24 million lives are lost each year in LMICs due to emergency medical conditions. The collaboration between VCU and the EMS Rwanda designed and implemented a pre-hospital medical emergencies training course and train-the-trainers program to address the rise of NCDs.Methods:During the course, pre and post 50 assessment questions were administered. Two cohorts participated 25 prehospital staff identified by EMS to form an instructor core and 19 emergency staff from public hospitals who are likely to respond to local emergencies in the community. A two-day EMCC was developed using established best practices. The Instructor core completed EMCC 1 and a one-day educator course and then taught the second cohort (EMCC2). Student’s t-test and matched paired t-tests were used to evaluate the assessments.Results:Mean score on EMCC 1 was 43% (SD: 20) compared to 85% (SD: 5) on post-course assessment. Pre-assessment failure rate was 88%. Mean scores for EMCC 2 were 45% (SD: 14) and 81% (SD: 10) on post-assessment. Pre-assessment score was low (50%). A paired t-test comparing pre-course to post-course assessment means demonstrated an increase by 42% (SD 30) for EMCC 1 (p<0.001) and 37% (SD: 14) for EMCC 2 (p<0.001) with 95% confidence. No items had to be removed from analysis based on the discrimination index (di).Discussion:NCDs often present as emergencies such as myocardial infarction and stroke. Effective management of these in the prehospital setting is essential to optimal outcomes. This study effectively implemented a training program in Kigali, Rwanda and created an instructor core to allow scale-up of effective pre-hospital services across the country.
Technology Development for Disaster Planning and Response: The Development of an Interactive Website to Communicate and Coordinate Primary Health Providers for Planning and Response Purposes
Authors: Callahan Deborah , McColl Graeme , Robertson Kelly 
Published: May 2019

Introduction:The Canterbury Primary Response Group (CPRG) was formed to provide a community-wide approach to manage, coordinate, plan for, and respond to health emergencies in the prehospital setting. Original communications within the CPRG group and to the primary sector were via email and the use of other organizations’ websites. These means were not easy to access and update content, and the group was depending on third parties.Aim:To outline the development of a primary health interactive website, provide up-to-date planning and event information, and provide information and support in relation to emergency planning for major emergency and non-emergency health events.Methods:The advancements of technology and planning practices have given CPRG the ability to develop information, planning, and operational reporting systems.Results:CPRG has developed a web-based portal that is available to primary health care (including community pharmacy) to provide planning assistance and templates as well as information on current events, such as the influenza season. It includes access to the CPRG suite of emergency plans and is a document repository for the Emergency Operations Centre (EOC). A further development has been a response management system for use in the CPRG EOC to assess any health situation and status of providers to enable a continually up-to-date dashboard and situational awareness reports to be visible to those coordinating the response.Discussion:Communication is a major factor, often the most criticized, when managing any response. The development of the CPRG website and system as described can alleviate this and provide accurate and consistent event and planning advice to those in the primary health sector.
Tailoring Disaster Risk Reduction for Adolescents: Perspectives from China and Nepal
Authors: Newnham Elizabeth , Gao Xue , Tearne Jessica , Guragain Bhushan , Jiao Feng , Ghimire Lajina , Balsari Satchit , Chan Emily , Leaning Jennifer 
Published: May 2019

Introduction:More than half of the world’s youth live in the Asia Pacific region, yet efforts to reduce disaster risk for adolescents are hindered by an absence of age-specific data on protection, health, and engagement.Aim:China and Nepal have faced a recent escalation in the number of climatic and geological hazards affecting urban and rural communities. We aimed to examine disaster-related threats experienced by adolescents and their caregivers in China and Nepal, determine the scope for adolescent participation, and elicit recommendations for improving disaster risk reduction.Methods:Sixty-nine adolescents (51% female, ages 13-19) and 72 adults (47% female, ages 22-66) participated in key informant interviews and focus group discussions in disaster-affected areas of southern China and Nepal. Using inductive content analysis, several themes were identified as key to adolescents’ needs.Results:Security and protection emerged as a central issue, interlinked with preparedness, timely and equitable disaster response, psychosocial support, and adolescent participation. The mental health risks emerging from trauma exposure were substantial. Adolescents made extensive contributions to disaster response including involvement in rescue efforts and delivering first aid, rebuilding homes and caring for family members. Participants forwarded a number of recommendations, including investing in psychological support, skills training, and stronger systems of protection for those at risk of family separation, trafficking, or removal from school.Discussion:The findings informed a multilevel, interconnected model for disaster risk reduction tailored to adolescents’ needs. Supporting adolescents’ recovery and long-term resilience after humanitarian crises will require coordinated efforts in preparedness, security, and mental health care.
Consideration and Practice on Hospital Incident Command System During Mass Casualty Incidents in Chinese Hospitals
Authors: Fan Haojun , Hou Shike , Zhao Yanmei 
Published: May 2019

Introduction:More and more hospitals are using the Hospital Incident Command System (HICS) for organizational management under emergency conditions. HICS is an incident management system based on principles of the Incident Command System (ICS), which assists hospitals and healthcare organizations in improving their emergency management planning, response, and recovery capabilities for unplanned and planned events. This study aims to explore how Chinese hospitals manage their organizations with HICS in Mass Casualty Incidents (MCI).Aim:To explore the feasibility of HICS in Chinese hospitals under MCI.Methods:A combination of literature analysis and empirical research was used in this study. Through case studies and experience summarization, the necessity and feasibility of the incident command system (ICS) and the emergency medical response system (EMRS) was demonstrated in the early stage of MCI. Based on this, a new "1 SECTION-5 GROUPS-10 TEAMS " model was proposed, and its value of practical application was discussed in MCI.Results:Multiple resources must be mobilized In MCI, and it is necessary to establish an ICS and an EMRS as soon as possible in the early stages of MCI. The earlier ICS is set up, the more initiative can be taken. The "1 SECTION-5 GROUPS-10 TEAMS" model proposed in this study has a good effect on the practice of drills and rescues, indicating that this model has a certain promotion effect in the hospital's response to MCI.Discussion:The "1 SECTION-5 GROUPS-10 TEAMS" model has high feasibility and can be further verified in the subsequent rescue practice.