bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reactions to Cold Exposure Emphasize the Need for Weather Protection in Prehospital Care: An Experimental Study
Authors: Lintu Niina S. , Health M. , Mattila Matti A.K. , Holopainen Jaana A. , Koivunen Mari , Hänninen Osmo O.P. 
Published: August 2016

AbstractIntroduction:Exposure to cold temperature is a serious but often neglected problem in prehospital care. It not only is an uncomfortable, subjective experience, but it also can cause severe disturbances in vital functions, gradually leading to hypothermia.Objective:The aim of this study was to examine healthy subjects'physiological and subjective reactions to cold exposure (30 minutes at -5°C in the a climatic chamber) while they were lying in a protective covering.Methods:Healthy volunteers (n = 20) participated in the experiment, which consisted of a 10-minute stabilization period of vital functions at room temperature (23°C), 30 minutes of cold exposure (-5°C), and a 30-minute recovery period at room temperature. Subjects lay supinely in protective covering during the entire experiment. Skin temperatures, oxygen saturation, pulse rates, pulse wave amplitude in the middle finger, and surface electromyography (EMG) activity of the major pectoral muscle were recorded continuously during the test. Before and immediately after the cold exposure, tympanic membrane temperatures were measured. In addition, subjects were asked to estimate cold using a standard scale.Results:During the cold exposure, the decrease in tympanic membrane temperature was not significant.The pulse wave amplitude in the finger decreased sharply upon entering the cold chamber. Skin temperatures, especially of the fingers and toes, decreased during the cold exposure.There were no clear signs of shivering in electromyographic recordings. Subjective cold feelings followed decreasing skin temperatures. Skin temperatures did not return quickly. Even 30 minutes after the exposure, all the skin temperatures still had not returnedto normal levels.However, subjective cold feeling was relieved immediately.Conclusions:Cold exposure provoked immediate protective vasoconstriction in the peripheral compartment, which caused linear decreases of local skin temperatures. This probably was triggered from the unprotected face and upper respiratory areas.
Express Railway Disaster in Amagasaki: A Review of Urban Disaster Response Capacity in Japan
Authors: Nagata Takashi , Rosborough Stephanie N. , VanRooyen Michael J. , Kozawa Shuichi , Ukai Takashi , Nakayama Shinichi 
Published: August 2016

AbstractIntroduction:On the morning of 25 April 2005, a Japan Railway express train derailed in an urban area of Amagasaki, Japan. The crash was Japan's worst rail disaster in 40 years.This study chroniclesthe rescue efforts and highlights the capacity of Japan's urban disaster response.Methods:Public reports were gathered from the media, Internet, government, fire department, and railway company. Four key informants, who were close to the disaster response, were interviewed to corroborate publicdata and highlight challenges facing the response.Results:The crash left 107 passengers dead and 549 injured. First responders, most of whom were volunteers, were helpful in the rescue effort, and no lives were lost due to transport delays or faulty triage. Responders criticized an early decision to withdraw rescue efforts, a delay in heliport set-up, the inefficiency of the information and instruction center, and emphasized the need for training in confined space medicine. Communication and chain-of-command problems created confusion at the scene.Conclusions:The urban disaster response to the train crash in Amagasaki was rapid and effective.The KobeEarthquake and other incidents sparked changes that improved disaster preparedness in Amagasaki. However, communication and cooperation among responders were hampered, as in previous disasters, by the lack of a structured command system. Application of an incident command system may improve disaster coordination in Japan.
A Pilot Assessment of Hospital Preparedness for Bioterrorism Events
Authors: Thorne Craig D. , Levitin Howard , Oliver Marc , Losch-Skidmore Sue , Neiley Beth A. , Socher Myra M. , Gucer Patricia W. 
Published: August 2016

AbstractObjective:Lessons on question content and refinement of a 2003 Agency for Healthcare Research and Quality-Health Resources Services Administration (Agency for Healthcare Research and Quality-Health Resources Services) pilot hospital preparedness assessment tool designed to capture activities in more detail than previous studies are reported in this study.Methods:Responses from fixed-choice questions, including organizational and geographical differences, were analyzed using the chi-square test. Openended questions were evaluated qualitatively.Results:Of the respondents, 91% had developed plans and 97% designated a bio-event coordinator, but only 47% had allocated funds. Urban hospitals were more likely to participate in regional infectious disease monitoring. Hospitals that participated in a network were more likely to fund preparedness, share bio-event coordinators and medical directors, and provide advanced training.Conclusions:Several issues deserve further study: (1) hospital networks may provide the structure to promote preparedness; (2) specific procedures (e.g., expanding outpatient treatment capacity) have not been tested; and (3) special attention should be directed towards integrating non-urban hospitals into regional surveillance systems to ensure early identification of infectious disease outbreaks.
Treatment Management in Disaster: A Review of the Bam Earthquake Experience
Authors: Saghafinia Masoud , Araghizade Hassan , Nafissi Nahid , Asadollahi Reza 
Published: August 2016

AbstractIn the early morning of 26 December 2003, Bam, an old city in southeastern Iran, was devastated by an earthquake measuring 6.6 on the Richter scale. Managing such situations always brings about many problems. In the case of the Bam Earthquake, two of the most serious problems were rescue operations and provision of appropriate treatment within a short period of time.By conducting an opinion survey, this study aims to assess different aspects of treatment management, including personnel, the transfer of the injured, equipment, facilities, and treatment planning. Questionnaires containing open questions regarding the management of treatment at five levels were prepared.Those engaged in treatment at different levels, including physicians, treatment workers, military personnel, and executives, were questioned. Several problems were revealed concerning the composition of the treatment forces dispatched, into the region, distribution of the tasks among treatment workers, and the transferring of equipment, and facilities. The most significant problem was a lack of coordination among the organizations responsible for the management of the disaster.A comprehensive disaster plan is required if prompt handling of masscasualty incidents and coordinating the management of such large-scale disasters are to be ensured.
Standards in Collaborative International Disaster Drills: A Case Study of Two International Search and Rescue Drills
Authors: Rokach Ariel , Pinkert Moshe , Nemet Dani , Goldberg Avishay , Bar-Dayan Yaron 
Published: August 2016

AbstractIntroduction:During the last few decades, various global disasters have ren-dered nations helpless (such as Thailand's tsunami and earthquakes in Turkey, Pakistan, Iran, and India). A lack of knowledge and resources make it difficult to address such disasters. Preparedness for a national disaster is expensive, and in most cases, unachievable even for modern countries. International collabo-ration might be useful for coping with large-scale disasters. Preparedness for international collaboration includes drills. Two such drills held by the Israeli Home Front Command and other military and civilian bodies with the nations of Greece and Turkey are described in this article.Methods:The data were gathered from formal debriefings of the Israeli teams collaborating in two separate drills with Greek and Turkish teams.Results:Preparations began four months before the drills were conducted and included three meetings between Israeli and foreign officials. The Israeli and foreign officials agreed upon the drill layout, logistics, communications, resi-dence, real-time medicine, hardware, and equipment. The drills took place in Greece and Turkey and lasted four days. The first day included meetings between the teams and logistics preparations. The second and third days were devoted to exercises. The drills included evacuating casualties from a demoli-tion zone and treating typical injuries such as crush syndrome. Every day ended with a formal debriefing by the teams' commanders. The fourth day included a ceremony and transportation back home. Members in both teams felt the drills improved their skills and had an important impact on creating common language that would enhance cooperation during a real disaster.Conclusions:A key factor in the management of large-scale disasters is coor-dination between countries. International drills are important to create com-mon language within similar regulations.
Practical Solutions for Injury Surveillance at Mass Gatherings
Authors: Zeitz Kathryn , Zeitz Chris , Arbon Paul , Cheney Fiona , Johnston Renee , Hennekam James 
Published: August 2016

AbstractIntroduction:Public safety at mass gatherings is the responsibility of multi-ple agencies. Injury surveillance and inter-agency communication are pivotal to ensure continued public safety.Objectives:The principal objective of this pilot study was to improve the identification of trends and patterns of injury presentations at mass gather-ings. This was achieved through an electronic process for data gathering to support timely reporting of injury data. In addition, what evolved was the devel-opment of an inter-agency communication model to support information transfer.Methods:An Electronic Injury Surveillance System was created and piloted at two mass gatherings in South Australia. Live, real-time data were collect-ed via customized software supported by electronic report generation.Results:The Injury Surveillance System captured data on 181 injured patients and assisted in the identification of trends and patterns of presenta-tions. The relevant injuries and patterns of injuries were reported to the appropriate organizations based on pre-defined communication models.Conclusions:The pilot study demonstrated that it was possible to perform “live”, portable injury surveillance during patient presentations at two mass gatherings. The Injury Surveillance System ensured immediate data capture. Well-defined communication systems established for this pilot also enabled early action to rectify hazards. Further development of electronic injury sur-veillance should be considered as an essential tool for managing public safety at mass gatherings.
Polonium-210 Poisoning in London: Hypochondriasis and Public Health
Authors: Morgan Oliver W. , Page Lisa , Forrester Sarah , Maguire Helen 
Published: August 2016

AbstractIntroduction:In November 2006, a Russian dissident died from radioactive Polonium-210 (210Po) poisoning in London. Providing reassuring messages during a public health incident may be ineffective for individuals with high health anxiety (hypochondriasis).Methods:Members of the public who called a 24-hour telephone helpline were offered a follow-up call by a health protection specialist for reassurance. A psychiatrist attempted to contact those callers who were unable to be reas-sured by the health protection specialist.Results:Of 872 individuals contacted for reassurance, seven (0.6%) could not be reassured. The psychiatrist contacted four of these individuals. Three had a history of health-related anxiety and two attributed somatic symptoms to 210 Po exposure.Conclusions:For individuals with hypochondriasis, reassurance during major public health incidents may be ineffective. Having a psychiatrist available was helpful in managing individuals with excessive health anxiety.
Use of “Shuttered” Hospitals to Expand Surge Capacity
Authors: Zane Richard D. , Biddinger Paul , Ide Lyndsley , Phillips Sally , Hurd Donna , Buatti Louisa , Eustace Hilary , Amsden Matthew , Carr Darcy , Hassol Andrea 
Published: August 2016

AbstractIntroduction:With limited available hospital beds in most urban areas, there are very few options when trying to relocate patients already within the hospital to make room for incoming patients from a mass-casualty incident (MCI) or epidemic (a patient surge). This study investigates the possibility and process for utilizing shuttered (closed or former) hospitals to accept medically stable, ambulatory patients transferred from a tertiary medical facility.Methods:Two recently closed, acute care hospitals were evaluated critically to determine if they could be made ready to accept inpatients within 3–7 days of a MCI. This surge facility ideally would be able to support 200–300 patients/beds. Two generic scenarios were used for planning: (1) a patient surge (including one caused by conventional war or terrorism, weapons of mass destruction, or a disaster caused by natural hazards) requiring transfer of ambulatory, medically-stable inpatients to another facility in an effort to increase capacity at existing hospitals; and (2) a bio-event or epidemic where a shuttered hospital could be used as an isolation facility.Results:Both recently closed hospitals had significant, but different challenges to reopening, although with careful planning and resource allocation it would be possible to reopen them within 3–7 days. Planning was the most conclusive recommendation. It does not appear possible to reopen shuttered hospitals with major structural deterioration or a complete lack of current mission (i.e., no current utilities). Staffing would represent the most challenging issue as a surge facility would represent an incremental additional need for existing and scarce human resources.Conclusions:With careful planning, a shuttered hospital could be reopened and ready to accept patients within 3–7 days of a MCI or epidemic.
Twenty-Five Years of Violence: The Epidemiology of Terrorism in South America
Authors: Báez Amado Alejandro , Sztajnkrycer Matthew D. , Zane Richard , Giráldez Ediza 
Published: August 2016

AbstractIntroduction:Terrorism is a global public health burden. South Americans have been victims of terrorism for many decades.While the causes vary, the results are the same: death, disability, and suffering.The objective of this study was to perform a comprehensive, epidemiological, descriptive study of terrorist incidents in South America.Methods:This is a cross-sectional, descriptive study. Data from January 1971 to July 2006 was selected using the RAND Terrorism Chronology 1968–1997 and RAND®-Memorial Institute for Prevention of Terrorism (MIPT) Terrorism Incident database (1998–Present). Statistical significance was set at 0.05.Results:The database reported a total of 2,997 incidents in South American countries that resulted in 3,435 victims with injuries (1.15 per incident) and 1,973 fatalities (0.66 per incident). The overall case fatality ratio (CFR) was 35.8%. Colombia had the majority of incidents with 57.9% (1,734 of 2,997), followed by Peru with 363 (12.1%), and Argentina with 267 (8.9%). The highest individual CFR occurred in Paraguay (83.3%), and the lowest in Chile with 4.8%. Of the total injuries and deaths, Colombia had 66.1% (2,269 of 2,997) of all injuries and 75.2% (1,443 out of 1,920) of all deaths. Living in the country of Colombia was associated with a 16 times greater likelihood of becoming a victim of terrorist violence [odds ratio (OR) 16.15; 95% CI 13.45 to 19.40; p <0.0001].The predominant method of choice for terrorist incidents was the use of conventional explosives with 2,543 of 2,883 incidents (88.2%).Conclusions:Terrorist incidents in South America have accounted for nearly 2,000 deaths, with conventional explosive devices as the predominant method of choice. Understanding the nature of terrorist attacks and the medical consequences assist emergency preparedness and disaster management officials in allocating resources and preparing for potential future events.
Decontamination of Multiple Casualties Who Are Chemically Contaminated: A Challenge for Acute Hospitals
Authors: Clarke Simon F.J. , Chilcott Rob P. , Wilson James C. , Kamanyire Robie , Baker David J. , Hallett Anthony 
Published: August 2016

AbstractPatients who have been contaminated by chemical compounds present a number of difficulties to emergency departments, in particular, the risk of secondary contamination of healthcare staff and facilities. The Department of Health in the United Kingdom has provided equipment to decontaminate chemically contaminated casualties who present at emergency departments. The capacity of this equipment is limited, and although both the ambulance and fire services have equipment to cope with mass casualties at the scene of a chemical incident, there is still the possibility that acute hospitals will be overwhelmed by large numbers of self-presenting patients. The risks and potential consequences of this gap in resilience are discussed and a number of possible practical solutions are proposed.
Simulation of a Hospital Disaster Plan: A Virtual, Live Exercise
Authors: Franc-Law Jeffrey M. , Bullard Michael , Corte F. Della 
Published: August 2016

AbstractIntroduction:Currently, there is no widely available method to evaluate an emergency department disaster plan. Creation of a standardized patient data- base and the use of a virtual, live exercise may lead to a standardized and reproducible method that can be used to evaluate a disaster plan.Purpose:A virtual, live exercise was designed with the primary objective of evaluating a hospital's emergency department disaster plan. Education and training of participants was a secondary goal.Methods:A database (disastermed.ca) of histories, physical examination findings, and laboratory results for 136 simulated patients was created using information derived from actual patient encounters.The patient database was used to perform a virtual, live exercise using a training version of the emergency department's information system software.Results:Several solutions to increase patient flow were demonstrated during the exercise. Conducting the exercise helped identify several faults in the hospital disaster plan, including outlining the important rate-limiting step. In addition, a significant degree of under-triage was demonstrated. Estimates of multiple markers of patient flow were identified and compared to Canadian guidelines. Most participants reported that the exercise was a valuable learning experience.Conclusions:A virtual, live exercise using the disastermed.ca patient database was an inexpensive method to evaluate the emergency department disaster plan. This included discovery of new approaches to managing patients, delineating the rate-limiting steps, and evaluating triage accuracy. Use of the patient timestamps has potential as a standardized international benchmark of hospital disaster plan efficacy. Participant satisfaction was high.
Media Coverage of Violent Deaths in Iraq: An Opportunistic Capture-Recapture Assessment
Authors: Siegler Anne , Roberts Leslie , Balch Erin , Bargues Emmanuel , Bhalla Asheesh , Bills Corey , Dzeng Elizabeth , Epelboym Yan , Foster Tory , Fulton Latressa , Gallagher Meghan , Gastolomendo Juan David , Giorgi Genessa , Habtehans Semhar , Kim Jennifer , McGee Blake , McMahan Andrew , Riese Sara , Santamaria-Schwartz Rachel , Walsh Fiona , Wahlstrom Jessica , Wedeles John 
Published: August 2016

AbstractIntroduction:Western media coverage of the violence associated with the 2003 US-led invasion of Iraq has contrasted in magnitude and nature with population-based survey reports.Objectives:The purpose of this study was to evaluate the extent to which first-hand reports of violent deaths were captured in the English language media by conducting in-depth interviews with Iraqi citizens.Methods:The England-based Iraq Body Count (IBC) has methodically monitored media reports and recorded each violent death in Iraq that could be confirmed by two English language media sources. Using the capturerecapture method, 25 Masters' Degree students were assigned to interview residents in Iraq and asked them to describe 10 violent deaths that occurred closest to their home since the 2003 invasion. Students then matched these reports with those documented in IBC. These reports were matched both individually and crosschecked in groups to obtain a percentage of those deaths captured in the English language media.Results:Eighteen out of 25 students successfully interviewed someone in Iraq. Six contacted individuals by telephone, while the others conducted interviews via e-mail. One out of seven (14%) phone contacts refused to participate. Seventeen out of 18 primary interviewees resided in Baghdad, however, some interviewees reported deaths of neighbors that occurred while the neighbors were elsewhere. The Baghdad residents reported 161 deaths in total, 39 of which (24%) were believed to be reported in the press as summarized by IBC. An additional 13 deaths (8%) might have been in the database, and 61 (38%) were absolutely not in the database.Conclusions:The vast majority of violent deaths (estimated from the results of this study as being between 68–76%) are not reported by the press. Efforts to monitor events by press coverage or reports of tallies similar to those reported in the press, should be evaluated with the suspicion applied to any passive surveillance network: that it may be incomplete. Even in the most heavily reported conflicts, the media may miss the majority of violent events.
Using Baseline Data to Address the Lack of Hospital Beds during Mass-Casualty Incidents
Authors: Hadef Hysham , Bartier Jean-Claude , Delplancq Herve , Dupeyron Jean-Pierre 
Published: August 2016

AbstractThe management of victims during mass-casualty incidents (MCIs) is improving. In many countries, physicians and paramedics are well-trained to manage these incidents. A problem that has been encountered during MCIs is the lack of adequate numbers of hospital beds to accommodate the injured. In Europe, hospitals are crowded. One solution for the lack of beds is the creation of baseline data systems that could be consulted by medical personnel in all European countries. A MCI never has occurred in northeastern Europe, but such an event remains a possibility. This paper describes how the use of SAGEC 67, a free-access, information database concerning the availability of beds should help the participating countries, initially France, Germany, and Switzerland, respond to a MCI by dispatching each patient to an appropriate hospital and informing their families and physicians using their own language.Baseline data for more than 20 countries, and for hospitals, especially those in Germany, Switzerland, and France, were collected. Information about the number of beds and their availability hour-by-hour was included. In the case of MCIs, the baseline data program is opened and automatically connects to all of the countries. In case of a necessary hospital evacuation, the required beds immediately are occupied in one of these three countries.Questions and conversations among medical staff or family members can be accomplished between hospitals through computer, secured-line chatting that automatically translates into appropriate language.During the patient evacuation phase of a MCI, respondents acknowledged that a combination of local, state, and private resources and international cooperation eventually would be needed to meet the demand. Patient evacuation is optimized through the use of SAGEC 67, a free baseline database.