bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosocial Health in Displaced Iraqi Care-Seekers in Non-Governmental Organization Clinics in Amman, Jordan: An Unmet Need
Authors: Bader Farah , Sinha Rakhi , Leigh Jennifer , Goyal Neerav , Andrews Allen ,   The IMC Study Team, Valeeva Natalia , Sirois Adam , Doocy Shannon 
Published: August 2016

AbstractIntroduction:Populations displaced by conflict face numerous threats to their psychological well-being; consequently, the prevalence of mental health problems, including anxiety, depression, and post-traumatic stress disorder can be elevated as compared to populations who have not experienced forced displacement.Problem:Little is known about the mental health needs of displaced Iraqis. The factors associated with a need for psychological services among patients at seven clinics served by two NGOs that are known sources of care for the displaced Iraqi population in Amman, Jordan were explored.Methods:The survey was conducted in January and February 2008 and included a random sample of care seekers from seven clinics selected using interval sampling. Interviews on the health needs of displaced Iraqis and their access to services, including mental health services lasting approximately 20 minutes were conducted.Results:Of the 664 survey participants, 49% (95% CI = 45–53%) of respondents reported needing mental health services and 5% (95% CI = 3–8%) of those in need had access to services. The length of time spent in Jordan (adjusted OR = 1.08; 95% CI = 1.00–1.11) was associated with the need for mental health services and the adjusted odds of requiring psychological services was 39% less for individuals from outside of Baghdad as compared to Baghdad residents (OR = 0.61; 95% CI = 0.38–0.98). Responders citing violence as a factor were twice as likely to be from Baghdad (OR = 2.28; 95% CI = 1.03–6.91), while interviewees reporting displacement as a cause for needing mental health services were twice as likely to be female (OR = 2.14; 95% CI = 1.12–4.18). In individuals 35–44 years of age (OR = 0.36; 95% CI = 0.14–0.87) the need for mental health services due to displacement decreased by 64%, while being a part of a female-headed household decreased the need by 81% (OR = 0.19; 95% CI = 0.06–0.57%).Conclusions:More attention should be given to expanding the local Jordanian health system capacity for the provision of mental service. Targeted social and psychiatric interventions that are culturally sensitive and aligned with Inter-Agency Standing Committee recommendations should be developed to compliment and expand the existing mental health service capacity in Jordan.
Impact of Facility Damages on Hospital Capacities for Decision Support in Disaster Response Planning for an Earthquake
Authors: Paul Jomon Aliyas , Lin Li 
Published: August 2016

AbstractHospitals provide life-saving functions and emergency assistance to communities when disaster strikes. Any damage to hospitals from a disaster, either structural and non-structural, can impair these capabilities. In addition, an inaccurate estimation of the treatment capacities available at hospitals in a disaster-affected region can severely affect the success of emergency relief plans. In this paper, the impact of facility damage on hospital operations is estimated using a generic simulation model. From the simulation results, parametric models are developed for estimating hospitals' capacities and patient waiting times that could be used by emergency response teams in making casualty dispatching/routing decisions.
Inadequate Mass-Casualty Knowledge Base Adversely Affects Treatment Decisions by Trauma Care Providers: Survey on Hospital Response following a Terrorist Bombing
Authors: Ashkenazi Itamar , Olsha Oded , Schecter William P. , Kessel Boris , Khashan Tawfik , Alfici Ricardo 
Published: August 2016

AbstractHealthcare professionals require a unique knowledge base to function effectively during a hospital's response to a mass-casualty incident (MCI). A survey of 128 physicians, nurses, and emergency medical technicians involved in trauma care was conducted to assess their knowledge base and how it affected their decision-making in response to a MCI following a terrorist bombing. Three-quarters of the study group responded that ≥20% of the surviving victims were critically injured. Only half of the responders indicated that the main objective of medical management is identifying and treating patients with critical injuries. Forty percent of responders indicated that they would not triage a critically injured victim to immediate care. This survey indicates that further education in the principles of MCI management should be based on critical evaluation of the literature.
Management of Traumatic Liver Injuries without a Valid Trauma System
Authors: Khorram-Manesh Amir , Pourseidi B. 
Published: August 2016

AbstractIntroduction:Despite a global increase in conservative treatment of blunt liver injuries, the number of surgically treated traumas in one major trauma center in Iran has increased. The aim of this study was to unveil the reasons behind this increase in operative management by studying 228 consecutive patients at this regional center.Hypothesis:The increased number of liver injuries operated upon is due to the lack of a solid, well-defined trauma system.Methods:A retrospective review of all patients admitted for liver trauma at Bahonar Hospital, Kerman, Iran, from March 2001 until March 2006 was conducted. Patient data were collected, studied and statistically processed with regard to demographics, clinical and laboratory findings, surgical procedures, complications, and mortality.Results:All patients who were admitted between 30–360 minutes after injury were included. Twelve hemodynamically stable patients were treated conservatively in an ordinary surgical ward.The remaining 216 patients, 153 of whom had blunt injuries, were hemodynamically unstable. A total of 70 patients were in hemorrhagic shock at the time of arrival. Hemodynamically unstable patients with either the suspicion of associated injuries and/or who displayed clinical deterioration and could not be observed in an ordinary surgical ward were treated surgically. The majority of patients who were operated upon in this series had a grade-II liver injury. The total mortality rate in surgically treated patients was 18.1%. None of the patients treated conservatively died.Conclusions:Despite the low grade of their liver injuries, the high number of surgically treated patients in this series was due to the absence of a valid trauma system. This result should encourage the authorities to review current trauma systems and trauma surgical guidelines.
Attitudes to Living and Working in Pandemic Conditions among Emergency Prehospital Medical Care Personnel
Authors: Watt Kerrianne , Tippett Vivienne C. , Raven Steven G. , Jamrozik Konrad , Coory Michael , Archer Frank , Kelly Heath A. 
Published: August 2016

AbstractIntroduction:Little is known about the risk perceptions and attitudes of healthcare personnel, especially of emergency prehospital medical care personnel, regarding the possibility of an outbreak or epidemic event.Problem:This study was designed to investigate pre-event knowledge and attitudes of a national sample of the emergency prehospital medical care providers in relation to a potential human influenza pandemic, and to determine predictors of these attitudes.Methods:Surveys were distributed to a random, cross-sectional sample of 20% of the Australian emergency prehospital medical care workforce (n = 2,929), stratified by the nine services operating in Australia, as well as by gender and location. The surveys included: (1) demographic information; (2) knowledge of influenza; and (3) attitudes and perceptions related to working during influenza pandemic conditions. Multiple logistic regression models were constructed to identify predictors of pandemic-related risk perceptions.Results:Among the 725 Australian emergency prehospital medical care personnel who responded, 89% were very anxious about working during pandemic conditions, and 85% perceived a high personal risk associated with working in such conditions. In general, respondents demonstrated poor knowledge in relation to avian influenza, influenza generally, and infection transmission methods. Less than 5% of respondents perceived that they had adequate education/training about avian influenza. Logistic regression analyses indicate that, in managing the attitudes and risk perceptions of emergency prehospital medical care staff, particular attention should be directed toward the paid, male workforce (as opposed to volunteers), and on personnel whose relationship partners do not work in the health industry.Conclusions:These results highlight the potentially crucial role of education and training in pandemic preparedness. Organizations that provide emergency prehospital medical care must address this apparent lack of knowledge regarding infection transmission, and procedures for protection and decontamination. Careful management of the perceptions of emergency prehospital medical care personnel during a pandemic is likely to be critical in achieving an effective response to a widespread outbreak of infectious disease.
Post-Conflict Transition and Sustainability in Kosovo: Establishing Primary Healthcare-Based Antenatal Care
Authors: Homan Fay F. , Hammond Cristina S. , Thompson Ellen F. , Kollisch Donald O. , Strickler James C. 
Published: August 2016

AbstractIntroduction:Kosovo is a post-conflict nation with an extensively damaged infrastructure, a weak primary care base, and poor maternal-child health outcomes. The Kosovo-Dartmouth Alliance for Healthy Newborns (the Alliance) sought to improve maternal and neonatal health in Kosovo by providing family medicine-based antenatal care (ANC).Methods:The ANC Program used a modification of the World Health Organization's four-visit, prenatal care model. The program is based in family medicine and requires minimal medical equipment, such as a blood pressure cuff, fetal doppler, measuring tape, urine dipstick, and charting materials. Patient education and counseling are stressed. Women are taught about danger signs in pregnancy and establishing an emergency plan, so that they can respond promptly if complications occur. Antenatal care doctors and nurses are trained to refer women to obstetricians for deviations from normal pregnancy. The providers are taught using a “Training of Trainers” approach, building on an existing system of family medicine trainers. In order to address challenges in implementation and sustainability, microsystems methodology is used to focus on implementing change and assuring quality improvement through shared decision-making and the study of outcomes.Results:Based on chart reviews and direct observation, ANC providers showed mastery of the components of ANC, including physical examination, recognition and referral of high-risk pregnancies, and patient education. After an initial pilot project, Kosovo's Ministry of Health recommended this program for dissemination throughout the country. During the next year, ANC was implemented at 27 Family Medicine Centers in nine municipalities; 1,671 women were seen for a total of 3,399 visits. Currently, the Alliance's model of ANC is offered in 30% of Kosovo's municipalities.Discussion:International aid projects often lack attention to long-term sustainability. Microsystems training gives participants the tools and framework to implement and sustain change, even after international support is withdrawn.Conclusions:The Alliance's model of family medicine-based ANC is simple to teach and emphasizes sustainability. It may be modified for use in different cultures and healthcare systems and offers the opportunity to improve maternal and infant health by providing low cost antenatal care, available in a woman's own community.
“Operation Helping Hands”: Massachusetts' Health and Medical Response to Hurricane Katrina
Authors: Condon Suzanne , Savoia Elena , Cadigan Rebecca Orfaly , Getchell Marya , Burstein Jonathan L. , Auerbach Bruce , Koh Howard K. 
Published: August 2016

AbstractIntroduction:As Hurricane Katrina bore down on New Orleans in August 2005, the city's mandatory evacuation prompted the exodus of an estimated 80% of its 485,000 residents. According to estimates from the US Centers for Disease Control and Prevention (CDC), at least 18 states subsequently hosted >200,000 evacuees.Hypothesis/Problem:In this case study, “Operation Helping Hands” (OHH), the Massachusetts health and medical response in assisting Hurricane Katrina evacuees is described. Operation Helping Hands represents the largest medical response to evacuees in recent Massachusetts history.Methods:The data describing OHH were derived from a series of structured interviews conducted with two leading public health officials directing planning efforts, and a sample of first responders with oversight ofoperations at the evacuation site. Also, a literature review was conducted to identify similar experiences, common challenges, and lessons learned.Results:Activities and services were provided in the following areas: (1) administration and management;(2) medical and mental health; (3) public health; and (4) social support. This study adds to the knowledge base for future evacuation and shelter planning, and presents a conceptual framework that could be used by other researchers and practitioners to describe the process and out comes of similar operations.Conclusions:This study provides a description of the planning and implementation efforts of the largest medical evacuee experience in recent Massachusetts history, an effort that involved multiple agencies and partners. The conceptual framework can inform future evacuation and shelter initiatives at the state and national levels, and promotes the overarching public health goal of the highest attainable standard of health for all.
Legal Issues of Humanitarian Assistance after the 2007 Earthquake in Pisco, Peru
Authors: Bambarén Celso 
Published: August 2016

AbstractThe earthquake that struck the central coast of Peru on 15 August 2007 was a disaster that mobilized international humanitarian assistance to address the needs of the affected people in the regions of Huancavelica, Ica, and Lima. It also was an opportunity to prove the effectiveness of regulations and procedures to facilitate the entry and distribution of donations and medical goods during a major emergency. In the first month after the earthquake, the national government approved new regulations that aimed to reduce waiting time while reducing the number of requisites required by customs. More than 5,500 tons of international donations arrived in Peru in a short period of time. Many donated medicines arrived unsorted, without an international non-proprietary (generic) name on the label, and some medicines did not have any relationship with the diseases that would appear in the aftermath of the event.
Care of Children at a Large Outdoor Music Festival in the United Kingdom
Authors: McQueen Carl P. 
Published: August 2016

AbstractIntroduction:Limited data exist on the standard of care provided for children at mass gatherings and special events (MGSE). Some studies provide valuable insight into the proportion of pediatric patients that can be expected at various types of MGSEs, but an accurate breakdown of the range of pediatric conditions treated at major events has yet to be produced. Such data are essential for the preparation of MGSEs so that the health and safety of children at such events can be adequately safeguarded. The aim of this study is to examine the care requirements for children at a large, outdoor music festival in the United Kingdom.Methods:A retrospective review of all patient report forms (PRFs) from a large, outdoor music festival held in Leeds (UK) in 2003. Data were extracted from the PRFs using a standardized proforma and analyzed using an Excel computer program.Results:Pediatric cases contributed approximately 15% to the overall workload at the event. Children presented with a range of conditions that varied from those seen in the adult population. Children were more likely than adults to present for medical attention following crush injuries (OR = 2.536; 95% CI = 1.537–4.187); after a collapse/syncopal episode (OR = 2.687; 95% CI = 1.442–5.007); or complaining of nausea (OR = 3.484; 95% CI = 2.089–5.813). Alcohol/drugs were less likely to be involved in the precipitating cause for medical attention in children compared to adults (OR = 0.477; 95% CI = 0.250–0.912). No critical care incidents involving children were encountered during the event.Conclusions:Mass gatherings and special events in the UK, such as outdoor music festivals, can involve a large number of children who access medical care for a different range of conditions compared to adults. The care of children at large, outdoor music events should not be overlooked. Event planning in the UK should include measures to ensure that appropriately trained and equipped medical teams are used at music festivals to safeguard the welfare of children who may attend. Further research into this exciting area is required.
Non-Invasive Carboxyhemoglobin Monitoring: Screening Emergency Medical Services Patients for Carbon Monoxide Exposure
Authors: Nilson Douglas , Partridge Robert , Suner Selim , Jay Gregory 
Published: August 2016

AbstractIntroduction:Carbon monoxide (CO) toxicity is a significant health problem. The use of non-invasive pulse CO-oximetry screening in the emergency department has demonstrated that the rapid screening of numerous individuals for CO toxicity is simple and capable of identifying occult cases of CO toxicity.Objective:The objective of this study was to extend the use of this handheld device to the prehospital arena, assess carboxyhemoglobin (SpCO) levels in emergency medical services (EMS) patients, and correlate these levels with clinical and demographic data.Methods:This was a retrospective, observational, chart review of adult patients transported to hospital emergency departments by urban fire department EMS ambulances during a six-week period. Each ambulance used a non-invasive pulse CO-oximeter (Rad-57, Masimo Inc.) to record patients' COHb concentrations (SpCO) along with the standard EMS assessment data. Spearman's Rank Correlation tests and Student's t-tests were used to analyze the data and calculate relationships between SpCO and other variables (age, gender, respiratory rate, heart rate, mean arterial pressure, and oxygen saturation measured by pulse oximetry).Results:A total of 36.4% of the patients transported during the study had SpCO documented. Of the 1,017 adults included in this group, 11 (1.1%) had an SpCO >15%. There was no correlation between SpCO and heart rate, ventilatory rate, mean arterial pressure, and oxygen saturation.Conclusions:Screening for CO toxicity in the EMS setting is possible, and may aid in the early detection and treatment of CO-poisoned patients.
Geographical Maldistribution of Pediatric Medical Resources in Seattle-King County
Authors: King Mary A. , Koelemay Kathryn , Zimmerman Jerry , Rubinson Lewis 
Published: August 2016

AbstractObjective:Seattle-King County (SKC) Washington is at risk for regional disasters, especially earthquakes. Of 1.8 million residents, >400,000 (22%) are children, a proportion similar to that of the population of the State of Washington (24%) and of the United States (24%). The county's large area of 2,134 square miles (5,527 km2) is connected through major transportation routes that cross numerous waterways; sub-county zones may become isolated in the wake of a major earthquake. Therefore, each of SKC's three sub-county emergency response zones must have ample pediatric medical response capabilities. To date, total quantities and distribution of crucial hospital resources (available in SKC) to manage pediatric victims of a medical disaster are unknown. This study assessed whether geographical distribution of hospital pediatric resources corresponds to the pediatric population distribution in SKC.Methods:Surveys were delivered electronically to all eight acute care hospitals in SKC that admit pediatric patients. Quantities and categories of pediatric resources, including inpatient treatment space, staff, and equipment, were queried and verified via site visits.Results:Within the seven responding hospitals of eight queried, the following were identified: 477 formal pediatric bed spaces (pediatric intensive care unit, neo-natal intensive care unit, general wards, and emergency department), 43 informal pediatric bed spaces (operating room and post-anesthesia care unit), 1,217 pediatric nurses, 554 pediatric physicians, and 252 infant/pediatric-adaptable ventilators. The City of Seattle emergency response zone contains 82.1% of bed spaces, 83.5% of nurses, and 95.8% of physicians, yet only 22.8% of all SKC children live in that zone.Conclusions:The majority of hospital pediatric resources are located in the SKC sub-region with the fewest children. These resources are potentially inaccessible and unable to be redistributed by ground transportation in the event of a significant regional disaster. Future planning for pediatric care in the event of a medical disaster in SKC must address this vulnerability.
Tactical Medical Skill Requirements for Law Enforcement Officers: A 10-Year Analysis of Line-of-Duty Deaths
Authors: Sztajnkrycer Matthew D. 
Published: August 2016

AbstractIntroduction:In the absence of other data, military Tactical Combat Casualty Care (TCCC) precepts are increasingly being adapted to law enforcement needs. The purpose of this study is to better describe the nature of potentially preventable law enforcement Line-of-Duty Deaths (LODDs) occurring as a result of felonious assaults.Methods:A retrospective analysis was performed of open source data available through the US Federal Bureau of Investigation (FBI) Uniform Crime Reporting (UCR) Law Enforcement Officers Killed and Assaulted (LEOKA) program for the years 1998–2007 inclusive.Results:After applying exclusion criteria, 341 victim officers were included in the study. The most common cause of death was head trauma (n = 198), followed by chest trauma (n = 90). There were 123 victim officers that suffered potentially preventable deaths; the majority of these injuries involved the chest. Over the 10-year study period, only two officers (0.6%) died from isolated extremity hemorrhage.Conclusions:The current emphasis of TCCC on control of exsanguinating extremity hemorrhage may not meet the needs of law enforcement personnel in an environment with expedited access to well-developed trauma systems. Further study is needed to better examine the causes of preventable deaths in law enforcement officers, as well as the most appropriate law enforcement tactical medical skill set and treatment priorities.