Recognising and understanding collective resilience in crowds of survivors

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Malignant Lymphomas

British Journal of Cancer (2002) 87, 372. doi:10.1038/sj.bjc.6600426 www.bjcancer.co

Immunoglobulin G; structure and functional implications of different subclass modifications in initiation and resolution of allergy.

IgE and not IgG is usually associated with allergy. IgE lodged on mast cells in skin or gut and basophils in the blood allows for the prolonged duration of allergy through the persistent expression of high affinity IgE receptors. However, many allergic reactions are not dependent on IgE and are generated in the absence of allergen specific and even total IgE. Instead, IgG plasma cells are involved in induction of, and for much of the pathogenesis of, allergic diseases. The pattern of IgG producing plasma cells in atopic children and the tendency for direct or further class switching to IgE are the principle factors responsible for long-lasting sensitization of mast cells in allergic children. Indirect class switching from IgG producing plasma cells has been shown to be the predominant pathway for production of IgE while a Th2 microenvironment, genetic predisposition, and the concentration and nature of allergens together act on IgG plasma cells in the atopic tendency to undergo further immunoglobulin gene recombination. The seminal involvement of IgG in allergy is further indicated by the principal role of IgG4 in the natural resolution of allergy and as the favourable immunological response to immunotherapy. This paper will look at allergy through the role of different antibodies than IgE and give current knowledge of the nature and role of IgG antibodies in the start, maintenance and resolution of allergy

Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK's Initial Operational Response (IOR)

The UK's Initial Operational Response (IOR) is a revised process for the medical management of mass casualties potentially contaminated with hazardous materials. A critical element of the IOR is the introduction of immediate, on-scene disrobing and decontamination of casualties to limit the adverse health effects of exposure. Ad hoc cleansing of the skin with dry absorbent materials has previously been identified as a potential means of facilitating emergency decontamination. The purpose of this study was to evaluate the in vitro oil and water absorbency of a range of materials commonly found in the domestic and clinical environments and to determine the effectiveness of a small, but representative selection of such materials in skin decontamination, using an established ex vivo model. Five contaminants were used in the study: methyl salicylate, parathion, diethyl malonate, phorate and potassium cyanide. In vitro measurements of water and oil absorbency did not correlate with ex vivo measurements of skin decontamination. When measured ex vivo, dry decontamination was consistently more effective than a standard wet decontamination method (“rinse-wipe-rinse”) for removing liquid contaminants. However, dry decontamination was ineffective against particulate contamination. Collectively, these data confirm that absorbent materials such as wound dressings and tissue paper provide an effective, generic capability for emergency removal of liquid contaminants from the skin surface, but that wet decontamination should be used for non-liquid contaminants

Responding to emergencies involving chemical, biological, radiological and nuclear (CBRN) hazards:Information for members of the public

This booklet contains information about how the Emergency Services respond toChemical, Biological, Radiological and Nuclear incidents. We call these CBRN incidents for short.It also contains information for members of the public about:• What CBRN incidents are• What the emergency services would usually do when there is a CBRN incident• What you can do, if you are involved in a CBRN incidentIf you are a professional responsible for emergency planning, preparing for and/or responding to contamination events (e.g. emergency services, local authorities,health care, etc.), please turn to p.22 for detailed guidance about the appropriate use of this manual.The information contained in thisbooklet can be used by members ofthe public and organisations involvedin communicating with members ofthe public about emergency situationsinvolving chemical, biological, radiologicaland nuclear (CBRN) hazards.Who is this for? This booklet containsgeneral information for members ofthe public to help them understandemergency response procedures.For what purpose? This booklet hasbeen designed to inform people aboutemergency procedures used during CBRNincidents. If people understand theseprocesses they will be better able to helpthemselves and their families during aCBRN incident. Research has shown thatthe emergency response process can bemade more efficient and effective if theemergency services and members of thepublic work together.What is in it? The information providedimproves the public understanding of:• Rare but potentially harmful incidentsinvolving CBRN hazards• The stages of a typical CBRN response• Which emergency responseorganisations would typically getinvolved in a CBRN responseHow to use it? This booklet can bedistributed to households, GP surgeries,and more in hard copy. It can also bedisplayed on the websites of emergencyresponse organisations, local authorities,and other institutions

Delivering extreme event preparedness education in schools:A systematic review of educational preparedness resources available in England

Extreme events are infrequent, high impact incidents which can cause a range of physical, emotional, and psychological impacts for those affected. Children and young people in schools can be disproportionately affected by such events. Conversely, schools are often viewed as a platform for teaching and fostering preparedness. The present study aimed to elucidate what educational materials, intended to bolster preparedness for extreme events, are provided to schools in England. We also reviewed the literature related to the roll-out of new compulsory first-aid training for English schools. The study involved a systematic review of academic and grey literature, using academic databases and Google searches to find UK examples of educational preparedness materials. Educational materials which met criteria based on type of resource, target population or context, and preparedness outcomes were included. Twenty-six included items focused on preparing pupils for a range of extreme events, or the delivery of first aid in schools. All were resources to be used by teachers to deliver either stand-alone lessons or support existing lessons in the national curriculum for England. Many were published by national or international organisations or charities (n = 23), fewer were produced at a local level (n = 3). There was no evidence of any formal assessment or evaluation of effectiveness in bolstering preparedness knowledge across school populations. This is, to the authors’ knowledge, the first review of preparedness education in schools within England. Outputs contribute novel findings and guidance for conducting further research in clarifying the needs of school populations and the improvement of preparedness for extreme events.</p

Responding to emergencies involving chemical, biological, radiological and nuclear CBRN hazards::Information for emergency responders about public responses to CBRN incidents

Who is it for? This booklet is for organisations and individuals responsible for communicating or engaging with members of the public during contamination incidents involving chemical, biological, radiological or nuclear (CBRN) hazards. This information would be useful for emergency responders (and non-specialised staff) from all emergency services (police, fire and ambulance), public health authorities, hospital staff, non-state organisations involved in emergency response (e.g. Red Cross, conference centre security staff), and others.For what purpose? This information booklet helps emergency responders to effectively engage with members of the public about CBRN incidents, in particular through appropriate communication. The response of members of the public to incidents involving CBRN hazards has a significant impact on the overall effectiveness of the professional response to such events. Public engagement before, during and after a CBRN incident can increase levels of public preparedness by creating a shared and improved understanding of CBRN incidents and the likely response to such incidents by members of the public. An improved understanding of CBRN incidents and emergency response procedures can increase the likelihood of members of the public becoming active partners in the emergency response process, resulting in improved health outcomes.What is in it? This information booklet improves engagement with members of the public by improving the emergency responders’ knowledge of what, how and why to communicate with members of the public about CBRN incidents.22 Putting this guidance into practiceSpecifically, the booklet sheds light on:• Public understanding of CBRN threats• Public behaviour in response to CBRN incidents• Public information needs in relation to CBRN incident emergency response procedures• Public engagement and communication preferences in relation to CBRN incidents and procedures• What emergency responders can do to effectively engage with members of the public whilst still prioritising the practical and logistical aspects of the responseHow to use it? This information booklet provides insight and guidance into public responses to CBRN incidents. The booklet is designed to facilitate engagement with the public. This booklet can be:• Used as a stand-alone document or – most effectively – in combination with the public information booklet (go to www.practice-fp7-security.eu).• Distributed to staff and partner organisations responsible for responding to CBRN incidents.• Displayed in hard copy or made available on the websites of emergency response organisations, local authorities and other institutions

Psychological resilience and post-traumatic growth in disaster-exposed organisations:Overview of the literature

As disasters become increasingly prevalent, and reported on, a wealth of literature on post-disaster mental health has been published. Most published evidence focuses on symptoms of mental health problems (such as post-traumatic stress disorder, depression and anxiety) and psychosocial factors increasing the risk of such symptoms. However, a recent shift in the literature has moved to exploring resilience and the absence of adverse lasting mental health effects following a disaster. This paper undertakes a qualitative review of the literature to explore factors affecting psychological resilience, as well as the potential positive impact of experiencing a disaster (post-traumatic growth) by examining the literature on employees in disaster-exposed organisations. We identify several protective factors: training, experience, and perceived (personal) competence; social support; and effective coping strategies. Post-traumatic growth frequently appeared to occur at both personal and professional levels for those rescue staff after a disaster, giving employees a greater appreciation of life and their relationships, enhancing their self-esteem and providing a sense of accomplishment and better understanding of their work. Implications, in terms of how to build a resilient workforce, are discussed.</jats:p