bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating Response Plans for Burn Mass Casualty Incidents
Authors: Taylor Morgan , Harris Curt 
Published: June 2023

Introduction:Across the United States (US), there are approximately 2,000 burn beds in 133 burn centers, only 72 of which are verified by the American Burn Association (ABA). As such, many areas in the US are hundreds of miles from the closest burn center. Eight states do not have a burn center, and another 11 do not have an ABA-verified center. Further, the average center has 15 beds, and, on average, there are 90 available beds across the US. Therefore, in addition to patient care complexities, the broader infrastructure for burn patients is severely limited. These constraints suggest the burn healthcare system is particularly vulnerable to disasters, where the needs will exceed the resources available.Method:A literature review was conducted of available burn mass casualty incident (BMCI) plans from stakeholders in each level of a response. These response partners included prehospital agencies, hospitals (those with and without trauma center designations), emergency management agencies (local, state, and federal), healthcare coalitions, public health (district, state, and federal), regional coordinating burn centers, and the ABA.Results:The amalgamation of the BMCI plans yields a tripartite infrastructure not unfamiliar to emergency management professionals. The burn care agencies integrate into a response, similar to the way in which public health integrates into the emergency management infrastructure. The local to state to federal escalation of assets is reflected by an escalation from the local burn center to the regional coordinating burn center to the ABA. However, gaps remain in the communication between response partners. Few plans, particularly at the local level, reflect the integration of the burn system response.Conclusion:The burn healthcare infrastructure in the US is constrained and therefore is particularly vulnerable to a BMCI. Emergency responders should preemptively examine their plans and systems to specifically integrate the burn care and response infrastructure.
Threat Awareness Training for Non-Governmental Organizations Deploying Humanitarian Aid Workers into Conflict Environments
Authors: Tin Derrick , Davis Terri , Hata Ryan , Court Michael , Issa Fadi , Hart Alexander , Voskanyan Amalia , Ciottone Gregory 
Published: June 2023

Introduction:The current war in Ukraine and the subsequent deployment of Non-Governmental Organizations (NGOs) from around the world has highlighted the many potential dangers faced by humanitarian aid workers operating in conflict zones. Humanitarian aid workers may face both direct and indirect threats and aggression whilst on deployment, and given the rising number of global conflicts, the authors postulate a need to incorporate threat awareness training as part of pre-deployment training.Method:A list of the top 22 rated NGOs providing international aid was obtained from CharityWatch. All 22 were contacted via their public email addresses or website contact pages to find out if they provide any form of security, tactical, or threat awareness training.Results:Seven of the 13 NGOs that responded did not deploy staff into recent conflict zones or surroundings. All six NGOs who deployed staff into Ukraine or surrounding border countries, provided either security, tactical, or threat awareness training to their staff.Conclusion:With the rising number of conflicts and disasters around the world, humanitarian aid workers are increasingly exposed to hostile environments and there is a compelling need for NGOs to ensure staff are adequately trained and prepared to handle any dangers and threats they may face.
Leadership Approach in a Complex Disease Outbreak Management: The Case of the Tenth Ebola Virus Disease Outbreak in the Democratic Republic of the Congo
Authors: Yao Michel 
Published: June 2023

Introduction:The world's second largest Ebola virus disease outbreak in DRC (August 2018-June 2020) caused 3,481 cases in 29 health zones, 2,299 deaths and about 250,000 contacts traced. It occurred in densely populated vast areas, with insecurity, ongoing humanitarian crisis and community reluctancy. Four hubs, sixteen sub-coordinations were set up with hundreds of experts to support local inexperienced health workers. Five health coordinators were deployed to lead more than 600 people at national and field level coordinations. This work aimed at reviewing coordinators’ leadership styles using leadership theories. Recommendations were made for future complex health operations.Method:The leadership styles of the five coordinators were reviewed retrospectively using different leadership theories. Three groups of theories: (1) Leader’s traits, characteristics, and skills; (2) Leader’s behaviors: behavioral, transformational, and situational; (3) Authentic and servant leadership.Results:Analysis with the three groups of leadership theory highlighted that leaders had mixed leadership approaches.1) Self-confident, calm, determined, extravert (one a bit shy), conscientious, motivators; Sociable and empathic while dealing with staffs affected by incidents; Few strong characters affecting interpersonal relations; Strong negotiation skills while dealing with local stakeholders; Experienced and knowledgeable in analyzing, making judgment and decisions.2) A participative approach when supporting nationals and partners; Using transformational leadership when coaching national counterparts and mobilizing partners, Directive when teams were to comply with rules or act quickly.3) Compassion; building trust, confidence and capacity; empowering and coaching.Conclusion:The complex disease outbreak imposed a mixed leadership style. Leaders had specific traits and technical skills. Servant leadership style was often used to trigger participation and build capacity in support of national and international experts. Directive approaches were used to trigger urgent actions. Findings could help in selecting and training leaders for public health emergencies. It may require further empirical and operational research in emergency contexts.
An Organizational Perspective of a COVID-19 Outbreak at a Tertiary Hospital
Authors: Braitberg George , Kapp Suzanne , Long Karrie 
Published: June 2023

Introduction:The COVID-19 pandemic challenged healthcare systems globally disrupting access to high quality essential health services. The pandemic may be viewed as a disaster impacting on patients and staff alike. There is a paucity of research describing how large health services have maintained, scaled and innovated care during the pandemic. The study was conducted to provide insights to inform hospital disaster management responses, specifically to identify organizational learnings from the COVID-19 response, capture instances of innovation, understand the impact of COVID-19 on models of care and to identify organizational priorities to prepare for a potential future disaster or terror event.Method:Survey research was conducted using a qualitative research strategy. The study was conducted at a 550-bed university-affiliated tertiary hospital located in the southeast corner of Australia in the State of Victoria. The survey was purpose designed, included open-ended questions requiring text responses, and was completed in an online survey form. A thematic analysis of the data was completed.Results:A total of 258 staff completed the survey, with staff representing doctors, nurses, allied health, and support personnel. There were four overarching domains of learning identified; People and Care, Staff Support, Implementation of Care, and Organizational Factors. These domains were supported by 14 topic areas which highlighted specific areas of learning and opportunity in preparing for or responding to a potential future disaster or terror eventConclusion:There was a need during the pandemic to pivot rapidly to reorganize services and workforce to operate and deliver care in a safe manner. Attention to and action in the domains of People and Care, Staff Support, Implementation of Care, and Organizational Factors can be considered by organizations when planning health service delivery in response to and during the COVID-19 pandemic, or more generally to a potential future disaster or terror event.
Not Just a Vaccination. Provision of Public Health, Environmental, and Social Needs in an Austere Environment in Miami, Florida
Authors: Kim Deborah 
Published: June 2023

Introduction:The recently approved COVID-19 vaccine in 2021 provided a glimmer of hope to all people who had isolated, or lost loved ones to the SARS-COVID-19 virus. Clinics were rapidly established in non-traditional settings in order to meet the need in the early phases of the vaccination program. Contractor support provided rapid personnel support to meet the needs of many locations in several states. Consideration of basic infrastructure requirements such as Incident Command, security, HVAC, electricity, water and sanitation were part of a state supported vaccine clinic in an economically challenged neighborhood in downtown Miami, Florida.Method:Topics to be discussed include staffing mixes, language/cultural concerns, handheld EMR applications, patient flow, immunization practices, testing practices, vaccine security, adverse event management, infection control procedures and the ever present supply chain challenges. The discussion will be framed from the perspective of the Chief Nursing Officer in an ever challenging vaccine environment.Results:Over 20,000 vaccines were successfully provided in a little over three months, and a community-based Student Internship program was also implemented.Conclusion:Vaccine administration is possible in a variety of settings. Foundational principles of vaccine security, management of the environment and provision of safety and security for patients and staff will help to ensure a successful public health campaign.
Tracking Post-Disaster Chronic Disease: Protocol for the RECOVER Cohort Study
Authors: Leppold Claire , Lockery Jessica , Burns Penelope , Brady Kate , O'Donnell Meaghan , Ryan Joanne , Gibbs Lisa 
Published: June 2023

Introduction:There is growing evidence that disasters may increase the risk of developing chronic diseases, including diabetes, dyslipidemia, chronic kidney disease, and cardiovascular disease. However, how much disaster exposure specifically affects chronic disease risk is unknown. This presentation introduces the study protocol for the Risk of hEalth ConditiOn AdVerse Events after disasteRs (RECOVER) Cohort Study, which addresses this gap.Method:The primary aim of RECOVER is to determine the extent to which disaster exposure specifically increases the risk of developing chronic disease (Aim 1). The secondary aims of the study are to determine if the nature, duration and severity of disaster exposure are risk factors for disease (Aim 2), to map mediators of post-disaster chronic disease risk (Aim 3), and to identify potential biomarkers of post-disaster chronic disease risk (Aim 4). RECOVER will recruit over 6000 adults (1:1 disaster exposed vs unexposed) in Australia to a nationally representative cohort for longitudinal follow-up. Detailed data will be obtained annually on disaster exposure, demographic, social and health factors. The primary health outcome (Aim 1) of chronic disease will be defined as new, incident diabetes, cardiovascular or respiratory disease, and will be ascertained through data linkage with the Pharmaceutical Benefits Scheme. A biomarker sub-stream will include ~1,000 participants who provide a hair and saliva sample for cortisol and epigenetic analysis.Results:N/AConclusion:There is an urgent need for detailed individual-level data to analyze the nature of the association between disaster exposure and chronic disease. In 2020 alone, 16.8 million Australians were exposed to disasters. The frequency and severity of disasters are only expected to grow due to climate change. As the first prospective cohort study to longitudinally track individual-level disaster exposure and chronic disease outcomes, RECOVER will fill a critical evidence gap.
Heatwaves Risk Perception and Knowledge-Empirical Evidence from Pakistan
Authors: Farman Ullah , Barone-Adesi Francesco , Hubloue Ives , Ragazzoni Luca , Valente Martina 
Published: June 2023

Introduction:Heatwaves are the leading weather-related causes of deaths globally. Since the mid 20th century, the frequency and intensity of heatwaves has increased with recent reports projecting a substantial warming in temperature extremes by the end of the 21st century.Method:In this cross-sectional study, we attempted to assess public perception and knowledge on heatwaves. Data was collected across Pakistan among a sample of people aged 18 years and above using an online survey questionnaire. Health Belief Model (HBM) constructs were used to assess risk perception using a total of 14 statements while knowledge was measured using 12 statements. The Unadjusted Odd Ratio (UOR) and Adjusted Odd Ratio (AOR) of 95% Confidence Intervals (CI) were employed through binary logistic regression. A total of twelve variables were included in the model (11 categorical and 1 continuous).Results:Out of the 686 participants, the majority of the people (57.73) showed high heatwaves risk perception and a high level of heatwave knowledge (59.91). The results of the multivariate regression model (AOR) showed that participants within the Secondary and/or higher Secondary (Grade 9th to Grade 12th) were less likely (OR=0.304) perceiving heatwaves risk compared to the reference group (Basic/Elementary Level i.e., (Grade 1st to Grade 8th)). As the number of participants who lives with others and who heard about heatwaves increases, the participants are more likely to perceive high heatwaves risk. For instance, participants who lives with others and have heard about heatwaves perceived heatwaves risk 1.982 and 1.816 times higher respectively than those who live alone and those who have not heard about heatwaves before.Conclusion:HBM can be useful in designing interventions aimed at increasing people’s adaptive behaviors during heat waves. This study provides useful insights to the policymakers across Pakistan in understanding the public’s perception that can lead to informed decision-making.
Data Disaster to Disaster Data: Outputs of the Inter-Agency Expert Group Disaster-related Statistics (DRS) Pilot
Authors: Ahmed Kanza , Cook Meghan , Ogunlayi Fatai , Weir Maddie , Malik Fahad 
Published: June 2023

Introduction:A Hazard Definition and Classification Review conducted by the UN Office for Disaster Risk Reduction (UNDRR) and International Science Council (ISC) resulted in publication of Hazard Information Profiles (HIPs). The HIPs provide groundwork for developing a statistical framework enabling better understanding of the true burden of hazards globally. Furthermore, standardized data is critical for effective monitoring of the Sendai Framework, Sustainable Development Goals, and Paris Agreement on Climate Change.Following the publication of the HIPs, governments and National Statistical Offices (NSOs) have been encouraged to review their systems for classifying, monitoring and reporting on disaster risk reduction with the aim to gradually implement the HIPs in databases and reporting systems.The aim of the pilot is to provide statistical feedback on the applicability of the reviewed hazard classification and its HIPs.Method:The DRS pilot utilizes mixed-qualitative methods:
Global stakeholder workshopsLiterature review to understand the gaps and good practiceUtilizing snowball methodology to cascade a survey to DRS international experts.Country-level expert focus-groups.In-country pilots (with Low, Middle, and High-income countries).Delphi Methodology with expert stakeholders to hone recommendationsResults:596 responses to the survey from across 38 countries and 90 papers were identified for literature review. Survey initially sent to 120 stakeholders, and snowball methodology increased survey reach, particularly to Global South colleagues. Expert stakeholder and country-level focus groups identified a series of good practices and recommendations enabling step-change towards a standardized global statistical framework. Delphi methodology to refine recommendations is underway.Conclusion:The DRS pilot has raised global awareness of the importance of using the HIPs in developing a robust statistical framework with usable disaster-related statistics. This will enable greater accuracy of data contributing to Sendai Framework targets A-D. Results of the pilot being used to inform the Office of National Statistics-UKHSA-Wellcome collaboration on developing Standards for Official Statistics on Climate-Health Interactions in Africa.
Flexible Composable Health IT Platforms for Emergency Response
Authors: Senathirajah Yalini 
Published: June 2023

Introduction:Health information technology, especially electronic health records (EHRs) pose difficult design problems due to the data and workflow complexity, high-stakes stressful nature of healthcare work, variability of information and collaboration needs and stakeholders. Emergency response poses further requirements. We propose a different, novel approach in which flexible ‘building block’ platforms composable by nonprogrammers could address rapid implementation and sharing of new functionality as needed at the point of care. In order to truly meet unpredicted emergency needs a philosophy of maximal flexibility and data comprehensiveness is required.Method:Existing technologies were used in new ways to permit prototype design of composable health IT platforms, intended to be added to existing health information systems, allowing nonprogrammers (including clinician end users) to assemble any desired data, visualization, and new logic to permit rapid tool deployment in emergencies. An example is the rapid composition of Covid-19 screening and treatment tools (in minutes) for fast implementation of new screening and care guidelines (as happens in a new epidemic), with usable visualization and decision tools.Results:Prototype systems were successfully built and configured for rapid tool creation for pandemic-specific needs including setup of automated screening and decision tools using EHR data plus point of care data gathering. These will be demonstrated. A modular, composable approach is usable by nonprogrammer clinicians, permitting those most familiar with rapidly changing clinical needs and guidelines to implement new health IT functionality directly instead of incurring delays typical when IT staff must do ad hoc programming. At this time new initiatives and mandates for health IT interoperability make this more easily doable than previously.Conclusion:Disaster response may be facilitated by a different approach to health IT design and use, with advantages for rapid response, streamlining clinician work, and ease of use.
Effects of an Early Detection System for Barotrauma During Hyperbaric Oxygen Therapy
Authors: Wang Soon-Joo , Kang Pooreun 
Published: June 2023

Introduction:Although hyperbaric oxygen therapy is required in disasters or emergency situations, barotrauma, which is the most common complication, continues to occur. If barotrauma occurs during hyperbaric oxygen treatment, treatment is stopped, and there is no proper preventive method for this. Therefore, the authors evaluated the degree of barotrauma prevention by applying a tympanometry-based anti-barotrauma device (ABT).Method:The candidates of the clinical trial are adults between the ages of 18 and 65 who correspond to academic indications for hyperbaric oxygen therapy. In a prospective parallel design, the candidates were placed in the test group and control group. Simple randomization and one-sided blinding were applied. The medical staff directly observed the severity of middle ear barotrauma through a video otoscope. The number of treatment interruptions and completions along with findings from the otoscope observation (Grade 0~5) such as level of ear pain (pain scale value) were collected at three university hospitals.Results:When ABT was applied, it was possible to prevent barotrauma earlier than the traditional medical observation. However, since the application of ABT requires the patient's voluntary cooperation, it is difficult to prevent barotrauma if a patient has reduced consciousness or is unable to follow the instructions of the medical staff.Conclusion:Applying ABT is an appropriate method for early detection of barotrauma. However, in order to be applicable to patients with reduced consciousness or difficulty in cooperation, an automatic intrinsic pressure reduction system should be developed.
Machine Learning Prediction for Supplemental Oxygen Requirement in Patients with COVID-19
Authors: Igarashi Yutaka , Miyake Nodoka , Mizobuchi Taiki , Shigeta Kenta , Obinata Hirofumi , Takayama Yasuhiro , Yokobori Shoji 
Published: June 2023

Introduction:The coronavirus disease (COVID-19) poses an urgent threat to global public health and is characterized by rapid disease progression even in mild cases. In this study, we investigated whether machine learning can be used to predict which patients will have a deteriorated condition and require oxygenation in asymptomatic or mild cases of COVID-19.Method:This single-center, retrospective, observational study included COVID-19 patients admitted to the hospital from February 1, 2020, to May 31, 2020, and who were either asymptomatic or presented with mild symptoms and did not require oxygen support on admission. Data on patient characteristics and vital signs were collected upon admission. We used seven machine learning algorithms, assessed their capability to predict exacerbation, and analyzed important influencing features using the best algorithm.Results:In total, 210 patients were included in the study. Among them, 43 (19%) required oxygen therapy. Of all the models, the logistic regression model had the highest accuracy and precision. Logistic regression analysis showed that the model had an accuracy of 0.900, precision of 0.893, and recall of 0.605. The most important parameter for predictive capability was SpO2, followed by age, respiratory rate, and systolic blood pressure.Conclusion:In this study, we developed a machine learning model that can be used as a triage tool by clinicians to detect high-risk patients and disease progression earlier. Prospective validation studies are needed to verify the application of the tool in clinical practice.
The Future Technologies that will Define Disaster Medicine
Authors: Hart Alexander , Hertelendy Attila 
Published: June 2023

Introduction:Advances in technology can drastically improve the ability of providers to care for survivors of a disaster. Research into new applications of technology in the Disaster Medicine space, and dissemination of new technological achievements are vital to saving lives. This presentation discusses several recently proven technologies in the field of disaster medicine which deserve further dissemination, as well as promising technologies currently being studied.Method:An overview of the current uses and upcoming research on several technologies will be definitive in future disaster responses.Results:Unmanned Aerial Vehicles (UAVs) and Telemedicine have been well studied and are proven game changers in field disaster response. Artificial intelligence continues to be studied and aid real-time, strategic and tactical decision making in the field. Virtual reality simulation has now advanced to be a feasible, cost effective and effective method of training disaster responders as well as for training the lay public in disaster risk reduction. Artificial Intelligence is also being studied for uses in the hospital and in all forms of Emergency Management, and is likely to be intricately tied to the future of the field.Conclusion:As new technologies are developed, it is important for Disaster medicine practitioners to consider how they can be applied to the field. Advocating for applying new technologies to disaster medicine, and for dissemination of proven technologies is a vital part of advancing the field of disaster preparedness and response.