- Principles of hospital disaster management: an integrated and multidisciplinary approach. [Journal Article]
- BB-ENT 2016; Suppl 26(2):139-148
- Principles of hospital disaster management: an integrated and multidisciplinary approach. Hospitals play an important role during a disaster response, and are also at risk for internal incidents. We ...
Principles of hospital disaster management: an integrated and multidisciplinary approach. Hospitals play an important role during a disaster response, and are also at risk for internal incidents. We propose an integrated and multidisciplinary approach towards hospital disaster management and preparedness. In addition to response strategies, much attention is given to risk assessment and preparedness in the pre-incident phase and to business continuity planning (BCP) in the post-incident phase. It is essential to train key players and all personnel to understand the Hospital Incident Management System (HIMS) and to perform specific emergency procedures. All emergency procedures should be grounded in evidence-based practice resulting from essential disaster response research.
- Challenges of Designing and Implementing High Consequence Infectious Disease Response. [Journal Article]
- DMDisaster Med Public Health Prep 2018 Mar 19; :1-4
- Ebola is a high consequence infectious disease-a disease with the potential to cause outbreaks, epidemics, or pandemics with deadly possibilities, highly infectious, pathogenic, and virulent. Ebola's...
Ebola is a high consequence infectious disease-a disease with the potential to cause outbreaks, epidemics, or pandemics with deadly possibilities, highly infectious, pathogenic, and virulent. Ebola's first reported cases in the United States in September 2014 led to the development of preparedness capabilities for the mitigation of possible rapid outbreaks, with the Centers for Disease Control and Prevention (CDC) providing guidelines to assist public health officials in infectious disease response planning. These guidelines include broad goals for state and local agencies and detailed information concerning the types of resources needed at health care facilities. However, the spatial configuration of populations and existing health care facilities is neglected. An incomplete understanding of the demand landscape may result in an inefficient and inequitable allocation of resources to populations. Hence, this paper examines challenges in implementing CDC's guidance for Ebola preparedness and mitigation in the context of geospatial allocation of health resources and discusses possible strategies for addressing such challenges. (Disaster Med Public Health Preparedness. 2018;page 1 of 4).
- Managing uncertainty: Lessons from volcanic lava disruption of transportation infrastructure in Puna, Hawaii. [Journal Article]
- JEJ Emerg Manag 2018 Jan/Feb; 16(1):29-40
- A recent lava flow in Puna, Hawaii, threatened to close one of the major highways serving the region. This article provides background information on the volcanic hazards and describes events, respon...
A recent lava flow in Puna, Hawaii, threatened to close one of the major highways serving the region. This article provides background information on the volcanic hazards and describes events, responses, and challenges associated with managing a complex, long-duration disaster. In addition to the need to better understand geologic hazards and threats, there is a need for timely information and effective response and recovery of transportation infrastructure. This requires coordination and sharing of information between scientists, emergency managers, transportation planners, government agencies, and community organizations. Transportation assets play a critical role in terms of problem definition, response, and recovery. The challenges with managing a long-duration event include: (1) determining when a sufficient threat level exists to close roads; (2) identifying transportation alternatives; (3) assessing impacts on communities including the direct threats to homes, businesses, structures, and infrastructure; (4) engaging communities in planning and deliberation of choices and alternatives; and (5) managing uncertainties and different reactions to hazards, threats, and risks. The transportation planning process provides a pathway for addressing initial community concerns. Focusing not just on roadways but also on travel behavior before, during, and after disasters is a vital aspect of building resilience. The experience in Puna with the volcano crisis is relevant to other communities seeking to adapt and manage long-term threats such as climate change, sea level risk, and other long-duration events.
- A Model for Measuring Ambulatory Access to Care Recovery after Disasters. [Journal Article]
- JAJ Am Board Fam Med 2018 Mar-Apr; 31(2):252-259
- CONCLUSIONS: Quantifying care disruptions around disasters is an important step in assessing interventions to improve emergency preparedness and response for clinics. The illustrative example of measures captured the disaster event duration and severity in relation to ambulatory care appointments.
- Travelling without a helmet: tourists' vulnerabilities and responses to disasters in Indonesia. [Journal Article]
- DDisasters 2018 Mar 13
- Tourists are particularly vulnerable when natural disasters occur in regions that they are visiting. It is assumed that they lack awareness and understanding of the actions that they need to take in ...
Tourists are particularly vulnerable when natural disasters occur in regions that they are visiting. It is assumed that they lack awareness and understanding of the actions that they need to take in such circumstances. This study examines the responses of tourists in times of disaster, building on empirical data collected through large-scale surveys conducted in Bali and Yogyakarta, Indonesia, in 2015. Both are important tourist destinations in the country that have suffered major disasters in recent years. The different types of responses to these events are framed using a grid/group analysis stemming from cultural theory. The study resulted in three key findings: (i) current disaster management planning largely follows a single rationale; (ii) tourists are not a homogeneous group, but rather a complex, diverse, and dynamic body of stakeholders; and (iii) the focus of disaster management planning should shift from a single rationale to a polyrational methodology. Disaster managers need to consider, therefore, these different aspects in the context of preparedness.
- Community-Based Academic Level I Trauma Center Prepares for the 2016 Republican National Convention. [Journal Article]
- JTJ Trauma Nurs 2018 Mar/Apr; 25(2):98-103
- Disaster preparedness has come to the forefront for hospitals since the 9/11 attacks in 2001. Many improvements have been made in emergency management and planning for catastrophic events. Both urban...
Disaster preparedness has come to the forefront for hospitals since the 9/11 attacks in 2001. Many improvements have been made in emergency management and planning for catastrophic events. Both urban and community hospitals have the same responsibilities and commitments to their patients and communities. When the announcement was made that the 2016 Republican National Convention was going to be held in Cleveland, OH, Cleveland Clinic Akron General (CCAG) had to be confident in its abilities to handle any situation that might arise not just as a community hospital but also as a Level I trauma center. Organizing and preparing for more than a year, CCAG developed a detailed and well-thought-out preparedness program, with senior leadership implementing a clear chain of command. Developing and maintaining a strong and steady defense through detailed preparation, communication, teamwork, and organization are the keys to success.
- Posttraumatic Stress Disorder 23 Years After the 1988 Spitak Earthquake in Armenia. [Journal Article]
- JTJ Trauma Stress 2018; 31(1):47-56
- This population-based longitudinal study examined the rates and predictors of posttraumatic stress disorder (PTSD) among 725 differentially exposed survivors of the 1988 Spitak earthquake in Armenia,...
This population-based longitudinal study examined the rates and predictors of posttraumatic stress disorder (PTSD) among 725 differentially exposed survivors of the 1988 Spitak earthquake in Armenia, 23 years after the event. Participants had been previously evaluated in 1991. Evaluations included assessment of current PTSD (based on DSM-5 criteria), and a variety of potential risk and protective factors. For the whole sample, the rate of PTSD attributed to the earthquake decreased from 48.7% in 1991 to 11.6% in 2012 (p < .001). A "dose of exposure" pattern persisted, and 15.7% of participants who were in Spitak (high exposure) and 6.6% of participants who were in Kirovagan (low exposure) during the earthquake met the criteria for PTSD (p = .003). Additionally, in 2012, another 9.9% of participants met PTSD criteria due to post-earthquake traumas, which is a 5-fold increase from pre- to postearthquake (p < . 001). Factors positively associated with PTSD included earthquake-related job loss, exposure to post-earthquake traumas, depression at baseline, and chronic illness since the earthquake. Factors inversely associated with PTSD included housing assistance within two years after the earthquake, support of family and/or friends, and to a lesser degree, higher education and high living standard. These variables accounted for 23.1% of the variance in current PTSD severity scores. These findings indicate that PTSD rates subside significantly after a catastrophic disaster, although earthquake-related PTSD persists among a subgroup of exposed individuals. Predictors of PTSD identified in this study provide guidance for planning acute and longer-term postdisaster public mental health recovery programs.
- Enhancing Global Health Security: US Africa Command's Disaster Preparedness Program. [Journal Article]
- DMDisaster Med Public Health Prep 2018 Mar 07; :1-11
- US Africa Command's Disaster Preparedness Program (DPP), implemented by the Center for Disaster and Humanitarian Assistance Medicine, partnered with US Government agencies and international organizat...
US Africa Command's Disaster Preparedness Program (DPP), implemented by the Center for Disaster and Humanitarian Assistance Medicine, partnered with US Government agencies and international organizations to promote stability and security on the African continent by engaging with African Partner Nations' (PN) civil and military authorities to improve disaster management capabilities. From 2008 to 2015, DPP conducted disaster preparedness and response programming with 17 PNs. DPP held a series of engagements with each, including workshops, strategic planning, developing preparedness and response plans, tabletop exercises, and prioritizing disaster management capability gaps identified through the engagements. DPP partners collected data for each PN to further capacity building efforts. Thus far, 9 countries have completed military pandemic plans, 10 have developed national pandemic influenza plans, 9 have developed military support to civil authorities plans, and 11 have developed disaster management strategic work plans. There have been 20 national exercises conducted since 2009. DPP was cited as key in implementation of Ebola response plans in PNs, facilitated development of disaster management agencies in DPP PNs, and trained nearly 800 individuals. DPP enhanced PNs' ability to prepare and respond to crises, fostering relationships between international agencies, and improving civil-military coordination through both national and regional capacity building. (Disaster Med Public Health Preparedness. 2018;page 1 of 11).
- Mental health among Iranian combat veterans with ankle-foot neuromusculoskeletal injuries. [Journal Article]
- MMMil Med Res 2017 Sep 26; 4(1):30
- CONCLUSIONS: Approximately half of the combat veterans with ankle-foot neuromusculoskeletal disorders likely had psychological problems. The evaluation of the patterns and predicting factors of psychological conditions may inform strategic planning efforts and decision-making, which, in turn, may provide a better quality of life for veterans. Further studies that utilize longitudinal designs are needed to evaluate and compare the psychological status of different groups of veterans and other groups in the general population.
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- Automated Translation of Clinical Parameters in Evaluating Acute Radiation Injury: Results From a Mass Casualty Exercise. [Journal Article]
- DMDisaster Med Public Health Prep 2018 Mar 04; :1-5
- CONCLUSIONS: This study clearly demonstrates the need for automated tools to help translate clinical data for effective patient triage after a nuclear or radiological incident. (Disaster Med Public Health Preparedness. 2018;page 1 of 5).