bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Pediatric and Adult Disaster Victims Differ? A Descriptive Analysis of Clinical Encounters from Four Natural Disaster DMAT Deployments
Authors: Gnauck Katherine A. , Nufer Kevin E. , LaValley Jonathon M. , Crandall Cameron S. , Craig Frances W. , Wilson-Ramirez Gina B. 
Published: August 2016

AbstractObjectives:The differences between pediatric (≤17 years of age) and adult clinical field encounters were analyzed from four deployments of Disaster Medical Assistance Teams(DMATs).Methods:A retrospective cohort review of all patients who presented to DMAT field clinics during two hurricanes, one earthquake, and one flood was conducted. Descriptive statistics were used to analyze: (1) age; (2) gender; (3) severity category level; (4) chief complaint; (5) treatments provided; (6) discharge diagnosis; and (7) disposition. Five subsets of pediatric patients were analyzed further.Results:Of the 2,196 patient encounters reviewed, 643 (29.5%) encounters were pediatric patients. Pediatric patients had a greater number of blank severity category levels than adults. Pediatric patients also were: (1) more likely to present with chief complaints of upper respiratory infections or wounds; (2) less likely to present with musculoskeletal pain or abdominal pain; and (3) equally likely to present with rashes. Pediatric patients were more likely to receive antibiotics, pain medication, and antihistamines, but were equally likely to need treatment for wounds. Dispositions to the hospital were less frequent for pediatric patients than for adults.Conclusions:Pediatric patients represent a substantial proportion of disaster victims at DMAT field clinics. They often necessitate special care requirements different from their adult counterparts. Pediatric-specific severity category criteria, treatment guidelines, equipment/medication stocks, and provider training are warranted for future DMAT response preparations.
KAMEDO Report No. 85: Collapse of Building during Wedding Reception in Jerusalem, 2001
Authors: Michel Per-Plof , Sylvan Anders , Brändström Helge , Magnusson Eva 
Published: August 2016

AbstractWhat is now known as the “Versailles Disaster” began as a wedding celebration in Jerusalem on 24 May 2001. The reception was held in the third floor banqueting hall of a hotel, the floor of which subsequently collapsed, crashing through the second and first floors of the building. Four hundred people fell with the floor, and 310 injured people were evacuated using the scoop-and-run principle. The total number of dead was 23, which was less than mighthave been expected. Israel's on-site disaster management system of giving control to the first paramedic on the scene appeared to work well; however, the other emergency services did not act in coordination with the paramedics. The hospitals managed patients efficiently and social workers were mobilized quickly to assist people experiencing psychological trauma.
KAMEDO Report No. 88: Floods in the Czech Republic and Southeastern Germany, 2002
Authors: Näsman Ulla , Zetterberg Randén Birgit , Brändström Helge 
Published: August 2016

AbstractSevere flooding in August 2002 devastated villages, towns, large areas of arable land, streets, roads, and industrial areas in the Czech Republic and Southeastern Germany. In the Czech Republic, 48,000 people were evacuated from Prague.Due to electrical outages, communication and the care of hospital patients suffered. Sanitation services and refuse collection also were not available, which increased the potential for the spread of disease. In Germany, five hospitals required evacuation. Electrical outages were problematic here as well, and it is recommended that the procedures for the longdistance transportation of a large number of severely ill or injured people be clarified in national plans.
Chlorine and its Impact on an Emergency Department
Authors: Ngo Adeline , Ponampalam R. , Leong Mark , Han Lim Swee 
Published: August 2016

AbstractIntroduction:An incident involving the release of chlorine gas from the pump room at a local swimming pool resulted in 54 patients seeking treatment in the emergency departments (EDs) of two local, tertiary-level hospitals in Singapore. The hospital hazardous materials (HAZMAT) disaster plan was activated. This report describes how one of the EDs organized in response to the disaster.Event:Of the 54 people seeking treatment, 36 were treated in the ED at the Singapore General Hospital. The patients were decontaminated at shower facilities prior to entering the ED. The ED was reorganized to cope with existing patients, as well as the large influx of patients from the event site. A protocol was established in coordination with the local drug and poison information center to manage the patients who suffered from chlorine inhalation. Most patients were observed in the ED and subsequently discharged.Outpatient review appointments were scheduled.Injuries:Acute respiratory symptoms were the most common symptoms. Four children and four adults were admitted to the hospital, and the other patients were discharged from the ED after observation. All of the chest xrays were normal on the day of the chlorine inhalation. There were no mortalities or significant morbidities, even up to six months after the incident.Conclusions:Although this chlorine HAZMAT incident did not cause severe injuries, and only a limited number of persons required admission to the hospital, some valuable lessons were learned.
Financial Implications of Hospital Response to Bioterrorism Based on Diagnosis-Related Group Analysis
Authors: Suyama Joe , Savitz Lucy , Chang Helen , Allswede Michael 
Published: August 2016

AbstractIntroduction:During an infectious disease outbreak, the ability of a hospital to continue routine operations depends upon its ability to absorb expected losses in revenue when the routine charge base is replaced by infectious disease-related charges.Objective:The purpose of this study was to determine the probable financial impact of a bioterrorism event or an infectious disease outbreak on an academic and a community hospital.Methods:During the fiscal year 01 July 2002–30 June 2003, the average number of inpatient charges identified by the diagnosis-related-groups (DRGs) of an academic, tertiary care, Level-1 trauma center (PUH) and a community hospital (StM) were obtained retrospectively. Per diem charges were determined for patients with: (1) gastroenteritis; (2) sepsis; (3) meningitis; (4) tuberculosis (TB); and (5) pneumonia. These charges were used to simulate the financial coding of patients exposed to biological agents.Results:The total average PUH per diem charges per patient for all 31,530 discharges was (US)$10,516. Specifically, the average changes were $20,499 for patients with transplants, $14,406 for receiving critical care services, $12,650 for the provision of cardiac care, $11,576 for trauma/orthopedic care, and $8,259 for services for patients who suffered a stroke. For patients with infectious diseases, the average per diem charges per patient were: (1) $6,184 for patients with gastroenteritis; (2) $7,842 for patients with sepsis; (3) $10,831 for patients with meningitis; (4) $6,118 for patients with TB; and (5) $4,586 for patients with pneumonia. Per patient per day, PUH would generate a potential net on average loss of: (1) $4,332 for gastroenteritis; (2) $2,674 for sepsis; (3) $4,398 for TB; and (4) $5,930 for pneumonia replaced an admission. Patients with meningitis on average generated a net gain ($315) compared to the average, but would not compensate for the denial of transplant, cardiac, trauma/orthopedic, and some critical care services during the event. Total average StM per diem charges per patient for all 10,470 discharges equaled $3,008. Specifically, $4,965 for critical care, $3,022 for cardiac care, $4,397 for trauma/orthopedic care, and $3,037 for stroke services. For infectious diseases, the average per diem charge per patient was: (1) $2,273 (+$735) for gastroenteritis; (2) $3,047 (+$39) for sepsis; (3) $2,504 (-$504) for meningitis; (4) $2,887 ($120) for TB; and (5) $2,652 (-$356) for pneumonia (net loss/gain in parenthesis).Conclusions:Through DRG analysis, the probable financial impact of a bioterrorist attack on a Health Care Delivery System is largely detrimental. Preparedness for a biological event must include an assessment of hospital capability and capacity to handle these types of patients, but also must consider the financial ability to absorb expected losses in charges or ways in which to recover the losses.
Traumatic Brain Injuries after Mass-Casualty Incidents: Lessons from the 11 September 2001 World Trade Center Attacks
Authors: Rutland-Brown Wesley , Langlois Jean A. , Nicaj Leze , Thomas Robert G. , Wilt Susan A. , Bazarian Jeffrey J. 
Published: August 2016

AbstractIntroduction:The 11 September 2001 terrorist attacks on the World Trade Center (WTC) resulted in thousands of deaths and injuries. Research on previous bombings and explosions has shown that head injuries, including traumatic brain injuries (TBIs), are among the most common injuries.Objective:The objective of this study was to identify diagnosed and undiagnosed (undetected) TBIs among persons hospitalized in New York City following the 11 September 2001 WTC attacks.Methods:The medical records of persons admitted to 36 hospitals in New York City with injuries or illnesses related to the WTC attacks were abstracted for signs and symptoms of TBIs. Diagnosed TBIs were identified using the International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes. Undiagnosed TBIs were identified by an adjudication team of TBI experts that reviewed the abstracted medical record information. Persons with an undiagnosed TBI were contacted and informed of the diagnosis of potential undetected injury.Results:A total of 282 records were abstracted. Fourteen cases of diagnosed TBIs and 21 cases of undiagnosed TBIs were identified for a total of 35 TBI cases (12% of all of the abstracted records). The leading cause of TBI was being hit by falling debris (22 cases). One-third of the TBIs (13 cases) occurred among rescue workers.More than three years after the event, four out of six persons (66.67%) with an undiagnosed TBI who were contacted reported they currently were experiencing symptoms consistent with a TBI.Conclusions:Not all of the TBIs among hospitalized survivors of the WTC attacks were diagnosed at the time of acute injury care. Some persons with undiagnosed TBIs reported problems that may have resulted from these TBIs three years after the event. For hospitalized survivors of mass-casualty incidents, additional in-hospital, clinical surveys could help improve pre-discharge TBI diagnosis and provide the opportunity to link patients to appropriate outpatient services. The use and adequacy of head protection for rescue workers deserves re-evaluation.
Factors That May Influence the Preparation of Standards of Procedures for Dealing with Mass-Casualty Incidents
Authors: Adini Bruria , Goldberg Avishay , Laor Danny , Cohen Robert , Bar-Dayan Yaron 
Published: August 2016

AbstractIntroduction:General hospitals in Israel are required to develop standards of procedures (SOPs) to facilitate the management of mass-casualty incidents (MCIs). These SOPs represent the initial step in a continuous process, providing guidelines for hospitals to manage MCIs in an organized and efficient manner. Evaluation of the preparedness levels of hospitals in dealing with MCIs is required in order to promote an effective response, and to identify factors that might impact the quality of SOPs. The aim of this study was to identify the characteristics of hospitals that have an impact on the preparation of SOPs.Methods:An evaluation tool was developed to assess the SOPs from 22 hospitals during the management of a MCI. The results of the evaluations were analyzed, in relation to the size, trauma capabilities, ownership, geographic location, urban versus rural status of the hospitals, the proximity to other hospitals, participation in drills during the year prior to the evaluation, and number of actual MCIs the hospital managed in the past three years.Results:The evaluation scores of the SOPs of 11 of the 22 hospitals (50%) were very high, so their SOPs did not require modifications.The SOPs of four hospitals (18%) were rated highly, requiring only minor modifications. The SOPs of four hospitals (18%) received poor ratings, requiring major modifications, and three hospitals (14%) were found to have incomplete SOPs and received very poor ratings.No significant differences were found between the ratings of SOPs in relation to the different characteristics of the hospitals analyzed. A low correlation between the level of SOPs and the number of MCIs that the hospital managed was found (r = 0.266, NS).Conclusions:The tool developed to evaluate the quality of the SOPs of hospitals to manage MCIs was logistically feasible and capable of differentiating between hospital SOPs. The comprehensiveness and completeness of the SOPs appears to be unrelated to the characteristics of the hospitals included in this study. Of particular note was the lack of a significant correlation between the SOP rating and the number of actual MCIs managed by a hospital.
Effect of Severe Acute Respiratory Syndrome on Bystander Willingness to Perform Cardiopulmonary Resuscitation (CPR)–Is Compression–Only Preferred to Standard CPR?
Authors: Lam Kin-Kwan , Lau Fei-Lung , Chan Wai-Kwong , Wong Wing-Nam 
Published: August 2016

AbstractObjective:The effect of the severe acute respiratory syndrome (SARS) outbreak on the willingness of laypersons to provide bystander cardiopulmonary resuscitation (CPR) using standard CPR (SCPR) or compression-only CPR (CCPR) was evaluated.The preferred type of SCPR in the post-SARS era was assessed.Methods:A descriptive study was conducted through telephone interviews. Persons who attended a CPR coursefrom January 2000 through February 2003 answered a structured questionnaire. The respondents' willingnessto perform SCPR or CCPR during a witnessed cardiac arrest of an average adult stranger or that of a family member in the pre-SARS and the post-SARS era was surveyed.Results:Data for 305 respondents were processed. For the scenario of cardiac arrest of an average stranger, more respondents would perform CCPR than SCPR in the pre-SARS era (83.6% vs. 61.3%, p <0.001) and in the post- SARS era (77.4% vs. 28.9%, p <0.001). In the scenario of the cardiac arrest of a family member, more would perform CCPR than SCPR in the pre-SARS era (92.8% vs. 87.2%, p <0.001) and in the post-SARS era (92.8% vs. 84.9%, p <0.001). After SARS, more respondents were unwilling to perform SCPR (p <0.001) and CCPR (p <0.001) on strangers. After SARS, more respondents were unwilling to perform SCPR on a family member (p = 0.039), but there was no difference in the preference to perform CCPR (p = 1.000).Conclusions:Concerns about SARS adversely affected the willingness of respondents to perform SCPR or CCPRon strangers and to perform SCPR on family members.Compression-only CPR was preferred to SCPR to resuscitate strangers experiencing cardiac arrest after the emergence of SARS.
Health Tracking for Improved Humanitarian Performance
Authors: Mock Nancy , Garfield Richard 
Published: August 2016

AbstractPresently, there is no shortage of methods for collecting data on populations requiring assistance from humanitarian health interventions. However, utilizing a working group, the authors of this paper have looked at these methods through a critical lens and found that there is need for improvement upon existing systems of data collection and analysis. The authors concluded that efforts to standardize the methods of data collection are needed to achieve universal uniformity, and that more funding should be allocated to analyze the data collected.
The Dilemma of Neutrality
Authors: Leaning Jennifer 
Published: August 2016

AbstractThis paper focuses on the dilemma that humanitarian non-governmental organizations (NGOs) face in their efforts to gain access to populations caught up in current wars. Narrow and broad concepts of humanitarian protection are discussed and it is argued that despite high levels of professionalism, the space for humanitarian action has constricted sharply since the events surrounding the attacks of 11 September 2001. Increasingly, aid workers are now being viewed with suspicion as agents of the great powers and assertions of humanitarian neutrality are not heeded or rejected. Non-governmental organizations have evolved a range of options to address this problem, but there is an urgent need to work collectively to find more durable and coherent solutions.
Usefulness of a DSM Criteria-Based Inventory for Screening for Post-Traumatic Stress Disorder
Authors: Farina Benedetto , Venturi Piero , Onofri Antonio , Raja Michele , Giannantonio Massimo Di 
Published: August 2016

AbstractThe aim of the study is to evaluate the self-administeredDiagnostic and Statistical Manual of Mental Disorders, 4thEdition criteria-based inventory for the screening of post-traumatic stress disorder. Due to its low sensitivity (57%) and high specificity (88%), it could be useful as a second step of a screening procedure in combination with other validated, self-report instruments. The clinical implications of the findings and the limitations of the study are discussed.
The accuracy of progeny testing with binomial auxiliary traits
Authors: Narain P. , Kaur A. P. 
Published: August 2016

AbstractThe accuracy of progeny testing for a continuous trait when the auxiliary information was based on ‘all-or-none’ type of traits with a multi-factorial threshold model was examined. The accuracy of the progeny test was found always to increase with the inclusion of the auxiliary trait. It followed the same pattern as in the case of continuous auxiliary trait. However, there was an additional feature in that the accuracy was also dependent on the probability of incidence of the discrete trait unless either the progeny group size was very large, and/or there was no genetic correlation or else the probability of incidence was itself extremely low. Compared with the case when the auxiliary trait was continuous, there was a loss in accuracy which can be looked upon in two ways. First, the continuous auxiliary trait is itself made ‘all-or-none’ type by a threshold and the accuracies compared in the two cases. The loss increases symmetrically in either direction with increase in positive or negative directions of the difference in genotypic and phenotypic correlations. Secondly, a comparison can be made of the accuracy when the auxiliary trait is normally distributed with that when it is binomially distributed but with the same amount of genetic information on the observed scale as given by the heritabilities and genetic correlations. No loss now occurs if the two classes of the binomial trait are equally likely and the loss in accuracy increases with the decrease in the standard deviation of the binomial distribution for given values of other parameters. It was found also that the use of binomial auxiliary trait reduced the number of progeny required to attain a pre-assigned level of accuracy, resulting in a decreased cost of the programme compared with that when no binomial auxiliary trait was used.
The effect of genotype × environment interactions on biological efficiency in beef cows
Authors: Wright I. A. , Jones J. R. , Maxwell T. J. , Russel A. J. F. , Hunter E. A. 
Published: August 2016

AbstractAn experiment was conducted to examine the response of three genotypes of beef cows to contrasting levels of nutrition supplied from grazed pasture. Twenty-two Hereford × Friesian (HF), 20 Aberdeen Angus × Friesian (AF) and 24 Welsh Black (WB) spring-calving beef cows with their Charolais-cross calves were used in 4 years consecutively. During the summer grazing period they grazed permanent pasture maintained at either 4 to 5 cm (short) or 7 to 8 cm (tall) sward surface height. Sward height treatment significantly (P < 0·001) affected cow and calf live-weight gain (0·498 v. 0·041 (s.e.d. 0·0405) kg/day and 1·12 v. 0·90 (s.e.d. 0·021) kg/day for cow and calf live-weight gain on the tall and short swards respectively). The live-weight gains of the HF and WB cows were similar, but the AF cows gained less weight on the tall sward and lost weight on the short sward. Calf live-weight gain reflected cow milk yield, with the calves from HF and AF cows having similar live weight gains (1·06 and 1·02 kg/day respectively) and those from WB cows having lower gains (0·95 kg/day; P < 0·001). The effect of sward height on calf live-weight gain was greatest in the WB-born calves because of the lower milk yield from WB cows. Body chemical composition changes of cows were predicted from live weight and body condition score, using prediction equations derived from separate groups of cows which were slaughtered at a range of body compositions for determination of chemical composition. Energy balances, calculated from changes in chemical composition, showed the AF cows to have the lowest energy balances with the WB cows the highest. Calculation of energetic efficiency and land use efficiency of weaned calf production taking account of annual food requirements indicated that the HF cows were most efficient, and the WB cows least efficient. The effect of increasing nutritional environment (as represented by sward height treatment) was such as to increase energetic efficiency for all genotypes, but land use efficiency was increased for HF and AF cows, and decreased for WB cows. These results indicate the factors such as size of cows, milk yield potential and pattern of nutrient partitioning can influence energetic land use efficiency of weaned calf production, and that important interactions between genotype and nutritional environment can occur in different measures of efficiency.
Approaches to the ethical evaluation of animal biotechnologies
Authors: Mepham T. B. 
Published: August 2016

AbstractThe paper explores a scheme for the ethical evaluation of animal biotechnologies, exemplified by animal transgenesis. It begins with an overview of prominent ethical theories (deontological and consequentialist) and proceeds to apply them to four ethical principles,viz.autonomy, justice, non-maleficence and beneficence, in relation to the interests of the treated animals and of different groups of people affected by the technology. Evaluation is facilitated by use of a schematic device — an ‘ethical grid’. The importance of public education and attitudes to biotechnology is illustrated by reference to recent public opinion surveys in the European Community. The paper concludes with a discussion of the impact of future trends in global population, food resources and environmental change, which emphasizes the need for a reappraisal of priorities in animal production systems. It is suggested that attempts to eradicate hunger, to improve animal welfare and to devise sustainable agricultural systems will be facilitated by greater investment in the emerging academic field of agricultural bioethics.