Investigating the status of disaster management within a world-wide context: a case study analysis

Disasters can be described as feats of spontaneous occurrences, in that they can happen at any minute at any time. There are two classifications of disasters, which are, natural disasters that cannot be predicted and continuously occur throughout society. While the other classification of disaster is that of man-made disasters, where disasters are caused not by natural phenomena, but by man's or society's actions, involuntary or voluntary, sudden or slow, with grave consequences to the population and the environment (Hays, 2008). Both these types of disasters can be controlled to a certain extent through appropriate disaster management plans and if managed efficiently have the potential to reduce the likelihood of overwhelming loss of lives and property. The Disaster Management cycle is split into four elements of response, recovery, mitigation and preparedness which contribute to emergency protocols of a nation when disaster strikes. Therefore, nations should incorporate them in their development plans and ensure efficient follow-up measures at community, national and international levels. This paper investigates worldwide disasters in order to examine how these disasters were managed and to identify the lessons learned. It provides an analysis of five worldwide case studies of recent disasters (Tsunami in Sri Lanka, Hurricane Katrina in New Orleans, Earthquake in Pakistan, Summer floods in the UK and Flooding of the West-Link in Northern Ireland) mapping those to the four staged disaster management cycle. The paper analyses in detail the strategies adopted at each stage of the cycle comparing strengths and weaknesses of each case. It concludes that there had been satisfactory progress in both response and recovery phases but more attention is needed for disaster mitigation and preparedness

Enabling self-directed computer use for individuals with cerebral palsy: a systematic review of available assistive devices and technologies

Aim  The purpose of this study was to systematically review published evidence on the development, use, and effectiveness of devices and technologies that enable or enhance self-directed computer access by individuals with cerebral palsy (CP). Methods  Nine electronic databases were searched using keywords ‘computer’, ‘software’, ‘spastic’, ‘athetoid’, and ‘cerebral palsy’; the reference lists of articles thus identified were also searched. Thirty articles were selected for review, with 23 reports of development and usability testing of devices and seven evaluations of algorithms to increase computer recognition of input and cursor movements. Results  Twenty-four studies had fewer than 10 participants with CP, with a wide age range of 5 to 77 years. Computer task performance was usually tested, but only three groups sought participant feedback on ease and comfort of use. International standards exist to evaluate effectiveness of non-keyboard devices, but only one group undertook this testing. None of the study designs were higher than American Academy for Cerebral Palsy and Developmental Medicine level IV. Interpretation  Access solutions for individuals with CP are in the early stages of development. Future work should include assessment of end-user comfort, effort, and performance as well as design features. Engaging users and therapists when designing and evaluating technologies to enhance computer access may increase acceptance and improve performance

Burden of road traffic injuries and related risk factors in low and middle-income Pacific Island countries and territories: a systematic review of the scientific literature (TRIP 5)

BACKGROUND: In Pacific Island countries and territories, the burden of road traffic injuries and their attendant risks are considered significant but are poorly quantified. As with other low and middle-income countries, understanding the epidemiology of road traffic injuries in Pacific countries is critical to informing sustainable research and policy initiatives aimed at reducing this burden. METHODS: We undertook a systematic review and critical appraisal of the relevant epidemiological literature between January 1980 and December 2010, using key search strings for incidence and aetiological studies focusing on RTIs in less resourced Pacific countries. RESULTS: Nineteen studies were identified. The majority were descriptive and were unable to provide population-based estimates of the burden of road crash injury, or reliable information on risk factors using well-designed aetiological research methods. All studies were published more than 10 years ago, and all but three reported on data from Papua New Guinea, thereby limiting the generalisability of findings to the current status in the region. Studies undertaken in Papua New Guinea suggested that RTIs were more frequent among young males, with head injuries the most common cause of death or hospital admission. Two thirds of fatalities occurred at the crash site or soon after admission. Most road crash victims were passengers or pedestrians. Factors postulated to influence the risk of RTIs were travel in open-back utility vehicles, utility vehicle overcrowding, and alcohol. CONCLUSIONS: This review suggests that, despite increasing awareness of the importance of addressing road safety among stakeholders in less resourced Pacific Island countries, road traffic injuries have not been a research priority with little relevant current evidence from the region to inform policy. Robust epidemiological research that can assess the magnitude and key determinants of road traffic injuries in these settings is essential to determine context-specific road safety initiatives that are relevant and affordable. Greater attention to harnessing routinely collected data (e.g., hospital information systems and police crash statistics) to inform policy is also required

Reliable Individual Change in Post Concussive Symptoms in the Year Following Mild Traumatic Brain Injury: Data From the Longitudinal, Population-based Brain Injury Incidence and Outcomes New Zealand in the Community (Bionic) Study

Objective: Post concussive syndromes (PCS) is common after mild-TBI, yet are not well studied on a population level. This study examined PCS symptoms, including reliable change over time in a population-based sample up to one year post-TBI. Methods: Prospective follow-up of 527 adults (≥16 years) with mild TBI (mTBI) and assessment data (Rivermead Post concussion Questionnaire; RPQ) at baseline, 1, 6, and/or 12-months post-TBI. Change in mean scores and clinically significant change across RPQ items for each person was calculated between assessment time points using a reliable change index (RCI). Results: While prevalence of all symptoms reduced over time, >30% of participants reported fatigue, slowed thinking, and forgetfulness 12-months postinjury. Using the RCI, <12% of individuals improved from baseline to 1-month, 50% from 1 to 6-months, and 4.2% from 6 to 12-months. Conclusions: Improvements in PCS post-mTBI were most obvious between 1 and 6-months, suggesting lengthy recovery trajectory. A third of patients experience residual cognitive problems 12-months following a mTBI, and while many individuals improve post-TBI, a large proportion remain stable or worsen

Alcohol industry sponsorship and hazardous drinking in UK university students who play sport

Aim: To examine whether receipt of alcohol industry sponsorship is associated with problematic drinking in UK university students who play sport. Methods: University students (n=2450) participating in sports were invited to complete a pen-and-paper questionnaire by research staff approaching them at sporting facilities and in university settings. Respondents were asked whether they personally, their team, and/or their club were currently in receipt of sponsorship (e.g., money, free or subsidised travel, or sporting products), from an alcohol-related industry (e.g., bars, liquor stores, wholesalers), and whether they had solicited the sponsorship. Drinking was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Results: Questionnaires were completed by 2048 of those approached (response rate=83%). Alcohol industry sponsorship was reported by 36% of the sample. After accounting for confounders (age, gender, disposable income, and location) in multivariable models, receipt of alcohol sponsorship by a team (adjusted βadj=.41, p=.013), club (βadj=.73, p=.017), team and club (βadj=.79, p=0.002), and combinations of individual and team or club sponsorships (βadj=1.27, p&lt;0.002), were each associated with significantly higher AUDIT-Consumption substance scores. Receipt of sponsorship by team and club (aOR=2.04; 95% CI: 1.04-3.99) and combinations of individual and team or club sponsorships (aOR=4.12; 95% CI: 1.29-13.15) were each associated with increased odds of being classified a hazardous drinker (AUDIT score &gt;8). Respondents who sought out sponsorship were not at greater risk than respondents who had, or whose teams or clubs had, been approached by the alcohol industry. Conclusions: University students in the United Kingdom who play sport and who personally receive alcohol industry sponsorship or whose club or team receives alcohol industry sponsorship appear to have more problematic drinking behaviour than UK university students who play sport and receive no alcohol industry sponsorship. Policy to reduce or cease such sponsorship should be considered

Disaster management in low- and middle-income countries: scoping review of the evidence base

Introduction: Globally, there has been an increase in the prevalence and scale of disasters with low- and middle-income countries (LMICs) tending to be more affected. Consequently, disaster risk reduction has been advocated as a global priority. However, the evidence base for disaster management in these settings is unclear. Methods: This study is a scoping review of the evidence base for disaster management in LMIC. Potentially relevant articles between 1990 and 2011 were searched for, assessed for relevance and subsequently categorised using a thematic coding framework based on the US Integrated Emergency Management System model. Results: Out of 1545 articles identified, only 178 were from LMIC settings. Most were of less robust design such as event reports and commentaries, and 66% pertained to natural disasters. There was a paucity of articles on disaster mitigation or recovery, and more were written on disaster response and preparedness issues. Discussion: Considerably more articles were published from high-income country settings that may reflect a publication bias. Current grey literature on disaster management tends not to be peer reviewed, is not well organised and not easy to access. The paucity of peer-reviewed publications compromises evidence review initiatives that seek to provide an evidence-base for disaster management in LMIC. As such, there is an urgent need for greater research and publication of findings on disaster management issues from these settings

Injuries to pedal cyclists on New Zealand roads, 1988-2007

<p>Abstract</p> <p>Background</p> <p>The risk of injury is one of the major barriers to engaging in cycling. We investigated exposure-based rates and profiles of traffic injuries sustained by pedal cyclists that resulted in death or hospital inpatient treatment in New Zealand, one of the most car dependent countries.</p> <p>Methods</p> <p>Pedal cyclist traffic injuries were identified from the Mortality Collection and the National Minimum Dataset. Total time spent cycling was used as the measure of exposure and computed from National Household Travel Surveys. Analyses were undertaken for the periods 1988-91, 1996-99 and 2003-07 in relation to other major road users and by age, gender and body region affected. A modified Barell matrix was used to characterise the profiles of pedal cyclist injuries by body region affected and nature of injury.</p> <p>Results</p> <p>Cyclists had the second highest rate of traffic injuries compared to other major road user categories and the rate increased from 1996-99 to 2003-07. During 2003-07, 31 injuries occurred per million hours spent cycling. Non-collision crashes (40%) and collisions with a car, pick-up truck or van (26%) accounted for two thirds of the cycling injuries. Children and adolescents aged under 15 years were at the highest risk, particularly of non-collision crashes. The rate of traumatic brain injuries fell from 1988-91 to 1996-99; however, injuries to other body parts increased steadily. Traumatic brain injuries were most common in collision cases whereas upper extremity fractures were most common in other crashes.</p> <p>Conclusions</p> <p>The burden of fatal and hospitalised injuries among pedal cyclists is considerable and has been increasing over the last decade. This underscores the development of road safety and injury prevention programmes for cyclists alongside the cycling promotion strategies.</p