Saving Lives, Saving from Death, Saving from Dying

Mark G. Kelman delivered the University of Georgia School of Law\u27s 104th Sibley Lecture on March 25, 2009 at 3:30 p.m. in the Hatton Lovejoy Courtroom

How critical infrastructure orients international relief in cascading disasters

Critical infrastructure and facilities are central assets in modern societies, but their impact on international disaster relief remains mostly associated with logistics challenges. The emerging literature on cascading disasters suggests the need to integrate the non-linearity of events in the analyses. This article investigates three case studies: the 2002 floods in the Czech Republic, Hurricane Katrina in 2005, and the 2011 Tohoku earthquake, tsunami, and Fukushima meltdown in Japan. We explore how the failure of critical infrastructure can orient international disaster relief by shifting its priorities during the response. We argue that critical infrastructure can influence aid request and delivery, changing needs to address the cascades and contain cascading technology-based events. The conclusions propose remaining challenges with applying our findings

Residential building and occupant vulnerability to pyroclastic density currents in explosive eruptions

International audienceA major hazard during the eruption of explosive volcanoes is the formation of pyroclastic density currents (PDCs). Casualties and physical building damage from PDCs are caused by the temperature, pressure, and particle load of the flow. This paper examines the vulnerability of buildings and occupants to the forces imposed by PDCs along with associated infiltration of PDC particle and gas mixtures into an intact building. New studies are presented of building and occupant vulnerability with respect to temperature, pressure, and ash concentration. Initial mitigation recommendations are provided

Toward resourcefulness: pathways for community positive health

Communities are powerful and necessary agents for defining and pursuing their health, but outside organizations often adopt community health promotion approaches that are patronizing and top-down. Conversely, bottom-up approaches that build on and mobilize community health assets are often critiqued for tasking the most vulnerable and marginalized communities to use their own limited resources without real opportunities for change. Taking into consideration these community health promotion shortcomings, this article asks how communities may be most effectively and appropriately supported in pursuing their health. This article reviews how community health is understood, moving from negative to positive conceptualizations; how it is determined, moving from a risk-factor orientation to social determination; and how it is promoted, moving from top-down to bottom-up approaches. Building on these understandings, we offer the concept of ‘resourcefulness’ as an approach to strengthen positive health for communities, and we discuss how it engages with three interrelated tensions in community health promotion: resources and sustainability, interdependence and autonomy, and community diversity and inclusion. We make practical suggestions for outside organizations to apply resourcefulness as a process-based, place-based, and relational approach to community health promotion, arguing that resourcefulness can forge new pathways to sustainable and self-sustaining community positive health

Puppeteering as a metaphor for unpacking power in participatory action research on climate change and health

The health impacts of climate change are distributed inequitably, with marginalized communities typically facing the direst consequences. However, the concerns of the marginalized remain comparatively invisible in research, policy and practice. Participatory action research (PAR) has the potential to centre these concerns, but due to unequal power relations among research participants, the approaches often fall short of their emancipatory ideals. To unpack how power influences the dynamics of representation in PAR, this paper presents an analytical framework using the metaphor of ‘puppeteering’. Puppeteering is a metaphor for how a researcher-activist resonates and catalyses both the voices (ventriloquism) and actions (marionetting) of a marginalized community. Two questions and continuums are central to the framework. First, who and where the puppeteer is (insider and outsider agents). Second, what puppeteering is (action and research; radical and managerial). Examples from climate change and health research provide illustrations and contextualizations throughout. A key complication for applying PAR to address the health impacts of climate change is that for marginalized communities, climate change typically remains a few layers removed from the determinants of health. The community’s priorities may be at odds with a research and action agenda framed in terms of climate change and health

Association between conflict and Cholera in Nigeria and the Democratic Republic of the Congo

Cholera outbreaks contribute substantially to illness and death in low- and middle-income countries. Cholera outbreaks are associated with several social and environmental risk factors, and extreme conditions can act as catalysts. A social extreme known to be associated with infectious disease outbreaks is conflict, causing disruption to services, loss of income, and displacement. To determine the extent of this association, we used the self-controlled case-series method and found that conflict increased the risk for cholera in Nigeria by 3.6 times and in the Democratic Republic of the Congo by 2.6 times. We also found that 19.7% of cholera outbreaks in Nigeria and 12.3% of outbreaks in the Democratic Republic of the Congo were attributable to conflict. Our results highlight the value of providing rapid and sufficient assistance during conflict-associated cholera outbreaks and working toward conflict resolution and addressing preexisting vulnerabilities, such as poverty and access to healthcare

Mining unexpected temporal associations: Applications in detecting adverse drug reactions

Copyright © 2008 IEEEIn various real-world applications, it is very useful mining unanticipated episodes where certain event patterns unexpectedly lead to outcomes, e.g., taking two medicines together sometimes causing an adverse reaction. These unanticipated episodes are usually unexpected and infrequent, which makes existing data mining techniques, mainly designed to find frequent patterns, ineffective. In this paper, we propose unexpected temporal association rules (UTARs) to describe them. To handle the unexpectedness, we introduce a new interestingness measure, residual-leverage, and develop a novel case-based exclusion technique for its calculation. Combining it with an event-oriented data preparation technique to handle the infrequency, we develop a new algorithm MUTARC to find pairwise UTARs. The MUTARC is applied to generate adverse drug reaction (ADR) signals from real-world healthcare administrative databases. It reliably shortlists not only six known ADRs, but also another ADR, flucloxacillin possibly causing hepatitis, which our algorithm designers and experiment runners have not known before the experiments. TheMUTARC performs much more effectively than existing techniques. This paper clearly illustrates the great potential along the new direction of ADR signal generation from healthcare administrative databases.Huidong (Warren) Jin, Jie Chen, Member, Hongxing He, Graham J. Williams, Chris Kelman and Christine M. O’Keef

Residential building and occupant vulnerability to tephra fall

International audiencePlinian and subplinian volcanic eruptions can be accompanied by tephra falls which may last hours or days, posing threats to people, buildings and economic activity. Numerous historical examples exist of tephra damage and tephra casualties. The mechanisms and consequences of roof collapse from static tephra load are an important area of tephra damage requiring more research. This paper contributes to this work by estimating the structural vulnerability of buildings to tephra load based on both analytical studies and observed damage. New studies are presented of roof strengths in the area around Mt. Vesuvius in southern Italy and of field surveys undertaken in other European volcanic locations to assess building vulnerability to tephra fall. The results are a proposed set of new European tephra fall roof vulnerability curves in areas potentially threatened by explosive volcanic eruptions along with comments on the human casualty implications of roof collapse under tephra loading. Some mitigation recommendations are provided

Modelling expected physical impacts and human casualties from explosive volcanic eruptions

A multi-hazard, multi-vulnerability impact model has been developed for application to European volcanoes that could significantly damage human settlements. This impact model is based on volcanological analyses of the potential hazards and hazard intensities coupled with engineering analyses of the vulnerability to these hazards of residential buildings in four European locations threatened by explosive volcanic eruptions. For a given case study site, inputs to the model are population data, building characteristics, volcano scenarios as a series of hazard intensities, and scenarios such as the time of eruption or the percentage of the population which has been evacuated. Outputs are the rates of fatalities, seriously injured casualties, and destroyed buildings for a given scenario. These results are displayed in a GIS, thereby presenting risk maps which are easy to use for presenting to public officials, the media, and the public. Technical limitations of the model are discussed and future planned developments are considered. This work contributes to the EU-funded project EXPLORIS (Explosive Eruption Risk and Decision Support for EU Populations Threatened by Volcanoes, EVR1-2001-00047). </p><p style='line-height: 20px;'>&nbsp;</p