Primary Health care and Disasters—The Current State of the Literature: What We Know, Gaps and Next Steps

Introduction: The 2009 Global Platform for Disaster Risk Reduction/Emergency Preparedness (DRR/EP) and the Hyogo Framework for Action 2005-2015 demonstrate increased international commitment to DRR/EP in addition to response and recovery. In addition, the World Health Report 2008 has re-focused the world's attention on the renewal of Primary Health Care (PHC) as a set of values/principles for all sectors. Evidence suggests that access to comprehensive PHC improves health outcomes and an integrated PHC approach may improve health in low income countries (LICs). Strong PHC health systems can provide stronger health emergency management, which reinforce each other for healthier communities. Problem: The global re-emphasis of PHC recently necessitates the health sector and the broader disaster community to consider health emergency management from the perspective of PHC. How PHC is being described in the literature related to disasters and the quality of this literature is reviewed. Identifying which topics/lessons learned are being published helps to identify key lessons learned, gaps and future directions. Methods: Fourteen major scientific and grey literature databases searched. Primary Health Care or Primary Care coupled with the term disaster was searched (title or abstract). The 2009 ISDR definition of disaster and the 1978 World Health Organization definition of Primary Health Care were used. 119 articles resulted. Results: Literature characteristics; 16% research papers, only 29% target LICs, 8% of authors were from LICs, 7% clearly defined PHC, 50% used PHC to denote care provided by clinicians and 4% cited PHC values and principles. Most topics related to disaster response. Key topics; true need for PHC, mental health, chronic disease, models of PHC, importance of PHC soon after a natural disaster relative to acute care, methods of surge capacity, utilization patterns in recovery, access to vulnerable populations, rebuilding with the PHC approach and using current PHC infrastructure to build capacity for disasters. Conclusions: Primary Health Care is very important for effective health emergency management during response and recovery, but also for risk reduction, including preparedness. There is need to; increase the quality of this research, clarify terminology, encourage paper authorship from LICs, develop and validate PHC- specific disaster indicators and to encourage organizations involved in PHC disaster activities to publish data. Lessons learned from high-income countries need contextual analysis about applicability in low-income countrie

Evacuation and Sheltering of Hospitals in Emergencies: A Review of International Experience

Abstract Objective: A scoping exercise to establish how common hospital evacuations are, identify hospital evacuation policies and review case studies to identify trig-gers, processes and challenges involved in the evacuation of hospitals globally. Design: A systematic search of PubMed and disaster agency online resources, search of grey literature and media reports. Results: This study showed that hospitals are vulnerable to both natural and man made disasters and that hospital evacuations do occur globally. It highlighted the paucity of published data and policy on hospital evacuation and emphasised the vital need to collect data on triggers, reasons for evacuation, sheltering facilities and the process of evacuation. Conclusions: This study recommends the collection of case studies and the development of a database to assist with the research and development of well tailored hospital evacuation plans. These recommendations reflect and support the 2008-2009 World Disaster Reduction Campaign on Hospitals Safe from Disasters and the timely 2009 Global Platform priority that, ‘Critical services and infrastructure such as health facilities and schools must be safe from disaster

How Genomics Is Changing What We Know About the Evolution and Genome of Bordetella pertussis

The evolution of Bordetella pertussis from a common ancestor similar to Bordetella bronchiseptica has occurred through large-scale gene loss, inactivation and rearrangements, largely driven by the spread of insertion sequence element repeats throughout the genome. B. pertussis is widely considered to be monomorphic, and recent evolution of the B. pertussis genome appears to, at least in part, be driven by vaccine-based selection. Given the recent global resurgence of whooping cough despite the wide-spread use of vaccination, a more thorough understanding of B. pertussis genomics could be highly informative. In this chapter we discuss the evolution of B. pertussis, including how vaccination is changing the circulating B. pertussis population at the gene-level, and how new sequencing technologies are revealing previously unknown levels of inter- and intra-strain variation at the genome-level

Scoping review of exploring the roles of primary care providers to increase disaster preparedness of vulnerable populations

Background: Primary care providers are well placed to improve disaster preparedness in communities. Their close position to their clients and understanding of theirhealth needs can be utilized to increase disaster preparedeness for vulnerable populations. However, there is still a lack of clarity about their roles and services in this area. The aim of this review was to explore the services provided by primary care providers in the context of disaster preparedness activities for vulnerable populations. Methods: Scoping review was performed with PubMed, Scopus and MEDLINE databases. Results: A total of 2193 articles were identified from the database screening and 22 full-text articles yielded for the final analysis. After thematic analysis was conducted, six themes were emerged. Conclusion: To utilise and maximise theprofessional roles of primary care providers effectively, there is a need to strengthen the expertise and involvement of providers in disaster risk management mechanisms and planning. In addition, there is a need for scientific research to explore the existing capabilities of primary care providers and to facilitate their existing ability to coordinate with disaster management agencies.</p

An investigation of the validity of the Edinburgh Social Cognition Test (ESCoT) in acquired brain injury (ABI)

Objectives: Social cognition is frequently impaired following an acquired brain injury (ABI) but often overlooked in clinical assessments. There are few validated and appropriate measures of social cognitive abilities for ABI patients. The current study examined the validity of the Edinburgh Social Cognition Test (ESCoT, Baksh et al., 2018) in measuring social cognition following an ABI. Methods: Forty-one patients with ABI were recruited from a rehabilitation service and completed measures of general ability, executive functions and social cognition (Faux Pas; FP, Reading the Mind in the Eyes; RME, Social Norms Questionnaire; SNQ and the ESCoT). Forty-one controls matched on age, sex and years of education also performed the RME, SNQ and ESCoT. Results: A diagnosis of ABI was significantly associated with poorer performance on all ESCoT measures and RME while adjusting for age, sex and years of education. In ABI patients, the ESCoT showed good internal consistency with its subcomponents and performance correlated with the other measures of social cognition demonstrating convergent validity. Better Trail Making Test performance predicted better ESCoT total, RME and SNQ scores. Higher TOPF IQ was associated with higher RME scores, while higher WAIS-IV working memory predicted better FP performance. Conclusions: The ESCoT is a brief, valid and internally consistent assessment tool able to detect social cognition deficits in neurological patients. Given the prevalence of social cognition deficits in ABI and the marked impact these can have on an individual’s recovery, this assessment can be a helpful addition to a comprehensive neuropsychological assessment

Characterising particulate random media from near-surface backscattering: A machine learning approach to predict particle size and concentration

To what extent can particulate random media be characterised using direct wave backscattering from a single receiver/source? Here, in a two-dimensional setting, we show using a machine learning approach that both the particle radius and concentration can be accurately measured when the boundary condition on the particles is of Dirichlet type. Although the methods we introduce could be applied to any particle type. In general backscattering is challenging to interpret for a wide range of particle concentrations, because multiple scattering cannot be ignored, except in the very dilute range. Across the concentration range from 1% to 20% we find that the mean backscattered wave field is sufficient to accurately determine the concentration of particles. However, to accurately determine the particle radius, the second moment, or average intensity, of the backscattering is necessary. We are also able to determine what is the ideal frequency range to measure a broad range of particles sizes. To get rigorous results with supervised machine learning requires a large, highly precise, dataset of backscattered waves from an infinite half-space filled with particles. We are able to create this dataset by introducing a numerical approach which accurately approximates the backscattering from an infinite half-space.EPSRC Grant EP/K033208/I and EP/R014604/

Glacial melt under a porous debris layer

In this paper we undertake a quantitative analysis of the dynamic process by which ice underneath a dry porous debris layer melts. We show that the incorporation of debris-layer airflow into a theoretical model of glacial melting can capture the empirically observed features of the so-called Østrem curve (a plot of the melt rate as a function of debris depth). Specifically, we show that the turning point in the Østrem curve can be caused by two distinct mechanisms: the increase in the proportion of ice that is debris-covered and/or a reduction in the evaporative heat flux as the debris layer thickens. This second effect causes an increased melt rate because the reduction in (latent) energy used for evaporation increases the amount of energy available for melting. Our model provides an explicit prediction for the melt rate and the temperature distribution within the debris layer, and provides insight into the relative importance of the two effects responsible for the maximum in the Østrem curve. We use the data of Nicholson and Benn (2006) to show that our model is consistent with existing empirical measurements

Application of gas chromatography mass spectrometry (GC-MS)-based metabolomics for the study of fermented cereal and legume foods:a review

A new era of cutting-edge technologies and advancements in analytical platforms and omics sciences is disruptively bringing a paradigm shift in fundamental and translational research. Metabolomics is one of the omics strategies that yields big data and has gained popularity in a wide spectrum of applications. Among various analytical platforms used in metabolomics, gas chromatography mass spectrometry (GC-MS) allows the measurement of thermally stable (volatiles and semi-volatiles) metabolites, with an advantage of spectral reproducibility. Cereal and legume-based fermented foods are part of the food culture in various countries throughout the world. Thus, this review provides an overview of recent applications of GC-MS-based metabolomics in the food fermentation field, specifically cereal and legume-based fermented foods. This emerging use of metabolomics in food fermentation studies illustrates the potentials of this omics science to elucidate metabolome landscapes of fermented foods. Such insights would advance our predictive understanding of fermentation processes and molecular descriptions of resultant food products; a necessary step for improvements and sustainability in food industry. Furthermore, the review echoes the current need of collaborative efforts in the scientific community (in this field) to harness and maximise the potentials of metabolomics in food fermentation studies