bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hurricane Sandy - Initial Evaluation of Patient Characteristics
Authors: Rosenthal Marc , Dunne Robert 
Published: May 2019

Introduction:Disaster medical team response by governmental and non-governmental responders is highly variable and poorly characterized. Each response is unique in terms of caseload, patient demographics, and medical needs encountered. This variability increases the difficulty of determining team member composition as well as supply and equipment needs. In an effort to demonstrate this issue, we have reviewed the National Disaster Medical Response to Hurricane Sandy.Methods:This project was a retrospective chart review of Hurricane Sandy data abstracted from the National Disaster Medical System (NDMS) Health Information Repository (HIR) medical records from the NDMS system response, and were abstracted for data including vital signs, ages, sex, chief complaint, and final impressions. In addition, length of stay among other parameters was abstracted. The data was analyzed using Microsoft Excel and Access with descriptive statistics. In addition, the results were compared to similar indices in a community emergency department and prior NDMS responses.Results:The results indicate a wide range of patient ages, chief complaints, and final impressions. The vast majority of patients seen by Disaster Medical Assistance Teams (DMAT) were stable with relatively low acuity issues. The total number of charts reviewed were 7,905. Respiratory complaints were the most frequent at 845 patients followed by toxicology/injuries at 706 patients and mental health issues at 452 patients. In approximately 3,400 patients, no diagnosis was present in the chart. Length of stay averaged below 1 hour and peak patient ages were between 50-60 with a significant number of infants less than 2 years.Discussion:Characterization of NDMS responses by DMATs and comparison with prior events and community emergency department caseloads can provide an insight into the needs of DMATs and other response organizations in future responses.
Level of Emergency Preparedness Before and After a False Missile Alert in Hawaii
Authors: Qureshi Kristine , Glauberman Gary , Bray Michele , Gershon Robyn , Zhi Qi , Chen John , Choi So-Yung 
Published: May 2019

Introduction:On January 13, 2018, a false ballistic missile alert that lasted 38 minutes was issued across Oahu, Hawaii, United States. As a result of a system failure, an erroneous text message was sent that stated, “Ballistic missile threat inbound to Hawaii. Seek immediate shelter.”Aim:The research team wanted to know the degree of reported anxiety triggered by the event and if knowledge, attitudes, or behaviors for individual/family emergency preparedness (EP) changed post-event.Methods:A 50-question survey that asked about individual and family EP pre- and post-event, and the level of anxiety triggered by the event, was administered to a convenience sample of full-time adult residents of Oahu. The study was conducted over a 6-8 week period post-event. Statistical analysis was used to identify factors associated with an increasing level of EP post-event and reported event-triggered anxiety.Results:209 participants completed the survey (29% male, 71% female) with about one half living with children. One third were essential workers. Key factors that correlate with increasing various areas of EP post-event include higher educational, receipt of electronic emergency alerts, prior emergency training, and higher reported connectedness to community. Those with higher event anxiety were more likely to develop and practice an EP plan post-event, encourage EP with friends, and report a higher level of community connectedness. The elderly were more likely to have higher levels of EP before and after the event but were less likely to receive emergency alert notifications or have EP training.Discussion:While the event was very unfortunate, it did seem to stimulate citizen disaster EP among some groups. Additional research should explore the utility of increasing EP education for communities immediately after disasters, tailoring this education for groups, and targeting the elderly for participation in the emergency alert system.
Victorian Compendium of Community-Based Resilience Building Case Studies - Critical Success Factors Help Communities Strengthen Resilience to Disasters
Authors: Spencer Caroline , Cross Suzanne , McArdle Dudley , Archer Frank 
Published: May 2019

Introduction:Global conversations emphasize strengthening communities’ resilience to disasters. These conversations inspired the Victorian Compendium of Community-Based Resilience Building Case Studies. The Compendium motivates community members to build expertise, reduce program duplication, and save valuable resources. Case study analysis identified critical success factors. Between 2012 and 2018, community groups completed an Expression of Interest to present at the MUDRI Advancing Community Resilience Forums, which provided an opportunity to impart resilience activities and knowledge. It also solved challenges and shared unforeseen learning. Over six years, 72 groups presented. Subsequently, 35 submitted their activity for consideration into the Compendium. Of these 35, 30 were included.Aim:This updated research analyses critical success factors of 30 case studies. Success factors support the key tenet of the Victorian Compendium of Community-Based Resilience Building Case Studies: to promote the sharing of achievable, practical resilience building activities. The online Compendium provides free access for all communities to explore activities before, during, and after disasters.Methods:A thematic analysis identified critical success factors of 30 Compendium case studies.Results:Case studies revealed unique and valuable learning in diverse settings. The critical success factors included: (1) strong governance, Board support, leadership and trust; (2) partnerships; (3) commitment, adaptability, and stamina; and (4) community-based initiatives. Other success factors included a paid facilitator and local government support, stamina, and celebrating success.Discussion:The Compendium represents an Australian first and offers an innovative contribution to resilience practice and research. It enhances other Victorian initiatives such as the Rockefeller funded Resilient Melbourne Strategy, which incorporates the Compendium to bring people together from across sectors to deliver distinct, yet connected actions to strengthen resilience. The Compendium enables diverse communities to adopt or adapt proven resilience activities, thereby preserving valuable resources. It offers the opportunity to extend to a national or international Compendium.
Youth Participation in Post-Terrorist Attack Recovery: A Case Study in Southern Philippines
Authors: Ferolin Maria Cecilia , Fernandez Glenn 
Published: May 2019

Introduction:In the southern Philippines, human-induced disasters, such as terrorist attacks, have caused unprecedented damage to the economic, social, and political life of the attacked and nearby areas. More gruesome is the direct impacts to human life and wellbeing. This study focuses on the 2017 Marawi armed siege, the longest urban battle in the Philippines. The 154-day siege took a heavy toll, including 1,132 deaths among militants, soldiers, police, and civilians, and caused the displacement of some 400,000 local inhabitants. The city is in total ruins leaving its economic center as “Ground 0.” The aftermath of the siege demands major interventions to address physical and economic damages, but more importantly, to ameliorate the human impacts caused by the brutalities of war. The displaced peoples need to recover from health impacts – psychological trauma, as well as social, environmental, and cultural. The Sendai Framework for Disaster Risk Reduction (DRR) 2015-2030 states that DRR requires society-wide engagement. Everyone, regardless of their age, gender, ethnicity, religion, or socio-economic position, should be involved in thinking, planning, and deciding about DRR. Studies on youth participation in disaster recovery are still scarce.Aim:This current research aims to help fill this gap and to contribute to providing the much-needed evidence base for the formulation and implementation of future policies to enable and improve youth participation in post-disaster initiatives in the Philippines.Results:Initial findings reveal that the following are crucial factors for youth mobilization: (1.) avenues for volunteering, (2.) access to adequate resources and support including information, funds, manpower, and social capital, (3.) opportunities for the youth to participate in the form of events or activities, (4.) legal mandate for youth participation in local, national, and international policies and frameworks. The study also looked at barriers or challenges to youth participation and their motivations.
A State of Biopreparedness
Authors: Varshney Kavita , Friend Caren , Bag Shopna , Murphy Margaret , Dempsey Kathy , Clark Penelope , Ferguson Patricia 
Published: May 2019

Introduction:Westmead Hospital (WMH) recognized gaps in its preparedness to respond to the Ebola 2014 outbreak in West Africa. A fragmented system was identified. A ‘State of Bio-preparedness’ project team convened to discuss all healthcare services in the planning, training, and implementation of a biopreparedness response.Methods:A survey targeting the staff’s competence and confidence in biologically hazardous infection management was conducted. Semi-structured interviews explored staff members’ experiences and perspectives of biopreparedness response. The collaborative team called “State of Biopreparedness” (SOB) was assembled and a clinical practice improvement project was undertaken. To assess readiness, nine simulated Viral Haemorrhagic Fever (VHF) exercises involving staff and consumers were conducted. These exercises were debriefed by the multidisciplinary committee and themes and issues were identified. These nine simulation drills then assessed readiness and evaluated performance.Results:A number of consistent issues continue to emerge including:
1.A standard communication pathway for notification was needed - use of the incident paging system (111 pages) to notify the hospital’s incident management team.2.A consistent and coordinated approach to the training and maintenance of standardized and high-level Personal Protective Equipment (PPE) protocols for frontline clinical and clinical staff was required.3.Clear delineation of roles and responsibilities and supporting these roles by translating the VHF Control Guideline and policy into task cards and checklists.4.Strengthening intra- and interdepartmental staff collaboration and communication.5.Infection control measures to be taken by staff after identifying a patient with possible VHF to reduce the risk of transmission of disease to staff, other patients, and visitors.Discussion:Integrating disaster management processes with clinical protocols had a positive impact on the hospital’s biopreparedness response. Simulation exercises were a vital and practical way for staff to feel confident and competent to perform their roles.
Disaster Medicine for India & Nepal: A Model for Developing Countries
Authors: Patel Peter , Kingsland James , Murray Virginia , O’Brien James , Sen Annapurna , Ramakrishnan T , Thangalvadi Tausif , Russell Robert 
Published: May 2019

Introduction:Both India and Nepal are prone to a wide range of natural and man-made disasters. Almost 85% of India’s area is vulnerable to one or more hazards, and more than 80% of the total population of Nepal is at risk of natural hazards. In terms of the number of people affected in reported disastrous events, India is in the top 10 and Nepal is in the top 20 globally. Over the last two decades, India and Nepal have taken steps to establish their respective National Disaster Management organizations, which provide essential disaster responses. However, key gaps still remain in trained clinical capacity for managing impacts from various disasters. Our review of the region has shown that large parts of the population suffer injuries, diseases, disabilities, psychosocial, and other health-related problems from disasters.Aim:Develop disaster medicine clinical capacity to reduce morbidities and mortalities from disasters.Methods:Independent published data and work undertaken by the lead author in various disasters in India and Nepal since 1993 formed the basis of establishing the Faculty of Disaster Medicine for South Asia. The Faculty of Disaster Medicine - India and Nepal (FDMIN) was launched from Pune in March 2015. This initiative is supported by the National Association of Primary Care (UK), Public Health England, Faculty of Pre-hospital Care of Royal College of Surgeons - Edinburgh and CRIMEDIM (Novara) - Italy.Discussion:FDMIN has international expert advisors and has outlined 16 modules training curriculum for health care professionals. FDMIN currently has partnerships for teaching disaster medicine program with 3 medical universities and 12 major health care providers. Six pilot training programmes have been conducted in Pune, Delhi, Chennai, and Kochin. Work is underway to submit an application to the Indian regulatory bodies for approval to establish a post-graduate diploma and Master’s for Disaster Medicine.
Seven First Minutes - Community Emergency Response Training
Authors: Herbst Raphael , Jaffe Eli 
Published: May 2019

Introduction:Following a mass casualty incident (MCI), it can take several minutes for emergency medical services (EMS) to arrive. The course was developed by Magen David Adom (MDA) based on unique experience in dealing with MCIs, and the time between alerting emergency services to such an incident until they arrive. The course is focused on teaching the general public to channel their desire to help in such a situation into useful skills which can potentially improve patient outcomes. The seminar focuses on key principles such as safety, calling for help, providing an accurate picture of the scene, and initiating basic treatment with an emphasis on hemorrhage control.Aim:MDA examined the ability of the general public with no previous medical training to perform a basic triage and treatment in an MCI situation. Additionally, the study examined the abilities of the study groups to manage a scene until the arrival of EMS based on the principles taught in the course.Methods:MDA has sent teams of instructors around the world to teach over 1,000 participants. Upon completing the course, the participants partake in a drill that assesses their ability to manage a scene of 20 patients. Their ability to initiate the call for help, provide an accurate picture, initiate treatment, and give an accurate report to arriving emergency responders are examined.Results:The average times were recorded. Within 38 seconds, dispatch was alerted to the situation. Within 2:30 minutes, treatment was initiated for all patients. Within 4:37 minutes, the scene was fully under control, and within 6:37 minutes, an accurate report was transferred to EMS on the scene.Discussion:The participants demonstrated an unexpected willingness to learn, practice, and partake in the drills, and the results were unexpected.
A Surprise Mass Casualty Incident Simulation: Does It Improve Knowledge or Is It Just a Bit of Fun?
Authors: Mitchell Brad , Hammad Karen , Aldwin Dana 
Published: May 2019

Introduction:We opened a national conference in Australia with a surprise mass casualty simulation scenario of a van versus multiple persons outside the conference venue. The purpose of this exercise was to increase awareness of, and preparation for, mass casualty incident (MCI) events for the conference delegates who were paramedics, emergency department nurses, and doctors.Aim:The aim of the research is to understand whether a surprise MCI simulation is a useful way to increase knowledge and motivate preparedness.Methods:A survey hosted on Qualtrics was circulated to delegates via email. The survey was designed by the research team and had 38 questions about demographics and respondents’ experience with MCIs, as well as their perceptions of the simulation exercise. The questions were a mixture of 5-point Likert scales, multiple choice, and short answers.Results:The majority of respondents were clinicians (n = 66, 76%) and those who worked in emergency departments or the prehospital setting (n = 75, 86%). While the majority had not responded to an MCI in the past 5 years (n = 67, 77%), more than half (n = 50, 57%) had undertaken MCI training during this time. Overall, a vast majority of respondents found the simulation to be a worthwhile exercise that increased knowledge and preparedness. An overwhelming majority also reported that the simulation was relevant to practice, of high quality, and a useful way to teach about major incidents.Discussion:Our surprise major incident simulation was a fun and effective way to raise awareness and increase knowledge in prehospital and emergency department clinicians about MCI response. This approach to simulation can be easily replicated at relatively low cost and is, therefore, a useful solution to training a group of multidisciplinary health professionals outside of the workplace.
Exploring the Ethical Dimensions of All-Hazards Public Health Emergency Preparedness in Canada
Authors: Caturay Alexa , O’Sullivan Tracey , Gibson Jennifer , Thompson Alison , Khan Yasmin 
Published: May 2019

Introduction:With increasing disaster risks from extreme weather, climate change, and emerging infectious diseases, the public health system plays a crucial role in community health protection. The disproportionate impacts of disaster risks demonstrate the need to consider ethics and values in public health emergency preparedness (PHEP) activities. Established PHEP frameworks from many countries do not integrate ethics into operational approaches.Aim:To explore the ethical dimensions of all-hazards public health emergency preparedness in Canada.Methods:A qualitative study design was employed to explore key questions relating to PHEP. Six focus groups, using the Structured Interview Matrix (SIM) format, were held across Canada with 130 experts from local, provincial, or federal levels, with an emphasis on local/regional public health. An inductive approach to content analysis was used to develop emergent themes, and iteratively examined based on the literature. This paper presents analyses examining the dimensions of ethics and values that emerged from the focus group discussions.Results:Thematic analysis resulted in the identification of four themes. The themes highlight the importance of proactive consideration of values in PHEP planning: challenges in balancing competing priorities, the need for transparency around decision-making, and consideration for how emergencies impact both individuals and communities.Discussion:Lack of consideration for the ethical dimensions of PHEP in operational frameworks can have important implications for communities. If decisions are made ad-hoc during an evolving emergency situation, the ethical implications may increase the risk for some populations, and lead to compromised trust in the PHEP system. The key findings from this study may be useful in influencing PHEP practice and policy to incorporate fairness and values at the core of PHEP to ensure readiness for emergencies with community health impacts.
University of Adelaide Higher Degree by Research Program Supported by an Australian Government Research Training Program Scholarship
Authors: Filmer Leighton 
Published: May 2019

Introduction:Collaboration between Foreign Medical Teams (FMT) and Host Health Personnel (HHP) is a core standard for healthcare in a medical response to disaster,1 but descriptions of its application from recipient nation HHP are rare. This paper details the findings from a qualitative study on the experience of collaboration between International Foreign Teams (IMT) and HHP in Gorkha, Nepal since the 2015 earthquake.Aim:To present findings from a study that explored the experience of collaboration by Nepal health workers working with IMT since the 2015 earthquake.Methods:A qualitative study design using semi-structured interviews regarding the experiences and perspectives on collaboration of 12 Nepali health workers was used. The interviews were transcribed, translated, and collated using Nvivo software by QSR international, and themes regarding collaboration were identified.Results:Data collection is not yet complete. However, preliminary results from early analysis indicate that collaborative practice is not uniformly applied by IMT. HHP Satisfaction with IMT appears highly dependent on collaboration. Emerging themes are that rigid organizational procedures, language and cultural barriers, and intimidating leadership inhibit collaboration. Objectives were assumed to align immediately post-disaster, with evidence of objectives increasingly diverging over time. IMT leadership that was experienced, responsive to suggestions, and regularly involved HHP in planning, implementing, and reviewing activities were highly appreciated.Discussion:Emerging themes indicate the time-critical nature of many disasters, along with cultural/institutional/administrative barriers, make the building of collaborative relationships difficult despite being foundational for successful missions. Participants in IMT must proactively involve HHP in the objectives setting, planning, implementation, and reviewing of activities. Successful IMT participation is not only clinically competent but actively seeks collaborative relationships with HHP throughout the mission.
Towards a Taxonomy of Workplace “Pressure” in Complex, Volatile, and Emergency Situations
Authors: Calahorrano Alicia Zavala , Plummer David , Day Gary 
Published: May 2019

Introduction:Pressure in the workplace has been studied in a number of settings. Many studies have examined pressure from physiological and psychological perspectives, mainly through studies on stress. Performing under pressure is a fundamentally important workplace issue, not least for complex, volatile, and emergency situations.Aim:This research aims to better understand performance under pressure as experienced by health and emergency staff in the workplace.Methods:Three basic questions underpin the work: (1) how do health and emergency workers experience and make sense of the ‘pressures’ entailed in their jobs? (2) What impacts do these pressures have on their working lives and work performance, both positively and negatively? (3) Can we develop a useful explanatory model for ‘working under pressure’ in complex, volatile, and emergency situations?The present paper addresses the first question regarding the nature of pressure; a subsequent paper will address the question of its impact on performance. Using detailed interviews with workers in a range of roles and from diverse settings across Ecuador, this study set out to better understand the genesis of pressure, how people respond to it, and to gain insights into managing it more effectively, especially with a view to reducing workplace errors and staff burnout. Rather than imposing preformulated definitions of either ‘pressure’ or ‘performance,’ we took an emic approach to gain a fresh understanding of how workers themselves experience, describe and make sense of workplace pressure.Results:This paper catalogs a wide range of pressures as experienced by our participants and maps relationships between them.Discussion:We argue that while individuals are often held responsible for workplace errors, both ‘pressure’ and ‘performance’ are multifactorial, involving individuals, teams, case complexity, expertise, and organizational systems, and these must be taken into account in order to gain better understandings of performing under pressure.