Disaster medicine and public health preparedness
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Disaster Med Public Health Prep · Oct 2015
Is There a Case for Quarantine? Perspectives from SARS to Ebola.
Quarantine has been used for centuries in an effort to prevent the introduction, transmission, and spread of communicable diseases. While backed by legal authority, the public and even the health care worker community's understanding of the term is murky at best and scientific evidence to support the use of quarantine is frequently lacking. ⋯ This article explains quarantine terminology and then uses a case study from Taiwan during the 2002-2003 severe acute respiratory syndrome (SARS) outbreak to illustrate the key principles associated with quarantine measures taken during the 2014 Ebola outbreak and the potential hazards that can arise from quarantines. Finally, we provide a quarantine and isolation decision tree to assist policy makers and public health officials in applying medically defensible, outcomes-based data and legal authorities to optimize management of emerging infectious diseases.
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Disaster Med Public Health Prep · Oct 2015
Rising to the Challenge: The Ebola Outbreak in Sierra Leone and How Insights Into One Nongovernmental Organization's Response Can Inform Future Core Competencies.
Nongovernmental organizations (NGOs) play a critical humanitarian role in the developing world. Over 100 NGOs currently operate in Sierra Leone, a country in West Africa that ranks 183 out of 187 in the United Nation's Human Development Index. Following a brutal 11-year war that ended in January 2002, the country has been unsuccessful at building a sufficiently resourced, robust, and anticipatory public health and medical care infrastructure. ⋯ Smaller NGOs endeavored to assist during this crisis as well. One of them, Caritas, has actively sought public health knowledge and has applied public health principles to reduce and contain Ebola virus disease transmission. The Ebola outbreak illuminates the importance of building basic public health capabilities within the core competences of NGOs.
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Disaster Med Public Health Prep · Aug 2015
School Closure Decisions Made by Local Health Department Officials During the 2009 H1N1 Influenza Outbreak.
The goal of this study was to gain insights into the decision-making processes used by California public health officials during real-time crises. The decision-making processes used by California public health officials during the 2009 H1N1 influenza pandemic were examined by a survey research team from the University of California Berkeley. ⋯ Public health decision-makers do not appear to have a standard process for crisis decision-making and would benefit from having an organized decision-making model. The survey showed that ethical, logistical, and political criteria were considered but were not prioritized in any meaningful way. A new decision-making tool kit for public health decision-makers plus implementation training is warranted.
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Disaster Med Public Health Prep · Aug 2015
ReviewCore Competencies in Disaster Management and Humanitarian Assistance: A Systematic Review.
Disaster response demands a large workforce covering diverse professional sectors. Throughout this article, we illustrate the results of a systematic review of peer-reviewed studies to identify existing competency sets for disaster management and humanitarian assistance that would serve as guidance for the development of a common disaster curriculum. A systematic review of English-language articles was performed on PubMed, Google Scholar, Scopus, ERIC, and Cochrane Library. ⋯ Eighteen papers (47%) defined competency domains and 36 (94%) reported list of competencies. Nineteen articles (50%) adopted consensus-building to define competencies, and 12 (31%) included competencies adapted to different professional responsibility levels. This systematic review revealed that the largest number of papers were mainly focused on the health care sector and presented a lack of agreement on the terminology used for competency-based definition.
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Disaster Med Public Health Prep · Jun 2015
Pediatric Disposition Classification (Reverse Triage) System to Create Surge Capacity.
Critically insufficient pediatric hospital capacity may develop during a disaster or surge event. Research is lacking on the creation of pediatric surge capacity. A system of "reverse triage," with early discharge of hospitalized patients, has been developed for adults and shows great potential but is unexplored in pediatrics. ⋯ The classification system has potential for an ethically acceptable risk-based taxonomy for pediatric inpatient reverse triage, including identification of those deemed safe for early discharge during surge events.