Showing papers on "Preparedness published in 2016"
TL;DR: An international expert group has outlined a framework for preparedness, detection, and response to future infectious-disease threats.
Abstract: The Ebola epidemic demonstrated how ill-prepared the global community is for major infectious disease crises. Now an international expert group has outlined a framework for preparedness, detection, and response to future infectious-disease threats.
222 citations
TL;DR: In this paper, the authors examine the evidence regarding the economic efficiency of disaster risk reduction (DRR) based on CBA and conclude that the benefits of investing in DRM outweigh the costs of doing so on average by about four times the cost in terms of avoided and reduced losses.
Abstract: There is a lot of rhetoric suggesting that disaster risk reduction (DRR) pays, yet surprisingly little in the way of hard facts. This review paper examines the evidence regarding the economic efficiency of DRM based on CBA. Specifically, it addresses the following questions: What can be said about current and best practice regarding CBA for DRR including limitations and alternatives? And, what, if at all, can be said in terms of quantitative insight for informing policy and practice? The review compares the documented evidence on the net benefits over a range of disaster management interventions, such as risk reduction, preparedness and risk financing. The review also critically discusses the applicability of cost–benefit analysis as well as other economic decision-supporting tools for assessing the efficiency of certain DRM interventions. Disaster risk is characterized by variability, which requires a risk-based assessment. As a key best practice criterion, and in order to avoid overestimating the benefits and returns on investment, the review focuses on studies that provide a risk-based estimate of benefits. This review shows that for the limited evidence reported the economic case for DRM across a range of hazards is strong and that the benefits of investing in DRM outweigh the costs of doing so on average, by about four times the cost in terms of avoided and reduced losses. In an age of austerity, cost–benefit analysis continues to be an important tool for prioritizing efficient DRM measures but with a shifting emphasis from infrastructure-based options (hard resilience) to preparedness and systemic interventions (soft resilience), other tools such as cost-effectiveness analysis, multi-criteria analysis and robust decision-making approaches deserve more attention.
144 citations
TL;DR: High levels of grief and low levels of preparedness during caregiving were associated with poor bereavement outcome such as complicated grief, while high preparedness was associated with improved caregiver outcome.
141 citations
TL;DR: It is found that while one can potentially leverage Twitter for disaster management, careful collection, assessment, and coordination with official disaster Twitter sites and local on-scene Twitter opinion leaders will be critical from a preparedness and early warning perspective.
135 citations
02 Apr 2016
TL;DR: In this paper, the role of education in promoting disaster preparedness is investigated, focusing on the pathways through which education enhances preparedness and the interplay between education and experience in shaping preparedness actions.
Abstract: This study aims at understanding the role of education in promoting disaster preparedness. Strengthening resilience to climate-related hazards is an urgent target of Goal 13 of the Sustainable Development Goals. Preparing for a disaster such as stockpiling of emergency supplies or having a family evacuation plan can substantially minimize loss and damages from natural hazards. However, the levels of household disaster preparedness are often low even in disaster-prone areas. Focusing on determinants of personal disaster preparedness, this paper investigates: (1) pathways through which education enhances preparedness; and (2) the interplay between education and experience in shaping preparedness actions. Data analysis is based on face-to-face surveys of adults aged ≥15 years in Thailand (N = 1,310) and the Philippines (N = 889, female only). Controlling for socio-demographic and contextual characteristics, we find that formal education raises the propensity to prepare against disasters. Using the KHB method to further decompose the education effects, we find that the effect of education on disaster preparedness is mainly mediated through social capital and disaster risk perception in Thailand whereas there is no evidence that education is mediated through observable channels in the Philippines. This suggests that the underlying mechanisms explaining the education effects are highly context-specific. Controlling for the interplay between education and disaster experience, we show that education raises disaster preparedness only for those households that have not been affected by a disaster in the past. Education improves abstract reasoning and anticipation skills such that the better educated undertake preventive measures without needing to first experience the harmful event and then learn later. In line with recent efforts of various UN agencies in promoting education for sustainable development, this study provides a solid empirical evidence showing positive externalities of education in disaster risk reduction.
125 citations
TL;DR: In this article, an objectively assessed measure of distance to a perceived flood zone, using a cognitive mapping methodology, is presented, which is a crucial factor in determining flood risk perception, both the cognitive and affective components.
Abstract: Natural hazards, such as major flood events, are occurring with increasing frequency and inflicting increasing levels of financial damages upon affected communities. The experience of such major flood events has brought about a significant change in attitudes to flood-risk management, with a shift away from built engineering solutions alone towards a more multifaceted approach. Europe's experience with damaging flood episodes provided the impetus for the introduction of the European Floods Directive, requiring the establishment of flood-risk management plans at the river-basin scale. The effectiveness of such plans, focusing on prevention, protection, and preparedness, is dependent on adequate flood awareness and preparedness, and this is related to perception of flood risk. This is an important factor in the design and assessment of flood-risk management. Whilst there is a modern body of literature exploring flood perception issues, there have been few examples that explore its spatial manifestations. Previous literature has examined perceived and real distance to a hazard source (such as a river, nuclear facility, landfill, or incinerator, etc.), whereas this article advances the literature by including an objectively assessed measure of distance to a perceived flood zone, using a cognitive mapping methodology. The article finds that distance to the perceived flood zone (perceived flood exposure) is a crucial factor in determining flood-risk perception, both the cognitive and affective components. Furthermore, we find an interesting phenomenon of misperception among respondents. The article concludes by discussing the implications for flood-risk management.
119 citations
TL;DR: Interventions are needed to engage a broader array of healthcare providers in PrEP provision and propose strategies that can be implemented and evaluated to increase PrEP prescribing by healthcare providers.
Abstract: Purpose of reviewTo review the most recent studies assessing the preparedness of healthcare practitioners to provide anti-HIV preexposure prophylaxis (PrEP) and suggest areas for future implementation research.Recent findingsAs PrEP is a biobehavioral intervention, healthcare providers are likely to
111 citations
TL;DR: This article developed a vision for the future of disaster nursing, identified barriers and facilitators to achieving the vision, and developed recommendations for nursing practice, education, policy, and research, as well as implementation challenges.
Abstract: Purpose
To develop a vision for the future of disaster nursing, identify barriers and facilitators to achieving the vision, and develop recommendations for nursing practice, education, policy, and research.
Design and Methods
A series of semistructured conference calls were conducted with 14 national subject matter experts to generate relevant concepts regarding national nursing workforce preparedness. An invitational daylong workshop hosted by the Veterans Emergency Management Evaluation Center, U.S. Department of Veterans Affairs, was held in December 2014 to expand and refine these concepts. Workshop participants included 70 nurses, emergency managers, and a broad range of public health professionals. Conference call notes and audiotapes of the workshop were transcribed and thematic analysis conducted to outline a vision for the future of nursing in disaster preparedness and response, and to articulate an agenda for nursing practice, education, policy, and research to achieve that vision.
Findings
The group developed a vision for the future of disaster nursing, and identified current barriers and opportunities to advance professional disaster nursing. A broad array of recommendations for nursing practice, education, policy, and research, as well as implementation challenges, are summarized in this article.
Conclusions
This project represents an important step toward enhancing nurses’ roles as leaders, educators, responders, policymakers, and researchers in disaster preparedness and response. Nurses and the health and human service organizations that employ them are encouraged to engage in an expansive national dialogue regarding how to best incorporate the vision and recommendations into their individual lives and the organizations for which they work.
Clinical Relevance
Nurses comprise the largest healthcare workforce, and opportunities exist to strengthen disaster readiness, enhance national surge capacity, and build community resiliency to disasters.
107 citations
TL;DR: The historical origins of the IHR and their performance over the past 10 years are reviewed and all of the ongoing reform panel efforts are analyzed to provide a series of politically feasible recommendations for fundamental reform.
Abstract: Policy Points: The International Health Regulations (IHR) are the governing framework for global health security yet require textual and operational reforms to remain effective, particularly as parallel initiatives are developed. The World Health Organization (WHO) is the agency charged with oversight of the IHR, and its leadership and efficient functioning are prerequisites for the effective implementation of the IHR. We reviewed the historical origins of the IHR and their performance over the past 10 years and analyzed all of the ongoing reform panel efforts to provide a series of politically feasible recommendations for fundamental reform. This article offers proposals for fundamental reform—with politically feasible pathways—of the IHR, their operations and implementation, WHO oversight, and State Party conformance. Context The International Health Regulations (IHR) have been the governing framework for global health security for the past decade and are a nearly universally recognized World Health Organization (WHO) treaty, with 196 States Parties. In the wake of the Ebola epidemic, major global commissions have cast doubt on the future effectiveness of the IHR and the leadership of the WHO. Methods We conducted a review of the historical origins of the IHR and their performance over the past 10 years and analyzed all of the ongoing reform panel efforts to provide a series of politically feasible recommendations for fundamental reform. Findings We propose a series of recommendations with realistic pathways for change. These recommendations focus on the development and strengthening of IHR core capacities; independently assessed metrics; new financing mechanisms; harmonization with the Global Health Security Agenda, Performance of Veterinary Services (PVS) Pathways, the Pandemic Influenza Preparedness Framework, and One Health strategies; public health and clinical workforce development; Emergency Committee transparency and governance; tiered public health emergency of international concern (PHEIC) processes; enhanced compliance mechanisms; and an enhanced role for civil society. Conclusions Empowering the WHO and realizing the IHR's potential will shore up global health security—a vital investment in human and animal health—while reducing the vast economic consequences of the next global health emergency.
107 citations
TL;DR: There are steps that can be taken at all stages of a disaster which may minimise risks to responders and enhance resilience, and the findings of this review could potentially be used to develop training workshops for professionals involved in disaster response.
Abstract: When disasters occur, there are many different occupational groups involved in rescue, recovery and support efforts. This study aimed to conduct a systematic literature review to identify social and occupational factors affecting the psychological impact of disasters on responders. Four electronic literature databases (MEDLINE®, Embase, PsycINFO® and Web of Science) were searched and hand searches of reference lists were carried out. Papers were screened against specific inclusion criteria (e.g. published in peer-reviewed journal in English; included a quantitative measure of wellbeing; participants were disaster responders). Data was extracted from relevant papers and thematic analysis was used to develop a list of key factors affecting the wellbeing of disaster responders. Eighteen thousand five papers were found and 111 included in the review. The psychological impact of disasters on responders appeared associated with pre-disaster factors (occupational factors; specialised training and preparedness; life events and health), during-disaster factors (exposure; duration on site and arrival time; emotional involvement; peri-traumatic distress/dissociation; role-related stressors; perceptions of safety, threat and risk; harm to self or close others; social support; professional support) and post-disaster factors (professional support; impact on life; life events; media; coping strategies). There are steps that can be taken at all stages of a disaster (before, during and after) which may minimise risks to responders and enhance resilience. Preparedness (for the demands of the role and the potential psychological impact) and support (particularly from the organisation) are essential. The findings of this review could potentially be used to develop training workshops for professionals involved in disaster response.
107 citations
TL;DR: Findings identify specific policy changes that could help physicians feel more prepared, and highlight how providers of all types will need to become familiar with interpreting WGS results.
Abstract: Although the integration of whole genome sequencing (WGS) into standard medical practice is rapidly becoming feasible, physicians may be unprepared to use it. Primary care physicians (PCPs) and cardiologists enrolled in a randomized clinical trial of WGS received genomics education before completing semi-structured interviews. Themes about preparedness were identified in transcripts through team-based consensus-coding. Data from 11 PCPs and 9 cardiologists suggested that physicians enrolled in the trial primarily to prepare themselves for widespread use of WGS in the future. PCPs were concerned about their general genomic knowledge, while cardiologists were concerned about how to interpret specific types of results and secondary findings. Both cohorts anticipated preparing extensively before disclosing results to patients by using educational resources with which they were already familiar, and both cohorts anticipated making referrals to genetics specialists as needed. A lack of laboratory guidance, time pressures, and a lack of standards contributed to feeling unprepared. Physicians had specialty-specific concerns about their preparedness to use WGS. Findings identify specific policy changes that could help physicians feel more prepared, and highlight how providers of all types will need to become familiar with interpreting WGS results.
TL;DR: SUD is a treatable and prevalent disease, yet a majority of general internists do not feel very prepared to screen, diagnose, provide a brief intervention, refer to treatment, or discuss treatment options with patients.
Abstract: Background: Previous research demonstrates that most primary care physicians feel unprepared to diagnose and treat substance use disorder (SUD). Confidence in SUD management has been associated wit...
TL;DR: In this paper, the authors present the methodological approach that led to the submission and subsequent approval of the Civil Protection Plan of Navaluenga (Central Spain), in which the first phase was to analyse flood hazard by combining the Hydrological Modelling System (HEC-HMS) and the Iber 2D hydrodynamic model.
TL;DR: A survey was conducted in five major cities in Chile during the year 2013 and was completed by a total sum of 2054 participants as discussed by the authors, who assessed risk perception of nine natural hazards and the level of trust in ten national institutions and authorities.
Abstract: It has been found that both preparedness for disasters and public response are significantly influenced by risk perceptions and trust in authorities and experts. Although Chile is a country with a long history of natural disasters, few studies have evaluated the risk perceptions of natural hazards or the degree of social trust. The aim of this study was to evaluate risk perception in Chile regarding various natural hazards and the degree of trust on authorities and institutions. A survey was conducted in five major cities in Chile during the year 2013 and was completed by a total sum of 2054 participants. We assessed risk perception of nine natural hazards and the level of trust in ten national institutions and authorities. According to declared levels of trust, the institutions and authorities included in this study were categorized into three groups: (1) low trust, which included governmental authorities and institutions; (2) medium trust, formed by institutions with educational and preparation roles; and (3) high trust, formed by institutions and authorities responsible for maintaining public order and conducting rescue and aid operations. Although our results show that earthquakes, tsunamis and wildfires were natural hazards of greatest concern to the national population, they also reflect that there are specific additional concerns in different cities that are coherent with their individual history of natural disasters. Implications for natural disaster risk preparedness are discussed.
TL;DR: A national sample of 698 licensed NPs who graduated between 2006 and 2011 and were practicing as NPs in the United States completed a survey related to clinical preparation and practice transition.
TL;DR: In this article, the authors examined the perspectives of hazards researchers, emergency management practitioners, and policymakers from New Zealand's Wellington region to understand what social resilience means at the community level, and found that the most frequently mentioned social resilience attributes are community gathering place, followed by social support, knowledge of risks and consequences, collective efficacy and sense of community.
Abstract: There is an increasing need to evaluate the underlying drivers of community resilience. Much of the existing research on resilience measurements assesses factors pertaining to a spectrum of societal domains that includes social, economic, institutional, infrastructural, and natural environments. Research has focused on the importance of social resilience – the capacity of people and communities to deal with external stresses and shocks – and how it contributes to community preparedness, disaster response, and post-disaster recovery. As a component of community resilience, social resilience has been examined by researchers across a multitude of academic disciplines. As a result, there are tremendous variations in how this concept is assessed. To better understand what social resilience means at the community level, this research examined the perspectives of hazards researchers, emergency management practitioners, and policymakers from New Zealand's Wellington region. The results of their responses revealed similarities in how social resilience is perceived across these three sectors. Overall, the most frequently mentioned social resilience attributes are community gathering place, followed by social support, knowledge of risks and consequences, collective efficacy, and sense of community. Through synthesising their responses and the literature, a core set of social resilience indicators is proposed.
TL;DR: Results suggest that a weighted flow capacity rate, which accounts for both the contribution of an edge to maximum network flow and the extent to which the edge is a bottleneck in the network, shows most promise across four instances of varying network sizes and densities.
TL;DR: Lawrence Gostin and colleagues offer a set of priorities for global health preparedness and response for future infectious disease threats and suggest a number of priorities that need to be addressed.
Abstract: Lawrence Gostin and colleagues offer a set of priorities for global health preparedness and response for future infectious disease threats.
TL;DR: In this paper, the authors provide case study evidence demonstrating the role of a grassroots organisation in shaping a community defined concept of resilience through self-organised disaster response action, and highlight the importance of pre-disaster community activity for facilitating social support and social learning.
Abstract: – When the devastating 6.3 magnitude earthquake hit Christchurch, Aotearoa New Zealand on the 22 February 2011 the landscape of the city and its communities were irrevocably changed. The purpose of this paper is to provide case study evidence demonstrating the role of a grassroots organisation in shaping a community defined concept of resilience through self-organised disaster response action. , – The case organisation, Project Lyttelton is a community group, located in the suburb of Lyttelton, dedicated to building community and resilience through local projects and action. This case study was conducted through in-depth qualitative interviews with key members of the organisation, as well as key individuals in the broader community. , – This research has found that Project Lyttelton played a strong role in providing avenues for citizen participation post disaster. Of particular significance was the role of the timebank in providing an already established network for active participation by citizens in the response and recovery. Other findings outline the importance of pre-disaster community activity for facilitating social support and social learning. , – This research contributes to the literature by providing case study evidence for the value of a community led and defined framework of resilience. The findings of this work support the need for further integration and support for local community led preparedness and response initiatives and demonstrate the possible value of pre-disaster community preparedness activities. Consequently, this work is of use to academics interested in the role of community following disasters, as well as emergency management practitioners interested in possible pathways for fostering and encouraging locally focused disaster preparedness activities. The findings may also be of interest to community groups working in the sphere of community building and resilience.
TL;DR: To examine the decision making process at ex ante and ex post disaster stages, a two-stage dynamic programming model is developed that optimally allocates preparedness and relief expenditures.
TL;DR: Key lessons learned from the Ebola outbreak can be clustered into three areas: environmental conditions related to early warning systems, host characteristics related to public health, and agent issues that can be addressed through the laboratory sciences.
Abstract: As the Ebola outbreak in West Africa wanes, it is time for the international scientific community to reflect on how to improve the detection of and coordinated response to future epidemics. Our interdisciplinary team identified key lessons learned from the Ebola outbreak that can be clustered into three areas: environmental conditions related to early warning systems, host characteristics related to public health, and agent issues that can be addressed through the laboratory sciences. In particular, we need to increase zoonotic surveillance activities, implement more effective ecological health interventions, expand prediction modeling, support medical and public health systems in order to improve local and international responses to epidemics, improve risk communication, better understand the role of social media in outbreak awareness and response, produce better diagnostic tools, create better therapeutic medications, and design better vaccines. This list highlights research priorities and policy actions the global community can take now to be better prepared for future emerging infectious disease outbreaks that threaten global public health and security.
TL;DR: Education and training resources in disaster mental health and the community-based model of psychological first aid are described to assist psychologists and others in preparing themselves to assist their communities in difficult times and to help their communities learn to support one another.
Abstract: Any community can experience a disaster, and many traumatic events occur without warning. Psychologists can be an important resource assisting in psychological support for individuals and communities, in preparation for and in response to traumatic events. Disaster mental health and the community-based model of psychological first aid are described. The National Preparedness and Response Science Board has recommended that all mental health professionals be trained in disaster mental health, and that first responders, civic officials, emergency managers, and the general public be trained in community-based psychological first aid. Education and training resources in these two fields are described to assist psychologists and others in preparing themselves to assist their communities in difficult times and to help their communities learn to support one another.
TL;DR: Training and assessing IPC practices in general health care facilities not designated as Ebola treatment units or centers became a priority for CDC as the number of Ebola virus transmissions among health care workers in West Africa began to affect the West African health care system and increasingly more persons became infected.
Abstract: The 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa underscores the need for health care infection prevention and control (IPC) practices to be implemented properly and consistently to interrupt transmission of pathogens in health care settings to patients and health care workers. Training and assessing IPC practices in general health care facilities not designated as Ebola treatment units or centers became a priority for CDC as the number of Ebola virus transmissions among health care workers in West Africa began to affect the West African health care system and increasingly more persons became infected. CDC and partners developed policies, procedures, and training materials tailored to the affected countries. Safety training courses were also provided to U.S. health care workers intending to work with Ebola patients in West Africa. As the Ebola epidemic continued in West Africa, the possibility that patients with Ebola could be identified and treated in the United States became more realistic. In response, CDC, other federal components (e.g., Office of the Assistant Secretary for Preparedness and Response) and public health partners focused on health care worker training and preparedness for U.S. health care facilities. CDC used the input from these partners to develop guidelines on IPC for hospitalized patients with known or suspected Ebola, which was updated based on feedback from partners who provided care for Ebola patients in the United States. Strengthening and sustaining IPC helps health care systems be better prepared to prevent and respond to current and future infectious disease threats.The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).
TL;DR: Analysis of data collected through a survey among 81 companies show that management preparedness may enhance sustainable supply chain strategies in the O&G industry more than commitment does, and management of supply chain operational risks is found to be vital to the sustainability of all supply chain functions except for production management practices.
TL;DR: A three-step operational learning framework is proposed that could be used for EMTs globally to ensure professional competence and license to practice, support adaptation of technical and non-technical professional capacities into the low-resource and emergency context and prepare for an effective team performance in the field.
Abstract: An increasing number of international emergency medical teams are deployed to assist disaster-affected populations worldwide Since Haiti earthquake those teams have been criticised for ill adapted care, lack of preparedness in addition to not coordinating with the affected country healthcare system The Emergency Medical Teams (EMTs) initiative, as part of the Word Health Organization's Global Health Emergency Workforce program, aims to address these shortcomings by improved EMT coordination, and mechanisms to ensure quality and accountability of national and international EMTs An essential component to reach this goal is appropriate education and training Multiple disaster education and training programs are available However, most are centred on individuals' professional development rather than on the EMTs operational performance Moreover, no common overarching or standardised training frameworks exist In this report, an expert panel review and discuss the current approaches to disaster education and training and propose a three-step operational learning framework that could be used for EMTs globally The proposed framework includes the following steps: 1) ensure professional competence and license to practice, 2) support adaptation of technical and non-technical professional capacities into the low-resource and emergency context and 3) prepare for an effective team performance in the field A combination of training methodologies is also recommended, including individual theory based education, immersive simulations and team training Agreed curriculum and open access training materials for EMTs need to be further developed, ideally through collaborative efforts between WHO, operational EMT organizations, universities, professional bodies and training agencies Keywords: disasters; education; emergencies; global health; learning
TL;DR: Investigation of affective and cognitive responses and social-contextual factors related to Ebola and their intercorrelations in a developed country without widespread Ebola transmission showed that most participants were not particularly concerned about Ebola and did not feel at risk of acquiring the virus.
Abstract: The purposes of the current study were twofold: (1) to investigate affective and cognitive responses and social-contextual factors related to Ebola and their intercorrelations in a developed country without widespread Ebola transmission; and (2) to examine the relationships among risk perception of Ebola, levels of knowledge about Ebola, and (blatant and subtle) prejudice toward African immigrants. Between January 2015 and March 2015, an anonymous cross-sectional survey was conducted among a convenience sample of 486 Italian adults. Results showed that most participants were not particularly concerned about Ebola and did not feel at risk of acquiring the virus. Cognitive dimensions of risk perception of Ebola (i.e., perceived severity of illness, perceived personal impact, perceived coping efficacy, and likelihood of infection), affective response (or worry) to Ebola, and social-contextual factors (i.e., perceived preparedness of institutions, family members' and friends' levels of worry) were interrelated. Prejudice toward African immigrants was positively related to risk perception of Ebola and negatively related to levels of knowledge about Ebola even when controlling for sociodemographic variables including political preference.
TL;DR: Results demonstrate youth’s ability to self-consent to age- and population-appropriate procedures, and underscore the value of empirical studies for informing institutional review board (IRB) protections of SGMY research participants.
Abstract: This project examined the attitudes of sexual and gender minority youth (SGMY) toward guardian permission for a pre-exposure prophylaxis (PrEP) adherence trial and their preparedness to provide informed, rational, and voluntary self-consent. Sixty sexually active SGMY (ages 14-17) participated in online survey and asynchronous focus group questions after watching a video describing a PrEP adherence study. Youth responses highlighted guardian permission as a significant barrier to research participation, especially for those not "out" to families. Youth demonstrated understanding of research benefits, medical side effects, confidentiality risks, and random assignment and felt comfortable asking questions and declining participation. Reasoning about participation indicated consideration of health risks and benefits, personal sexual behavior, ability to take pills every day, logistics, and post-trial access to PrEP. Results demonstrate youth's ability to self-consent to age- and population-appropriate procedures, and underscore the value of empirical studies for informing institutional review board (IRB) protections of SGMY research participants.
TL;DR: Eight of the ten themes related to perceptions of preparedness are potentially amenable to curricula strategies to improve the transition experience and support clinical skills refreshers, clarification of roles and expectations, demystification of healthcare hierarchy and assessment processes and student-student handovers.
Abstract: The transition from university-based to clerkship-based education can be challenging. Medical schools have introduced strategies to ease the transition, but there has been no systematic review synthesizing the evidence on the perceptions of preparedness of medical students for their first clerkship to support these interventions. This study therefore aimed to (1) identify and synthesize the published evidence on medical students’ perceptions of preparedness for their first clerkship, and (2) identify factors that may impact on preparedness for clerkship, to better inform interventions aimed at easing this transition. Electronic databases (Medline, Journals@Ovid, CINAHL, ERIC, Web of Science, Embase) were searched without restriction and secondary searching of reference lists of included studies was also conducted. Included studies used quantitative or qualitative methodologies, involved medical students and addressed student/supervisor perceptions of preparedness for first clerkship. The first clerkship was defined as the first truly immersive educational experience during which the majority of learning was vocational and self-directed, as per the MeSH term ‘clinical clerkship’ and associated definition. Using an inductive thematic synthesis approach, 2 researchers independently extracted data, coded text (from results and discussion sections), and identified themes related to preparedness. Any disagreements were resolved by discussion and findings were then narratively synthesized. The initial search identified 1214 papers. After removing duplicates and assessing abstracts and full articles against the inclusion criteria, 8 articles were included in the review. In general, the body of evidence was of sound methodological quality. Ten themes relating to perceptions of preparedness of medical students for their first clerkship were identified; competence, disconnection, links to the future, uncertainty, part of the team, time/workload, adjustment, curriculum, prior life experiences and learning. Eight of the ten themes related to perceptions of preparedness are potentially amenable to curricula strategies to improve the transition experience. The evidence supports clinical skills refreshers, clarification of roles and expectations, demystification of healthcare hierarchy and assessment processes and student-student handovers. Evidence also supports preclinical educational strategies such as enhancing content contextualization, further opportunities for the application of knowledge and skills, and constructive alignment of assessment tasks and pedagogical aims.
TL;DR: A systematic review of evaluation tools for hospital disaster preparedness found none of the evaluated checklists and tools included all dimensions required for an appropriate hospital preparedness evaluation.
Abstract: Hospitals need to be fully operative during disasters. It is therefore essential to be able to evaluate hospital preparedness. However, there is no consensus of a standardized, comprehensive and reliable tool with which to measure hospital preparedness. The aim of the current study was to perform a systematic review of evaluation tools for hospital disaster preparedness. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words "crisis," "disaster," "disaster medicine," "emergency," "mass casualty," "hospital preparedness," "hospital readiness," "hospital assessment," "hospital evaluation," "hospital appraisal," "planning," "checklist," and "medical facility" were used in combination with the Boolean operators "OR" and "AND." PubMed (National Library of Medicine, Bethesda, MD), ISI Web of Science (Thomson Reuters, New York, NY), and Scopus (Elsevier, New York, NY) were searched. A total of 51,809 publications were screened. The following themes were required for relevance: logistics, planning, human resources, triage, communication, command and control, structural and nonstructural preparedness, training, evacuation, recovery after disaster, coordination, transportation, surge capacity, and safety. The results from 15 publications are presented. Fifteen articles fulfilled the criteria of relevance and considered at least 1 of the 14 predetermined themes. None of the evaluated checklists and tools included all dimensions required for an appropriate hospital preparedness evaluation. The results of the current systematic review could be used as a basis for designing an evaluation tool for hospital disaster preparedness. (Disaster Med Public Health Preparedness. 2016;page 1 of 8).
TL;DR: A systematic literature review aims at identifying current research and directions for future research in terms of Volunteered Geographic Information (VGI) within natural hazard analysis, and reveals auspicious approaches regarding community engagement and data fusion, but also important research gaps.
Abstract: With the rise of new technologies, citizens can contribute to scientific research via Web 2.0 applications for collecting and distributing geospatial data. Integrating local knowledge, personal experience and up-to-date geoinformation indicates a promising approach for the theoretical framework and the methods of natural hazard analysis. Our systematic literature review aims at identifying current research and directions for future research in terms of Volunteered Geographic Information (VGI) within natural hazard analysis. Focusing on both the preparedness and mitigation phase results in eleven articles from two literature databases. A qualitative analysis for in-depth information extraction reveals auspicious approaches regarding community engagement and data fusion, but also important research gaps. Mainly based in Europe and North America, the analysed studies deal primarily with floods and forest fires, applying geodata collected by trained citizens who are improving their knowledge and making their own interpretations. Yet, there is still a lack of common scientific terms and concepts. Future research can use these findings for the adaptation of scientific models of natural hazard analysis in order to enable the fusion of data from technical sensors and VGI. The development of such general methods shall contribute to establishing the user integration into various contexts, such as natural hazard analysis.