Project "Homeopathy for L'aquila" Classical Homeopathy applied in the case of earthquake as a medical assistance plan

Background: The project “Homeopathy for L’Aquila” was developed in order to provide humanitarian and professional assistance to the people of L’Aquila, who were the victims of a devastating earthquake during the night of April 6th, 2009. This project was promoted by the Federazione Italiana Associazioni Medici Omeopati (FIAMO) and supported by the governmental organization for Emergencies (Protezione Civile). Aim: This paper is the report of that experience in the state of absolute emergency, which lasted 17 months. It aims to be a feasibility study as well as a model for further emergencies. Methodology: A medical office was located in a container of 60 square meters which was open from Monday to Friday, beginning in August 2009 and lasting until December 2010. This was provided by Protezione Civile with all the basic equipment, including a reception with a secretary. There were 16 homeopathic physicians and 2 acupuncturists, coming from all over Italy. Every month they rotated to offer free consultations of Classical Homeopathy, as well as Acupuncture and Neuraltherapy. Only people coming from the earthquake area were admitted: all of them signed an informed consent. An operational protocol was defined for the data collection. Each consultation was reported in a special register. The follow-up period lasted 17 months. The protocol consisted of the first consultation and at least 3 control visits, when possible at 30, 60 and 120 day intervals. As a primary outcome the main complaint of the patient was considered in its relation to the quality of life. This evaluation followed a slightly modified criterion of a qualitative scale: Outcome in Relation to Impact on Daily Living (ORIDL). A statistical analysis with some non parametric tests was carried out (Kolmogorof, ). Even the most frequently prescribed homeopathic medicines were taken into consideration. Results: 674 patients were visited from August 2009 to December 2010. In total 1,542 medical visits and treatments were carried out (1,070 as Homeopathy; 280 as Neuraltherapy; 192 as Acupuncture). 366 patients received Classical Homeopathy. The most frequently treated syndromes were of the “psychiatric” type (162 cases=44%), prevalently due to the consequences of the earthquake, such as sleeping disturbances, phobic states, anxious-depressive syndromes, etc. The drop-outs were 235 out of 366 (=64%). 107 patients presented for a minimum 3 follow-ups. Here are the results: cured (52%), major improvement (33%), moderate and slight improvement (12%), no change (3%), deterioration (0%). The statistical analysis (D = 51 > 1,949; = 48,039 > 10,83) showed a significance higher than 1‰. Within this group, 68 patients suffering from psychiatric syndromes, who came for a 3rd follow up, showed a similar trend: cured (50%), major improvement (24%), moderate and slight improvement (19%), no change (7%), deterioration (0%). Also in this case the statistical analysis indicated a significance higher than 1‰ (D = 30 > 1,949). The most frequently prescribed medicines were Pulsatilla, Sepia, Arsenicum Album, Argentum Nitricum and Lycopodium. Discussion: The numerous inconveniences due to the emergency certainly did not permit the usual control visits. Moreover a strict observance of the protocol was not always possible, which could explain such a high number of drop-outs. Those patients who completed the therapy had an incremental improvement in their health between the 1st and the 3rd follow-up visit. In the final analysis a series of “strengths” and “weaknesses” in the project were noted. This knowledge could be helpful for future emergencies. Conclusions: The project “Homeopathy for L’Aquila” allowed, for the first time in Italy, an official implementation of Homeopathy in an emergency plan of great impact, on the one hand; and, on the other hand, made a precious human and professional experience possible. Moreover the results obtained have demonstrated that Homeopathy can play an important role socially as well as therapeutically. To the present date there have neither been internationally recognized guidelines nor publications with similar data concerning emergencies. Therefore this project could represent an important reference point for similar events.

The Development of Task Sharing Policy and Guidelines in Kenya

Background: The global critical shortage of health workers prevents expansion of healthcare services and universal health coverage. Like most countries in sub-Saharan Africa, Kenya’s healthcare workforce density of 13.8 health workers per 10,000 population falls below the World Health Organization (WHO) recommendation of at least 44.5 doctors, nurses, and midwives per 10,000 population. In response to the health worker shortage, the WHO recommends task sharing, which is a strategy to alleviate the burden on certain health workers through the redistribution of tasks. To improve the utilization of human and financial health resources in Kenya for HIV and other essential health services, the Kenya Ministry of Health (MOH) in collaboration with various institutions developed national task sharing policy and guidelines (TSP). To advance task sharing, this article describes the process of developing the Kenya TSP. Methods: The development and approval of Kenya’s TSP occurred from February 2015 to May 2017. The U.S. Centers for Disease Control and Prevention (CDC) allocated funding to Emory University through the United States President’s Emergency Plan for AIDS Relief (PEPFAR) Advancing Children’s Treatment initiative. After obtaining support from leadership in Kenya’s MOH and health professional institutions, the TSP team conducted a desk review of policies, guidelines, scopes of practice, task analyses, grey literature, and peer-reviewed research. Subsequently, a policy advisory committee was established to guide the process and worked collaboratively to form technical working groups to draft the policy.Results: The collaborative, multidisciplinary process led to the identification of gaps in service delivery resulting from health workforce shortages. This facilitated the development of the Kenya TSP, which provides a general orientation of task sharing in Kenya. The guidelines list priority tasks for sharing by various cadres as informed by evidence, such as HIV testing and counseling tasks. The TSP documents were disseminated to all county healthcare facilities in Kenya.Conclusions:Task sharing could increase access to healthcare services in resource-limited settings. To advance task sharing, TSP and clinical practice could be harmonized, and necessary adjustments made to other policies that regulate practice. Revisions to pre-service training curricula could be conducted to ensure health professionals have the requisite competencies to perform shared tasks. Monitoring and evaluation could ensure that task sharing is implemented appropriately to ensure quality outcomes.

Dam Break Analysis of Salomekko Dam Using Zhong Xing HY21

Every Dam must have an emergency plan document in which there is a dam collapse analysis. Based on previous research, it is stated that dam collapse often occurs due to runoff and piping. In this case, the Dam that will be studied is Salomekko Dam, located in Bone Regency. Salomekko Dam is located in the Salomekko Hamlet of Ulu Balang Village, Salomekko Subdistrict, Bone Regency, South Sulawesi Province, which provides water for agricultural irrigation. Analysis of the collapse of the Salomekko Dam was carried out due to overtopping and piping. The stillness of the air overflows through the top of the Dam. At the same time, the piping is caused by seepage in the dam body, which carries the dam material gradually. Analysis of the Salomekko Dam collapse using the Zhong Xing HY21 application can produce maps of flood inundation distribution, flood outflow hydrographs, and flood times. Based on these results, it can also have a hazardous impact to define boundaries of disaster-affected areas.

Data Collection on Donor-Supported Health Workers: Lessons Learned From Improving Health Workforce Data Supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)

The Global Strategy on Human Resources for Health: Workforce 2030 has called for the improvement of health workforce data and implementation of health workforce registries. It is critical to capture the health workforce supported by donors in order to have a complete understanding of the health workforce across countries. The United States Agency for International Development (USAID) developed an innovative pilot human resources for health (HRH) data collection system (including a data entry template and structured dataset) to collect HRH data for the health workforce supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The pilot system filled HRH data gaps in nine key countries, providing valuable insight for program planning. The implementation details of this exercise can be used as a case study on collecting and applying data on health workers, including those supported by donor funding.

Protecting Your Assets: an Evaluation of Museum Emergency Planning Practices in New Zealand Museums

<p>Museums around the world are often affected by major catastrophes, and yet planning for these disasters is an often neglected aspect of museum practice. New Zealand is not immune from these events, as can be seen in the recent series of serious earthquakes in Christchurch in 2010 and 2011. This dissertation considers how prepared the New Zealand museum sector is to handle unexpected events that negatively affect its buildings, staff, operations and treasured collections. The central research question was: What is the overall state of emergency planning in the New Zealand museum sector? There was a significant gap in the literature, especially in the local context, as there has been only one other comparable study conducted in Britain, and nothing locally. This dissertation makes a valuable contribution to the field of museum studies by drawing on theory from relevant areas such as crises management literature and by conducting original empirical research on a topic which has received little attention hitherto. The research employed a number of methods, including a review of background secondary sources, a survey and interviews. After contextualising the study with a number of local examples, Ian online survey was then developed an which enabled precise understanding of the nature of current museum practices and policies around emergency planning. Following this I conducted several interviews with museum professionals from a variety of institutional backgrounds which explored their thoughts and feelings behind the existing practices within the industry. The findings of the research were significant and somewhat alarming: almost 40% of the museum and galleries in New Zealand do not have any emergency plan at all, and only 11% have what they considered ‘complete’ plans. The research revealed a clear picture of the current width and depth of planning, as well as practices around updating the plans and training related to them. Within the industry there is awareness that planning for emergencies is important, but museum staff typically lack the knowledge and guidance needed to conduct effective emergency planning. As a result of the analysis, several practical suggestions are presented aimed at improving emergency planning practices in New Zealand museums. However this study has implications for museum studies and for current museum practice everywhere, as many of the recommendations for resolving the current obstacles and problems are applicable anywhere in the world, suggesting that New Zealand museums could become leaders in this important area.</p>

Protecting Your Assets: an Evaluation of Museum Emergency Planning Practices in New Zealand Museums

<p>Museums around the world are often affected by major catastrophes, and yet planning for these disasters is an often neglected aspect of museum practice. New Zealand is not immune from these events, as can be seen in the recent series of serious earthquakes in Christchurch in 2010 and 2011. This dissertation considers how prepared the New Zealand museum sector is to handle unexpected events that negatively affect its buildings, staff, operations and treasured collections. The central research question was: What is the overall state of emergency planning in the New Zealand museum sector? There was a significant gap in the literature, especially in the local context, as there has been only one other comparable study conducted in Britain, and nothing locally. This dissertation makes a valuable contribution to the field of museum studies by drawing on theory from relevant areas such as crises management literature and by conducting original empirical research on a topic which has received little attention hitherto. The research employed a number of methods, including a review of background secondary sources, a survey and interviews. After contextualising the study with a number of local examples, Ian online survey was then developed an which enabled precise understanding of the nature of current museum practices and policies around emergency planning. Following this I conducted several interviews with museum professionals from a variety of institutional backgrounds which explored their thoughts and feelings behind the existing practices within the industry. The findings of the research were significant and somewhat alarming: almost 40% of the museum and galleries in New Zealand do not have any emergency plan at all, and only 11% have what they considered ‘complete’ plans. The research revealed a clear picture of the current width and depth of planning, as well as practices around updating the plans and training related to them. Within the industry there is awareness that planning for emergencies is important, but museum staff typically lack the knowledge and guidance needed to conduct effective emergency planning. As a result of the analysis, several practical suggestions are presented aimed at improving emergency planning practices in New Zealand museums. However this study has implications for museum studies and for current museum practice everywhere, as many of the recommendations for resolving the current obstacles and problems are applicable anywhere in the world, suggesting that New Zealand museums could become leaders in this important area.</p>

A deterministic seismic risk macrozonation of Seville

The seismicity of the southwestern Iberian Peninsula is moderate but large events with long return periods occur (≈ 200 years). This exceeds the life of various generations, making the population unacquainted with the seismic hazard. On the one hand, this results in a low demanding seismic code which increases the seismic vulnerability and, therefore, the seismic risk. On the other hand, the local emergency services must be properly prepared to face a destructive seismic event, with emergency plans and mitigation strategies. This assumption enhances the need of assessing the seismic risk of Seville in a civil protection context. For all the aforementioned and for the lack of instrumental data of relevant earthquakes, the assessment of the seismic hazard in this area is challenging. To do this, seismogenic zones of the new seismic hazard map of Spain have been used as sources. The peak ground acceleration (PGA) for each scenario has been calculated by means of ground motion prediction equations (GMPE). To estimate the site effects, in a 1D model environment, a shear wave velocity (Vs) map of the top 5 m has been depicted based on the standard penetration test (SPT). Seville’s building stock has been classified in agreement with the previous works in Lorca and Barcelona to determine its vulnerability. The main goal of this work was to investigate the influence of the soil amplification on the seismic behaviour of different building typologies. Therefore, the final target was to plot the damage scenarios expected in Seville under a maximum credible earthquake by means of a deterministic seismic hazard assessment (DSHA). As outputs, the scenario modelled showed that around 27 000 buildings would experience a moderate damage and that 26 000 would suffer pre-collapse or even collapse. Thus, approximately 10% of the population would lose their dwellings. Regarding the human loses, around 22 000 people would suffer serious injuries and approximately 5 000 people would die. Owing to these conclusions, this research evidences the crucial need by civil protection services to implement a local emergency plan as a tool to mitigate the probable consequences that arise from this threat.

The Preparedness Level of Housewives in Dealing with the Earthquake Disaster in Tempel, Sidomulyo, Bambanglipuro, Bantul

One of geological disasters which cannot be predicted when it will occur is an earthquake. On May 27, 2006, an earthquake struck Bantul which cause many fatalities. The highest fatalities in Tempel were housewives. This study aims to know: (1) the preparedness levels of housewives in dealing with the dangers of earthquakes, and (2) the improvement efforts of housewives in dealing with the dangers of earthquakes in Tempel, Sidomulyo, Bambanglipuro, Bnatul. The method that used in this research is a qualitative method with a quantitative approach. The geographical approach used in this study is the environmental approach. This is a population study. The population of the study is all of the housewives in Tempel as many as 111 housewives. The data were obtained by using observations, interview, and documentations. The data analysis techniques used were a frequency table and descriptive analysis. The result of the study show that : (1) the preparedness levels of the housewives in dealing with earthquake dangers is on category of “full ready” (43,24%). Knowledge and attitude variables the housewives is on category of full ready (34,23%). Emergency plan variables the hosewives is on category ready (45,94%). Early warning system variables the housewives is on category ready (37,82%). Resource mobilization capabilities variables the housewives is on category ready (43,24%). (2) the improvement efforts to dealing with earthquake dangers are by conducting earthquake trainings and simulations as well as evacuation route installations.

Community Preparedness of the Fire Hazard in Jetis District, Yogyakarta City

This study aims: (1) to determine the level of community preparedness in facing fire hazards in the Jetis District of Yogyakarta City and (2) to understand the efforts to increase community preparedness to deal with fire hazards in the Jetis District of Yogyakarta City. This research uses descriptive methods with quantitative and qualitative approaches. In this research, we utilize the environmental approach as a tool. The indicator that we use here is based on the 2006 UNESCO / ISDR LIPI to measure the level of community preparedness. This research was conducted at Jetis District of The City of Yogyakarta. The population of this study was all family heads in Jetis Subdistrict, at least we came to 9282 families. The number of samples was determined using the Slovin formula and obtained 99 respondents. We chose the Proportional Random Sampling in three villages in Jetis Subdistrict as the sampling technic. The data was gained from the process of observations, structured interviews with standardized guidelines, in-depth interviews with three main resource persons, and documentation. The analysis technique that we used is the frequency table and descriptive analysis. The results show that: (1) the level of community preparedness in the Jetis Subdistrict in facing the danger of fire was in the "Less Ready" category (55.56%). The level of community preparedness on the knowledge and attitudes of the majority was in the category of “Ready” with 63.63%. The majority of emergency plan variables are in the unprepared category as much as 56.57%. The majority of disaster warning system variables are in the ready category that is 56.57%. Resource mobilization ability is a variable with respondents who are at the lowest level of preparedness, the majority are in the category of not ready as much as 76.77%. (2) the efforts to increase fire hazard preparedness in the community in Jetis District have been carried out, namely: conducting training and simulation of fire prevention, procurement of supporting facilities for fire prevention, making fire engines, and establishing disaster relief posts in Jetis District. Efforts that must be increased are: educating the public about the risks of fire hazards, increasing synergy between community organizations and local governments, and adding firefighting infrastructure.