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Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members. 为澳大利亚灾害医疗援助队提供的后勤支持:对队员进行的全国调查的结果。
Pub Date : 2012-01-01 Epub Date: 2012-02-13 DOI: 10.3402/ehtj.v5i0.9750
Peter Aitken, Peter Leggat, Hazel Harley, Richard Speare, Muriel Leclercq

Background: It is likely that calls for disaster medical assistance teams (DMATs) continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support.

Methods: Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster.

Results: The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59) strongly agreeing. Only one respondent (2%) disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59), however, 34% (20/59) felt that transport to the site itself was problematic. Only 37% (22/59) felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59) and 47% (28/59) respectively, while only 28% (17/59) felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59) felt that equipment could be moved easily between areas by team members and 37% (22/59) that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59).

Conclusions: This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between 20 and 40 kg, which would assist transport around the site, while transport to the site was seen as problematic. There was also support for training of all team members in use of basic equipment such as communications equipment, tents and shelters and water purification systems.

背景:灾难医疗援助队(DMAT)很可能会在应对国际灾难时继续出现。作为全国调查的一部分,本研究旨在评估澳大利亚灾难医疗援助队的经验以及对后勤支持的需求:方法:通过匿名邮寄调查表的方式收集数据,调查表通过澳大利亚健康保护委员会的州和地区代表分发,这些代表确认了与澳大利亚在 2004 年亚洲海啸灾难中部署的 DMAT 相关的团队成员:本次调查的回复率为 50%(59/118)。大多数人员都曾被派往东南亚海啸灾区。DMAT 成员拥有丰富的临床和国际经验。80%的受访者(47/59)非常同意提供专门的后勤支持,并获得一致支持。只有一名受访者(2%)不同意小组至少在 72 小时内自给自足。大多数人认为现场周围的交通不成问题(59%;35/59),但有 34%(20/59)的人认为前往现场的交通有问题。只有 37%(22/59)的人认为部署前的信息是准确的。分别有 53%(31/59)和 47%(28/59)的人认为与当地医疗服务提供者和其他机构的沟通是充分的,而只有 28%(17/59)的人认为记录方法易于使用且可靠。不到一半(47%;28/59)的人认为设备可以方便地在团队成员之间移动,37%(22/59)的人认为包装可以方便地找到材料。58%(34/59)的人认为容器的最大安全重量在 20 至 40 公斤之间:这项研究强调了为非杀伤人员地雷行动提供专门后勤支持的重要性,以及小组至少在 72 小时内自给自足的必要性。有必要提供准确的部署前信息,以指导资源的优先排序,并在预包装上贴上清晰的标签,以协助在现场使用。集装箱重量应限制在 20 至 40 千克之间,这将有助于在现场周围的运输,而向现场的运输则被认为是个问题。还支持对所有小组成员进行使用基本设备的培训,如通信设备、帐篷和住所以及净水系统。
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引用次数: 0
Bangladesh arsenic mitigation programs: lessons from the past. 孟加拉国砷缓解计划:从过去吸取的教训。
Pub Date : 2012-01-01 Epub Date: 2012-04-30 DOI: 10.3402/ehtj.v5i0.7269
Abul Hasnat Milton, Samar Kumar Hore, Mohammad Zahid Hossain, Mahfuzar Rahman

Ensuring access to safe drinking water by 2015 is a global commitment by the Millennium Development Goals (MDGs). In Bangladesh, significant achievements in providing safe water were made earlier by nationwide tubewell-installation programme. This achievement was overshadowed in 1993 by the presence of arsenic in underground water. A total of 6 million tubewells have been tested for arsenic since then, the results of which warranted immediate mitigation. Mitigation measures included tubewell testing and replacing; usage of deeper wells; surface water preservation and treatment; use of sanitary dug wells, river sand and pond sand filters; rainwater collection and storage; household-scale and large-scale arsenic filtrations; and rural pipeline water supply installation. Shallow tubewell installation was discouraged. Efforts have been made to increase people's awareness. This paper describes the lessons learned about mitigation efforts by the authors from experience of arsenic-related work. In spite of national mitigation plans and efforts, a few challenges still persist: inadequate coordination between stakeholders, differences in inter-sectoral attitudes, inadequate research to identify region-specific, suitable safe water options, poor quality of works by various implementing agencies, and inadequate dissemination of the knowledge and experiences to the people by those organizations. Issues such as long-time adaptation using ground water, poor surface water quality including bad smell and turbidity, and refusal to using neighbor's water have delayed mitigation measures so far. Region-specific mitigation water supply policy led by the health sector could be adopted with multisectoral involvement and responsibility. Large-scale piped water supply could be arranged through Public Private Partnerships (PPP) in new national approach.

确保到2015年获得安全饮用水是千年发展目标的一项全球承诺。在孟加拉国,早些时候通过全国管井安装方案在提供安全用水方面取得了重大成就。这一成就在1993年因地下水中砷的存在而黯然失色。从那时起,总共对600万口管井进行了砷检测,结果表明有必要立即采取缓解措施。缓解措施包括管井测试和更换;深井的使用;地表水的保存和处理;使用卫生挖井、河砂和池塘砂过滤器;雨水收集和储存;家庭规模和大规模砷过滤;及农村管道供水安装。浅管井不鼓励安装。已经做出了努力来提高人们的意识。本文介绍了作者从与砷有关的工作经验中获得的缓解努力的经验教训。尽管有国家缓解计划和努力,但仍然存在一些挑战:利益攸关方之间协调不足、部门间态度不同、为确定适合区域的安全用水选择进行的研究不足、各执行机构的工作质量差、以及这些组织向人民传播知识和经验不足。长期使用地下水、地表水水质差(包括恶臭和浑浊)以及拒绝使用邻居的水等问题,迄今为止推迟了缓解措施。可在多部门参与和承担责任的情况下,采用由卫生部门主导的区域缓解供水政策。在新的国家模式下,可以通过公私合作(PPP)安排大规模的管道供水。
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引用次数: 35
Optimism of health care workers during a disaster: a review of the literature. 灾难期间卫生保健工作者的乐观主义:文献综述。
Pub Date : 2012-01-01 Epub Date: 2012-01-24 DOI: 10.3402/ehtj.v5i0.7270
Noga Boldor, Yosefa Bar-Dayan, Tova Rosenbloom, Joshua Shemer, Yaron Bar-Dayan

Optimism has several orientations. One such outlook is a general tendency to regard the world as a positive place, accepting difficulties as mere challenges instead of impassable barriers. Among health care workers, optimism improves their level of functioning, their patients' satisfaction, and their therapeutic results. Optimistic staff members report feeling less pressure, use fewer avoidance strategies, focus on practical problem solutions, seek social support, and have more trust in people and organizations. The aim of this article is to provide a review of the literature concerning the role of optimism, both in daily life and in crisis situations. An attempt was made to find the linkage between optimism among health care workers during disasters and their active response, with special emphasis on the relationship between optimism and knowledge, feelings or behavior. Based on the literature, optimism was found to be helpful both in daily medical work and in cases of medical emergencies. Optimism was also revealed one of the key components of resilience and self-efficacy. Therefore, it is recommended to consider strengthening the optimism through initiative programs. Obtaining optimism can be included in toolkit preparedness for health care workers in order to confront the complications in the aftermath of disaster. These programs, together with appropriate information, social support, professional trust, and leaders modeling behavior, will raise the well-being and enhance coping skills of the health care workers during and aftermath of disaster scenarios.

乐观主义有几个方向。一种这样的观点是,人们普遍倾向于把世界看作一个积极的地方,把困难仅仅视为挑战,而不是不可逾越的障碍。在卫生保健工作者中,乐观可以提高他们的工作水平、病人的满意度和治疗效果。乐观的员工报告说,他们感到的压力更小,使用的回避策略更少,关注实际问题的解决方案,寻求社会支持,对人和组织有更多的信任。这篇文章的目的是提供有关乐观的作用,在日常生活和危机情况下的文献综述。试图找出灾害期间保健工作者的乐观主义与其积极反应之间的联系,特别强调乐观主义与知识、感觉或行为之间的关系。根据文献,乐观主义在日常医疗工作和医疗紧急情况下都是有帮助的。乐观情绪也是心理弹性和自我效能感的重要组成部分之一。因此,建议考虑通过主动性项目来加强乐观情绪。获得乐观情绪可纳入卫生保健工作者的工具包准备工作,以应对灾后的并发症。这些项目,加上适当的信息、社会支持、专业信任和领导者的模范行为,将提高卫生保健工作者在灾难期间和灾后的幸福感和应对技能。
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引用次数: 38
Is it reliable to assess visual attention of drivers affected by Parkinson's disease from the backseat?-a simulator study. 从后座评估受帕金森病影响的驾驶员的视觉注意力是否可靠?
Pub Date : 2012-01-01 Epub Date: 2012-02-27 DOI: 10.3402/ehtj.v5i0.15343
Hoe C Lee, Derserri Yanting Chee, Helena Selander, Torbjorn Falkmer

Background: Current methods of determining licence retainment or cancellation is through on-road driving tests. Previous research has shown that occupational therapists frequently assess drivers' visual attention while sitting in the back seat on the opposite side of the driver. Since the eyes of the driver are not always visible, assessment by eye contact becomes problematic. Such procedural drawbacks may challenge validity and reliability of the visual attention assessments. In terms of correctly classified attention, the aim of the study was to establish the accuracy and the inter-rater reliability of driving assessments of visual attention from the back seat. Furthermore, by establishing eye contact between the assessor and the driver through an additional mirror on the wind screen, the present study aimed to establish how much such an intervention would enhance the accuracy of the visual attention assessment.

Methods: Two drivers with Parkinson's disease (PD) and six control drivers drove a fixed route in a driving simulator while wearing a head mounted eye tracker. The eye tracker data showed where the foveal visual attention actually was directed. These data were time stamped and compared with the simultaneous manual scoring of the visual attention of the drivers. In four of the drivers, one with Parkinson's disease, a mirror on the windscreen was set up to arrange for eye contact between the driver and the assessor. Inter-rater reliability was performed with one of the Parkinson drivers driving, but without the mirror.

Results: Without mirror, the overall accuracy was 56% when assessing the three control drivers and with mirror 83%. However, for the PD driver without mirror the accuracy was 94%, whereas for the PD driver with a mirror the accuracy was 90%. With respect to the inter-rater reliability, a 73% agreement was found.

Conclusion: If the final outcome of a driving assessment is dependent on the subcategory of a protocol assessing visual attention, we suggest the use of an additional mirror to establish eye contact between the assessor and the driver. The clinicians' observations on-road should not be a standalone assessment in driving assessments. Instead, eye trackers should be employed for further analyses and correlation in cases where there is doubt about a driver's attention.

背景:目前,决定驾照保留或吊销的方法是通过道路驾驶测试。以往的研究表明,职业治疗师经常是坐在驾驶员对面的后座上评估驾驶员的视觉注意力。由于驾驶员的眼睛并不总是可见的,因此通过目光接触进行评估就成了问题。这种程序上的缺陷可能会影响视觉注意力评估的有效性和可靠性。就注意力的正确分类而言,本研究的目的是确定从后座对视觉注意力进行驾驶评估的准确性和评分者之间的可靠性。此外,通过在挡风玻璃上增设一面镜子,在评估员和驾驶员之间建立目光接触,本研究旨在确定这种干预能在多大程度上提高视觉注意力评估的准确性:方法:两名患有帕金森病(PD)的驾驶员和六名对照组驾驶员在驾驶模拟器中驾驶固定路线,同时佩戴头戴式眼动仪。眼动仪的数据显示了眼窝视觉注意力的实际指向。这些数据都有时间戳,并与同时对驾驶员的视觉注意力进行的人工评分进行了比较。在四名驾驶员(其中一名患有帕金森病)中,挡风玻璃上安装了一面镜子,以便驾驶员与评估员进行目光接触。在其中一名帕金森病驾驶员的驾驶下,但在没有镜子的情况下,进行了评分者之间的可靠性测试:在不使用镜子的情况下,评估三名对照组驾驶员的总体准确率为 56%,使用镜子的情况下为 83%。然而,对于帕金森病驾驶员来说,不带后视镜的准确率为 94%,而对于帕金森病驾驶员来说,带后视镜的准确率为 90%。在评分者之间的信度方面,一致性为 73%:如果驾驶评估的最终结果取决于协议中评估视觉注意力的子类别,我们建议使用额外的镜子来建立评估者和驾驶者之间的目光接触。在驾驶评估中,临床医生对路面情况的观察不应作为一项独立的评估。相反,如果对驾驶员的注意力存在疑问,则应使用眼动仪进行进一步分析和关联。
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引用次数: 0
Knowledge, attitudes and perceptions of health professionals in relation to A/H1N1 influenza and its vaccine. 卫生专业人员对甲型 H1N1 流感及其疫苗的认识、态度和看法。
Pub Date : 2012-01-01 Epub Date: 2012-01-11 DOI: 10.3402/ehtj.v5i0.7266
Amanda López-Picado, Antxon Apiñaniz, Amaia Latorre Ramos, Erika Miranda-Serrano, Raquel Cobos, Naiara Parraza-Díez, Patricia Amezua, Mónica Martinez-Cengotitabengoa, Felipe Aizpuru

Objective: To determine the intention of health professionals, doctors and nurses, concerning whether or not to be vaccinated against A/H1N1 influenza virus, and their perception of the severity of this pandemic compared with seasonal flu.

Material and methods: A cross-sectional study was carried out based on an questionnaire e-mailed to health professionals in public healthcare centres in Vitoria between 6 and 16 November 2009; the percentage of respondents who wanted to be vaccinated and who perceived the pandemic flu to carry a high risk of death were calculated.

Results: A total of 115 people completed the questionnaire of whom 61.7% (n=71) were doctors and 38.3% (n=44) were nurses. Of these, 33.3% (n=23) of doctors and 13.6% (n=6) of nurses intended to be vaccinated (p=0.019). Even among those who considered themselves to be at a high risk, 70.6% (n=48) of doctors and 31.7% (n=13) of nurses participating in the study (p=0.001) planned to have the vaccination.

Conclusions: Most health professionals, and in particular nurses, had no intention to be vaccinated against A/H1N1 influenza virus at the beginning of the vaccination campaign.

目的确定医务人员、医生和护士是否打算接种甲型 H1N1 流感疫苗,以及他们对这一流行病与季节性流感相比的严重性的看法:2009 年 11 月 6 日至 16 日,我们通过电子邮件向维多利亚市公共医疗保健中心的医疗专业人员发送了一份调查问卷,在此基础上开展了一项横断面研究;研究计算了希望接种疫苗的受访者比例和认为大流行性流感死亡风险高的受访者比例:共有 115 人填写了问卷,其中 61.7% (71 人)为医生,38.3% (44 人)为护士。其中,33.3%(23 人)的医生和 13.6%(6 人)的护士打算接种疫苗(P=0.019)。即使在那些认为自己处于高风险的人群中,也有 70.6% (48 人)的医生和 31.7% (13 人)的护士计划接种疫苗(p=0.001):结论:大多数医疗专业人员,尤其是护士,在疫苗接种活动开始时并不打算接种甲型 H1N1 流感病毒疫苗。
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引用次数: 0
International society for disease surveillance conference 2011: building the future of public health surveillance. 2011年国际疾病监测学会会议:建设公共卫生监测的未来。
Pub Date : 2011-12-06 DOI: 10.3402/ehtj.v4i0.11702
Daniel B Neill, Karl A Soetebier
The International Society for Disease Surveillance (ISDS) celebrates its 10th annual meeting with the arrival of the 2011 ISDS Annual Conference, ‘Building the Future of Public Health Surveillance’. This milestone in the Society's history is punctuated not only by the achievements of the disease surveillance community but also by the promise of what lies ahead. The Annual Conference brings together a community of researchers and practitioners focused on monitoring, understanding and improving population health. The abstracts appearing in this special supplement, accepted for presentation at the Annual Conference, include innovative analytical techniques, progressive public health practice and cutting edge informatics that support a timely, accurate and informed response to emerging outbreaks of disease and other health threats. The breadth of topics addressed ranges from detection of novel symptom patterns indicative of newly emerging outbreaks to development of a web platform for the text mining of clinical reports and from surveillance of the illegal wildlife trade for detecting emerging zoonoses to assessing the validity of emergency department-based influenza-like illness syndromes against confirmed laboratory results in children. In addition to the 160 contributed oral and poster presentations, the conference also features a keynote talk from Dr. Farzad Mostashari, National Coordinator for Health Information Technology, and plenary sessions on international surveillance, novel technologies and postdisaster surveillance, as well as a variety of informal round table discussions, workshops and committee meetings. The diversity of thinking represented here is great and yet the fibers of these works come together in a yarn that, woven throughout the fabric of public health surveillance, informs the best of what is and what in the future can be.
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引用次数: 1
Use of CDC's epidemic information exchange system as a disease surveillance tool 利用疾病预防控制中心的疫情信息交换系统作为疾病监测工具
Pub Date : 2011-12-06 DOI: 10.3402/EHTJ.V4I0.11108
J. Schwendinger, Eric Lahr, Jonathan Lynch, Molly McCollom, A. Evanson
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引用次数: 0
Impact of training on Disease Surveillance and Notification Officers in Nigeria 培训对尼日利亚疾病监测和通报官员的影响
Pub Date : 2011-12-06 DOI: 10.3402/EHTJ.V4I0.11186
O. Adeoye, A. Aman-Oloniyo, Clement Nwaeke, Angela Mbata, A. Oduneye
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引用次数: 1
Monitoring Twitter content related to influenza-like Illness in Spanish-speaking populations 监测西班牙语人群中与流感样疾病相关的Twitter内容
Pub Date : 2011-12-06 DOI: 10.3402/EHTJ.V4I0.11185
A. López-Pineda, C. Floudas, F. S. Obando, Gerald Douglas, Nara Um
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引用次数: 1
Predictors of vaccination uptake for the 2009 influenza pandemic (H1N1) in Montréal 蒙特卡马2009年流感大流行(H1N1)疫苗接种的预测因素
Pub Date : 2011-12-06 DOI: 10.3402/EHTJ.V4I0.11070
Luc de Montigny, Aman Verma, K. Charland, D. Buckeridge
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引用次数: 0
期刊
Emerging health threats journal
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