bluuebunny/crossref_metadata_2025_split huggingface dataset:
(A87) Sea-Level Rise Disaster in Micronesia: Sentinel Event for Climate Change?
Authors: Keim M. 
Published: May 2011

BackgroundIn 2007, several atoll islands in the Federated States of Micronesia (FSM) were inexplicably flooded by sea water.ObjectivesTo describe the impact of an acute-onset sea-level-rise disaster in 2 coral atoll populations.MethodsHouseholds of Lukunoch and Oneop islands, FSM were assessed for demographics, asset damage, food availability, and water quantity and quality. Every fourth household on Lukunoch, (n = 40), was randomly selected and surveyed. All Oneop households were surveyed (n = 72). Prevalence data were analyzed.ResultsA total of 112 total households were surveyed representing 974 inhabitants. On Lukunoch, roughly half of all households surveyed reported at a partial loss of their primary dietary staple and source of calories (taro and breadfruit). Six (15%) of 40 Lukunoch households surveyed (95% CI, 6%–30%) reported a complete loss of taro and four (10%) of the 40 households (95% Cl. 3%-24%) reported a complete loss of breadfruit. On Oneop, nearly all households reported at least a partial loss of these same food staples. Twenty four (31%) of all 76 Oneop households reported a complete loss of taro and another 24 (31%) households reported a complete loss of breadfruit. One third of all households surveyed reported a complete loss. On Lukunoch 11(28%) of 40 households, (95% Cl. 15%–43%) reported damage from well salination, but none were damaged to the point of a complete loss. Forty-nine (64%) of 76 Oneop households reported salination and five (6%) reported complete loss of their well.ConclusionThese findings suggest that FSM populations experienced disastrous losses due to a sea level rise event damaging crop productivity and freshwater sources.
(A88) Public Health Consequences of Climate Change in the Republic of Palau: A Photojournalism Project
Authors: Mahany M. , Kuartei S. , Marumoto P. 
Published: May 2011

IntroductionThe Republic of Palau, like other small, island, developing states, is particularly vulnerable to climate change due to a number of factors, including: (1) small size; (2) remoteness; (3) limited natural resources; and (3) vulnerability to disasters and extreme weather events. Other factors include social and economic factors such as: (1) economies sensitive to external shocks; (2) high population growth rates and densities; (3) poorly developed infrastructure; (4) limited financial and human resources; and (5) emigration. The (US) Centers for Disease Control and Prevention (CDC) partnered with the Republic of Palau Ministry of Health (MoH) and Southern Illinois University (SIU) to investigate public health consequences in Palau. The goal of the project is to reduce morbidity and mortality due to climate change in Palau by improving awareness using three tools: (1) a photojournalism book to document the local experience in Palau; (2) a marketing campaign to increase awareness in Palau about climate change as it relates to human health; and (3) a Website to raise regional and international awareness of the findings, and act as a forum for discussion and resource-sharing.MethodsThe CDC, SIU, and Palau MoH conducted interviews with community members including government officials, traditional leadership, fishermen, gardeners, physicians, scientists and local residents to explore their experiences concerning climate change in their community. Photojournalists took thousands of images documenting locally identified effects of climate change that were perceived as having direct or indirect health consequences for the people of Palau.ResultsCoral bleaching, beach erosion, irregular rainfall, sea level rise, and salt water inundation directly impact food security and tourism in Palau, while other less obvious, but important consequences, such as potential loss of traditional practices and cultural identity were also identified.ConclusionsThe people of Palau reported significant impact from climate change on agriculture, economics, health, and culture.
(A117) Outcomes and Quality of Life after Injury
Authors: Turner J. , Nicholl J. 
Published: May 2011

BackgroundMost research into the outcomes of injury has focused on mortality rather than the physical, social, and psychological sequelae of non-fatal injuries. The health and long-term outcomes of a cohort of accidentally-injured patients were studied in order to assess the impact on quality of life.MethodsThe cohort of patients was derived from six previous studies spanning 1988–2003. Patients were followed-up with to ascertain if they were still alive, and survivors were sent a follow-up questionnaire in 2006. The questionnaire asked about current problems resulting from past injuries, use of health services, and measures of health related quality of life (the EQ-5D and SF-36 or Nottingham Health Profile (NHP)). A sample of 114 also received detailed face-to-face interviews.ResultsA total of 2,418 patients were followed-up on between 4–15 years post-injury, of whom 311 had died. There were 580 completed follow-up questionnaires, and of these 64% reported health problems related to past injuries. The mean EQ-5D score at follow-up was 0.132 tariff points below the mean for a normal age-sex matched population, and SF-36 scores were 5–15 points worse than population norms. At all ages, EQ-5D and SF-36 scores were similar to those of the normal population aged 75. Interviewed patients also reported substantially more disability than the general population. Increasing injury severity was associated with almost all aspects of worse health at follow-up, and severe lower extremity injuries were strongly associated with poorer outcomes.ConclusionsInjured patients continue to experience significant reductions in health and health-related quality of life for many years after their injury.
(A118) Evidence-Based Disaster Medicine: What Can We Learn from a “Science” Spread across 900 Journals?
Authors: Smith E. , Burkle F.M. , Aitken P. , Archer F. 
Published: May 2011

IntroductionDisasters and large-scale crises continue to increase in frequency. To mitigate the potential catastrophes that confront humanity in the new millennium, an evidence-based approach to disaster medicine is required urgently. This paper moves towards such an approach by identifying the current evidence-base for disaster medicine.MethodsUsing a search strategy developed by the Cochrane Prehospital and Emergency Health Field, three independent reviewers searched the electronically indexed database MEDLINE (January 2000 – August 2010) to identify peer-reviewed literature relevant to disaster medicine. Reviewers screened the titles and abstracts identified by the search strategy and applied predetermined criteria to classify the reported publications for date, source and study type and topic.ResultsA total of 8149 publications were identified. Of these, 8% focused on mitigation, 22% on preparedness, 19% on response and 51% on recovery. The publications were overwhelmingly anecdotal or descriptive (89%) while 5% were quantitative studies and 6% used qualitative methodologies. Only 66 of these publications were classified as being high level evidence. The publications were published in 928 journals, of which 34% were mental health related journals and 28% were public health journals. The journal “Prehospital and Disaster Medicine” had the greatest number of publications (5%) of all journals publishing on issues within the scope of disaster medicine. The events with the greatest numbers of publications were the 9/11 terrorist attacks, Hurricane Katrina, the Indian Ocean Tsunami, and the conflict in Iraq. Of note, this search highlights the lack of publications reporting on the application of evaluation tools or frameworks.ConclusionGiven that the “science” of disaster medicine is spread across over 900 different journals, keeping on top of the evolving evidence-base of this emerging discipline will continue to be a challenge. Furthermore, the overall low quality of the evidence is an ongoing concern.
(A139) Profile of Likely Needs in a Disaster Alternate Site Care in Honolulu, Hawaii
Authors: Qureshi K. 
Published: May 2011

BackgroundIn the US, a system has been developed to provide disaster sheltering for persons with special needs in what are now termed alternate care sites (ACS). As in many other developed countries, as the population ages, the rates of people with chronic diseases that require complex health care management in the home setting has increased. The aim of this study was to identify the key chronic diseases, conditions, and therapies that should be planned for in ACS operations.MethodsA convenience sample (n = 402) of senior citizens (≥ 65) who resided in Honolulu, Hawaii were interviewed and completed a 15-item survey that asked about demographics, existing health conditions, activities of daily living abilities (ADL), and requirements for ongoing care.ResultsThe mean age was 68 years; 56% were female. The most common health issues included: hypertension (53.4%), heart disease (24.6%), diabetes mellitus (23.3%), and asthma (15.1%); while 11% (n = 47) reported they required daily physical assistance ADLs, including: getting up from a chair (15.1%), walking (8.1%), taking medications (8.1%), dressing (5.2%), and toileting (4.2%). Of these 47 people, most (81%) had someone who would help them in a disaster shelter, while nine (19% of the total who required assistance) had no one to help them. On average, of the respondents who reported they took medication daily, 14% had less than a seven-day supply of medication for their chronic disease.ConclusionsAs the population ages, the burden of chronic disease in the population increases. During a disaster with large numbers of displaced persons, accommodations for such persons must be accounted for in order to prevent a second disaster related to de-compensation of those with chronic health problems in the ACS shelter. Understanding the population needs beforehand can mitigate the effects of displacement on this population.
(A146) Disaster Patient Tracking – Local, State and Federal Interoperability during a Multi-Hospital Evacuation Exercise
Authors: Andress K. , Downey E. 
Published: May 2011

IntroductionAssociated with hospital evacuation is the need to track multiple patient evacuees from point of origination to final hospital reception. Patient tracking, a component of the hospital emergency operations plan, is vital to patient care; family association, resource management, financial reimbursement, risk management, and repatriation. Tracking strategies and plans can include a variety of vendors, hardware, software, and coordination issues. Hospital evacuee tracking plans and platforms exist at multiple jurisdictional levels but may not be interoperable.MethodsThree patient tracking platforms representing a local, state and federal application were used during a multi-hospital evacuation exercise, initiated in New Orleans, Louisiana, May 2010. Simulated patients were flown and tracked to multiple patient reception centers in the southern United States, including the Federal Coordinating Center in Shreveport, Louisiana, and receiving National Disaster Medical System hospitals. This review summarizes tracking operations, patient data characteristics captured and interoperability at the Shreveport reception location.Results7 New Orleans hospitals entered 51 patients for evacuation into Louisiana's web-based, At-Risk-Registry (ARR) database including 8 patient identifiers each. ARR data was shared with federal and Louisiana Region 7 patient evacuee receivers for flight manifest construction and reception planning. 34 ARR evacuee patients were indicated for the Shreveport, Louisiana, reception site. 34 patients with 6 identifying characteristics were entered from ARR into EMTrack, the local patient tracking system. A C130 arrived with a TRAC2ES manifest of 20 simulated patients with 6 patient data characteristics. The local tracking system was reconfigured for the hardcopy manifest; simulated patients were received at the airport; transported and received at local hospitals.ConclusionsTracking system interoperability may be challenged by tracking technologies, jurisdictional requirements and degree of implementation at the local, state and federal level. Tracking should be standardized based on national recommendations with local systems remaining flexible for just-in-time requirements.
(A153) Analysis of Chest Compressions: Measured Using the Quality Compression Index and Performance Disparities among Demographic Characteristics
Authors: Schwab J.H. , Williams A.L. , Birnbaum M.L. , Emberts Z.T. , Padjen P.D. , Bhattacharya A. , Olson S.K. 
Published: May 2011

IntroductionCardiopulmonary resuscitation (CPR) guidelines throughout the world stress the importance of high quality chest compressions soon after cardiac arrest as the most significant factor in determining survival. Little evidence exists, internationally, documenting the quality of compressions provided by healthcare providers. In this study investigators sought to determine the quality of chest compressions delivered by rescuers. It was hypothesized that greater variably in compression quality exists between rescuers than variability in individual rescuers over time.MethodsIn this observational pilot study, basic life support (BLS) providers from prehospital and in-hospital settings were invited to participate in the investigation. Ten minutes of continuous chest compressions were recorded on the Resusci Anne and the Laerdal PC Skillreporting System. An adequate compression was defined as a compression with depth > 38mm, full chest recoil, and correct hand position. The Quality Compression Index (QCI) was developed to factor rate into the characteristics of an adequate compression. QCI is a scaled performance index calculated every 30 seconds.ResultsProviders came from a variety of clinical backgrounds, aged 35.5 ± 11.0 years. Of the 103 total participants, 94 (91.3%) completed 10 minutes of compressions. The most significant degradation in the quality of compressions occurred within the first two minutes. There was greater variability between different rescuers than the variability over time. Mean Square Error (MSE) due to subjects was comparatively greater than the MSE due to time (63.2 vs. 7.68). Performance of CPR, male sex, < 45 years of age, and prehospital background, correlated with higher quality. Time since last BLS certification and the number of times a rescuer completed a BLS class did not correlate with the quality.ConclusionsGreater variability in the quality of compressions exists between different rescuers than a rescuer over time. Some participants were not able to deliver ideal compressions from the start, when the effects of fatigue were minimal.
(A189) The U.S. National Veterinary Stockpile: Science-Based Logistics Improving Animal Disease Response
Authors: Myers L.M. 
Published: May 2011

BackgroundAgriculture emergency responders always will require equipment and supplies. A rapid and effective logistical response depends upon having the right item in the right quantity at the right time at the right place for the right price in the right condition to the right responder. Established in 2004 by U.S. Homeland Security Presidential Directive 9, the National Veterinary Stockpile (NVS) within the U.S. Department of Agriculture (USDA), Animal and Plant Health Inspection Service, Veterinary Services is the nation's repository of critical veterinary supplies, equipment, vaccines, and services appropriate to respond to the most damaging animal diseases affecting human health and the economy. An overview of the NVS program, its capabilities, training and exercise strategy, and outreach to stakeholders will be presented.The NVS ProgramThe goals of the NVS program are to deploy countermeasures against the 17 most damaging animal disease threats within 24 hours, and to help states/tribes/territories plan, train, and exercise the receipt, processing, and distribution of NVS countermeasures. To meet these goals, the NVS program heavily relies upon science-based logistics to identify animal vaccines and other countermeasures to respond, and sound business processes to purchase, hold, maintain, and deploy the countermeasures. Significant resources also are dedicated to the NVS outreach activities, which interface directly with federal/state/tribe/territory animal health stakeholders. NVS team members work hand-in-hand with these leaders to help develop written NVS-specific plans for their jurisdictions, provide logistics training, and sponsor discussion-based and operations-based exercises in accordance with the Homeland Security Exercise and Evaluation Program.ConclusionThe USDA NVS exists to provide states/tribes/territories the countermeasures they need to respond to catastrophic animal disease outbreaks created by either terrorists or nature. As logistical experts, the NVS team develops plans for logistical emergency response, manages their supply chain of countermeasures, and helps stakeholders improve logistical response capabilities.
(A170) Health Sector Coordination Following Civil Conflict in Sri Lanka, 2009
Authors: Wickramage K. , Ranasinghe T. , Vithana E.K. , Herath H. 
Published: May 2011

BackgroundThree decades of internal conflict, displacing 300,000 civilians, in the Northern and Eastern Provinces of Sri Lanka ended in May 2009. Civilians affected by the fierce fighting in the proceeding months were ushered by the military into internally displaced persons (IDP) camps in an area called “Manik Farm” in Vavuniya District until they could be resettled. The Ministry of Health led the provision of health services to the displaced in coordination with the humanitarian health cluster at the national and field level immediately after of the war.MethodsThe Ministry of Health plans and reports were reviewed, along with reports from health sector partners and national and international guidelines on coordination in humanitarian relief operations. The way the Ministry of Health coordinated with health sector partners via the health cluster was different from other coordination models where military and civil administration were involved in providing humanitarian relief also was compared.ConclusionsThe review shows that the health sector coordination mechanism adapted in Sri Lanka had a clear leadership and guidance for health sector partners according to national plans and frameworks. It was indicated by better health outcomes like mortality and morbidity among displaced population in IDP camps in Manik Farm.
(A171) Daily Crude Mortality Rate (DCMR) as an Indicator to Measure the Success of Provision of Services to Internally Displaced Population (IDP) in Sri Lanka
Authors: Vithana E.K. 
Published: May 2011

BackgroundSri Lanka's 28 year protracted civil conflict between the government forces and Liberation Tigers of Tamil Eelam (LTTE) in the North of country saw dramatic end by May 2009 when the military forces succeeded in crushing the LTTE. Around 300,000 people were displaced due to the conflict and they were settled in welfare villages established in the North.DiscussionThe Government of Sri Lanka working in partnership with all other actors mounted a major humanitarian response to address the needs of the war displaced population. The Ministry of Health took a leading role in coordinating the health care programs for the Internally Displaced Population(IDP).ObservationsHigher morbidity and mortality observed during early phase of settlement of IDPs was due to the results of two scenarios, one being the conflict situation and its direct consequences that have caused injuries, disabilities and mental trauma among the population. The second being the result of the collapse of the health system in conflict affected areas, long period of displacement of people and the disruption of social structures that have led to the indirect consequences of increase of infectious diseases and worsening of chronic diseases. Ministry of Health used Daily Crude Mortality Rate (DCMR) to measure the success of the response. According to the Sphere Project guidelines that developed a set of minimum standards in a disaster situation, the DCMR should be 0.25 per 10 000 population for South East Asia. The emergency threshold level is 0.5 per 10 000 per day for this region.ConclusionsOf the number of people reaching the IDP welfare villages in early stages of emergency phase in May, DCMR averaged to 0.7. The figure settled to less than 0.5 per 10000 in June 2009. Thereafter daily DCMR remained less than 0.5 indicating success of the provision of care for IDPS.
(A193) Concurrent Measles and Rubella Outbreaks in Transit Camps in Cote D' Ivoire
Authors: Kouadio I.K. , Oshitani H. , Kamigaki T. , Koffi A.K. , Attoh-Toure H. 
Published: May 2011

BackgroundMeasles still remains an important cause of morbidity and mortality among children in many developing countries, especially in refugee settings where fatality rates as high as 33% have been documented. From January to April 2004, concurrent measles and rubella outbreaks had occurred in four transit camps hosting 2,767 Liberian refugees in Cote d'Ivoire.ObjectiveThis study describes the epidemiology of concurrent measles and rubella outbreaks, and the investigation of a Disease Surveillance Team.MethodsPatients meeting the case-definition (rash and fever > 38°C) were detected actively. Blood sample were collected for measles and rubella IgM antibody confirmation.ResultsSixty rash and fever cases were identified. During weeks 8 to 13, measles IgM testing had resulted in 61.1% positive tests. The highest incidence (18.5%) was observed in children below 9 months. Ninety-three percent of children aged between 6 months and 12 years received a measles vaccination but the rash and fever cases continued to occur. This prompted a systematic test for both measles and rubella IgM antibodies. Rubella IgM testing had resulted in 74.0% positive tests. The highest incidence (3.88%) was found in children between 5–15 years. Supplemental immunization with a measles-mumps-rubella (MMR) vaccine was conducted, following which, no fever and rash cases were documented.ConclusionsThis study indicates the importance of an early serological testing for measles and rubella together or the use of the MMR vaccine rather than only measles vaccine in disasters settings. Good management of surveillance data will be an asset for effective immunization strategies in refugee settings.