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Disaster planning [keywords]
- Hospital evacuation decisions in emergency situations--reply. [Comment, Letter]
- JAMA 2013 Apr 17; 309(15):1586.
- Hospital evacuation decisions in emergency situations. [Comment, Letter]
- JAMA 2013 Apr 17; 309(15):1585-6.
- A framework and methodology for navigating disaster and global health in crisis literature. [Journal Article]
- PLoS Curr 2013.
Both 'disasters' and 'global health in crisis' research has dramatically grown due to the ever-increasing frequency and magnitude of crises around the world. Large volumes of peer-reviewed literature are not only a testament to the field's value and evolution, but also present an unprecedented outpouring of seemingly unmanageable information across a wide array of crises and disciplines. Disaster medicine, health and humanitarian assistance, global health and public health disaster literature all lie within the disaster and global health in crisis literature spectrum and are increasingly accepted as multidisciplinary and transdisciplinary disciplines. Researchers, policy makers, and practitioners now face a new challenge; that of accessing this expansive literature for decision-making and exploring new areas of research. Individuals are also reaching beyond the peer-reviewed environment to grey literature using search engines like Google Scholar to access policy documents, consensus reports and conference proceedings. What is needed is a method and mechanism with which to search and retrieve relevant articles from this expansive body of literature. This manuscript presents both a framework and workable process for a diverse group of users to navigate the growing peer-reviewed and grey disaster and global health in crises literature.Disaster terms from textbooks, peer-reviewed and grey literature were used to design a framework of thematic clusters and subject matter 'nodes'. A set of 84 terms, selected from 143 curated terms was organized within each node reflecting topics within the disaster and global health in crisis literature. Terms were crossed with one another and the term 'disaster'. The results were formatted into tables and matrices. This process created a roadmap of search terms that could be applied to the PubMed database. Each search in the matrix or table results in a listed number of articles. This process was applied to literature from PubMed from 2005-2011. A complementary process was also applied to Google Scholar using the same framework of clusters, nodes, and terms expanding the search process to include the broader grey literature assets.A framework of four thematic clusters and twelve subject matter nodes were designed to capture diverse disaster and global health in crisis-related content. From 2005-2011 there were 18,660 articles referring to the term [disaster]. Restricting the search to human research, MeSH, and English language there remained 7,736 identified articles representing an unmanageable number to adequately process for research, policy or best practices. However, using the crossed search and matrix process revealed further examples of robust realms of research in disasters, emergency medicine, EMS, public health and global health. Examples of potential gaps in current peer-reviewed disaster and global health in crisis literature were identified as mental health, elderly care, and alternate sites of care. The same framework and process was then applied to Google Scholar, specifically for topics that resulted in few PubMed search returns. When applying the same framework and process to the Google Scholar example searches retrieved unique peer-reviewed articles not identified in PubMed and documents including books, governmental documents and consensus papers.The proposed framework, methodology and process using four clusters, twelve nodes and a matrix and table process applied to PubMed and Google Scholar unlocks otherwise inaccessible opportunities to better navigate the massively growing body of peer-reviewed disaster and global health in crises literature. This approach will assist researchers, policy makers, and practitioners to generate future research questions, report on the overall evolution of the disaster and global health in crisis field and further guide disaster planning, prevention, preparedness, mitigation response and recovery.
- Budget forces tough look at biodefence. [News]
- Nature 2013 Apr 11; 496(7444):149.
- Nurses' Preparedness and Perceived Competence in Managing Disasters. [JOURNAL ARTICLE]
- J Nurs Scholarsh 2013 Apr 9.
PURPOSE:This article is a descriptive analysis of rural nurses' perceived readiness to manage disaster situations.
DESIGN AND METHODS:The 58-item Disaster Readiness Questionnaire was used to survey hospital-based nurses from rural communities in Texas during the summer of 2011. The data were collected by emailing a link through the various hospital intranet sites, resulting in a sample size of 620 nurses.
RESULTS:Findings revealed that most nurses are not confident in their abilities to respond to major disaster events. The nurses who were confident were more likely to have had actual prior experience in disasters or shelters. Self-regulation of behavior (motivation) was a significant predictor of perceived nurse competence to manage disasters only in regard to the nurse's willingness to assume the risk of involvement in a disaster situation. Healthcare climate (job satisfaction) was not a determinant of disaster preparedness.
CONCLUSIONS:Global increases in natural and human-induced disasters have called attention to the part that health providers play in mitigation and recovery. Since nurses are involved in planning, mitigation, response, and recovery aspects of disasters, they should actively seek opportunities to participate in actual disaster events, mock drills, and further educational opportunities specific to disaster preparedness. Administrators must support and encourage disaster preparedness education of nurses to promote hospital readiness to provide community care delivery in the event of a disaster situation.
CLINICAL RELEVANCE:Nursing comprises the largest healthcare workforce, and yet there is very little research examining nurses' readiness for disaster.
- Providing culturally competent care during disasters: strategies for nurses. [Journal Article, Research Support, U.S. Gov't, P.H.S.]
- J Contin Educ Nurs 2013 Apr; 44(4):151-2.
Planning for and responding to disasters involves more than traditional emergency management; members of vulnerable populations should be included in the disaster response cycle. Nurses are key to employing culturally competent strategies with vulnerable populations during disasters, enhancing the access of these populations to care and reducing their health disparities.
- Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study. [Journal Article]
- PLoS One 2013; 8(3):e60192.
Safety of evacuation is of paramount importance in disaster planning for elderly people; however, little effort has been made to investigate evacuation-related mortality risks. After the Fukushima Daiichi Nuclear Plant accident we conducted a retrospective cohort survival survey of elderly evacuees.A total of 715 residents admitted to five nursing homes in Minamisoma city, Fukushima Prefecture in the five years before 11th March 2011 joined this retrospective cohort study. Demographic and clinical characteristics were drawn from facility medical records. Evacuation histories were tracked until the end of 2011. The evacuation's impact on mortality was assessed using mortality incidence density and hazard ratios in Cox proportional hazards regression.Overall relative mortality risk before and after the earthquake was 2.68 (95% CI: 2.04-3.49). There was a substantial variation in mortality risks across the facilities ranging from 0.77 (95% CI: 0.34-1.76) to 2.88 (95% CI: 1.74-4.76). No meaningful influence of evacuation distance on mortality was observed although the first evacuation from the original facility caused significantly higher mortality than subsequent evacuations, with a hazard ratio of 1.94 (95% CI: 1.07-3.49).High mortality, due to initial evacuation, suggests that evacuation of the elderly was not the best life-saving strategy for the Fukushima nuclear disaster. Careful consideration of the relative risks of radiation exposure and the risks and benefits of evacuation is essential. Facility-specific disaster response strategies, including in-site relief and care, may have a strong influence on survival. Where evacuation is necessary, careful planning and coordination with other nursing homes, evacuation sites and government disaster agencies is essential to reduce the risk of mortality.
- An investigation into the socioeconomic aspects of two major earthquakes in Iran. [JOURNAL ARTICLE]
- Disasters 2013 Apr 2.
An evaluation of the socioeconomic consequences of earthquakes is an essential part of the development of risk reduction and disaster management plans. However, these variables are not normally addressed sufficiently after strong earthquakes; researchers and relevant stakeholders focus primarily on the physical damage and casualties. The importance of the socioeconomic consequences of seismic events became clearer in Iran after the Bam earthquake on 26 December 2003, as demonstrated by the formulation and approval of various laws and ordinances. This paper reviews the country's regulatory framework in the light of the socioeconomic aspects of two major and destructive earthquakes: in Manjil-Rudbar in 1990, and in Bam in 2003. The results take the form of recommendations and practical strategies for incorporating the socioeconomic dimensions of earthquakes in disaster risk management planning. The results presented here can be applied in other countries with similar conditions to those of Iran in order to improve public preparedness and risk reduction.
- Research as a part of public health emergency response. [Journal Article]
- N Engl J Med 2013 Mar 28; 368(13):1251-5.
- Tsunami-tendenko and morality in disasters. [JOURNAL ARTICLE]
- J Med Ethics 2013 Mar 26.
Disaster planning challenges our morality. Everyday rules of action may need to be suspended during large-scale disasters in favour of maxims that that may make prudential or practical sense and may even be morally preferable but emotionally hard to accept, such as tsunami-tendenko. This maxim dictates that the individual not stay and help others but run and preserve his or her life instead. Tsunami-tendenko became well known after the great East Japan earthquake on 11 March 2011, when almost all the elementary and junior high school students in one city survived the tsunami because they acted on this maxim that had been taught for several years. While tsunami-tendenko has been praised, two criticisms of it merit careful consideration: one, that the maxim is selfish and immoral; and two, that it goes against the natural tendency to try to save others in dire need. In this paper, I will explain the concept of tsunami-tendenko and then respond to these criticisms. Such ethical analysis is essential for dispelling confusion and doubts about evacuation policies in a disaster.