bluuebunny/crossref_metadata_2025_split huggingface dataset:
Issues of the Nuclear Disaster Core Facility Through Nuclear Disaster Training
Authors: Okui Yoko , Cyuta Chiaki , Yoshioka Hayato , Ueda Takahiro , Homma Masato 
Published: June 2023

Introduction:In addition to national nuclear disaster training, local training is conducted once a year to identify issues with training.Method:The facility is located in the urgent protective action planning zone (UPZ), an exposure medical facility was built in 2015 and has conducted four trainings so far. The fifth training was conducted this time to develop human resources (training), manage equipment and materials, receive medical teams, collaborate with the Advanced Radiation Medical Support Center, review manuals, and inform local residents.Results:There are currently eleven nurses registered as nuclear disaster response nurses at the facility, and two nurses participate in the national nuclear disaster training program each year. On the other hand, unlike physicians and other professionals, the number of nurses enrolled for reasons such as relocation has not increased. The facility also functions as a core hospital in the event of a disaster, and currently has about 30 nurses who are willing to be dispatched in the event of a disaster. It was found that even in core facilities for nuclear disaster response, awareness of nuclear disasters within the facilities is low and few personnel are willing to work there. Previous studies have shown that they are anxious about radiation, the possibility of late effects from low-dose exposure, and concerns about the genetic effects of exposure and its effects on themselves in nursing.Conclusion:As a core facility for nuclear disasters, issues were reported on and identified through training, such as human resource development, management of materials and equipment, and review of manuals.
Development of the “Conductor Type Human Resources Development” program for Disaster Medicine and Health Care by Tohoku University and Fukushima Medical University
Authors: Ishii Tadashi , Shimada Jiro 
Published: June 2023

Introduction:On March 11, 2011, the Great East Japan Earthquake with a 9.0 magnitude struck the northeastern coast of Japan. The death toll reached 15,892 and 2,576 people were reported missing. Tohoku University and Fukushima Medical University, both of which are located in the affected prefectures, responded massively to the disaster.Method:To deal with the next disaster, both universities established the “Conductor type Human Resources Development” (CHRD) program for Disaster Medicine and Health Care in 2019, not only for doctors, but also other medical professionals (such as dentists, nurses, pharmacists, etc.) supported by the Japanese government. The main course of CHRD program, “Disaster Management course,” which is also a certification program at Tohoku University, comprises 14 practical educational contents (seven practical trainings and seven lectures) based on the work experience of both universities in collaboration with various organizations.Results:To date, 59 students have enrolled in the Disaster Management course, two students are enrolled in the board-certified physician in public health and social medicine acquisition course, three students are enrolled in the master's course, a Tohoku University Graduate School of Medicine course, and two students are enrolled in the doctoral course. Until October 2022, a total of 17 people were certified to have completed the "Disaster Management course," and one person completed the board-certified physician in public health and social medicine acquisition course. A total of 68 practical trainings and lectures were held until 2021, the total number of times this program was attended by students until 2021 was 916. Average comprehension rate and satisfaction rate with practical trainings and lectures by students are 97.2% and 98.3%, respectively.Conclusion:All the students who complete the CHRD program are believed to acquire comprehensive skills related to disaster health and medical care and will be able to respond effectively in all phases.
Hurricane Ida Emergency Medicine Resident Disaster Response
Authors: Herbert Kyle , Fenton Ronald , Flitter Ben , Kessler Raymond , Maslanka Meghan 
Published: June 2023

Introduction:This report describes the response, action plan, and after-action changes adopted by the Louisiana State University New Orleans (LSU-NO)–Emergency Medicine (EM) Residency Program in response to Hurricane Ida, which occurred in New Orleans, Louisiana in late August through early September 2021. Summarized are the redistribution of emergency department (ED) residents within the primary clinical site, University Medical Center New Orleans (UMCNO); the daily communication flow from chief residents and program leadership; and discussions pertaining to procedural revisions instituted following investigation of pre- and post-hurricane operations.Method:Small-group debrief sessions and after-action reports were conducted post-storm to discuss perceived deficiencies from a resident stand-point. Debriefing occurred between chief residents and individual classes through standardized residency forums. Additionally, an after-action committee, comprised of senior residents, academic faculty, and ancillary personnel, convened a separate counsel with hospital administration-level leadership to analyze retrospective limitations that occurred both during, and immediately following, Code Grey activation.Results:Following data collection and analysis from the various feedback channels, several changes were made to the residency’s Code Grey activation plan going into the 2022-2023 academic residency year. The information obtained was used to develop a more formalized Code Grey process, and to create more robust orientation and education materials for residents.Conclusion:Throughout the events of Hurricane Ida, the LSU-NO Emergency Medicine Department at University Medical Center New Orleans managed a substantial intensification in daily emergency medical activity, while contending with a near-immediate reduction in available resources. Consequently, our program has formalized a more durable residency response to future disasters, including real-time, evolving evacuation correspondence and modernized protocols for rapid re-distribution of resident-power. These procedures are now distributed and practiced throughout each residency year and reinforced on an ad hoc basis in advance of any major weather-related events predicted to impact the greater New Orleans metropolitan area.
Mental Health and Psychosocial Support for Ukrainian Refugees in the Netherlands from Fragmentation to Integration
Authors: Vetten-Mc Mahon Marjonneke , Jansen Noor , Zwart Femke 
Published: June 2023

Introduction:More than 7.8 million people fled Ukraine since the invasion of Russia and are registered as refugees in Europe (as of November 1, 2022). Almost 89,000 of them are registered to the Netherlands (as of November 3, 2022). It is expected that this number will rise. Appropriate and accessible Mental Health and Psychosocial Support (MHPSS) is essential for conflict survivors to address psychological harm from traumatic events and distress both during the escape and after, while trying to adjust to an unfamiliar place. Receiving countries have the obligation to provide MHPSS as part of their international commitment to the right to health. This is recognized in the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the Convention on the Rights of Persons with Disabilities (CRPD). Nevertheless, the Netherlands is failing to honor this commitment with fragmented services that do not seem to fit support needs. The longer it takes to put a comprehensive approach in place, the greater the damage to the refugees will be. This interactive session aims to shed light on practical challenges and opportunities for the implementation of appropriate, accessible and integrated MHPSS. What is needed to go from a fragmented to an integrated approach?Method:Being active as advisors in the field of Disaster Health and MHPSS in the Netherlands, the presenters review their experienced challenges thereafter opportunities and good practices are explored together with the participants.Results:Experienced challenges include complexity, fragmented organization, lack of ownership and inadequate access to knowledge and information about support needs.Conclusion:More is needed to meet the commitment to the right of health and to provide adequate MHPSS to refugees in the Netherlands and beyond. International exchange and learning can help us to understand and overcome implementation challenges.
Pediatric Disaster Readiness and Community Hospitals in a Rural American State
Authors: Kearns Randy , Gross Toni , Perry Amanda 
Published: June 2023

Introduction:Pediatric patients represent a small (but important) subset of the patient population routinely visiting emergency departments (ED) each year. With the aim of better understanding the disaster preparedness level for pediatric-specific mass casualty and surge incidents, a survey was conducted involving all hospitals that routinely manage pediatric patients in their emergency departments, to better understand the preparedness levels for these facilities.Method:This is a retrospective analysis of data collected in 2014 and repeated in 2021. Our focus included one predominantly rural state in the United States of America (USA). We examined results from surveys conducted where facilities self-reported objective criteria that resulted in a readiness score (as it relates to pediatric readiness). Reporting stratification reflected the annual pediatric ED volume with groups of; Low (<1800/year), Medium (1800-4999 /year), Medium to High (5000-9999/year), and High (>10,000/year).Results:Low-volume hospitals scored (Mean=59/Median=56), Medium volume hospitals scored (Mean=62/Median=60), Medium to High volume hospitals (Mean=67/Median=65), and hospitals with High volumes (Mean=82/Median=83). All hospital volume ranges had outlier hospitals that scored between 82-97. The general tendency, lower volume hospitals had a lower level of readiness, and higher volume hospitals had a higher (to much higher) level of readiness.Conclusion:Pediatric disaster readiness needs to be improved at the community level. It is encouraging that pediatric disaster readiness has been addressed in the larger medical centers. Yet, it should be noted that even very low-volume hospitals (had outliers with) scores as high as 94 indicating that with ample support, and resources, pediatric disaster preparedness is achievable in every hospital regardless of size or volume. The results point to a need to develop, improve, and distribute resources and support local hospitals with pediatric disaster readiness.
Impact of Covid-19 in Health Emergency and Disaster Risk Management System: Healthcare Workforce Management in Covid-19
Authors: Chimed-Ochir Odgerel , Amarsanaa Jargalmaa , Yumiya Yui , Kayano Ryoma , Kubo Tatsuhiko 
Published: June 2023

Introduction:COVID-19 conforms to key baseline characteristics of disaster which is defined as “a situation or event that overwhelms local capacity, necessitating a request for national or international level of assistance.” Many countries faced shortages of health workforce, maldistribution, misalignment of needs and skills of healthcare workers.The research goal is to identify the country responses on the shortage of workforce, their best practices and the lessons learned that may help to better handle any similar crisis in the future.Method:The scoping review was conducted in four electronic academic databases, namely, Medline, Web of Science, EBSCO, and TRIP and 24 scientific articles were reviewed. This study is funded by the World Health Organization Centre for Health Development (WKC-HEDRM-K21001).Results:The main strategies implemented were a financial coordination mechanism, relaxing standards/rule, redeployment, recruiting volunteers, fast tracking medical students, and using other resources in the workforce such as: the recruitment of inactive healthcare workers, returnees whose registration has lapsed within the last 1-2 years and integration of internationally educated health professionals. All these strategies demonstrated advantages like establishing mutual support across nations, organizations, motivating healthcare workers, lessening the workload of healthcare workers, and creating a new staff model for the next pandemic. If a pandemic lasts longer, financial support mechanisms are no longer feasible and longer working hours result in burnout. Managing volunteers, including supervision of their safety and allocation to the area in need, required hard effort and high-level coordination, especially when a needs assessment is unavailable. Another problem was the absence of an available list of resources, including volunteers and retired medical personnel.Conclusion:To date, countries have not yet determined clear policies on how to ensure the sustainability and resilience of the workforce during major health shocks. A follow-up study investigating the strategies implemented is needed.
Emergency Preparedness: Training Outcome in Hospital Staff
Authors: Roblin Patricia , Guzman Jennifer , Arquilla Bonnie , Braynt Clarence , Doukas Donald , Daniel Pia 
Published: June 2023

Introduction:A widely acknowledged aspect of emergency preparedness is hospital-wide staff education. Maintaining interest in hospital emergency preparedness among hospital staff is challenging. A hospital-wide education process involving a robust lecture and hands on donning and doffing sessions followed by periodic disaster drills has been recently undertaken as a quality improvement process.Method:A prospective pre- and post-test study of 256 hospital staff were given a six-hour training course in comprehensive Hospital Incident Command Systems (HICS), Hazmat (Hazardous Materials), and CBRNE (Chemical, Biological, Radiation, Nuclear, and Explosive) events. The same pre and post-test were given to all participants that contained questions to assess emergency preparedness knowledge.Results:256 registrars within seven months (two classes per month) completed training with pre and post-tests. The average class size was 18.3 (range= 14 to 26 registrars). 3 of 256 (1.1 % 95% confidence interval) registrars achieved the pass mark of 70% in the pre-test survey and 230 (89.8 %) registrars achieved the pass mark in the post-test (χ2-test P < 0.001) with an absolute increase in the pass rate of 84%.Conclusion:This finding justifies Emergency Preparedness Training at our institution, showing a marked improvement in staff knowledge of HICS and CBRNE management. This study should encourage continuous widespread use of Emergency Preparedness training in hospital Emergency Preparedness.
EMS and Bioterrorism Response
Authors: Houser Ryan 
Published: June 2023

Introduction:Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the COVID-19 pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services (EMS), even in the accelerating environment of biothreats.Method:This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS providers. The survey was available for 1 month in 2021 during which 190 EMS providers responded to the survey.Results:Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a biological agent. Provider Clinical Competency levels ranged from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution, and community). Only 10% of the respondents were both willing and able to effectively function in a bioterror environment.Conclusion:To effectively prepare for and respond to a bioterrorist attack, all levels of the healthcare system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed to biological agents. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system, which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.
Who Were the Most Vulnerable to the COVID-19 Pandemic? A Nationwide Panel Survey on Infection, Exercise Habits, and Weight in Japan
Authors: Ochi Sae 
Published: June 2023

Introduction:Behaviors to avoid infection are key to minimizing casualties of the COVID-19 pandemic. Even so, infection-avoidance behavior may also cause distant health impacts like immobility and obesity. This research aims at identifying behavioral patterns associated with SARS-CoV-2 infection, exercise habits, and being overweight in the Japanese population.Method:Nationwide online questionnaires were conducted five times from October 2020 to October 2021. Individuals who answered with consistency to have been diagnosed with SARS-CoV-2 at a medical facility were categorized into a SARS-CoV-2 group. The difference in lifestyle is compared using multiple regression and inverse probability weighing. In addition, the change in exercise habits, body mass index (BMI), and status of overweight (BMI>25kg/m2) were compared between the first questionnaire and the later ones. Risk factors of losing exercise habits or developing overweight were analyzed using multiple regression.Results:Diagnosis of SARS-CoV-2 was negatively correlated with crowd avoidance, mask wearing, hand washing behavior. On the contrary, the diagnosis was positively correlated with some behaviors that appear as preventive actions against the infection, such as changing clothes frequently, sanitizing belongings, and remote working. Regarding exercise habit and overweight, people with high income and elderly females showed higher risk of decreased exercise days. The proportion of overweight was increased from 22.2% to 26.6% in males and from 9.3% to 10.8% in females. Middle-aged males, elderly females, males who experienced SARS-CoV-2 infection were at higher risks of developing overweight.Conclusion:It is important to conduct an evidence-based intervention on people’s behaviors and to avoid excessive intervention that is less effective so that people can minimize indirect harm such as exhaustion, economic loss, and other chronic health impacts. Our findings suggest that high-risk groups of COVID-19 infection and immobility and/or overweight are quite different. Further research may enable us to establish more effective interventions for each group.
A «Push&Plug» Lifesaving Device to Prevent Exsanguination
Authors: Plass Andre , Babicki Josef , Emmert Maximilian 
Published: June 2023

Introduction:Severe bleeding from external wounds is a major reason for death. Immediate control of hemorrhage is of highest priority. We present the novel Acute Wound Occluder (AWO) which was developed for rapid and targeted wound occlusion. Here, we present the design, in-vitro testing, and in-vivo performance compared to QuikClot® using a clinically-relevant pig model.Method:AWO is made of an applicator with pushing function into which a self-expanding, Silicone coated Nitinol meshgraft is mounted to enable plugging into the wound-channel. In-vitro tests included biocompatibility, cytotoxicity, skin sensitization, and aging validation. Next, 12 pigs underwent standardized sized femoral-artery puncture to mimic life-threatening bleeding and were either treated with the AWO (n=6) or QuikClot® (control). Animals were followed-up for 4hrs, before device-removal macroscopic assessment.Results:The AWO successfully passed all in-vitro tests. The AWO could be delivered within 40±15 seconds to the wound to achieve instant bleeding control, and no additional manual compression needed. Quick Clot application was less convenient, with approximately four minutes (application 56±8ss, plus three minutes of manual compression) to achieve bleeding control. In all AWO treated pigs, exsanguination could be prevented immediately, no major blood-pressure drops occurred, with four pigs where bleeding could be completely stopped, and two pigs with irrelevant oozing which stopped within 75-150 seconds leading to minimal blood-loss of 12ml and 2ml. Tissue-analysis showed only small hematomas in five out of six animals. In contrast, QuickClot treated pigs showed significant bleeding and a blood-loss of 19ml. All six pigs showed substantial hematomas, two out of six showed very large hematomas. AWO application appeared to be safe with no peri-procedural adverse-events (AEs) or collateral damage to surrounding tissues.Conclusion:The AWO enables rapid and targeted control of life-threatening bleeding without any AEs. The AWO may represent a promising hemostatic device for bullet or knife-stab wounds.
Benefits of RFID Technology in the Provision of Medical Services at Mass Gathering Events
Authors: Munn Matthew , Hanrahan Page 
Published: June 2023

Introduction:Radiofrequency Identification (RFID) is becoming a ubiquitous technology that provides methods of tracking and organizing complex processes, and has had previously described benefits when used in medical and clinical situations such as disaster and mass casualty incidents. However, the potential benefits of this technology have not yet been examined or applied to mass gathering events such as music festivals using the medical lens.Method:RFID at music festivals was observed and characterized at a Canadian multi-day festival through a combination of (1) observation of real world application of the use of RFID-enabled attendee wristbands and (2) the development of a proposed implementation framework using expert input in event medical care, public health, festival safety and event organization. Potential roles for RFID technology in enhancing attendee safety, facilitating event medical care and collaborating with other on-site services, and promoting research agendas for these unique events were explored.Results:Observed and theoretical roles for RFID fell into four main domains: (1) the presence of important encoded personal health data and contacts specific to individuals that would be accessible in case of an emergency, (2) the unique, anonymous identification of attendees who access (and re-access) medical as well as other services, including during handovers between these services, (3) support for any larger public health research projects aimed at understanding the behaviors and flow of attendees, including recreational substance use and related harm reduction efforts, and (4) the storage of festival-tailored data throughout the event on RFID-enabled wristbands (eg previous medical visit details, self-entered substance use history, etc).Conclusion:The use of RFID at music festivals has clear benefits. It allows for the dynamic access and retrieval of important data that can aid safety and support the provision of timely and tailored medical care. Security and privacy issues need consideration where attendee data is concerned.