bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Evaluation of the Self-Reported Knowledge Base of Disaster Management Core Competencies of Australian Paramedics
Authors: Horrocks Peter , Tippett Vivienne , Aitken Peter 
Published: May 2019

Introduction:Evidence-based training and curriculum are seen as vital in order to be successful in preparing paramedics for an effective disaster response. The creation of broadly recognized standard core competencies to support the development of disaster response education and training courses for general health care providers and specific health care professionals will help to ensure that medical personnel are truly prepared to care for victims of mass casualty events.Aim:To identify current Australian operational paramedic’s specific disaster management education and knowledge as it relates to disaster management core competencies identified throughout the literature and the frequency of measures/techniques which these paramedics use to maintain competency and currency.Methods:Paramedics from all states of Australia were invited to complete an anonymous online survey. Two professional bodies distributed the survey via social media and a major ambulance service was surveyed via email.Results:The study population includes 130 respondents who self-identified as a currently practicing Australian paramedic. Paramedics from all states except South Australia responded, with the majority coming from Queensland Ambulance Service (N= 81%). In terms of experience, 81.54% of respondents report being qualified for greater than 5 years. Initial analysis shows that despite the extensive experience of the practitioners surveyed when asked to rate from high to low their level of knowledge of specific disaster management core competencies a number of gaps exist.Discussion:Core competencies are a defined level of expertise that is essential or fundamental to a particular job, and serve to form the foundation of education, training, and practice for operational service delivery. While more research is needed, these results may help inform industry, government, and education providers to better understand and to more efficiently provide education and ongoing training to paramedics who are responsible for the management of disaster within the Australian community.
Experience of Activation of the J-SPEED(MDS) in Japan
Authors: Kubo Tatsuhiko , Tomioka Joji , Kondo Hisayoshi , Koido Yuichi 
Published: May 2019

Introduction:The Emergency Medical Team (EMT) Strategic Advisory Group of the World Health Organization has endorsed the EMT Minimum Data Set (MDS) as the standard methodology for EMT daily report. The MDS had been developed on a similar methodology called J-SPEED which developed in Japan. Thus, lessons learned from the J-SPEED can be applied to the MDS.Aim:To review previous J-SPEED activations and to extract lessons learned.Methods:Cases of the J-SPEED activation at the Kumamoto earthquake in 2016, West Japan Heavy Rain in 2018, and Hokkaido Earthquake in 2018 were reviewed.Results:The first large-scale activation of the J-SPEED at the Kumamoto earthquake revealed a significant burden in aggregations of submitted paper forms at the EMT Coordination Cell (EMTCC). To strengthen this function of the EMTCC, electronic system and human capacity development have been identified as key issues. To fulfill this gap, a smartphone app so-called J-SPEED+ has been developed. Also, the J-SPEED offsite analysis support team, which is a team to support analysis of data from outside of an affected area has been established. These two functions contributed to significant improvement of J-SPEED data flow at the West Japan Heavy Rain and Hokkaido Earthquake. These two responses reinforced the necessity of strengthening the capacity of J-SPEED onsite coordinator working at the ETMCC, and national education and training for all EMTs.Discussion:In order to strengthen the mechanism to run the J-SPEED, nationwide training for all EMTs, onsite coordinators, and the off-site analysis support team have been established. The authors regard this structural approach as a requirement for other countries to run the MDS.
Focused Ultrasound: Applications and Implications for Education
Authors: Moore Cameron , Rowntree Pamela 
Published: May 2019

Introduction:Focused or point of care ultrasound applications have been integrated into prehospital assessments, triage capacities, military applications, trauma, and emergency health care settings, and medical school curriculums. Often, the inclusion of focused ultrasound is to answer specific clinical questions. However, the value is ultimately determined by the experience, skills, and training of the operator performing and interpreting the examination. Ultrasound was reserved for traditional imaging providers as little as two decades ago. However, as the application of ultrasound expands within clinical medicine, there is an increasing necessity for associated education and training.Aim:To highlight the applications and uses of focused ultrasound in the current diverse health care landscape while identifying the associated educational considerations, including the undergraduate tertiary education sector.Methods:A search of peer-reviewed published literature was undertaken to determine the range of current usage of ultrasound imaging across professions, and to identify the education and training available.Results:The results discussed within this presentation will highlight identified trends, ultrasound applications, educational considerations, and potential future practices based on the content of the literature explored.Discussion:Technology is rapidly advancing in the field of medical ultrasound with handheld ultrasound scanners now smaller, less expensive, and more accessible than ever before. Paralleled with these advances and the more generous use of ultrasound come the expectation and pressures of competent skill diversity among healthcare staff and specialists. Significantly, sonography is still considered by many as the most technically demanding and operator dependent medical imaging modality available. Therefore, as the application of ultrasound expands within clinical medicine, educational considerations must also align with this expansion to maintain diagnostic accuracy. This means an increasing demand for associated education and training, including in the undergraduate tertiary education sector.
How Antibiotic Resistance Impacts Responses to Public Health Emergencies and Strategies to Mitigate the Impacts
Authors: Robnett Kathrine 
Published: May 2019

Introduction:Antibiotic resistance is when bacteria change and adapt in response to antibiotics, becoming able to defeat these drugs when used to treat infections. A direct consequence of this adaptation is an increased difficulty in treating multiple diseases. Because of increased antibiotic resistance, the World Health Organization has declared it a significant threat to public health.Aim:One frequent consequence of natural disasters is infections, as seen in the December 2004 Indian Ocean tsunami. Survivors sustained a variety of wound infections that ranged from common pathogens to rarely seen organisms including fungi.Methods:This research analyzes the microbiology observed in wound infections associated with exposure to freshwater, seawater, soil, fecal, and other contamination after Hurricane Harvey in 2017 and Hurricane Florence in 2018.Discussion:Therapies for infections will also be discussed in addition to how the utilization of rapid detection technology for antimicrobial resistance and correct treatments require antimicrobial susceptibility knowledge to improve health outcomes, lower economic costs, prevent further spread of multi-drug resistant outbreaks and assist with antimicrobial stewardship.
How to Shorten the Rescue Time in Marathon by Using BLE Communication Devices: A New Study for the EMS System in Taiwan
Authors: Chang Kuo-song , Chun-I Sun , Huang Jung-Tang , Weng Shih-Chi , Chien Meng-Fan 
Published: May 2019

Introduction:More than one million runners have joined the marathon games since 2007 in Taiwan. There were over 150 marathon games held in Taiwan in 2018. The increase rate was 21% as compared to that of 2014. The medical encounter rate was 1.33% in 2015 and increased to 1.41% in 2017. The most common type of injury was muscle spasm. The second most common was abrasion due to falls. The treatment for muscle spasm was RICE only. Cardiac arrest of marathon runners was reported occasionally and time is critical for rescue.Aim:To shorten the rescue time of the runners in an emergency. Base on the prodromal research, BLE communication technology is further used to improve the rescue positioning communication technology in the marathon.Methods:After rescue notification devices have been set up in each 0.5 km on the runway of the marathon, the runner can send a rescue signal through the rescue notification devices in case of emergency. The rescue signal, periodically advertisement SN# with rescue mark, of the runner can be precisely located and the rescue can be started very soon.Results:In the simulation, the rescue signal can be located in 7.5 minutes, fastest in 3 seconds. The precision rate of timing is ±160ms/6σ that under IAAF accuracy requirement. The location error is less than 20 meters, and the rescue time can be shortened to one half as before.Discussion:The rescue time of runner is correlated with the quality of marathon EMS. It is critical to the runner, especially in cardiac arrest. By using BLE communication devices, the runner can be located faster and more precisely. As rescue time shortened, CPR & AED can be given sooner. The quality of marathon EMS will be improved substantially.
The Impact of the New European Union General Data Protection Regulation (GDPR) on Data Collection at Mass Gatherings
Authors: Scholliers Annelies , De Fré Dimitri , D’haese Inge , Gogaert Stefan 
Published: May 2019

Introduction:As of May 2018, a new European privacy law called the General Data Protection Regulation (GDPR) is in order. With this law, every organization operating in the European Union (EU), needs to adhere to a strict set of rules concerning collection and processing of personal data.Aim:To explore the consequences of the GDPR for data collection at mass gatherings in the European Union.Methods:Since the law was published on April 27, 2016, a thorough reading of the law was conducted by 4 persons with a background in mass gathering health. The GDPR consists of 99 articles organized into 11 chapters. There are also 173 recitals to further explain certain ambiguities. Key articles and recitals relating to healthcare and scientific research were identified. Possible pitfalls and opportunities for data collection and processing at mass gatherings were noted.Discussion:Under article 4, key definitions are noted. There is a clear definition of “data concerning health”. According to the GDPR, health data is a special category of personal data which should not be processed according to article 9(1). However, there is an exception for scientific research (article 9(2)(j)). There are a few safeguards in place, as laid out in article 89. One interesting point is that according to article 89(2), certain derogations can take place if the law interferes with scientific research. The GDPR has major consequences for data collection and processing in the EU. However, with the use of certain safeguards (e.g., pseudonymization) there are still ample opportunities for scientific research. It is important to review one’s method of data collection to make sure it complies with the GDPR.
Influenza Vaccine Uptake and Associated Factors in Aged Care Facilities
Authors: Kunasekaran Mohana , Trent Mallory , Lai Elisa , Tan HaoYi , Chughtai Abrar , Poulos Chris , MacIntyre Raina 
Published: May 2019

Introduction:Influenza vaccine is recommended for high-risk populations in Australia (including those aged over 65 years) but is less effective in the elderly due to a progressive and predictable age-related decline in immune function, referred to as immunosenescence. Aged care facilities (ACF) are known to be at high risk of explosive outbreaks of influenza (even in highly vaccinated populations) and may reflect a higher intensity of transmission within the closed setting of ACF, as well as lower immunity and immunosenescence in the frail elderly.Methods:To measure the impact of influenza in aged-care staff (ACS) and residents as well as vaccine effectiveness, a prospective observational epidemiological study was conducted in collaboration with an aged-care provider with multiple sites from March to October 2018. Weekly active surveillance on influenza-like symptoms and questionnaires were used to collect data on two groups: ACS and residents. A range of variables was examined against their 2018 influenza vaccination status in statistical analysis.Results:Vaccination rates were high in residents and consistent with other studies. Vaccine rates in aged-care staff were lower and consistent with other studies.Discussion:Residents and relatives are unlikely to change their minds about vaccination from year to year unless there is targeted effort to persuade them to so, and negative perception of the vaccine is likely to persist. Workplace influenza vaccination programs targeted at staff could be an effective method of raising vaccine uptake.
The Integration of a Unique QR® Code and Video to Improve the Correct Application of a Hemorrhage-control Tourniquet by a Naïve Population - A Feasibility Study
Authors: Rega Paul , Vallejo Shaun , Accumanno John , Fink Brian 
Published: May 2019

Introduction:The use of tourniquets by the civilian population has been deemed a critical aspect of the initial response during an active shooter situation. Tourniquet deployment in public-access must be accompanied by education. Studies indicate that the act itself is not an intuitive process and enclosed instructions may be inadequate. However, civilians for diverse reasons may not avail themselves of accepted training programs.Aim:To develop an alternative means of “Just-In-Time” education to enable a naïve responder to apply a commercial tourniquet efficaciously.Methods:A video (~40 seconds long) was created highlighting the actual application of a C-A-T® (Combat Application Tourniquet) on a human model. It was uploaded to YouTube on a public channel. A QR® code was generated using https://www.qr-code-generator.com, embedding the link for the YouTube® video. An appropriately-sized QR® code was printed and applied with packaging tape (Scotch®) to the exterior wrapping of a C-A-T® device. The C-A-T® with code was then accessed with the iPhone®.Results:With the iPhone® camera app activated and focused on the C-A-T’s QR® code, a request popped-up to open “YouTube.com” in Safari. When pressed, the full-screen video appeared immediately with audio of excellent quality.Discussion:The use of a QR® code and its video link is a feasible option to provide “Just-In-Time” training to a naïve civilian population who are responding to an active shooter situation. This offers the naïve responder two options of immediate education: the enclosed instructions and the QR® code. Redundancy in communications is essential in any emergency response. An important limitation of this innovation is the inability to obtain Internet® access and therefore, the availability of the enclosed instructions is still critical. Research to prove that this innovation will allow the application of a tourniquet to proceed expeditiously with few errors is currently underway.
Lack of Prioritization Causes Extended Time to Assessment of Severely Injured Trauma Patients in a Resource-Scarce Emergency Department
Authors: Lampi Maria , Tabu John , Junker Johan , Wladis Andreas 
Published: May 2019

Introduction:The time between injury and medical intervention is crucial in trauma care. Triage is essential to ensure prioritization and timely assessment of injured patients.Aim:To investigate how the lack of triage system impacts timely intervention in a sub-Saharan hospital emergency department, and to investigate potential benefits of triage towards efficient management of trauma patients.Methods:A prospective study including adult trauma patients admitted to the emergency department at Moi Teaching and Referral Hospital in Eldoret, Kenya, was conducted. Mode of arrival, vital parameters, time before physician’s assessment, and mortality were registered. Retrospectively, Injury Severity Score (ISS) was calculated, and patients were categorized according to the Rapid Emergency Triage and Treatment System (RETTS).Results:A total of 571 patients were analyzed, revealing a mean ISS of 12.2 (SD 7.7) and a mean length of stay of 11.6 (SD 18.3) days. 70% of the patients arrived by taxi, private car, or police car; only 17.6% were transported by ambulance. RETTS categorization was compared with ISS using a Kruskal-Wallis test with Dunn’s multiple comparisons post-test. A higher average ISS was found in the red category compared to other categories (H(df) = 24.47(4), p < 0.001). A Spearman correlation test between ISS and time to assessment revealed an r value of −0.041 (p = 0.43).Discussion:The results clearly illustrate a lack of correct prioritization of patients in relation to the need for timely assessment. Since there was no difference in time to assessment regardless of ISS, the need for a triage system is apparent. Currently, the implementation and evaluation of a validated triage tool at the emergency department are underway. Moreover, the finding that less than 18% of trauma patients are transported to the emergency department by ambulance illustrates the need to develop prehospital care systems.
Living Condition Relating to Social Isolation and Suicidal Thoughts Over 65 Years Old Living in Prefabricated Temporary Housing After the Great East Japan Earthquake (GEJE)
Authors: Masuno Kanako , Ohtsuka Rika , Nobuko Kamada 
Published: May 2019

Introduction:The Great East Japan Earthquake (GEJE) and subsequent devastating tsunami struck the northeastern coast of Japan on March 11, 2011. According to the previous studies about displaced evacuees, increases in suicide rates and social isolation (especially among older adults) have been reported. However, the living condition of residents at prefabricated temporary housing after GEJE is unclear.Aim:To explore potential factors which might relate to social isolation and suicidal thoughts among older adults by using a qualitative method.Methods:Inclusion criteria for this study were older adults over 65 years living in prefabricated temporary housing since the GEJE. Data were collected by face-to-face-interviews with semi-structured questionnaire between October and December 2014. The protocol of this study was approved by the Ethics Board of the Tokyo Metropolitan Institute of Gerontology. This research was supported by the Ministry of Health, Labor, and Welfare of Japan (No.H25-iryou-shitei-003).Results:Twenty older adults participated in the study. Most of them had been engaged in agriculture or fishery and experienced the sudden loss of family members, friends, and property in the aftermath of the GEJE. Findings indicated that social connections formed through the collective construction of prefabricated temporary housing. The study found that individuals who had less emotional and financial support experienced a greater feeling of sadness, social isolation, and suicidal thoughts. The study also suggested that people who live in temporary housing are strongly affected by economic insecurity and that it aggravates the risks for social isolation and psychological distress.Discussion:Although there were limitations regarding standardization and compatibility, this research found that the qualitative method can obtain the data which the quantitative method cannot reach. Scale-up of universal guidelines including the knowledge from qualitative research and case report under the devastating disaster setting is anticipated for better evidence base for next coming disaster.
No More Suffering: Building Human Resource Capacities with the Sphere Standard
Authors: Harada Nahoko , Kai Soichiro , Chishima Kayako , Miyamoto Junko , Kodama Mitsuya , Koda Masahide , Bando Makoto , Tani Hirofumi 
Published: May 2019

Introduction:Nankai Trough earthquake, with an anticipated death toll of 323,000, is a disaster for which the country of Japan set the highest priority on building capacities. Tokushima prefecture aims to minimize preventable death among survivors and has strived to build a medical and health response system and strengthen outreach systems for vulnerable populations. To actualize these aims, Tokushima prioritized human resource development.Methods:Tokushima has initiated periodic trainings based on the Sphere Standard, the internationally recognized minimum standards for humanitarian aid, since 2015. The trainings were conducted by certified trainers and trainees received an official certification recognized by the Sphere Project, Geneva. The training materials were localized and the trainings were contextualized to Japan as a developed and super-aged nation. The learning outcome was evaluated by a pre-post test.Results:Between April 2015 and November 2018 the two-day training was held seven times. There were two hundred twelve participants from various clusters such as health, education, logistics, nutrition and food, security, and protection. The results of the pre-post test were statistically significant (still in process) indicating the effectiveness of the training on knowledge. Training evaluations suggest nurturing ethical attitudes and skills utilizing the Sphere Handbook.Discussion:Despite under-recognizing the Sphere Standard in Japan, the Standard has been incorporated into the disaster risk reduction plan in Tokushima. For larger scale human resource development, training local representatives to be trainers would be the next step.
Organohalogen Contamination in Vietnamese Women Electronic Waste Recyclers Living and Working in Rural Northern Vietnam
Authors: Kincaid Jenevieve 
Published: May 2019

Introduction:Electronic waste (e-waste) is increasing worldwide and is often shipped from developed to developing countries. Many of these products contain toxic levels of metals, organics, etc. When unsafe recycling approaches or methods are used (e.g., burning wire to reclaim copper), the resulting occupational exposures can adversely affect the health of e-waste recyclers.Aim:To identify which polybrominated and which polychlorinated dibenzo-p-dioxins/furans are higher in electronic waste recyclers when compared to non-recyclers.Methods:This study focused on female e-waste recyclers and non-recyclers that live in rural northern Vietnam. Whole blood, urine, and serum of forty e-waste recyclers and twenty Vietnamese comparisons and were evaluated for metals, organics, and dioxin-like exposure by the Center for Disease Control. This paper will be reporting on serum organohalogens. The Vietnamese cohorts were compared to the U.S. general population, using the National Health And Nutrition Examination Survey. TEQ’s were calculated and statistical significance was determined using Wilcoxon Rank Sum Test. The IRB of the University of Texas Health Science Center Houston and the Ethics Board of the Hanoi School of Public Health oversee this study.Results:12378-PeCDF, 123678-HxCDD, 123678-HxCDF, and 1234678-HpCDF were significantly different between recyclers and Vietnamese comparisons. Total dioxin TEQ was higher in e-waste recyclers than comparisons. Of the polybrominated dioxins and furans, 12378-PeBDD and 2378-TeBDF were significantly different between recyclers and comparisons.Discussion:This is the only study with data on polybrominated dibenzo-p-dioxins/furans in female electronic waste recyclers from rural Northern Vietnam, and the first to describe serum levels of both polychlorinated and polybrominated dibenzo-p-dioxins/furans in Vietnamese female e-waste recyclers. Improved occupational protocols may reduce potential adverse health effects such as cancer, endocrine, reproductive, developmental, and other disorders.