bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Health Challenges of South Asian Women at the Evacuation Centers after Disasters
Authors: Chowdhury Tazrina , Arbon Paul , Steenkamp Malinda , Kako Mayumi , Gebbie Kristine 
Published: May 2019

Introduction:Globally, women are considered to be more vulnerable during disasters. South Asia including India, Pakistan, Bangladesh, Sri Lanka, Myanmar, and Nepal experience many disasters, and are also ranked lowest on the gender equality index. Women of these countries tend to face many health challenges while staying at evacuation centers after disasters.Aim:This study highlights the health challenges South Asian women face while staying in evacuation centers after disasters.Methods:A narrative review was conducted using the keywords, “women after disaster,” “evacuation centers,” and “emergency health care.” Literature identified from the references were also added until reaching saturation. 47 articles were obtained through Elsevier, Google Scholar, Scopus, and ProQuest.Results:Women in shelters in South Asian countries experienced many health challenges including genito-urinary tract infections (studies from India, Sri Lanka and Bangladesh), increased maternal mortality (Nepal and Pakistan), and sexual assault with resulting unwanted pregnancies and sexually transmitted diseases, including HIV (Nepal). Factors that contributed were the unavailability of separate toilets, inadequate sanitation, lack of sanitary supplies, and inadequate childbirth and maternity care resources. Rape victims at the shelters of Myanmar received delayed medical treatments, causing long-term health complications. Post-disaster stress and trauma were evident among women at the shelters initiated by insecurity, fear of abuse, and unfair relief distribution.Discussion:Women face certain challenges when staying in evacuation shelters in South Asian countries, which impacts their wellbeing after disasters. It is important to recognize women’s special requirements and to preserve women’s rights while developing disaster preparedness strategies. Socio-cultural perspectives of the disaster-prone areas should be considered at the policy planning level to ensure an effective and practical health-safety system. Additionally, further research focusing on women’s wellbeing at the evacuation centers is required to inform and overcome health challenges faced by women living in the shelters.
The Health Impacts of Toxic Remnants of War on Civilian Populations: A Scoping Review
Authors: Durham Jo , Pizzino Stacey 
Published: May 2019

Introduction:An estimated two billion people are currently affected by war, with civilian populations increasingly exposed to the hazards of armed conflict. While the effect of explosive remnants of conflict is well documented, the impacts of the toxic remnants of war on civilian health are less well understood.Methods:This study was a scoping review examining the human health impacts of exposure to toxic remnants of war. Toxic remnants of war refer to any toxic or radiological substances arising from military activities. In this study, however, the focus was limited to the health effects of exposure to toxic substances and explosive by-products from munitions fired, dropped, or abandoned during conflict. The following databases were searched: Embase PubMed, Scopus, and Web of Science. The Mixed Methods Appraisal Tool (MMAT) was used to assess the methodological quality of studies that met the inclusion criteria.Results:Common toxicants reported on were Tetrachlorodibenzo-p-dioxin TCDD, white phosphorus, depleted uranium, lead, mercury, and sulfur mustard. Common health effects included respiratory diseases as well as cutaneous, cardiovascular, reproductive, and congenital effects. Posttraumatic stress disorder, depression, anxiety, cognitive impairments, and decreased quality of life were also commonly reported. The evidence base, however, is mixed with heterogeneity in study design and outcome measures. Lack of baseline data and inadequate exposure models make establishing an adverse causal relationship between an agent and a disease challenging.Discussion:Civilian exposures to toxic remnants of conflict remain understudied and under-addressed. The study suggests assessment of the human health impacts of toxicants should be part of a post-conflict response, especially given the potential long-term intergenerational effects. The current lack of recognition of the human health impacts of toxic remnants of conflict also limits the amount of global resources assigned to post-conflict decontamination.
The Impact on Local Emergency Departments During a “Schoolies Week” Youth Mass Gathering
Authors: Crilly Julia , Ranse Jamie , Bost Nerolie , Donnelly Tonya , Timms Jo , Gilmour Kate , Aitken Michael , Johnston Amy 
Published: May 2019

Introduction:Community-based strategies designed to minimize the impact on local emergency services during mass gathering events (MGEs) require evaluation to provide evidence to inform best practice.Aim:This study aimed to describe characteristics and outcomes for people aged 16-18 years requiring emergency care before, during, and after a planned youth MGE “Schoolies week” on the Gold Coast, Australia.Methods:A retrospective observational study was undertaken. Presentations from all young adults to the emergency department (ED) or In-Event Health Service (IEHS) over a 21-day period in 2014 were included. Descriptive and inferential analyses were performed to compare across time and to describe characteristics of and outcomes for young adults requiring healthcare.Results:A total of 1029 presentations were made by youth aged 16 – 18 to the ED and IEHS over the study period (ED: 139 pre, 275 during, and 195 post; IEHS: 420 during). Patient characteristics and outcomes to the ED that varied significantly between pre, during, and post Schoolies periods included patient’s age (higher proportion of 17-year-olds), residing outside the Gold Coast region, and not waiting for treatment. All were higher during Schoolies week. Of the 24,375 MGE attendees, 420 (1.72% [95% CI, 1.57 – 1.89], 17.2/1,000) presented to the IEHS. The majority were toxicology related (n=169, 44.9%). Transportation to hospital rate was low (0.03% [95% CI, 0.01 – 0.06], 0.3/1,000) for the 24,375 MGE attendees.Discussion:Findings from this study support previous research indicating that MGEs can impact local emergency healthcare services. The provision of the IEHS may have limited this impact. The recipients of care delivery, predominantly males with trauma- or toxicology-related problems, warrants further investigation. Research describing the structures and processes of the IEHC could further inform health care delivery in and out of hospital settings.
Proposing a Minimum Data Set for Mass Gathering Health
Authors: Steenkamp Malinda , Arbon Paul , Lund Adam , Turris Sheila , Ranse Jamie , Hutton Alison , Munn Brendan , Bowles Ron 
Published: May 2019

Introduction:There is currently no standardized approach to collecting mass gathering health data, which makes comparisons across or between events challenging. From 2013 onward, an international team of researchers from Australia and Canada collaborated to develop a Minimum Data Set (MDS) for Mass Gathering Health (MGH).Aim:The process of developing the MDS has been reported on previously at the 2015 and 2017 World Congresses on Disaster and Emergency Medicine, and this presentation will present a final MDS on MGH.Methods:This study drew from literature, including the 2015 Public Health for Mass Gatherings key considerations, previous event/patient registry development, expert input, and the results of the team’s work. The authors developed an MDS framework with the aim to create an online MGH data repository. The framework was populated with an initial list of data elements using a modified Delphi technique.Results:The MDS includes the 41 data elements in the following domains: community characteristics, event characteristics, venue characteristics, crowd characteristics, event safety considerations, public health considerations, and health services. Also included are definitions and preliminary metadata.Discussion:The development of an MGH-MDS can grow the science underpinning this emerging field. Future input from the international community is essential to ensure that the proposed MDS is fit-for-purpose, i.e., systematic, comprehensive, and rigorous, while remaining fluid and relevant for various users and contexts.
The Sun Herald Sydney City-2-Surf Fun Run: Historical Injury Patterns and Development of a Predictive Model to Inform Health Service Planning
Authors: Heslop David , Vassil John , Winn Linda 
Published: May 2019

Introduction:The Sydney City-2-Surf is the world’s largest annual run entered by around 80,000 people. First aid planning at mass participation running events such as the City-2-Surf is an area in the medical literature that has received little attention. Consequently, first aid planning for these events is based on experience rather than evidence. The models for predicting casualties that currently exist in the literature are either dated or not statistically significant.Aim:The aim of this study was to characterize patterns of injuries linked to geographic location across the course of the City-2-Surf, and to explore relationships of injury types with location and meteorological conditions.Methods:Records for formally treated casualties and meteorological conditions were obtained for the race years 2010-2016 and statistically analyzed to find associations between meteorological conditions, geographic conditions, casualty types, and location.Results:The most common casualties encountered were heat exhaustion or hyperthermia (39.2%), musculoskeletal (25.4%), and physical exhaustion (10.2%). Associations were found between gradient and the location. Type of casualty incidence with the individual distribution trends of casualty types were quite clear. Clusters of musculoskeletal casualties emerged in the parts of the course with the steepest negative gradients, while a cluster of cardiovascular events was found to occur at the top of the ‘heartbreak hill,’ the longest climb of the race. Regression analysis highlighted the linear relationship between the number of heat and physical exhaustion casualties and the apparent temperature (AT) at 12pm (R²= 0.59, P=0.044). This linear equation was used to formulate a model to predict these casualties.Discussion:The findings of this study demonstrate the relationship between meteorological conditions, geographic conditions, and casualties. This will assist planners of other similar events to determine optimum allocation of resources to anticipated injury and illness burden.
Typhoon Preparedness Measures of the Hong Kong Public for Typhoon Mangkhut
Authors: Yeung Tiffany , Lam Eva CC 
Published: May 2019

Introduction:Climate change has brought more extreme weather events to Hong Kong. The increasing number of powerful tropical cyclones that hammered Hong Kong in recent years reminded the territory to review typhoon preparedness of the community.Aim:Typhoon Mangkhut slammed Hong Kong in September 2018 and caused significant devastation. Three weeks after the devastation, the Hong Kong Jockey Club Disaster Preparedness and Response Institute commissioned the Public Opinion Programme at The University of Hong Kong to conduct a survey to understand the general Hong Kong public’s typhoon preparedness measures and their information seeking behaviors.Methods:A cross-sectional population-based anonymous telephone survey was conducted on a random sample of 1,018 Cantonese-speaking adults aged 18 or above.Results:The most common typhoon preparedness measures were taping windows (45%), followed by food stockpiling (18%), and closing of doors/windows (10%). Only 2% and 1% of the respondents were prepared for water and power outage, respectively. 36% of the respondents did not take any precautionary measures. 29% sought typhoon precautionary measures information from the mass media and 31% of respondents relied on their previous experience. Other sources of information included government sources (7%) and social media (7%).Discussion:Though no death cases were reported related to Typhoon Mangkhut, the effect of the superstorm caused over 300 casualties, blocked roads, and transportation chaos caused by fallen trees and other debris, power and water outage, serious floods, and severely damaged public and private facilities. Around 40,000 households experienced a power outage and some residential estates were left without water. The survey revealed the lack of precautionary measures of the Hong Kong public for power and water outage. More education on typhoon preparedness, especially on power and water outage and more community-level support on localized disaster preparedness advice, would likely improve disaster preparedness for the Hong Kong public.
Mapping the Disaster Competency Landscape in Undergraduate Nursing - A Case Study of Nursing Educators in British Columbia, Canada
Authors: Mckenzie Wendy 
Published: May 2019

Introduction:In British Columbia (BC), Canada, it is increasingly commonplace for communities to experience yearly disaster events such as floods, forest fires, avalanches, and mudslides. Nurses are known to be one of the largest groups of healthcare workers and are often challenged to care for members of the public during these events. Many nurses have stated that they do not have enough education to provide quality care in a disaster role, as they received no education in their undergraduate nursing degrees.Aim:The aim of this study was to explore how and what nurse educators are teaching undergraduate nursing students regarding the disaster nursing role within Schools of Nursing in BC, Canada. Understanding the current practice of teaching will serve as a starting point for shaping future best practice undergraduate nursing disaster educational frameworks.Methods:This study used a qualitative case study methodology guided by Merriam’s procedural approach with a theoretical framework of adult teaching and learning.Results:The findings indicate that disaster nursing knowledge is taught either within existing global health courses or rarely is leveled throughout the program. Many challenges exist for educators, which include lack of current resources, workload restrictions, and lack of personal disaster knowledge. Content is determined by the educator. However, there is no specific model or link to disaster nursing competencies or assessment strategies. Most content is delivered didactically by the educator with some expert guest speakers or collaborative simulation events.Discussion:The identified priority challenge is to obtain clarity and understanding around just what knowledge is required and how it should be evaluated. Some suggestions for a specific undergraduate disaster nursing model will be presented in order to ensure that students have the foundational knowledge that they require and that our educators are prepared to teach them.
A Primary Care Role in Building Local Capacity Following Volcanic Activity in Vanuatu
Authors: Lyon Alison 
Published: May 2019

Introduction:Vanuatu is situated in the Pacific Ring of Fire. In July 2018, there was increased volcanic activity on Ambae, an island with a population of 11,000 people. Due to the destruction of food sources, contamination of water supply, and respiratory issues caused by ash fall, an immediate compulsory evacuation was ordered by the government.Aim:To describe the role of the primary care team response to urgent and ongoing healthcare needs of evacuees following volcanic activity.Methods:A non-governmental organization (NGO) primary care team of a general practitioner, nurse practitioner, and two healthcare assistants undertook the initial assessment of a group of newly arrived evacuees. This allowed the identification and management of urgent care needs. Over the subsequent weeks, the primary care clinic provided care to the evacuees. A prospective database of anonymized case files was undertaken to monitor evolving primary healthcare needs of the evacuees.Results:Twenty-five patients were assessed initially. Two patients required urgent transfer to a hospital for acute management. Six diabetic patients required medication supplies. There were eight hypertensive patients. Two patients required urgent BP reduction and four required medication supplies. Over the following two weeks, 104 patients were reviewed at the clinic. During this time, 45 patients were treated for respiratory tract infections. Medication supplies were replenished for antihypertensives and diabetic medications for seven patients. Opportunistic cardiovascular and diabetes risk reviews were performed and follow up arranged for nine patients.Discussion:The primary care team role was part of a local services collaborative approach initiated by the government. Involving local primary care clinicians in disaster management builds local capacity. Patients are able to receive continuity of care for acute and ongoing medical problems. Clinicians are able to evaluate evolving care needs and gain an improved understanding of the impact of displacement on the community.
Using Geographic Information System Analysis to Understand West Virginia’s Growing Opioid-Overdose Epidemic - What Are We Missing?
Authors: Rihter Sasha , Menke Nathan 
Published: May 2019

Introduction:The opioid epidemic is overwhelming communities across the United States. West Virginia (WV) has been devastated, heralding a 86% increase in deaths from 2012-2016, and over 1,000 deaths last year as per WV Health Statistics Center. Treatment centers and providers have emerged throughout the state to provide medication-assisted treatment (MAT). The impact of these clinics on the opioid abusing population is not yet fully understood.Aim:Utilizing Geographic Information System (GIS), a comparison of MAT provider locations versus regions of historical overdoses can indicate areas of deficiency. If no providers emerge in underserved counties, overdose deaths in those areas will continue to rise.Methods:Maps were created using current DEA-X licenses in WV registered through Substance Abuse and Mental Health Services Administration (SAHMSA). Overdose death rates were taken from WV Public Health Records from 2010-2017. Two maps and corresponding data were compared for overlap or lack thereof.Results:Of the 338 locations of DEA-X licenses registered, 17.5% are in Cabell County, which led the state in overdose deaths in 2017. Only 2.5% of the total providers are currently in Wayne County, which had the second highest overdose death rate. Berkeley County, which was 3rd highest, has a mere 6.5% of total providers. Comparatively, Kanawah County, home to the state’s capital, has over twice this number of providers despite consistently having at or below the state average of overdose rates. Resources are pulled towards population-dense areas or university centers, where the epidemic is present but misses counties with higher overdose rates.Discussion:Results show a lack of MAT providers in many of WV’s devastated counties. Treatment centers exist throughout the state but are concentrated in regions with large cities or academic centers. This distribution limits accessibility to a marginalized patient population, making improvements unlikely in WV’s future opioid-overdose death rates.
Development and Implementation of First Hospital-Based Epidemic Outbreak Management Plan: Lessons Learned from Nepal
Authors: Shrestha Ashis , Khouli Michael , Bajracharya Sumana , House Rose , Mugele Joshua 
Published: May 2019

Introduction:Patan Hospital, located in Kathmandu Valley, Nepal is a 400-bed hospital that has a long history of responding to natural disasters. Hospital personnel have worked with the Ministry of Health (MOH) and the World Health Organization (WHO) to develop standardized disaster response plans that were implemented in multiple hospital systems after the earthquake of 2015. These plans focused primarily on traumatic events but did not account for epidemics despite the prevalence of infectious diseases in Nepal.Aim:To develop and test a robust epidemic/pandemic response plan at Patan Hospital in Kathmandu that would be generalizable to other hospitals nationwide.Methods:Using the existing disaster plan in conjunction with public health and disaster medicine experts,we developed an epidemic response plan focusing on communication and coordination (between the hospital and MOH, among hospital administration and staff), logistics and supplies including personal protective equipment (PPE), and personnel and hospital incident command (IC) training. After development, we tested the plan using a high-fidelity, real-time simulation across the entire hospital and the hospital IC using actors and in conjunction with the MOH and WHO. We adjusted the plan based on lessons learned from this exercise.Results:Lessons learned from the high-fidelity simulation included the following: uncovering patient flow issues to avoid contamination/infection; layout issues with the isolation area, specifically accounting for donning/doffing of PPE; more sustained duration of response compared to a natural disaster with implications for staffing and supplies; communication difficulties unique to epidemics; need for national and regional surveillance and inter-facility planning and communication. We adjusted our plan accordingly and created a generalizable plan that can be deployed at an inter-facility and national level.Discussion:We learned that this process is feasible in resource-poor hospital systems. Challenges discovered in this process can lead to better national and system-wide preparedness.
Are There Adequate Policies and Programmes in Place to Protect Infants and Young Children During Emergencies?
Authors: Dale Tracey , Hansson Foster 
Published: May 2019

Introduction:In emergencies, infants and young children are disproportionately affected due to specific food and fluid requirements, immature immune system, susceptibility to dehydration, and dependence on others. Provision of safe food and water to infants and young children is critical. However, it is challenging in the emergency context. Specific planning is vital to support infant and young child feeding in emergencies (IYCF-E).Aim:To identify the extent to which Australian emergency management plans and guidance account for the needs of infants and young children.Methods:An audit of Australian emergency management plans and guidance was conducted as a part of the 2018 World Breastfeeding Trends Initiative assessment of Australian infant feeding policies. All national and state/territory emergency preparedness plans, and a sample of local government area preparedness plans, response plans, and other guidance were identified and searched for content related to the needs of infants and young children. Plans and guidance were searched for content related to the needs of animals as a comparison.Results:Vulnerability of infants and young children was commonly noted. However, content related to supporting the specific needs of infants and young children through appropriate IYCF-E was almost totally absent. In some cases, the guidance that did exist was misleading or dangerous. No agency at the federal, state/territory, or local government level was identified as having met the responsibility for ensuring the needs of infants and young children. The absence of any coordinated response for the needs of infants and young children is in stark contrast to consideration of animal needs, which have a delegated authority, plans, and guidance at all levels of government.Discussion:Planning for the needs of infants and young children in emergencies in Australia is dangerously inadequate. Action should be taken to ensure that appropriate plans exist at all levels of government.