bluuebunny/crossref_metadata_2025_split huggingface dataset:
Planning for Resilience in Hospital Internal Disaster
Authors: Sternberg Ernest 
Published: August 2016

Abstract
This article seeks to clarify the terminology and methods of planning to
avert hospital internal disaster. It differentiates “crisis” from “disaster”
in the in-hospital setting. Preparedness, as contrasted with mitigation, is
meant to reduce the likelihood that a crisis will turn into a disaster.
Though there are some recurring features of crises, allowing for
preparedness through the identification of a few high-likelihood
contingencies, crises are subject to numerous, overwhelming uncertainties.
These include hazard uncertainty, incident uncertainty, sequential
uncertainty, informational uncertainty, consequential uncertainty, cascade
uncertainty, organizational uncertainty, and background uncertainty. In view
of the uncertainties, the primary aim of planners should not be to try to
create plans for ever more contingencies, since contingencies are far too
numerous and perhapsapproach infinity, but rather to create capabilities
(through proper preparedness) for resilience during crisis. Resilience can
be cultivated through improvements in information acquisition and
dissemination, communication systems, resource management, mobility
management, design for resilience, incident command, and staff
versatility.
Preventing After-Effects of Disaster Trauma: The Information and Support Centre
Authors: Weisæth Lars 
Published: August 2016

AbstractThis paper describes the establishment and activities of the Information and Support Centres developed in Norway in the aftermath of large-scale accidents and disasters between 1980 and 1990. The function of these Centres is to provide rapid, authoritative information and psychosocial support services for the next-of-kin of disaster victims, including the families of those missing. By gathering together those affected by a particular event, the Centres provide a setting in which individuals and families can support each other. The activities of the psychosocial team include triage for mental-health emergencies, orienting survivors to immediately available local services, communication with family, friends, and community, and other forms of psychological first aid. The psychosocial team also provides linkages to local health, clergy, and other local resources that are near to the family's home and could provide continued care if necessary.
Challenges of Major Incident Management When Excess Resources are Allocated: Experiences from a Mass Casualty Incident after Roof Collapse of a Military Command Center
Authors: Romundstad Luis , Sundnes Knut Ole , Pillgram-Larsen Johan , Røste Geir K. , Gilbert Mads 
Published: August 2016

AbstractDuring a military exercise in northern Norway in March 2000, the snowladen roof of a command center collapsed with 76 persons inside. Twentyfive persons were entrapped and/or buried under snow masses. There were three deaths. Seven patients had serious injuries, three had moderate injuries, and 16 had minor injuries.A military Convalescence Camp that had been set up in a Sports Hall 125 meters from the scene was reorganized as a causality clearing station. Officers from the Convalescence Camp initially organized search and rescue. In all, 417 persons took part in the rescue work with 36 ambulances, 17 helicopters, three ambulance airplanes and one transport plane available. Two ambulances, five helicopters and one transport aircraft were used. Four patients were evacuated to a civilian hospital and six to a field hospital.The stretcher and treatment teams initially could have been more effectively organized. As resources were ample, this was a mass casualty, not a disaster. Firm incident command prevented the influx of excess resources.
Information-Sharing in Out-of-Hospital Disaster Response: The Future Role of Information Technology
Authors: Arnold Jeffrey L. , Levine Brian Neil , Manmatha R. , Lee Francis , Shenoy Prashant , Tsai Ming-Che , Ibrahim Taha K. , O'Brien Daniel J. , Walsh Donald A. 
Published: August 2016

AbstractNumerous examples exist of the benefits of the timely access to information in emergencies and disasters. Information technology (IT) is playing an increasingly important role in information-sharing during emergencies and disasters.The effective use of IT in out-of-hospital (OOH) disaster response is accompanied by numerous challenges at the human, applications, communication, and security levels.Most reports of IT applications to emergencies or disasters to date, concern applications that are hospital-based or occur during non-response phases of events (i.e., mitigation, planning and preparedness, or recovery phases). Few reports address the application of IT to OOH disaster response.Wireless peer networks that involve ad hoc wireless routing networks and peer-to-peer application architectures offer a promising solution to the many challenges of information-sharing in OOH disaster response. These networks offer several services that are likely to improve information-sharing in OOH emergency response, including needs and capacity assessment databases, victim tracking, event logging, information retrieval, and overall incident management system support.
Hazardous Substances Releases Causing Fatalities and/or People Transported to Hospitals: Rural/Agricultural vs. Other Areas
Authors: Berkowitz Zahava , Horton D. Kevin , Kaye Wendy E. 
Published: August 2016

AbstractIntroduction:Mass-casualty and hospital preparedness has been analyzed widely. However, information regarding the types of areas where these events occur is limited. Therefore, the characteristics of acute hazardous substances releases resulting in death/multiple-victim events occuring in rural/agricultural areas and in all other areas were studied and compared. Methods: Data reported to the Hazardous Substances Emergency Events Surveillance (HSEES) system from 16 state health departments during 1993–2000 were used to examine factors associated with events with death/multiple victims involving acute release of hazardous substances. A death/multiple-victim event is defined as any event resulting in a death and/or at least five people being transported to a hospital.Results:Of a total of 43,133 events, 6,661 occurred in rural/agricultural areas. Of these, 107 were death/multiple-victim events with 632 victims, of whom 91 died and 77 were hospitalized. All other areas had 472 death/multiple-victim events with 7,981 victims, of whom 116 died and 413 were hospitalized. Death/multiple-victim events in rural/agricultural areas were more likely to be associated with transportation (Proportional Ratio (PR) = 4.1, 95% CI = 3.1–5.4) and fires and/or explosions (PR = 1.4, 95% CI = 0.95–2.0) than were death/multiple-victim events in all other areas. Among transportation-related events in rural/agricultural areas, 19 were associated with air transport—mainly crop dusters—and resulted in 18 deaths. Responders were three times more likely to be injured in rural/agricultural areas. Of responders, volunteer firefighters constituted 52% compared with 6.7% in all other areas. The most frequently released chemicals in rural/agricultural areas were ammonia, chlorine, and pesticides. In all other areas, ammonia, chlorine, hydrochloric acid, carbon monoxide, and 0-chlorobenzylidene malononitrile, a tearing agent often associated with an illegal or unauthorized act, were released most frequently.Conclusions:Findings from this analysis suggest that remedial actions should address safety measures in both transportation and fixed facilities containing acute hazardous substances. These include regular maintenance of equipment, education of workers about the substances used in their facility, rigorous training and licensing of drivers and crop duster operators, and education and training of employees and first responders in the use of protective equipment. These activities may reduce the number of events, casualties, and costs associated with hazardous substance events.
Health Indicators for Mothers and Children in Rural Herat Province, Afghanistan
Authors: Ahmed Ayan , Edward Anbrasi , Burnham Gilbert 
Published: August 2016

AbstractIntroduction:Following years of conflict and neglect, major efforts now are underway to develop health policy and rehabilitate the health facilities in Afghanistan. As part of these efforts, there is a need to better understand the health status and health-seeking behaviors. As part of an effort to assist local non-governmental organizations (NGOs), a household survey of mothers with children under the age of five years was conducted in two rural districts of Herat Province, Karokh and Chesht-e-Sharif.Methods:A two-stage, 30-cluster approach was used for each district. This included 622 mothers of 926 children under the age of five years living in the two districts. Outcome measures included demographic characteristics, antenatal services, immunization coverage, hemoglobin levels of the mothers, nutritional status and practices, environmental health indicators, recent illness, and health seeking behaviors.Results:The mean value of ages of the mothers was 27 years with an average parity of 6.1. Less than 5% of mothers ever had attended school. Half of women had lost at least one child before the child reached the age of five years. Under-five-year mortality was estimated at 325. Only 29% of the women had attended an antenatal clinic during their last pregnancy. Virtually all deliveries occurred at home. Only 7.6% of women had received three doses of tetanus toxoid. Less than 9% of the children 12–59 months of age were fully immunized. According to the measurements of mid-upperarm circumference (MUAC), 11% of children were malnourished. Although breastfeeding almost was universal, greater than one-third of the women did not start breastfeeding until the second day after delivery. Protected water sources and appropriate control of feces were lacking in both districts. In the previous two weeks, 45.7% of children had experienced diarrhea, and dysentery had occurred in 10%. Fever had been present in one-quarter of the children.Conclusions:Household health indicators indicate serious maternal and child health concerns in these two districts. Of particular concern is the poor immunization coverage, lack of reproductive health service, and the prevalence of common childhood illness in these populations. The feeding practices for children and the anemia among mothers also raised concerns. Poor environmental health contributes substantially to childhood illness.Without special emphasis, efforts to rebuild the health sector are likely to reach the household level only late in the process. An aggressive program to integrate community development and promotion of sound health practices is needed to improve the health of the Afghanistan people.
Seismic Intensity and Risk of Cerebrovascular Stroke: 1995 Hanshin-Awaji Earthquake
Authors: Sokejima Shigeru , Nakatani Yoshimi , Kario Kazuomi , Kayaba Kazunori , Minowa Masumi , Kagamimori Sadanobu 
Published: August 2016

AbstractIntroduction:No epidemiological data exist concerning the influence of an earthquake on the risk of stroke. Whether the incidence of cerebrovascular stroke increased after the 1995 Hanshin-Awaji earthquake (EQ) in Japan and whether seismic intensity affected stroke risk dose-dependently was examined.Methods:A retrospective cohort study was conducted among residents, who were living in two towns on the island of Awaji and were participants of the National Health Insurance (NHI) program. The two towns were divided into 11 districts and their respective damage and socioeconomic states were investigated. Reviewing the NHI documents issued before and after the EQ, people who had strokes (9th International Classification of Diseases, codes 430–431 or 433–434.9) were identified. Risk of stroke in relation to the seismic intensities, was assessed with the Cox proportional hazard model.Results:Among subjects aged 40 to 99 years, 45 of 8,758 (0.514%) had a stroke the year before the EQ, 72 of 8,893 (0.810%) had a stroke in the first year following the EQ, and 49 of 8,710 (0.566%) had a stroke in the second year following the EQ. In districts where the earthquake's intensity was ≤9.5 on the modified Mercalli intensity (MMI), compared with the year prior to the EQ, the relative risk (RR) of stroke was 2.4 (95% confidence interval (CI) 1.1, 5.0) in the first year following the EQ, after adjusting for age, gender, and income. In that year, compared with MMI of &lt;8.5–9.0, RRs for 9.0–9.5 and ≥9.5 were 1.6 (CI 0.9, 2.1) and 2.0 (CI 1.1, 3.7), respectively (pfor trend 0.02). No trend for the RR was observed in the year before the EQ or in the second year following the EQ.Conclusion Stroke increased in the first year following the EQ. The increase was associated with seismic intensity in a dose-response manner. Results suggest a potential threshold for RR of &gt;2.0 in areas near 9.5 on the MMI scale.
Prehospital Spirituality: How Well Do We Know Ambulance Patients?
Authors: Jang Timothy , Kryder George D. , Char Douglas , Howell Randy , Primrose Joseph , Tan David 
Published: August 2016

AbstractObjective:To assess the religious spirituality of EMS personnel and their perception of the spiritual needs of ambulance patients.Methods:Emergency medical technicians (EMTs) and paramedics presenting to an urban, academic emergency department (ED) were asked to complete a three-part survey relating to demographics, personal practices, and perceived patient needs. Their responses were compared to those of ambulance patients presenting to an ED during a previous study period and administered a similar survey.Results:A total of 143 EMTs and 89 paramedics returned the surveys. There were 161 (69.4%) male and 71 (30.6%) female respondents with a median age range of 26–35 years old. Eighty-seven percent believed in God, 82% practiced prayer or meditation, 62% attended religious services occasionally, 55% belonged to a religious organization, 39% felt that their beliefs affected their job, and 18% regularly read religious material. This was similar to the characteristics of ambulance patients.However, only 43% felt that occasionally ambulance patients presented with spiritual concerns and 78% reported never or rarely discussing spiritual issues with patients. Contrastingly, &gt;40% of ambulance patients reported spiritual needs or concerns at the time of ED presentation, and &gt;50% wanted their providers to discuss their beliefs. Twenty-six percent of respondents reported praying or meditating with patients, while 50% reported praying or meditating for patients.Females were no more religious or spiritual than males, but were more likely to engage in prayer with (OR = 2.38,p= 0.0049) or for (OR = 6.45,p&lt;0.0001) patients than their male counterparts.Conclusion:EMTs and paramedics did not perceive spiritual concerns as often as reported by ambulance patients, nor did they commonly inquire about the religious/spiritual needs of patients.
Effects of Prehospital Spinal Immobilization: A Systematic Review of Randomized Trials on Healthy Subjects
Authors: Kwan Irene , Bunn Frances 
Published: August 2016

AbstractObjective:To evaluate the effects of spinal immobilization on healthy participants.Methods:A systematic review of randomized, controlled trials of spinal immobilization on healthy participants.Results:Seventeen randomized, controlled trials compared different types of immobilization devices, including collars, backboards, splints, and body strapping. For immobilization efficacy, collars, spine boards, vacuum splints, and abdominal/torso strapping provided a significant reduction in spinal movement. Adverse effects of spinal immobilization included a significant increase in respiratory effort, skin ischemia, pain, and discomfort.Conclusions:Data from this review provide the best available evidence to support the well-recognized efficacy and potential adverse effects of spinal immobilization. However, comparisons of different immobilization strategies on trauma victims must be considered in order to establish an evidence base for this practice.
Information Technology and Public Health Management of Disasters—A Model for South Asian Countries
Authors: Mathew Dolly 
Published: August 2016

AbstractThis paper highlights the use of information technology (IT) in disaster management and public health management of disasters. Effective health response to disasters will depend on three important lines of action: (1) disaster preparedness; (2) emergency relief; and (3) management of disasters. This is facilitated by the presence of modern communication and space technology, especially the Internet and remote sensing satellites. This has made the use of databases, knowledge bases, geographic information systems (GIS), management information systems (MIS), information transfer, and online connectivity possible in the area of disaster management and medicine.This paper suggests a conceptual model called, “The Model for Public Health Management of Disasters for South Asia”. This Model visualizes the use of IT in the public health management of disasters by setting up the Health and Disaster Information Network and Internet Community Centers, which will facilitate cooperation among all those in the areas of disaster management and emergency medicine. The suggested infrastructure would benefit the governments, non-government organizations, and institutions working in the areas of disaster and emergency medicine, professionals, the community, and all others associated with disaster management and emergency medicine. The creation of such an infrastructure will enable the rapid transfer of information, data, knowledge, and online connectivity from top officials to the grassroots organizations, and also among these countries regionally. This Model may be debated, modified, and tested further in the field to suit the national and local conditions. It is hoped that this exercise will result in a viable and practical model for use in public health management of disasters by South Asian countries.
Disasters and Development: Part 3: Assessing Trade-offs in Investing in Vulnerability Reduction
Authors: Stephenson Rob S. , DuFrane Charles 
Published: August 2016

AbstractThis lesson describes how a government decides whether and how much it should spend on vulnerability reduction. There are techniques and methods by which decision-makers compare development alternatives. The differences between the risk that a potentially catastrophic event will occur and uncertainty are described, with uncertainty providing greater difficulty in economic analyses. There is a range of methods for identifying the complex mix of competing costs and benefits associated with any restructuring of investment priorities to accomplish disaster mitigation. The possibilities are described in terms of the opportunity costs and present value. Impact and consequent losses include: (1) direct monetary effects; (2) indirect monetary effects; (3) direct, non-monetary effects; (4) indirect, non-monetary effects; and (5) loss of non-renewable natural resources. The difficulties in assigning values to these effects are described, as well as the means of judging the costeffectiveness of such interventions. An advantage of screening projects using a framework of analytical methods is that it can assist in focusing on a variety of possible outcomes and make the factors influencing these outcomes quite explicit.
Risk and Risk Assessment in Health Emergency Management
Authors: Arnold Jeffrey L. 
Published: August 2016

AbstractThis article considers the critical roles of risk and risk assessment in the management of health emergencies and disasters. The Task Force on Quality Control of Disaster Management (TFQCDM) has defined risk as the “objective (mathematical) or subjective (inductive) probability that something negative will occur (happen)”. Risks with the greatest relevance to health emergency management include: (1) the probability that a health hazard exists or will occur; (2) the probability that the hazard will become an event; (3) the probability that the event will lead to health damage; and (4) the probability that the health damage will lead to a health disaster. The overall risk of a health disaster is the product of these four probabilities.Risk assessments are the tools that help systems at risk—healthcare organizations, communities, regions, states, and countries—transform their visceral reactions to threats into rational strategies for risk reduction. Type I errors in risk assessment occur when situations are predicted that do not occur (risk is overestimated). Type II errors in risk assessment occur when situations are not predicted that do occur (risk is underestimated). Both types of error may have serious, even lethal, consequences.Errors in risk assessment may be reduced through strategies that optimize risk assessment, including the:(1) adoption of the TFQCDM definition of risk and other terms; (2) specification of the system at risk and situations of interest (hazard, event, damage, and health disaster); (3) adoption of a best practice approach to risk assessment methodology; (4) assembly of the requisite range of expert participants and information; (5) adoption of an evidence-based approach to using information; (6) exclusion of biased, irrelevant, and obsolete information; and (7) complete characterizations of any underlying fault and event trees.
Injuries and Illnesses Treated at the World Trade Center, 14 September–20 November 2001
Authors: Perritt Kara R. , Boal Winifred L. ,   The Helix Group Inc
Published: August 2016

AbstractIntroduction:In response to the 11 September 2001 terrorist attacks on the World Trade Center (WTC), the United States Public Health Service (USPHS) deployed Disaster Medical Assistance Teams (DMATs) and the Commissioned Corps to provide on-site, primary medical care to anyone who presented. Patients included rescue and recovery workers, other responders, and some members of the general public.Objective:A descriptive analysis of WTC-USPHS patient records was conducted in order to better understandthe short-term impact of the WTC site on the safety and health of individuals who were at or near the site from 14 September–20 November 2001.Methods:The Patient Treatment Record forms that were completed for each patient visit to these USPHS stations over the 10-week deployment period were reviewed.Results:Patient visits numbered 9,349, with visits peaking during Week 2 (21–27 September). More than one-quarter of the visits were due to traumatic injuries not including eye injuries (n = 2,716; 29%). Respiratory problems comprised more than one-fifth of the complaints (n = 2,011; 22%). Eye problems were the third most frequent complaint (n = 1,120; 12%). With respect to the triage class, the majority of visits fell into the lowest category of severity (n = 6,237; 67%).Conclusion:USPHS visits probably were skewed to milder complaints when compared to analyses of employer medical department reports or hospital cases; however, given the close proximity of the USPHS stations to the damage, analysis of the USPHS forms provides a more complete picture of the safety and health impact on those who were at or near the WTC site.