Near-Real-Time Analysis of Publicly Communicated Disaster Response Information

Analysis of a disaster event can identify strengths and weaknesses of the response implemented by the disaster management system; however, analysis does not typically occur until after the response phase is over. The result is that knowledge gained can only benefit future responses rather than the response under investigation. This article argues that there is an opportunity to conduct analysis while the response is operational due to the increasing availability of information within hours and days of a disaster event. Hence, this article introduces a methodology for analyzing publicly communicated disaster response information in near-real-time. A classification scheme for the disaster information needs of the public has been developed to facilitate analysis and has led to the establishment of best observed practice standards for content and timeliness. By comparing the information shared with the public within days of a disaster to these standards, information gaps are revealed that can be investigated further. The result is identification of potential deficiencies in communicating critical disaster response information to the public at a time when they can still be corrected

Regionalization of pediatric emergency care in Korea

In order to care for an ill or injured child, it is crucial that every emergency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill or injured victim. Regionalization of healthcare means a system providing high-quality and cost-effective care for victims who present with alow frequency, but critical condition, such as multiple trauma or cardiac arrest. Within the pediatric field, neonatal intensive care and pediatric trauma care are good examples of regionalization. For successful regionalized pediatric emergency care, all aspects of a pediatric emergency system, from pre-hospital field to hospital care, should be categorized and coordinated. Efforts to set up the pediatric emergency care regionalization program based on a nationwide healthcare system are urgently needed in Korea

Classificatory multiplicity: intimate partner violence diagnosis in emergency department consultations

Aims and Objectives The aim of this research was to explore the naming, or classification, of physical assaults by a partner as ‘intimate partner violence’ during emergency department consultations. Background Research continues to evidence instances when intimate partner physical violence is ‘missed’ or unacknowledged during emergency department consultations. Methods Theoretically this research was approached through complexity theory and the sociology of diagnosis. Research design was an applied, descriptive and explanatory, multiple-method approach that combined: qualitative semi-structured interviews with service users (n=8) and emergency department practitioners (n=9), and qualitative and quantitative document analysis of emergency department health records (n=28). Results This study found that multiple classifications of intimate partner violence were mobilised during emergency department consultations and that these different versions of intimate partner violence held different diagnostic categories, processes, and consequences. Conclusion The construction of different versions of intimate partner violence in emergency department consultations could explain variance in people’s experiences and outcomes of consultations. The research found that the classificatory threshold for ‘intimate partner violence’ was too high. Strengthening systems of diagnosis (identification and intervention) so that all incidents of partner violence are named as ‘intimate partner violence’ will reduce the incidence of missed cases and afford earlier specialist intervention to reduce violence and limit its harms. Relevance to Clinical Practice This research found that identification of and response to intimate partner violence, even in contexts of severe physical violence, was contingent. By lowering the classificatory threshold so that all incidents of partner violence are named as ‘intimate partner violence’, practitioners could make a significant contribution to reducing missed intimate partner violence during consultations and improving health outcomes for this population. This research has relevance for practitioners in any setting where service-user report of intimate partner violence is possible.   SUMMARY BOX What does this paper contribute to wider global community? • Identification of and response to intimate partner violence, even in contexts of severe physical violence was found to be contingent. • Classification of intimate partner violence was connected to: legal duty to respond statutory frameworks of risk of harms; socio-cultural discourses about what counts as intimate partner violence; and health care practitioners’ perceptions of usual modes of disclosure. • Connecting all reports of partner perpetrated violence to intimate partner violence identification and intervention will reduce missed cases in health consultations and mobilise earlier intervention to reduce violence and limit its harms. • The sociology of diagnosis is a valuable conceptual tool for examining variance in identification and response for a wide range of determinants of health of concern for nurses and allied professions

Seismic Reliability Assessment of Aging Highway Bridge Networks with Field Instrumentation Data and Correlated Failures. II: Application

The Bridge Reliability in Networks (BRAN) methodology introduced in the companion paper is applied to evaluate the reliability of part of the highway bridge network in South Carolina, USA, under a selected seismic scenario. The case study demonstrates Bayesian updating of deterioration parameters across bridges after spatial interpolation of data acquired from limited instrumented bridges. The updated deterioration parameters inform aging bridge seismic fragility curves through multidimensional integration of parameterized fragility models, which are utilized to derive bridge failure probabilities. The paper establishes the correlation structure among bridge failures from three information sources to generate realizations of bridge failures for network level reliability assessment by Monte Carlo analysis. Positive correlations improve the reliability of the case study network, also predicted from the network topology. The benefits of the BRAN methodology are highlighted in its applicability to large networks while addressing some of the existing gaps in bridge network reliability studies

Engaging the public in healthcare decision making: Results from a citizens’ jury on emergency care services

Background: Policies addressing ED crowding have failed to incorporate the public's perspectives; engaging the public in such policies is needed. Objective: This study aimed at determining the public's recommendations related to alternative models of care intended to reduce crowding, optimising access to and provision of emergency care. Methods: A Citizens' Jury was convened in Queensland, Australia, to consider priority setting and resource allocation to address ED crowding. Twenty-two jurors were recruited from the electoral roll, who were interested and available to attend the jury from 15 to 17 June 2012. Juror feedback was collected via a survey immediately following the end of the jury. Results: The jury considered that all patients attending the ED should be assessed with a minority of cases diverted for assistance elsewhere. Jurors strongly supported enabling ambulance staff to treat patients in their homes without transporting them to the ED, and allowing non-medical staff to treat some patients without seeing a doctor. Jurors supported (in principle) patient choice over aspects of their treatment (when, where and type of health professional) with some support for patients paying towards treatment but unanimous opposition for patients paying to be prioritised. Most of the jurors were satisfied with their experience of the Citizens' Jury process, but some jurors perceived the time allocated for deliberations as insufficient. Conclusions: These findings suggest that the general public may be open to flexible models of emergency care. The jury provided clear recommendations for direct public input to guide health policy to tackle ED crowding

Application of the HIV prevention cascade to identify, develop and evaluate interventions to improve use of prevention methods: examples from a study in east Zimbabwe

Introduction: The HIV prevention cascade could be used in developing interventions to strengthen implementation of efficacious HIV prevention methods, but its practical utility needs to be demonstrated. We propose a standardized approach to using the cascade to guide identification and evaluation of interventions and demonstrate its feasibility for this purpose through a project to develop interventions to improve HIV prevention methods use by adolescent girls and young women (AGYW) and potential male partners in east Zimbabwe. Discussion: We propose a six-step approach to using a published generic HIV prevention cascade formulation to develop interventions to increase motivation to use, access to and effective use of an HIV prevention method. These steps are as follows: (1) measure the HIV prevention cascade for the chosen population and method; (2) identify gaps in the cascade; (3) identify explanatory factors (barriers) contributing to observed gaps; (4) review literature to identify relevant theoretical frameworks and interventions; (5) tailor interventions to the local context; and (6) implement and evaluate the interventions using the cascade steps and explanatory factors as outcome indicators in the evaluation design. In the Zimbabwe example, steps 1-5 aided development of four interventions to overcome barriers to effective use of pre-exposure prophylaxis (PrEP) in AGYW (15-24 years) and voluntary medical male circumcision in male partners (15-29). For young men, prevention cascade analyses identified gaps in motivation and access as barriers to voluntary medical male circumcision uptake, so an intervention was designed including financial incentives and an education session. For AGYW, gaps in motivation (particularly lack of risk perception) and access were identified as barriers to PrEP uptake: an interactive counselling game was developed addressing these barriers. A text messaging intervention was developed to improve PrEP adherence among AGYW, addressing reasons underlying lack of effective PrEP use through improving the capacity (“skills”) to take PrEP effectively. A community-led intervention (community conversations) was developed addressing community-level factors underlying gaps in motivation, access and effective use. These interventions are being evaluated currently using outcomes from the HIV prevention cascade (step 6). Conclusions: The prevention cascade can guide development and evaluation of interventions to strengthen implementation of HIV prevention methods by following the proposed process

Transition to Specialty Practice Program characteristics and professional development outcomes

publisher: Elsevier articletitle: Transition to Specialty Practice Program characteristics and professional development outcomes journaltitle: Nurse Education Today articlelink: http://dx.doi.org/10.1016/j.nedt.2016.05.017 content_type: article copyright: © 2016 The Author(s). Published by Elsevier Ltd

Stop there's water on the road! Identifying key beliefs guiding people's willingness to drive through flooded waterways

Floods are among the most widespread of natural disasters and exposure to floodwaters increases drowning risk. A leading cause of flood related drowning deaths is driving through flooded waterways. Drawing on the Theory of Planned Behaviour, a two-phased research program was conducted. Phase 1 (N = 25; Mage = 32.38, SD = 11.46) identified common beliefs about driving through a flooded waterway. Phase 2 (N = 174; Mage = 27.43, SD = 10.76) adopted a cross-sectional design to examine the belief predictors of drivers’ willingness to drive through a flooded waterway. Given differences in consequences due to the depth of water, scenarios of low (road covered in 20 cm of water) and high (road covered in 60 cm of water) risk situations were investigated. A range of beliefs emerged as predicting drivers’ willingness to engage in this unsafe driving behaviour. These included attitudinal beliefs (e.g., sustain vehicle damage, become stuck/stranded), beliefs of social expectations (e.g., pressure from friends, family members, police), and efficacy beliefs (e.g., small distance of water to drive through, presence of signage). The results of the current study support using a Theory of Planned Behaviour belief-based approach to the understanding of risky transport-related aquatic activities. The findings highlight the role that specific key beliefs play in guiding people's willingness to drive through flooded waterways and, in turn, provide possible targets for future interventions to curb this risky and potentially fatal driving behaviour

Accessing parental perspectives to inform the development of parent training in autism in south-eastern Europe

Parent training has been shown to be an important means of supporting families living with autism – but such services are not universally accessible. A multinational project funded by the European Commission has been developed in order to establish such parent training in three south-eastern European countries. To ensure that the training was relevant and appropriate, a survey was carried out in autumn 2015 to ascertain the attitudes of parents of children with autism in Croatia, Cyprus and the Former Yugoslav Republic of Macedonia regarding this issue, and to identify the areas of training that they felt most important. Two hundred and fifty-three surveys were distributed, and 148 were returned, a response rate of 58%. Respondents in the three counties were overwhelmingly positive about parent training, with almost 90% stating that they would like to attend such training. Weekend training sessions were preferred by the majority of respondents. There was wide variation between the three countries with regard to what content was felt important to be included, with parents in the FYR of Macedonia seeking information in the greatest number of areas. Five topics were prioritised by parents across all three countries. These were: • Strategies for enhancing my child’s communication • Strategies on facilitating my child’s interaction with other children • Sensory integration and development • General information on behavioural management strategies • Identifying and/or developing socialisation opportunitie