scholarly journals Code Orange: A Systematic Review of Psychosocial Disaster Response

2019 ◽  
Vol 34 (s1) ◽  
pp. s69-s70 ◽  
Author(s):  
Melissa B. Korman ◽  
Lauren Goldberg ◽  
Cailtin Klein ◽  
Marjan Khanjani ◽  
Gemma Cox ◽  
...  
Keyword(s):  
Disaster Response ◽  
Psychological Treatment ◽  
Data Extraction ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Free Text ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Mass Trauma ◽  
Disaster Situation

Introduction:Survivors of mass casualty incidents are vulnerable to both physical and psychological injuries. Hospitals need to triage the walking wounded victims, their loved ones, and witnesses for symptoms of emotional distress to ensure that those who are traumatized benefit from proactive psychological treatment. Hospitals must also manage the influx of searching family and friends, and be able to reunite them with their loved ones, to reduce chaos and prevent hospital skipping.Aim:To analyze previous research on institutional psychosocial disaster response, what has or has not worked, and lessons learned in order to develop evidence-based future planning suggestions.Methods:A literature search was conducted on the following electronic databases: (Medline 2007 to July 2018), (Embase 2007 to July 2018), (PsycInfo 2007 to July 2018). A combination of subject headings and free text keywords were used to perform the searches. After removing duplicates, abstracts were screened independently by two reviewers for the following inclusion criteria: 1) crisis intervention (in a disaster situation), 2) mention of psychosocial response or lack thereof and lessons learned, 3)relevant outcomes, 4) OECD countries, and 5) journal articles published 2007–Present. Review articles were excluded. Primary and secondary reviewers are in the process of discussing discrepancies. Data extraction will be conducted from all articles that meet the inclusion criteria. Key themes to be analyzed include psychological casualties, searching family and friends, and family reunification plans.Results:The initial search yielded 6,267 results. 5,294 articles remained after duplicates were removed. Of the 4,890 reviewed thus far, 269 articles met inclusion criteria.Discussion:Although a wealth of existing literature notes the need for an effective psychosocial response in mass trauma and disaster situations, no prior study has analyzed the efficacy of such interventions or laid out an evidence-based plan. This study will fill this much-needed gap in the literature.

Developing a Hospital Disaster Preparedness Plan for Mass Casualty Incidents: Lessons Learned From the Downtown Beirut Bombing

2017 ◽  
Vol 12 (3) ◽  
pp. 379-385 ◽  
Author(s):  
Mazen El Sayed ◽  
Ali F. Chami ◽  
Eveline Hitti
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Hospital Staff ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
Preparedness Plan ◽  
Security Issues ◽  
Response System ◽  
General Response

AbstractMass casualty incidents (MCIs) are becoming more frequent worldwide, especially in the Middle East where violence in Syria has spilled over to many neighboring countries. Lebanon lacks a coordinated prehospital response system to deal with MCIs; therefore, hospital preparedness plans are essential to deal with the surge of casualties. This report describes our experience in dealing with an MCI involving a car bomb in an urban area of downtown Beirut, Lebanon. It uses general response principles to propose a simplified response model for hospitals to use during MCIs. A summary of the debriefings following the event was developed and an analysis was performed with the aim of modifying our hospital’s existing disaster preparedness plan. Casualties’ arrival to our emergency department (ED), the performance of our hospital staff during the event, communication, and the coordination of resources, in addition to the response of the different departments, were examined. In dealing with MCIs, hospital plans should focus on triage area, patient registration and tracking, communication, resource coordination, essential staff functions, as well as on security issues and crowd control. Hospitals in other countries that lack a coordinated prehospital disaster response system can use the principles described here to improve their hospital’s resilience and response to MCIs. (Disaster Med Public Health Preparedness. 2018; 12: 379–385)

scholarly journals Adaptive Elements in Internet-Delivered Psychological Treatment Systems: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Suresh Kumar Mukhiya ◽  
Jo Dugstad Wake ◽  
Yavuz Inal ◽  
Ka I Pun ◽  
Yngve Lamo
Keyword(s):  
Mental Health ◽  
Psychological Treatment ◽  
Adaptive Strategies ◽  
Mental Health Disorders ◽  
User Preferences ◽  
Information Architecture ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Design Elements ◽  
Health Disorders

BACKGROUND Internet-delivered psychological treatments (IDPTs) are built on evidence-based psychological treatment models, such as cognitive behavioral therapy, and are adjusted for internet use. The use of internet technologies has the potential to increase access to evidence-based mental health services for a larger proportion of the population with the use of fewer resources. However, despite extensive evidence that internet interventions can be effective in the treatment of mental health disorders, user adherence to such internet intervention is suboptimal. OBJECTIVE This review aimed to (1) inspect and identify the adaptive elements of IDPT for mental health disorders, (2) examine how system adaptation influences the efficacy of IDPT on mental health treatments, (3) identify the information architecture, adaptive dimensions, and strategies for implementing these interventions for mental illness, and (4) use the findings to create a conceptual framework that provides better user adherence and adaptiveness in IDPT for mental health issues. METHODS The review followed the guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The research databases Medline (PubMed), ACM Digital Library, PsycINFO, CINAHL, and Cochrane were searched for studies dating from January 2000 to January 2020. Based on predetermined selection criteria, data from eligible studies were analyzed. RESULTS A total of 3341 studies were initially identified based on the inclusion criteria. Following a review of the title, abstract, and full text, 31 studies that fulfilled the inclusion criteria were selected, most of which described attempts to tailor interventions for mental health disorders. The most common adaptive elements were feedback messages to patients from therapists and intervention content. However, how these elements contribute to the efficacy of IDPT in mental health were not reported. The most common information architecture used by studies was tunnel-based, although a number of studies did not report the choice of information architecture used. Rule-based strategies were the most common adaptive strategies used by these studies. All of the studies were broadly grouped into two adaptive dimensions based on user preferences or using performance measures, such as psychometric tests. CONCLUSIONS  Several studies suggest that adaptive IDPT has the potential to enhance intervention outcomes and increase user adherence. There is a lack of studies reporting design elements, adaptive elements, and adaptive strategies in IDPT systems. Hence, focused research on adaptive IDPT systems and clinical trials to assess their effectiveness are needed.

scholarly journals (A145) Simulation for the Assessment and Optimization of Medical Disaster Management

2011 ◽  
Vol 26 (S1) ◽  
pp. s41-s42
Author(s):  
E.L. Dhondt ◽  
F. Van utterbeek ◽  
C. Ullrich ◽  
M. Debacker
Keyword(s):  
Decision Making ◽  
Disaster Management ◽  
Disaster Response ◽  
Large Scale ◽  
Simulation Optimization ◽  
Mass Casualty ◽  
Optimization Techniques ◽  
Evidence Based ◽  
Outcome Indicators ◽  
Medical Response

BackgroundThe ultimate goal of medical disaster management must be to predictably orchestrate transition from “standard of care” to “sufficiency of care” using evidence-based methods. However, neither descriptive reports of disaster responses nor epidemiological studies investigating disaster risk factors have been able to provide validated outcome measures as to what constitutes a “good” disaster response. Moreover, it either has been considered impossible, ethically inappropriate, or both, to identify experimental and control groups essential for hypothesis testing for the conduct of scientific randomized controlled clinical trials.ObjectiveThe aim of this study was to identify a number of performance and outcome indicators and define optimal disaster response and management decision-making for various disaster scenarios using simulation optimization.Methods and ResultsA system model of medical disaster management was designed, and victim models and performance and outcome indicators were developed. Various mass-casualty and large-scale disaster scenarios were developed, including: (1) a hospital emergency incident/disaster; (2) a CBRNE incident; (3) an airplane crash and airport disaster; (4) a mass gathering; and (5) a military battlefield mass casualty. Using “Discrete Event Driven Simulation”, multiple replications were made for different decision-making modalities, different resource allocations, and different disaster response procedures. Statistical analysis and optimization techniques were applied to achieve the best available setting of parameters of the simulation model. In such a way, the “Medical Disaster Management Simulator” runs the “missing experimental studies” in a simplified artificial simulated disaster environment.ConclusionsSimulation optimization is an adequate tool for judging and evaluating the effectiveness and adequacy of health and relief services provided during disaster medical response. Evidence-based recommendations and codes of best practice were formulated for optimal medical disaster and military battlefield management in different large-scale event scenarios as well as for teaching, training, and research in medical disaster management.

ZOE Paste Pulpectomies Outcome in Primary Teeth: A Systematic Review

2011 ◽  
Vol 35 (3) ◽  
pp. 241-248 ◽  
Author(s):  
R Barcelos ◽  
MPA Santos ◽  
LG Primo ◽  
RR Luiz ◽  
LC Maia
Keyword(s):  
Systematic Review ◽  
Primary Teeth ◽  
Data Extraction ◽  
Research Question ◽  
Free Text ◽  
Inclusion Criteria ◽  
Medical Subject Headings ◽  
Filling Materials ◽  
Radiographic Outcomes

Objective: To perform a systematic review in which the clinical research question for primary teeth with irreversible pulpal pathosis was "how pulpectomies with zinc oxide eugenol (ZOE) paste performed compared to other materials in their clinical and radiographic outcomes after twelve months or more follow-up period.Study design: A literature survey of the electronic database (1950-2010) used the Medical Subject Headings and free text terms. Forty three references were retrieved and inclusion criteria were applied; 15 articles remained for full-text evaluation. From these, two were selected for data extraction regarding quality characteristics and results. Results: Selected studies showed moderate or high risk of bias. The overall success of pulpectomy was 80.0% (Calcicur), 60.0% (Sealapex) and varied from 85.0% to 100.0% (ZOE) and 89.0% to 100.0% (Vitapex). Solely Calcicur presented success rate significantly lower when compared to ZOE and Vitapex. These pastes lead to overfilled canals and particles of extruded ZOE were still evident even after the evaluation period. Resorption of Vitapex, Calcicur and Sealapex within the root canal was also reported. Conclusions: In primary teeth with irreversible pulpal changes ZOE pulpectomies yielded similar outcome than Vitapex and Sealapex, although there was no agreement with regard to filling materials' resorption.

scholarly journals Program for data extraction in primary health records: a valid tool for knowledge production in general practice?

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Martin Holte ◽  
Jostein Holmen
Keyword(s):  
Blood Pressure ◽  
General Practice ◽  
Diastolic Blood Pressure ◽  
Data Extraction ◽  
Free Text ◽  
Inclusion Criteria ◽  
Health Records ◽  
Primary Health ◽  
Correct Data

Abstract Objectives Research in general practice demands it-tools which give the practitioner trusty results. Medrave 4 is a program designed for extraction of data from all areas of the health record. We wanted to do research on the database in a health center, but found no proof of the quality of the data extracted by Medrave 4. Today the database contains about 40,000 records. In this study we wanted to examine if the program could extract correct data. Results From the database 20 records were randomly selected from five different time periods, making a total of 100 records. 14 records did not meet the inclusion criteria, resulting in 86 records included in the study. In phase one these variables were registered manually from the records: Age, gender, systolic and diastolic blood pressure (from free text) and six different laboratory tests. In phase two, Medrave 4 extracted the same variables from the same records. Medrave 4 found correct systolic and diastolic blood pressure values in 79 records (92%). The laboratory results were extracted correct in all 86 records (100%). We conclude that Medrave 4 can be a useful tool in quantifying the work of general practitioners.

Development of evaluation modules for use in hospital disaster drills

2007 ◽  
Vol 2 (2) ◽  
pp. 87-95 ◽  
Author(s):  
Mollie W. Jenckes, MHSc, BSN ◽  
Christina L. Catlett, MD ◽  
Edbert B. Hsu, MD, MPH ◽  
Karen Kohri ◽  
Gary B. Green, MD, MPH ◽  
...  
Keyword(s):  
Disaster Response ◽  
Healthcare Providers ◽  
Physical Space ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Evaluation Tool ◽  
General Observation ◽  
Incident Command ◽  
Structure Communication ◽  
Command Center

Introduction: Disaster drills are a valuable means of training healthcare providers to respond to mass casualty incidents resulting from acts of terrorism or public health crises. We present here a proposed hospital-based disaster drill evaluation tool that is designed to identify strengths and weaknesses of hospital disaster drill response, provide a learning opportunity for disaster drill participants, and promote integration of lessons learned into future responses. Methods: Clinical specialists, experienced disaster drill coordinators and evaluators, and experts in questionnaire design developed the evaluation mod-ules based upon a comprehensive review of the litera-ture, including evaluations of disaster drills. The tool comprises six evaluation modules designed to capture strengths and weaknesses of different aspects of hospital disaster response. The Predrill Module is completed by the hospital during drill planning and is used to define the scope of the exercise. The Incident Command Center Module assesses command structure, communication between response areas and the command center, and communication to outside agencies. The Triage Zone Module captures the effect of a physical space on triage activities, efficiency of triage operations, and victim flow. The Treatment Zone Module assesses the relation of the zone’s physical characteristics to treatment activities, efficacy of treatment operations, adequacy of supplies, and victim flow. A Decontamination Zone Module is available for evaluating decontamination operations and the use of decontamination and/or personal protective equipment in drills that involve biological or radiological hazardous materials. The Group Debriefing Module provides sample discussion points for drill participants in all types of drills. The tool also has addenda to evaluate specifics for 1) general observation and documentation, 2) victim tracking, 3) biological incidents, and 4) radiological incidents. Conclusion: This evaluation tool will help meet the need for standardized evaluation of disaster drills. The modular approach offers flexibility and could be used by hospitals to evaluate staff training on response to natural or man-made disasters.

scholarly journals Reporting for Duty During Mass Casualty Events: A Survey of Factors Influencing Emergency Medicine Physicians

2013 ◽  
Vol 5 (3) ◽  
pp. 417-426 ◽  
Author(s):  
Carly Snipes ◽  
Charles Miramonti ◽  
Carey Chisholm ◽  
Robin Chisholm
Keyword(s):  
Emergency Medicine ◽  
Health Care Professionals ◽  
Disaster Response ◽  
Mass Casualty ◽  
Disciplinary Action ◽  
Factors Influencing ◽  
Mass Casualty Events ◽  
Disaster Situation ◽  
Key Resources ◽  
Willingness To Report

Abstract Background Academic medical centers play a major role in disaster response, and residents frequently serve as key resources in these situations. Studies examining health care professionals' willingness to report for duty in mass casualty situations have varying response rates, and studies of emergency medicine (EM) residents' willingness to report for duty in disaster events and factors that affect these responses are lacking. Objective We sought to determine EM resident and faculty willingness to report for duty during 4 disaster scenarios (natural, explosive, nuclear, and communicable), to identify factors that affect willingness to work, and to assess opinions regarding disciplinary action for physicians unwilling to work in a disaster situation. Methods We surveyed residents and faculty at 7 US teaching institutions with accredited EM residency programs between April and November 2010. Results A total of 229 faculty and 259 residents responded (overall response rate, 75.4%). Willingness to report for duty ranged from 54.1% for faculty in a natural disaster to 94.2% for residents in a nonnuclear explosive disaster. The 3 most important factors influencing disaster response were concern for the safety of the family, belief in the physician's duty to provide care, and availability of protective equipment. Faculty and residents recommended minimal or no disciplinary action for individuals unwilling to work, except in the infectious disease scenario. Conclusions Most EM residents and faculty indicated they would report for duty. Residents and faculty responses were similar in all but 1 scenario. Disciplinary action for individuals unwilling to work generally was not recommended.

scholarly journals Precision Augmentation of Medical Surge Capacity for Disaster Response

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Weifeng Shen ◽  
Libing Jiang ◽  
Xiaojun He
Keyword(s):  
Disaster Response ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Standards Of Care ◽  
Specific Situation ◽  
Surge Capacity ◽  
The World ◽  
Disaster Situation ◽  
Serious Injuries ◽  
Internal Capacity

Background. In recent years, serious injuries associated with extreme climate, earthquakes, terrorism, and other natural and man-made disasters have occurred frequently throughout the world. A surge in medical demand that extends beyond local medical surge capacity in mass casualty incidents following major disasters is common. Materials and Methods. We reviewed and analyzed emergency medical rescue efforts after major disasters in recent years to elaborate the precision strategy of augmenting medical surge capacity for disaster response. Results. Precision augmentation of medical surge capacity for disaster response can be achieved through several measures. These include (1) release of internal capacity through precision launching or through upgrading the levels of response, (2) precision support for medical surge capacity from external efforts, (3) centralized response, and (4) altering standards of care. We should adopt precision augmentation of medical surge capacity according to the specific situation. Conclusions. Augmentation of medical surge capacity as a basic strategy can be used to achieve effective disaster response. In disaster response, due to the complexity of disaster medical capacity amplification, it is important to select the appropriate medical capacity strategy accurately according to the actual disaster situation.

scholarly journals Adaptive Elements in Internet-Delivered Psychological Treatment Systems: Systematic Review

10.2196/21066 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e21066
Author(s):  
Suresh Kumar Mukhiya ◽  
Jo Dugstad Wake ◽  
Yavuz Inal ◽  
Ka I Pun ◽  
Yngve Lamo
Keyword(s):  
Mental Health ◽  
Psychological Treatment ◽  
Adaptive Strategies ◽  
Mental Health Disorders ◽  
User Preferences ◽  
Information Architecture ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Design Elements ◽  
Health Disorders

Background Internet-delivered psychological treatments (IDPTs) are built on evidence-based psychological treatment models, such as cognitive behavioral therapy, and are adjusted for internet use. The use of internet technologies has the potential to increase access to evidence-based mental health services for a larger proportion of the population with the use of fewer resources. However, despite extensive evidence that internet interventions can be effective in the treatment of mental health disorders, user adherence to such internet intervention is suboptimal. Objective This review aimed to (1) inspect and identify the adaptive elements of IDPT for mental health disorders, (2) examine how system adaptation influences the efficacy of IDPT on mental health treatments, (3) identify the information architecture, adaptive dimensions, and strategies for implementing these interventions for mental illness, and (4) use the findings to create a conceptual framework that provides better user adherence and adaptiveness in IDPT for mental health issues. Methods The review followed the guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The research databases Medline (PubMed), ACM Digital Library, PsycINFO, CINAHL, and Cochrane were searched for studies dating from January 2000 to January 2020. Based on predetermined selection criteria, data from eligible studies were analyzed. Results A total of 3341 studies were initially identified based on the inclusion criteria. Following a review of the title, abstract, and full text, 31 studies that fulfilled the inclusion criteria were selected, most of which described attempts to tailor interventions for mental health disorders. The most common adaptive elements were feedback messages to patients from therapists and intervention content. However, how these elements contribute to the efficacy of IDPT in mental health were not reported. The most common information architecture used by studies was tunnel-based, although a number of studies did not report the choice of information architecture used. Rule-based strategies were the most common adaptive strategies used by these studies. All of the studies were broadly grouped into two adaptive dimensions based on user preferences or using performance measures, such as psychometric tests. Conclusions  Several studies suggest that adaptive IDPT has the potential to enhance intervention outcomes and increase user adherence. There is a lack of studies reporting design elements, adaptive elements, and adaptive strategies in IDPT systems. Hence, focused research on adaptive IDPT systems and clinical trials to assess their effectiveness are needed.

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