bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental Health Impacts on People Living in Subdivided Flats in Hong Kong
Authors: Ng Angel W L 
Published: May 2019

Introduction:Housing has always been a source of stress for people in Hong Kong (HK), especially to those living in sub-optimal settings. About 210,000 people are forced to live in subdivided flats in HK. Most of these flats cannot meet health standards set by the UN even for prisoners, in terms of the floor space, climatic conditions, lighting, air quality, and ventilation. Fire and public safety equipment are lacking. Most believed that the substandard environment has a negative impact on one’s mental health.Aim:To investigate how the living condition in a subdivided flat affects a person’s mental health.Methods:104 households living in the subdivided flats in Kwai Tsing, one of the 18 Districts of HK, were surveyed by HKJCDPRI’s Collaborating Partner, HKSKH Lady MacLehose Centre in February 2017; while a follow-up study with purposive sampling was conducted in October 2017 to interview 10 households on their mental health status. A mixed Methods was used combining the quantitative Results of the WHO Quality of Life-BREF scale and Depression Anxiety Stress Scale 21, and qualitative Results of face-to-face interviews.Results:80% of 104 households surveyed suffered from mental distress. The follow-up study revealed that seven of them displayed signs of depression and/or anxiety, while two were diagnosed with a mental disorder. Distress is proven to associate with the environmental and health risks, including fire and disease outbreak, as well as chronic issues resulting from poor indoor air quality and extreme weather.Discussion:Low level of perception and preparedness among HK people is making these public health risks more apparent. The already desperate housing and land policy don’t seem to offer any help in the near future. Public educations efforts need tremendous enhancement, to engage, mobilize and empower individuals and communities, to actively plan and prepare for future shocks.
Neuropsychiatric Manifestations of Wildfire Exposure
Authors: Mohammad Sohail 
Published: May 2019

Introduction:Wildfires are life threatening incessant fires in thickly vegetated areas that spread extremely rapidly to human habitat and are difficult to control by human force. The impact of wildfires is enormous on population health and causes tremendous financial burden to individuals and communities.Aim:The aim is to understand the potential disease burden secondary to wildfires both at an individual and population level and reflect upon the immediate and delayed neuropsychiatric manifestations of smoke exposure.Methods:Data on wildfires associated direct and indirect costs on individual health and health care delivery appears to be scant. The effort of this presentation is to present the federal data from 2012 to 2016 on nationwide wildfires, estimated acreage consumed in wildfires, the population exposed, and deaths. Information was extracted from the National Interagency Fire Center, the United States Fire Administration, and the Federal Emergency Management Agency. Through literature review on neuropsychological sequelae of wildfires smoke inhalation and associated trauma, the goal is to reflect upon potential healthcare burden secondary to neuropsychiatric manifestations.Results:Per National Center for Health Statistics, the national fire death rates from 2012 to 2016 ranged 10 to 11 per million population each year, and the property loss both residential and non-residential was estimated at 9 to 10 billion dollars each year. We know healthcare cost is expensive in the United States, and with the stated estimates, one can only envision the health care and public health system burden.Discussion:The characteristic neuropathology of carbon monoxide toxicity is bilateral Globus pallidus necrosis and the common neuropsychological symptoms include fatigue, affective conditions, emotional distress, memory deficits, sleep disturbance, vertigo, dementia, and psychosis. The health effects and associated disability demand policymakers to allocate resources for wildfire prevention/ containment and primary health care providers education, research, and building effective healthcare delivery systems.
Next Level Triage: Applications of Point-of-Care Ultrasound in Disaster Response and Recovery
Authors: Stannard Tyler , Liu E. Liang , Flax Lindsay A. , Swienton Raymond E. , Klein Kelly R. , Jones Jodi D. , Pascual Mandy M. 
Published: May 2019

Introduction:Ultrasound applications are widespread, and their utility in resource-limited environments are numerous. In disasters, the use of ultrasound can help reallocate resources by guiding decisions on management and transportation priorities. These interventions can occur on-scene, at triage collection points, during transport, and at the receiving medical facility. Literature related to this specific topic is limited. However, literature regarding prehospital use of ultrasound, ultrasound in combat situations, and some articles specific to disaster medicine allude to the potential growth of ultrasound utilization in disaster response.Aim:To evaluate the utility of point-of-care ultrasound in a disaster response based on studies involving ultrasonography in resource-limited environments.Methods:A narrative review of MEDLINE, MEDLINE InProcess, EPub, and Embase found 20 articles for inclusion.Results:Experiences from past disasters, prehospital care, and combat experiences have demonstrated the value of ultrasound both as a diagnostic and interventional modality.Discussion:Current literature supports the use of ultrasound in disaster response as a real-time, portable, safe, reliable, repeatable, easy-to-use, and accurate tool. While both false positives and false negatives were reported in prehospital studies, these values correlate to accepted false positive and negative rates of standard in-hospital point-of-care ultrasound exams. Studies involving austere environments demonstrate the ability to apply ultrasound in extreme conditions and to obtain high-quality images with only modest training and real-time remote guidance. The potential for point-of-care ultrasound in triage and management of mass casualty incidents is there. However, as these studies are heterogeneous and observational in nature, further research is needed as to how to integrate ultrasound into the response and recovery phases.
Nursing Can Improve Shelter Environment: Cluster Approach and the Sphere Standard Based Community Shelter Drill
Authors: Harada Nahoko , Tanoue Hiroki , Aiboshi Yuma 
Published: May 2019

Introduction:As Florence Nightingale stated, nursing plays a critical role in environmental management for people in sick, injured, and even good conditions. In current practice, affected people are forced to reside in the evacuation shelters for a prolonged period in Japan. Unfavorable living conditions lead to adverse physical and psychological outcomes including cardiovascular events, depression, and more. However, environment management cannot be achieved without involving the community.Aim:To initiate community into shelter environment management a multi-cluster drill was coordinated by the Department of Psychiatric and Mental Health Nursing, University of Miyazaki, which appointed a director of Shelter Management for the annual nation-wide disaster drill hosted by the Cabinet Office of Japan.Methods:With the Department of Health and Pharmaceuticals, Miyazaki Prefecture, the director invited local communities and held an exhibition type disaster drill on August 4, 2018.Results:36 organizations, including prefectural and municipal crisis management departments, health care organizations, a social welfare council, Red Cross, a telecommunication company, WASH cluster organizations, and the Japan Ground Self-Defense Force participated. The director requested to develop a plan filled with tactics and techniques protecting the health of people living in the shelter. Through meetings, the organizations recognized similarities and differences in roles, responsibilities, and capacities leading to an organized inter-cluster network. Participants created and prosecuted the plan independently and the director only orchestrated and negotiated with other supporting entities. The organizations exhibited and demonstrated how residents can protect their own physical and psychological health by setting up a proper shelter environment. Direct feedback from residents to organizations resulted in an expanded local network and the organizations improving their capacities.Discussion:Shelter environment cannot be managed by nursing solely but coordination by nurses may consolidate multi-cluster aid organizations so that shelter environment management would be done by residents and local organizations.
One Hospital’s Timeline for In-Hospital Vertical Evacuation during a Flood Disaster
Authors: Iwasaki Megumi , Shoko Tomohisa , Akahoshi Koki , Adachi Tomohiro , Yoshikawa Kazuhide 
Published: May 2019

Introduction:Recently, the risk of flood disasters due to concentrated heavy rains has been increasing in Japan. While some cases of hospital evacuation have been reported, standards for hospital evacuation have not been established and regional administrative evacuation plans do not include medical facilities.Aim:To clarify the timeline for in-hospital vertical evacuation during a flood disaster.Methods:A timeline was set for vertical evacuation as criteria of the hospital’s emergency response based on the Arakawa River Downstream Timeline, which is an estimate of the time until river flooding based on the water level of the Arakawa River located near the facility. The timeline was calculated backward from 0 hours to when the river floods. A drill was held for verification.Results:The timeline was based on the water level of the Arakawa River and objective evidence of risky transfer of critical patients; therefore, the decision to evacuate was made when the water level reached a dangerous level (-3 hours). However, this did not provide enough time to evacuate patients in all hospital departments simultaneously, resulting in a shortage of human resources. There was a planned shutdown of the electronic clinical record system at 0 hours to avoid water damage and evacuation of its server, but three hours were not enough to prepare patient clinical summaries.Discussion:There is a need for greater and earlier preparation for evacuation to reduce or discharge patients who can leave the hospital when a flood disaster is predicted. Only in-hospital vertical evacuation was considered because it is very risky to transfer critical patients without an evacuation order from government or municipal officials. In fact, over 10,000 patients would need to be evacuated in the region if the Arakawa River floods. Therefore, a regional plan is indispensable for such large scale and simultaneous hospital evacuations.
Perspective of an Academic Consortium for Preparedness of Emergency/Disaster Medical Response during 2020 Tokyo Olympic/Paralympic Games
Authors: Morimura Naoto 
Published: May 2019

Introduction:A large number of visitors to Tokyo during the Tokyo Olympic and Paralympic Games in 2020 resulted in an increase of injury/illness and burden to the routine emergency medical services system. Furthermore, extremely hot and humid weather, terrorism, and outbreaks of infectious diseases are marked risks.Aim:We introduce the present status of an academic consortium (AC2020) to fulfill our mission as academic organizations. The Japanese Association for Acute Medicine (JAAM) and six academic associations have initially established the AC2020 since 2016, which consists of the 23 associations at this time. The role of the AC2020 is to provide knowledgeable evidence, intelligence, and support for constructing response plans for medical problems via the website (http://2020ac.com/).Methods:The joint committee of the AC2020 (JC-AC2020) has been launched to accomplish consortium activities; make statements and recommendations, compile manuals, conduct seminars, and coordinate the training program of on-site medical teams. The JC-AC2020 organizes nine working groups of heat stroke, lightning strike, nursing, athletes, first responders, foreigners, pre and in-hospital response of MCI, and data collection for audit.Results:As of December in 2018, AC2020 has released 30 documents and 10 event-news on the website including seven statements, two recommendations of a prerequisite of the on-site medical team, and two manuals concerning the treatment of gunshot and explosive injuries. Based on some of these statements, the Tokyo government has already enhanced the previous plan.Discussion:The AC2020 will propose the web site as a portal site and platform, disseminate the activities widely to society, and ask for the cooperation of other related organizations and academic societies. The AC2020 will aim to provide the landmark project of mass-gathering medical care in Japan as well as the transition to the Olympic Games in Paris in 2024.
Pharmaceutical Relief Activities at Western Japan Torrential Rain Disaster
Authors: Egawa Takashi , Watanabe Akihiro , Nakano Takafumi , Kubo Tatsuhikiko , Nawata Rie , Hayashida Yuki , Raisen Natsuki , Kataoka Yasufumi , Kondo Hisayoshi , Koido Yuichi 
Published: May 2019

Introduction:The torrential rain triggering massive flooding and hundreds of landslides was the worst weather disaster in Western Japan. A temporary pharmacy was established in the Kurashiki health center, which provided medicine to victims.Aim:To evaluate the supply status of prescription under the health insurance system during a disaster.Methods:When the enormous disaster occurred, victims get a prescription in the hospital or community pharmacy under the Disaster Relief Act or Health Insurance Act. Under the Disaster Relief Act, prescriptions that are given at a first aid station are able to be filled at the mobile pharmacies at no cost to the patient from the local government. Prescriptions that are issued by a medical institution, and are in accordance with the Health Insurance Act or National Health Insurance Act, can be dispensed at hospitals or community pharmacies. Patients may be exempt from the co-payment by being covered by their health insurance. Here, we investigated the supply status of prescription to affected people.Results:The good points of the supply status were as following: 1) dispensing out of disaster area was a good system to relieve a pharmacist2. ) J-SPEED was also a good reporting system to provide appropriative medicine inventory management, and 3) sending prescription using a mobile phone was very useful for pharmaceutical activities. On the other hand, the points for improvement were as following: 1) more time to learn the medical insurance system during the disaster was needed, and 2) the mobile pharmacy is better to make the rounds of shelters including health care consultation.Discussion:In case of a disaster, two different medicine supply systems cause confusion to medical relief teams. It is considered that collaboration relief activities with relief teams that included a pharmacist was very important.
Pharmaceutical Services Preparedness of Military Units in an Institution of Brazilian Armed Forces
Authors: de Souza Tatiana Holanda Pereira , Miranda Elaine Silva 
Published: May 2019

Introduction:Military participation in humanitarian operations, both in cases of armed conflict and in response to natural disasters, is a common phenomenon in several countries. In Brazil, the Armed Forces have a history in providing humanitarian assistance to victims of emergencies through their field hospitals, such as medical and dental care, laboratory and imaging diagnosis, and pharmaceutical services.Aim:To verify pharmaceutical services preparedness of military units in an institution of Brazilian Armed Forces to disaster response and humanitarian aid.Methods:A transversal study was carried out. The methodological approach was based on a logical model and indicators related to the preparedness of pharmaceutical services. Field research was carried out and good storage practices were investigated in loco. Key stakeholders were interviewed based on an open-ended questionnaire on the preparedness of pharmaceutical services. Interviews were transcribed and analyzed for overall content, according to analytical categories stemming from the literature and indicators prior defined.Results:Key stakeholders of three military units were interviewed, and official documents and guidelines were also analyzed. Some pronounced shortcomings were identified, such as the lack of a specific budget for medicines management, no surplus of health supplies, lack of appropriate transports, and need of capacity building of health professionals and support team. The existence of a disaster plan, selection of essential medicines for primary reaction, forecasting of medicines, field hospitals as mobile and adaptable health structures, and a system for military mobilization are some of the strengths identified. Two military units are better structured in the management of pharmaceutical service. The third unit still needs to mature its processes to fit the health purposes of its mission.Discussion:These findings can subsidize the improvement of pharmaceutical services’ efficiency and quality in means of providing better response in emergency situations supported by the Brazilian Armed Forces.
Putting the Theoretical to Practical Use
Authors: Jaffe Eli 
Published: May 2019

Introduction:Managing an MCI (Mass Casualty Incident) can be a daunting task for emergency responders. Effective management can be a matter of life and death but can be directly impacted by the feelings of the incident commander.Aim:Students were trained to be incident commanders, then following the course were given a survey. In the days following the training, an MCI occurred involving a train full of passengers. The students were then given another survey to assess their readiness following the practical use of their studies.Methods:Students were given a survey to determine their mean level of confidence in managing MCIs prior to training, and following the training. Following the training, there was an increase in confidence. After the training, there was an MCI in which their theoretical knowledge was put to the test.Results:The pre-training self-efficacy mean scores of younger students (M=3.5, SD+0.23) increased after the training (M=3.8, SD+0.28) and rose even more following the presentation of the Turin train accident (M=4, SD+0.26). While a similar increase in self-efficacy was found among the more mature students post-training compared to the level prior to the training (M=3.7, SD+0.44 versus M=3.4, SD+0.56), the mean self-efficacy score of the mature students decreased following the presentation of the Turin train accident to the pre-training level (M=3.4, SD+0.51).Discussion:Mean scores of self-efficacy and confidence in managing MCIs were found to be higher among medical students that were previously trained in coping with MCIs compared to medical students who participated in such a training program for the first time.
A Qualitative Study of Household Emergency Preparedness of the Elderly and the Medically Frail Living in Coastal Urban Environments
Authors: Heagele Tara 
Published: May 2019

Introduction:As more chronically ill people are living in the community and disasters are occurring frequently, the elderly and the medically frail vulnerable populations are experiencing significantly more disaster-related morbidity and mortality than the rest of the population. A failure to adequately address these vulnerabilities has been shown to have negative effects on the response to the disaster and the community as a whole.Aim:The purpose of this research was to understand how older and/or medically frail adults have experienced disaster and how this experience impacts what they do now to prepare for disaster. A second purpose was the generation of theory regarding the process through which community members prepare for disasters.Methods:This study employed a qualitative descriptive methodology, Situational Analysis, to explore the social processes of disaster preparedness in older and/or medically frail adults.Results:The core category was “Experience is the Best Teacher.” Based on the findings, it was theorized that these community members are generally considered unprepared for disaster. Their lack of preparedness is due in large part to a lack of education on how best to prepare. Once educated, motivation for self-responsibility of household emergency preparedness can be expected. Community interventions like distributing disaster supply kits and offering evacuation assistance help overcome their situational impediments to preparedness and provide the best chance for these community members to survive disasters without becoming ill or injured or experiencing a decline in their baseline functional status. If these community members are incidentally prepared, it is largely due to their past experience with disaster or their professional experience.Discussion:The results from this study could inform emergency plans and policy efforts to better meet the needs of elderly and medically frail community members during disaster.
Regional Engagement Program: Supporting Local Leadership and Building Local Skills and Knowledge in Order to Develop a Systematic Approach to Disaster Medical Management
Authors: Vermeulen Lisa , Stephens Dianne 
Published: May 2019

Introduction:One of the key components in any effective disaster response is the capacity of local communities to respond in a timely and efficient manner. Over the last 3 years, the National Critical Care and Trauma Response Centre in Darwin has been involved in building regional capacity across the Asia-Pacific, supporting local leadership and building local skills and knowledge in order to develop a systematic approach to disaster medical management.Aim:This presentation is to describe the Regional Engagement Program, its strengths, weaknesses, and outcomes.Methods:We will describe the background to the program, the process for regional engagement and the Results of our evaluation. The program used the Major Incident Medical Management Systems (MIMMS) approach which was delivered in-country and included identifying and using local personnel to deliver the program. The program was conducted across the region in Myanmar, Fiji, Tonga, Vanuatu, Samoa, Timor, and Indonesia. Initially the courses were run by personnel from Australia but through engagement with local Ministries of Health and collaboration with identified key stakeholders, we have been able to build local faculty to ensure sustainability and local ownership.Results:Thirty-six personnel have been trained across four countries. Thirty-six candidates are now instructors, with a further 36 identified for future development as instructors. The evaluation illustrates the long-term partnerships that have been developed and the ongoing capacity development of key regional partners.Discussion:The Regional Engagement program demonstrates that prolonged engagement with key regional stakeholders and adequate and sustained mentoring will successfully build local capacity to the level needed to mount a successful response to a disaster. Personnel trained through this program helped guide the response to the Lombok earthquake and in Fiji, a MIMMS Team Member training program was conducted with minimal external support.