bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disaster and Terrorism: Cognitive-Behavioral Interventions
Authors: Walser Robyn D. , Ruzek Josef I. , Naugle Amy E. , Padesky Christine , Ronell Diana M. , Ruggiero Ken 
Published: August 2016

AbstractThe mental health effects of disaster and terrorism have moved to the forefront in the recent past following the events of 11 September 2001 in the United States. Although there has been a protracted history by mental health researchers and practitioners to study, understand, prevent, and treat mental health problems arising as a result of disasters and terrorism, there still is much to learn about the effects and treatment of trauma. Continued communication among disaster workers, first-response medical personnel, and mental health professionals is part of this process. This paper outlines current knowledge regarding the psychological effects of trauma and best cognitive-behavioral practices used to treat trauma reactions. More specifically, the information presented is a summary of Cognitive-Behavioral Therapy (CBT) interventions that are relevant for responding to and dealing with the aftermath of disasters.
Disaster Intervention: Long-term Psychosocial Benefits in Armenia
Authors: Najarian Louis M. 
Published: August 2016

AbstractThis paper describes a unique situation in which disaster intervention following a massive earthquake led to significant, uninterrupted, psychosocial benefits to the entire country, and an intervention program that continues to evolve. The mental health program initially provided service to the victims, and then, training to local professionals during which personnel simultaneously conducted clinical research. Members of the mental health team made a life-long commitment to the country, and continue their activities to expand its impact on public health policy. The difficult history and life circumstances of the Armenian people provided the opportunity for disaster interventions to have extensive psychosocial benefits.
The Challenges Facing Mental Health Programs for Post-Conflict and Refugee Communities
Authors: Silove Derrick 
Published: August 2016

AbstractThe majority of refugees and communities exposed to warfare and oppression live in low-income countries with few resources or special skills. Yet, epidemiological studies have identified high levels of traumatic stress reactions in such populations. These stress reactions can be intensified by harsh policies aimed at deterring survivors from seeking refuge in technologically advanced societies. The scale of the problem of mass violence and displacement creates formidable challenges for mental health professionals in their efforts to develop practical frameworks for responding to the extensive needs of displaced persons. In this article, a model is proposed for low-income, post-conflict countries, based on a two-tiered formulation. At the eco-social level, mental health professionals can play a supportive, but not a lead, role in facilitating recovery of core adaptive systems that hasten natural recovery from stress for the majority of the population. Where small-scale, community mental health services are established, the emphasis should be on assisting persons and their families who are at greatest survival and adaptive risk. Training and promotion of local workers to assume leadership in such programs are essential. In technologically advanced societies in which refugees are in a minority, torture and trauma services can focus more specifically on traumatic stress reactions, acculturation, and resettlement. In a historical epoch in which displaced persons are facing particularly harsh treatment, there is a pressing need for consensus amongst mental health professionals in advocating for their needs.
Using Ethnographic Methods in the Selection of Post-Disaster, Mental Health Interventions
Authors: Bolton Paul , Tang Alice M. 
Published: August 2016

AbstractThis paper describes a short, ethnographic study approach for understanding how people from non-Western cultures think about mental health and mental health problems, and the rationale for using such an approach in designing and implementing mental health interventions during and after disasters. It describes how the resulting data can contribute to interventions that are more acceptable to local people, and therefore, more effective and sustainable through improved community support.
Ethnic Differences in Symptoms of Post-traumatic Stress after the Exxon Valdez Oil Spill
Authors: Palinkas Lawrence A. , Petterson John S. , Russell John C. , Downs Michael A. 
Published: August 2016

AbstractIntroduction:Previous studies have reported ethnic differences in the prevalence of post-traumatic stress disorder (PTSD), but the reasons for these differences remain unclear.Hypothesis:Ethnic differences in the prevalence of PTSD may reflect ethnic differences in (1) exposure to traumatic events; (2) appraisal of such event as traumatic; and (3) culturally-determined responses to standardized diagnostic instruments, reflecting differences in cultural meanings associated with physical symptoms and idioms of distress.Methods:Ethnic differences in risk factors and factor structures of PTSD symptoms were examined in 188 Alaskan Natives and 371 Euro-Americans exposed to the Exxon-Valdez oil spill in 1989.Results:High levels of social disruption were associated with PTSD one year after the oil spill in both ethnic groups. However, low family support, participation in spill clean-up activities, and a decline in subsistence activities were significantly associated with PTSD in Alaskan Natives, but not in Euro-Americans. Factor analysis of the Diagnostic Interview Schedule PTSD subscale revealed five factors for both ethnic groups. However, the items comprising these factors were dissimilar.Conclusions:These results suggest that social disruption is sufficiently traumatic to be associated with symptoms of post-traumatic stress, but that a diagnosis of PTSD must take into consideration local interpretations of these symptoms.
A Paradox and a Dilemma
Authors: Birnbaum Marvin L. 
Published: August 2016

The issues surrounding “life” continue to increase in number and complexity. Those of us in the health professions believe that once a life is established, we must do all that is possible to preserve it. For most of us, this is an absolute, regardless of circumstances and setting.But, it is essential that we recognize that this value that we place on all life is not held universally. Members of some societies believe that the after-life is of greater value than is life in this earthly realm. For some, the “ultimate sacrifice” is relinquishing one's own life for a higher cause.
Long-Range Rescue Helicopter Missions in the Arctic
Authors: Haagensen Rolf , Sjøborg Karl-Åke , Rossing Anders , Ingilæ Henry , Markengbakken Lars , Steen Peter-Andreas 
Published: August 2016

AbstractBackground:Search and rescue helicopters from the Royal Norwegian Air Force conduct ambulance and search and rescue missions in the Barents Sea. The team on-board includes an anesthesiologist and a paramedic. Operations in this area are challenging due to long distances, severe weather conditions, and arctic winter darkness.Methods:One-hundred, forty-seven ambulance and 29 search and rescue missions in the Barents Sea during 1994–1999 were studied retrospectively with special emphasis on operative conditions and medical results.Results and Discussion:Thirty-five percent of the missions were carried out in darkness. The median time from the alarm to first patient contact was 3.3 hours and the median duration of the missions was 7.3 hours. Forty-eight percent of the missions involved ships of foreign origin. Half the patients had acute illnesses, dominated by gastrointestinal and heart diseases. Most of the injuries resulted from industrial accidents with open and closed fractures, amputations, and soft tissue damage. Ninety percent of the patients were hospitalized; 7.5% probably would not have survived without early medical treatment and rapid transportation to a hospital.Conclusion:Using a heavy search and rescue helicopter in the Barents Sea was the right decision in terms of medical gain and operative risk.
Public Health Preparedness for Mass-Casualty Events: A 2002 State-by-State Assessment
Authors: Mann N. Clay , MacKenzie Ellen , Anderson Cheryl 
Published: August 2016

AbstractIntroduction:The ongoing threat of a terrorist attack places public agencies under increasing pressure to ensure readiness in the event of a disaster. Yet, little published information exists regarding the current state of readiness, which would allow local and regional organizations to develop disaster preparedness plans that would function seamlessly across service areas. The objective of this study is to characterize state-level disaster readiness soon after September 2001 and correlate readiness with existing programs providing an organized response to medical emergencies.Methods:During the first quarter of 2002, a cross-sectional survey assessing five components of disaster readiness was administered in all 50 states. The five components of disaster readiness included: (1) statewide disaster planning; (2) coordination; (3) training; (4) resource capacity; and (5) preparedness for biological/chemical terrorism.Results:Most states reported the presence of a statewide disaster plan (94%), but few are tested by activation, (48%) and still fewer contain a bioterrorism component (38%). All states have designated disaster operations centers (100%), but few states have an operating communications system linking health and medical resources (36%). Approximately half of states offer disaster training to medical professionals; about 10% of states require the training. Between 22–48% of states have various contingency plans to treat victims when service capacity is exceeded. Biochemical protective equipment for health professionals is lacking in all but one state, and only 10% of states indicate that all hospitals have decontamination capabilities. States with a functioning statewide trauma system were significantly more likely to possess key attributes of a functioning disaster readiness plan.Conclusion:These findings suggest that disaster plans are prevalent among states. However, key programs and policies were noticeably absent. Communication systems remain fragmented and adequate training programs and protective equipment for health personnel are markedly lacking. Statewide trauma systems may provide a framework upon which to build future medical disaster readiness capacity.
Remote Site Production of Sterile Purified Water from Available Surface Water
Authors: Taylor Michael A. , Alambra Elaine F. , Anes John , Behnke Joel , Enachescu Brandusa , Fitzgerald Carolyn L. , Fortado Megan , Sizelove Mark L. 
Published: August 2016

AbstractA water purification and sterilization device was tested for its functional capabilities. Challenge water consisting of potable water augmented with bacteria, endotoxin, virus, suspended solids, and dissociable ions (sodium chloride, lead or arsenic salts) was passed through the device. The product water quality attributes were analyzed. The device demonstrated reduction in bacteria of >7 logs, endotoxin was reduced by >4 logs, virus was reduced by >4 logs, and dissociable ions were reduced by >3 logs. The product water of the device met the limits for a range of chemical entities specified by the United States Pharmacopeia and Association for the Advancement of Medical Instrumentation. The product water met the quality attributes of Sterile Water for Injection, USP, Sterile Purified Water, USP, and the Water for Dialysis. The device provides a logistical advantage in reducing the weight of transport of packaged water by 83% and the cube by 67%. It operates manually by gravity and is disposable after a single use. The device provides an effective alternative to the transport and use of packaged sterile water in remote locations by production of sterile water at the pointof-need using available water. It also is capable of producing safe drinking water following the production of clinical waters. This device has been cleared by the US Food and Drug Administration for production of three liters Sterile Purified Water, USP from Environmental Protection Agency (EPA) grade drinking water.
Suicides in Los Angeles County in Relation to the Northridge Earthquake
Authors: Shoaf Kimberley , Sauter Cary , Bourque Linda B. , Giangreco Christian , Weiss Billie 
Published: August 2016

AbstractIntroduction:Recently, there has been speculation that suicide rates increase after a disaster. Yet, in spite of anecdotal reports, it is difficult to demonstrate a systematic relationship between suicide and disaster. Suicides are fairly rare events, and single disasters rarely have covered geographic areas with large enough populations to be able to find statistically significant differences in such relatively rare events (annual suicide rates in the United States average 12/100,000 population).Hypothesis:Suicide rates increased in the three calendar years (1994–1996) following the Northridge earthquake as compared to the three calendar years (1991–1993) prior to the earthquake. Likewise the suicide rates for 1993 are compared with the rates in 1994. By looking at the suicide rates in a three-year period after the earthquake, the additional disasters that befell Southern California in 1995 and 1996 may have had an additive effect on psychological disorders and suicide rates that can be measured.Methods:Data on suicide mortality were compiled for the years from 1989 through 1996. Differences in rates for 1993 compared with 1994 and for three-year periods before and after the earthquake (1991–1993 vs. 1994 –1996) were analyzed using az-statistic.Results:There is a statistically significant difference in the rates for the years prior to the earthquake (1991–1993) when pooled and compared to the suicide rates for the years after the earthquake (1994–1996). The rates of suicide are lower in the three years following the earthquake (11.85 vs. 13.12/100,000 population) than they are in the three years prior to the earthquake (z= -3.85,p&lt;0.05). Likewise, there is a similar difference when comparing 1993 to 1994 (11.77 vs. 13.84,z= -3.57,p&lt;0.05). The patterns of suicide remain similar over time, with males and non-Hispanic Whites having the highest rates of suicide.Conclusion:It does not appear that suicide rates increase as a result of earthquakes in this setting. This study demonstrates that the psychological impacts of the Northridge earthquake did not culminate in an increase in the rates of suicide.
Current Status of International Emergency Medicine Fellowships in the United States
Authors: Bledsoe Gregory H. , Dey Chayan C. , Kabrhel Christopher , VanRooyen Michael J. 
Published: August 2016

AbstractObjective:A consensus panel of Emergency Physicians with experience in international health has published a recommended curriculum for a formal fellowship in International Emergency Medicine. This article reviews the current International Emergency Medicine (IEM) fellowships available to residency-trained Emergency Physicians in the United States.Methods:Every allopathic Emergency Medicine (EM) residency program in the United States was contacted via e-mail or telephone. Programs that reported having an IEM fellowship were asked detailed information about their program, including: (1) the number of years the program has been offered; (2) the duration of the program; (3) the number of fellows taken each year; (4) the number of fellowship graduates from each program and their current practice patterns; (5) how the fellowship is funded; and (6) whether a Masters Degree in Public Health (MPH) is offered.Results:All 127 allopathic EM residency programs responded. Eight (6.8%) of these programs offered IEM fellowships. Of a total of 29 graduates identified, 23 (79.3%) were employed in academic medicine. All of the fellowships offered formal public health training and were funded by a combination of clinical billing and project-specific grants and scholarships. All IEM fellowships described a curriculum that reflected the previously published recommendations.Conclusion:Opportunities in formal training in international health are increasing for graduates of EM residencies in the United States. The proposed curriculum for IEM fellowships seems to have been implemented and graduates of IEM fellowships seem to be applying their training in international projects.
The Use of Trained Observers as an Evaluation Tool for a Multi-Hospital Bioterrorism Exercise
Authors: Klein Kelly R. , Brandenburg Dale C. , Atas Jenny G. , Maher Ann 
Published: August 2016

AbstractIntroduction:Evidence suggests that regular disaster exercises have beneficial effects on subsequent mock and actual disaster responses. The purpose of this report is to describe a multiple hospital, bioterrorism exercise, evaluated by independent observers who used an evaluation template.Methods:The overall tabletop exercise design included participation from 23 Joint Commission Accreditation of Healthcare Organizations hospitals, four health departments, and a representative from one federal agency. The exercise was evaluated by trained exercise observers utilizing an independently prepared, evaluation protocol.Results:All exercise sites successfully identified the bio-agent involved and answered after-exercise debriefing questions without much difficulty. Evaluations, in the form of an after-action report by the independent observers, commented upon the many limitations to the construct of the exercise.Conclusion:Having an independent observer group at the exercise appeared to provide a value-added benefitfor capturing subjective information and data. However, these data were not in a form conducive to statisticalanalysis. Further work is needed to create an evaluation tool that would allow for statistical analysis so that exercises can be compared and improvements can be objective.
Communication and Health Protection Issues Arising from a Flooding Emergency
Authors: Wilson Nick , McIntyre Mary , McDonald Mark , Tanner Helen , Hart Kelli , Tomlinson Reuben , Thach Thu , Campion Vicki , Lee Dominique , Morrison Frances , Andersen Erik , Bibby Susan 
Published: August 2016

AbstractObjective:To identify and describe the key communication and health protection issues surrounding a flooding emergency.Methods:A telephone questionnaire was used to assess health and safety information sources, information recalled, and behavioral responses among residents of the town of Feilding, New Zealand following a major floodin February 2004. This was supplemented by key informant interviews and a newspaper content analysis.Results:A total of 154 adult residents were surveyed (76% of those successfully contacted and eligible). Of the respondents, 79% recalled being provided with health and safety information from authorities. The majorsources were: radio (41%), pamphlets (23%), and newspapers (20%). The regional newspaper had extensive coverage of this flooding emergency but “health” only was mentioned in 46 (7%) of the 664 flood-related articles.Of those who recalled receiving information from authorities, most (89%) perceived that it was adequate. Nevertheless, 18% actively sought out information (mainly about water safety and availability). In the post-flood period, 73% of all respondents boiled water; however, only 4% maintained boiling water or bottled water use for the necessary nine-week period. Some forms of emergency preparations did not change substantially from before the flood, compared to four months afterwards (e.g., having a radio with batteries increased from 62% to 68%). Perceived health concerns around the flooding were low, though 59% were concerned about the risk ofwater contamination. Actual self-reported, health consequences from the flood were rare, as only two (1%) people out of 154 reported flood-related health problems.Conclusions:Health and safety information generally was communicated successfully and was regarded as appropriate by the population of this floodaffected town. Nevertheless, there are further improvements needed in the emergency response by both residents and authorities.
Comparative Analysis of Traumatic Deaths in Nigeria
Authors: Ehikhamenor Edeaghe Eni , Ojo Mike A. 
Published: August 2016

AbstractIntroduction:The number of deaths due to trauma from road traffic accidents (RTAs), and from the use of firearms either for homicide or armed robbery, ethnic conflicts, and other events, such as flooding, explosions from petroleum products, and religious violence, is on the rise in Nigeria. This preliminary study is a comparative analysis of the frequency of deaths caused by RTAs and the deaths caused by the use of firearms during armed robbery. The study sought to identify the number of traumatic deaths caused by RTAs or armed robbery as well as the number of victims who sustained injuries in the process of RTA or armed robberies.Methods:An indigenous, non-governmental organization (NGO) network was used to abstract data for the frequency of RTAs associated with death or injuries and for deaths caused by armed robberies and was supplemented with data obtained from the Nigerian police.Results:For RTAs, the victims included drivers, passengers, and pedestrians. In 3,032 cases of RTAs, the total number of deaths was 1,239 (29.1%): one Nigerian dies for every three to four crashes. The total number of deaths due to RTAs was significantly higher than was the number of deaths due to the use of firearms in commission of robbery.Police reports relative to the use of firearms during armed robberies indicate that of a total of the 652 victims who were killed, 348 (68.1%) were the armed robbers, 134 (26.2%) were bystanders, and 29 (5.7%) were policemen.Conclusions:The enormity of the problems of traumatic deaths from RTAs and armed robberies in a developing country has been highlighted.