bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study of Psychiatric Morbidity among the Displaced and Non-Displaced Populations in the Andaman and Nicobar Islands following the Tsunami
Authors: Math Suresh Bada , John John P. , Girimaji Satish Chandra , Benegal Vivek , Sunny Biju , Krishnakanth K. , GS Uday Kumar , Hamza Ameer , Tandon Shweta , Jangam Kavitha , Meena K.S. , Chandramukhi Biju , Nagaraja D. 
Published: August 2016

AbstractObjective:The objective of this study was to compare the psychiatric morbidity between the displaced and non-displaced populations of the Andaman and Nicobar Islands during the first three months following the 2004 earthquake and tsunami.Methods:The study was conducted at the 74 relief camps in the Andaman and Nicobar Islands. Port Blair had 12 camps, which provided shelter to 4,684 displaced survivors. There were 62 camps on Car-Nicobar Island, which provided shelter to approximately 8,100 survivors who continued to stay in their habitat (non-displaced population). The study sample included all of the survivors who sought mental health assistance inside the camp. A psychiatrist diagnosed the patients using the ICD-10 criteria.Results:Psychiatric morbidity was 5.2% in the displaced population and 2.8% in the non-displaced population. The overall psychiatric morbidity was 3.7%. The displaced survivors had significantly higher psychiatric morbidity than did the non-displaced population.The disorders included panic disorder, anxiety disorders not otherwise specified, and somatic complaints. The existence of an adjustment disorder was significantly higher in the non-displaced survivors. Depression and post-traumatic stress disorder (PTSD) were distributed equally in both groups.Conclusions:Psychiatric morbidity was found to be highest in the displaced population. However, the incidence of depression and PTSD were distributed equally in both groups. Involvement of community leaders and survivors in shared decision-making processes and culturally acceptable interventions improved the community participation. Cohesive community, family systems, social support, altruistic behavior of the community leaders, and religious faith and spirituality were factors that helped survivors cope during the early phase of the disaster.
Drug Abuse-Related Emergency Calls: A Metropolis-Wide Study
Authors: Togia Athanasia , Sergentanis Theodoros N. , Sindos Michael , Ntourakis Dimitrios , Doumouchtsis Evangelos , Sergentanis Ioannis N. , Bachtis Constantinos , Pyrros Demetrios , Papaefstathiou Nikolaos 
Published: August 2016

AbstractIntroduction:Drug abuse is an important sociomedical problem in large metropolitan areas. Drug addicts represent a group with particularities, since they hesitate to seek medical care and often refuse hospitalization. Therefore, there is a scarcity of data on drug abuse-related calls. The burden imposed by such calls on emergency health services has not been evaluated in detail.Objectives:The objectives of this study are to: (1) assess the profile of drug abuse-related calls in a large European metropolis, including the spatiotemporal distribution, as well as the frequency and variability of cancellations; and (2) evaluate the mobilization of emergency prehospital care services in response to the calls.Methods:In 2005, the Hellenic National Centre for Emergency Care received 5,836 emergency drug abuse-related calls pertaining to the metropolitan area of Athens, Greece. The analysis focused on: (1) spatiotemporal features of calls/cases; (2) step-by-step cancellation rates in the mobilization of ambulances or other means (mobile intensive care units, specially equipped motorcycles, and super-mini city cars); and (3) response time of the mobilized means. Pearson's chi-square, goodness-of-fit chi-square, and the Kruskal-Wallis tests were used as appropriate.Results:Drug abuse-related calls represented 2% of all emergency calls. Only one-third of these cases were transported to the Accident and Emergency Departments of area hospitals. A total of 9% of the calls were cancelled before transportation arrived; another 20% of victims could not be found when authorities arrived on-scene, and 36% of patients refused transport to the hospital. The cancellation rate is significantly higher in the evening and at night, as well as in summer and autumn. The major burden is imposed on the municipality of Athens (67% of all calls).Conclusions:Drug abuse-related calls represent a significant load for emergency medical services in metropolitan Athens. However, a relatively small percentage of the drug addicts finally are transported to the hospital. Appropriately equipped motorcycles seem to be an effective means for the prehospital management of drug-abuse cases.
Chief Complaints, Diagnoses, and Medications Prescribed Seven Weeks Post-Katrina in New Orleans
Authors: Howe Erica , Victor David , Price Eboni G. 
Published: August 2016

AbstractBackground:In the aftermath of Hurricane Katrina, widespread flooding devastated the New Orleans healthcare system. Prior studies of post-hurri-cane healthcare do not consistently offer evidence-based recommendations for re-establishing patient care post-disaster. The primary objective of this study is to examine associations between patient characteristics, chief com-plaints, final diagnoses, and medications prescribed at a post-Katrina clinic to better inform strategic planning for post-disaster healthcare delivery (e.g., charitable donations of medications and medical supplies).Methods:This study is a retrospective chart review of 465 patient visits from 02 September 2005 to 22 October 2005 at a post-Katrina clinic in New Orleans, Louisiana that was open for seven weeks, providing urgent care services in the central business district. Using logistic regression, the relationships between patient characteristics (date of visit, gender, age, evacuation status), type of chief complaint, final diagnosis, and type of medication prescribed was examined.Results:Of 465 patients, 49.2% were middle-aged, 62.4% were men, 35% were relief workers, and 33.3% were evacuees; 35% of visits occurred in week five. Of 580 chief complaints, 71% were illnesses, 21% were medication refill requests, and 8.5% were injuries. Among 410 illness complaints, 25% were ears, nose, and throat (ENT)/dental, 17% were dermatologic, and 11% were cardiovascular. Most requested classes of medication refills for chronic medical conditions (n = 121) were cardiovascular (52%) and endocrine (24%).Most illness-related diagnoses (n = 400) were ENT/dental (18.2%), dermatologic (14.8%), cardiovascular (10.2%), and pul-monary (10.2%). Thirty-six percent of these diagnoses were infectious. Among 667 medications prescribed, 21% were cardiac agents, 13% pulmonary, 13% neurologic/musculoskeletal/pain, 11% antibiotics, 10% endocrine, and 9.3% anti-allergy. The likelihood of certain chief complaints, diagnoses, and medica-tions prescribed varied with patient characteristics.Conclusions:Donations of certain classes of medications were more useful than others. Prevalence of select co-morbidities, the nature of patient involve-ment in recovery activities in the disaster area, and post-disaster health haz-ards may explain variations in chief complaints, diagnoses, and medications prescribed by patient characteristics.
Faith-Based Organizations and Sustainable Sheltering Operations in Mississippi after Hurricane Katrina: Implications for Informal Network Utilization
Authors: Pant Anjali T. , Kirsch Thomas D. , Subbarao Italo R. , Hsieh Yu-Hsiang , Vu Alexander 
Published: August 2016

AbstractIntroduction:In the aftermath of Hurricane Katrina, a significant number of faith-based organizations (FBOs) that were not a part of the formal National Response Plan (NRP) initiated and sustained sheltering operations.Objective:The objective of this study was to examine the sheltering opera-tions of FBOs, understand the decision-making process of FBO shelters, and identify the advantages and disadvantages of FBO shelters.Methods:Verbal interviews were conducted with FBO shelter leaders. Inclusion criteria were: (1) opening in response to the Katrina disaster; (2) oper-ating for more than three weeks; and (3) being a FBO. Enrolled shelters were examined using descriptive data methods.Results:The majority of shelters operating in Mississippi up to three weeks post-Katrina were FBO-managed. All of the operating FBO shelters in Mississippi that met the inclusion criteria were contacted with a response rate of 94%. Decisions were made by individuals or small groups in most shelters regarding opening, operating procedures, and closing. Most FBOs provided at least one enabling service to evacuees, and all utilized informal networks for sheltering operations. Only 25% of FBOs had disaster plans in place prior to Hurricane Katrina.Conclusions:Faith-based organization shelters played a significant role in the acute phase of the Katrina disaster. Formal disaster training should be ini-tiated for these organizations. Services provided by FBOs should be standard-ized. Informal networks should be incorporated into national disaster planning.
Differences in Sources of Information Used by the Population between the Affected Area and the General Population during the First Phase of a Bird Flu Outbreak
Authors: Peltz Rami , Galit Avisar-Shohat , Ventura-Gabay Miri , Bar-Dayan Yaron 
Published: August 2016

AbstractIntroduction:In March 2006, a few cases of bird flu were discovered in approximately 10 rural settlements in Israel. As a result, approximately one million birds were destroyed within a three kilometer radius of the settle-ments. The Israeli population was instructed to take preventive measures against the spread of the infection.Objectives:The objective of this study was to compare the frequency of use of different sources of information by the population in the affected area with the general population during the first phase of a bird flu outbreak in Israel.Methods:A telephone survey among two randomly selected, representative samples of adults was conducted. One sample involved 500 adult Israeli resi-dents; the other sample involved 103 adult residents from the affected area during the first phase of the outbreak. The use of different sources of infor-mation by the population concerning the disease was assessed. The differences in these parameters between the affected area and the nationwide population were analyzed using a chi-square andt-test analysis. Ap-value of <0.05 was considered statistically significant.Results:Television was a significantly more common source of information in Israel as a whole (p<0.05), whereas friends (p<0.05) and local authorities (p<0.05) were significantly more common sources of information in the affected area.Conclusions:The frequency of use of the sources of information by the pop-ulation during the early phase of a bird flu outbreak is different in the affect-ed area compared with the general population in the same country. Authorities must pay attention to this phenomenon and use the correct sources of information in each area in order to achieve better exposure of the population to the recommended behaviors during an outbreak.
Defining the Problem, Main Objective, and Strategies of Medical Management in Mass-Casualty Incidents Caused by Terrorist Events
Authors: Ashkenazi Itamar , Kessel Boris , Olsha Oded , Khashan Tawfik , Oren Meir , Haspel Jacob , Alfici Ricardo 
Published: August 2016

AbstractBased on the experience of managing >20 such events during the last decade, the authors' understanding of a mass-casualty incident is that it is an event in which there may be many victims, but only a few that actually suffer from life-threatening injuries. To make an impact on survival, one must identify those who are severely wounded as quickly as possible and offer those patients opti-mal care. Experienced trauma physicians are the most important resource available to achieve this objective, and they should be allocated to the treat-ment of seriously injured victims instead of more traditional management roles such as triage and incident manager.
Introduction of a Prehospital Critical Incident Monitoring System—Pilot Project Results
Authors: Stella Julian , Davis Anna , Jennings Paul , Bartley Bruce 
Published: August 2016

AbstractBackground:Hospital medical incident monitoring improves preventable morbidity and mortality rates. Error management systems have been adopted widely in this setting. Data relating to incident monitoring in the prehospital setting is limited.Problem:Implementation of an incident monitoring process in a prehospital setting.Methods:This is a prospective, descriptive study of the pilot phase of the implementation of an incident monitoring process in a regional prehospital setting, with a focus on trauma care. Paramedics and emergency department staff submitted anonymous incident reports, and a chart review was performed on patients who met major trauma criteria. Selected trauma cases were analyzed by a structured interview/debriefing process to elucidate undocumented incidents.A project committee coded and logged all incidents and developed recommendations.Results:Of 4,429 ambulance responses, 41 cases were analyzed.Twenty-four (58.5%; 95% CI = 49.7–67.4%) were reported anonymously, and the rest were major trauma patients. A total of 77 incidents were identified (mean per case = 1.8; CI = 1.03–2.57). Anonymous cases revealed 26 incidents (mean = 1.1; CI = 0.98–1.22); eight trauma debriefings revealed 38 incidents (mean = 4.8; CI = 0.91–8.69) and nine trauma chart reviews revealed 13 incidents (mean = 1.6; CI = 1.04–2.16). A total of 56 of 77 (72.7%; CI = 65.5–80.0%) incidents related to system inadequacies, and 15 (57.7%; CI = 46.7–68.6%) anonymously reported incidents related to resource problems. A total of 35 of 77 (45.5%; CI = 40.4–50.5%) incidents had minimal or no impact on the patients' outcomes. Thirty-four of 77 (44.2%; CI = 39.3–49.1%) incidents were considered mitigated by circumstance. Incident monitoring led to generalized feedback in most cases (65 of 77; 84.4%; CI = 77.6–91.3%); in three cases (3.9%; CI = 3.7–4.1%), specific education occurred; two cases were reported to an external body (2.6%; CI = 2.5–2.7%); three cases resulted in remedial action (3.9%; CI = 3.7–4.1%); four for trend/further observation and analysis responses (5.2%; CI = 4.9–5.5%).Conclusions:The pilot project demonstrates successful implementation of an incident monitoring system within a regional, prehospital environment. The combination of incident detecting techniques has a high yield with potential to capture different error types.The large proportion of incidents in the “near miss” category allows analysis of incidents without patient harm. The majority of incidents were system related and many were mitigated by circumstance. The model used is appropriate for ongoing incident monitoring in this setting.
Why the Closest Ambulance Cannot be Dispatched in an Urban Emergency Medical Services System
Authors: Dean Stephen F. 
Published: August 2016

AbstractIntroduction:Response time performance is related to increased survival for a relatively small group of patients with critical emergencies. Effectively utilizing current resources is a challenge for all emergency medical services (EMS) systems for reasons of cost-effectiveness and safety.Problem:The objective of this study was to identify opportunities for improving ambulance response-time performance in an urban EMS system using fixed deployment.Methods:This was a qualitative and quantitative case study which consisted of structured interviews with policy makers, managers, and workers in a fire department EMS division, as well as analysis of dispatch data and observation of dispatch operations.Results:The current computer-aided dispatch (CAD) system does not identify the closest ambulance to the emergency, and therefore, dispatchers must guess which unit is closer when units are not within their stations or “first due” areas. There is no means to track how often dispatchers guess correctly or how often the closest ambulance actually is dispatched to the emergency.Temporal and geographic patterns were identified. Opportunities also were identified to improve response time performance through the use of dynamic deployment and peak-load staffing.Conclusions:The results suggest that there were opportunities for improving ambulance response times by implementing strategies such as peak-load staffing and dynamic deployment. However, the most important improvement would be the implementation of a policy to send the closest ambulance to the emergency. More research is needed to identify how prevalent the failure to send the closest ambulance is within EMS systems that use fixeddeployment response strategies and computer-aided dispatch systems that are incapable of tracking unit locations outside of their stations.
Disaster Preparedness: Hospital Decontamination and the Pediatric Patient— Guidelines for Hospitals and Emergency Planners
Authors: Freyberg Christopher W. , Arquilla Bonnie , Fertel Baruch S. , Tunik Michael G. , Cooper Arthur , Heon Dennis , Kohlhoff Stephan A. , Uraneck Katherine I. , Foltin George L. 
Published: August 2016

AbstractIn recent years, attention has been given to disaster preparedness for first responders and first receivers (hospitals). One such focus involves the decontamination of individuals who have fallen victim to a chemical agent from an attack or an accident involving hazardous materials. Children often are overlooked in disaster planning. Children are vulnerable and have specific medical and psychological requirements. There is a need to develop specific protocols to address pediatric patients who require decontamination at the entrance of hospital emergency departments. Currently, there are no published resources that meet this need. An expert panel convened by the New York City Department of Health and Mental Hygiene developed policies and procedures for the decontamination of pediatric patients.The panel was comprised of experts from a variety of medical and psychosocial areas.Using an iterative process, the panel created guidelines that were approved by the stakeholders and are presented in this paper.These guidelines must be utilized, studied, and modified to increase the likelihood that they will work during an emergency situation.
Disasters and Humanitarian Crises: A Joint Future for Responders?
Authors: Leaning Jennifer 
Published: August 2016

In the last 35 years, the disaster and humanitarian communities have evolved rapidly in two parallel cohorts. The disaster enterprise in the US and Latin America grew up in the 1970s in response to a series of major earthquakes, hurricanes, and forest fires, culminating with the nuclear disaster at Three Mile Island and the formation of the Federal Emergency Management Agency (FEMA) in 1979/80. The Disaster Program at the Pan-American Health Organization also took form in the 1980s.The humanitarian enterprise can be traced to the Biafran War of 1968/69, where a range of international, non-governmental organizations (NGOs) converged to respond to support a population that was fleeing a civil war and famine. In the years since, drawn to refugees and internally displaced persons in war circumstances as varied as Angola, Afghanistan, and Bosnia, the humanitarian community has expanded in numbers, reach, and budget.
Burn Survival in Mass-Casualty Situation Planning, Preparation, Response: What is the Key?
Authors: Wood Fiona 
Published: August 2016

When facing a situation involving mass casualties, we must consider the choices we have as individuals and as communities. The range of opportunity and privilege across the world is vast. Set against the background of natural and manmade disasters, how do we provide the right care at the right time for those in need? How can we share our collaborative knowledge?.The recognition of the dignity of those in need is the first step.Relationship building in the time of non-disaster leads to mutual understanding, facilitating care. Medicine brings science and experience into the art of clinical problem-solving. Disaster situations require rapid solutions based on prior planning, communicated with the understanding that optimal outcomes depend upon relationships based on respect, sharing knowledge of the local environmental resources, coupled with clinical care.
Preparedness of Primary Healthcare Centers for Critical Emergency Situations in Southwest Turkey
Authors: Yorganci Mustafa , Yaman H. 
Published: August 2016

AbstractIntroduction:Primary healthcare centers (PHCCs) frequently are contacted for emergency reasons and are expected to provide basic and advanced life support during emergency situations.Objectives:The aim of this study was to assess the availability of emergency equipment and the knowledge of the staff working in PHCCs.Methods:The survey was conducted in 21 PHCCs located in the rural city of Isparta, Turkey, in 2001. The availability of emergency equipment, emergency drugs, intravenous parenteral solutions, and diagnostic-therapeutic equipment was evaluated. Knowledge of basic life support of the staff (n = 195) was evaluated using a 10-item test.Results:Two (9.5%) PHCs had a complete emergency kit with an airways bag, mask, intravenous parenteral solutions, emergency drugs, and other diagnostic equipment. Emergency equipment was easily accessible in 19 PHCCs (90.5%), while in the remaining centers, the equipment and drugs were stored in locked cabinets.The staff that was evaluated consisted of 43 doctors (22%), 132 nurses and midwifes (67%), and 20 health officers (11%). Doctors scored the highest knowledge score (65.5%), followed by nurses and midwives (58.6% and 56.7%, respectively), and health officers (52.5%).Conclusions:Primary healthcare centers were not prepared to provide advanced life support. Knowledge scores were low and the staff was in need of basic life support training. Further arrangements must be stressed to make PHCC's “emergency-friendly centers” in Isparta, Turkey.
Cognitive-Behavioral Psychology: Implications for Disaster and Terrorism Response
Authors: Ruzek Josef I. , Walser Robyn D. , Naugle Amy E. , Litz Brett , Mennin Douglas S. , Polusny Melissa A. , Ronell Dianna M. , Ruggiero Kenneth J. , Yehuda Rachel , Scotti Joseph R. 
Published: August 2016

AbstractGiven the personal and societal costs associated with acute impairment and enduring post-traumatic stress disorder (PTSD), the mental health response to disasters is an integral component of disaster response planning. The purpose of this paper is to explore the compatibility between cognitive-behavioral psychology and the disaster mental health model, and explicate how cognitivebehavioral perspectives and intervention methods can enhance the effectiveness of disaster mental health services. It is argued that cognitive-behavioral methods, if matched to the contexts of the disaster and the needs of individuals, will improve efforts to prevent the development of PTSD and other trauma-related problems in survivors of disaster or terrorist events. First, the similarities between models of care underlying both disaster mental health services and cognitive-behavioral therapies are described. Second, examples of prior cognitive-behavioral therapy-informed work with persons exposed to disaster and terrorism are provided, potential cognitive-behavioral therapy applications to disaster and terrorism are explored, and implications of cognitive-behavioral therapy for common challenges in disaster mental health is discussed. Finally, steps that can be taken to integrate cognitive-behavioral therapy into disaster mental health are outlined. The aim is to prompt disaster mental health agencies and workers to consider using cognitive-behavioral therapy to improve services and training, and to motivate cognitive-behavioral researchers and practitioners to develop and support disaster mental health response.