emergency preparedness

应急准备
  • 文章类型: Journal Article
    背景:2023年2月6日,土耳其南部和中部以及叙利亚西北部发生了Mw7.8地震,影响了460万和250万儿童的生活,分别。在这样的危机中,依赖商业配方奶粉(CMF)的婴儿面临更多的疾病和营养不良的脆弱性,因为CMF的安全制备变得困难,有时甚至不可能.《紧急情况下婴幼儿喂养操作指南》(OG-IFE)为保护和支持推荐的婴幼儿喂养以及最大程度地减少CMF喂养带来的风险提供了指导。此外,《国际母乳代用品销售守则》(《守则》)通过保护和促进母乳喂养以及确保正确使用CMF来确保婴儿的充足营养。这项研究旨在记录在抗震救灾工作中违反《守则》和OG-IFE的行为,以帮助加强婴幼儿喂养应急反应,并为未来的救灾政策提供信息。
    方法:数据从2023年2月6日至3月10日通过互联网来源收集。社交媒体,新闻网站,和紧急营养网络论坛用于数据收集。土耳其语内容被翻译成英文进行分析,重点关注与捐赠有关的信息和与婴儿食品和婴儿喂养有关的违反法规的行为。
    结果:关于CMF的总共40份报告,补充食品,并收集了喂养设备的捐赠。确定了违反OG-IFE和《守则》的三种主要类型,其中大多数是个人的事件,人道主义组织,政府机构寻求或接受捐赠。婴儿配方奶粉公司继续违反守则,向土耳其红新月会捐赠大量CMF和喂养设备,政府机构,和救灾婴幼儿喂养(IYCF)协调机构。
    结论:这些事件反映了系统违反准则和不遵守OG-IFE。由于早期反应分散,全球接受的IYCF标准和建议没有得到一致遵循。迫切需要加紧努力,以确保在紧急情况下保护和支持母乳喂养和非母乳喂养的婴儿的适当和安全的IYCF做法。
    BACKGROUND: On 6 February 2023, an Mw 7.8 earthquake struck southern and central Türkiye and north-western Syria, affecting the lives of 4.6 and 2.5 million children, respectively. In such crises, infants who are dependent on commercial milk formula (CMF) face increased vulnerability to diseases and malnutrition as safe preparation of CMF becomes difficult and sometimes impossible. The Operational Guidance on Infant and Young Child Feeding in Emergencies (OG-IFE) provides guidance on protecting and supporting recommended infant and young child feeding and minimizing the risks that come with CMF feeding. In addition, the International Code of Marketing of Breastmilk Substitutes (the Code) ensures adequate nutrition for infants by protecting and promoting breastfeeding and ensuring the proper usage of CMF. This study aims to document violations of the Code and the OG-IFE during the earthquake relief efforts to help strengthen infant and young child feeding emergency responses and inform future disaster relief policies.
    METHODS: Data was collected from 6 February to 10 March 2023 through Internet sources. Social media, news websites, and the Emergency Nutrition Network forum were used for data collection. Turkish content was translated into English for analysis, with a focus on donation-related information and Code violations related to baby food and infant feeding.
    RESULTS: A total of 40 reports on CMF, complementary food, and feeding equipment donations were collected. Three main types of violations of the OG-IFE and the Code were identified, with the majority of them being incidences of individuals, humanitarian organizations, and government agencies seeking or accepting donations. Infant formula companies continued to violate the Code by donating large quantities of CMF and feeding equipment to the Turkish Red Crescent, government agencies, and disaster relief infant and young child feeding (IYCF) coordination authorities.
    CONCLUSIONS: These incidents reflected a systematic violation of the Code and non-compliance with the OG-IFE. Globally accepted IYCF standards and recommendations were not consistently followed due to fragmented early responses. There is a critical need to step up efforts to ensure appropriate and safe IYCF practice protecting and supporting breastfed and non-breastfed infants in emergencies.
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  • 文章类型: Journal Article
    对冠状病毒病(COVID-19)大流行的反应显示,旧金山县在医疗供应质量、人员培训和熟悉程度方面存在差距,促使对县灾难补给库和紧急医疗服务(EMS)系统减压协议进行重新检查。项目RESPOND(灾难中院前行动的快速应急物资)的开发旨在弥合短期或无预警灾难期间患者护理基础设施的差距,并通过引入新颖的能力来安全治疗和出院患者来增强EMS系统卸载事件现场的轻伤。这个设计,在适应独特大都市人口需求的同时,可以用作重新构想灾难响应政策和开发灾难供应缓存的模板。
    Response to the coronavirus disease (COVID-19) pandemic revealed gaps in medical supply quality and personnel training and familiarity in San Francisco County, prompting the reexamination of county disaster supply caches and emergency medical services (EMS) system decompression protocols. Project RESPOND (Rapid Emergency Supplies for Prehospital Operations in Disaster) was developed to bridge the gap in patient care infrastructure during short- or no-warning disasters and enhance EMS system offloading by introducing a novel capacity for the safe treatment and discharge of patients with minor injuries from the scene of an event. This design, while scaled to the needs of a unique metropolitan population, can be used as a template for the reimagining of disaster response policy and development of disaster supply caches.
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  • 文章类型: Journal Article
    早期核事故的经验清楚地表明,需要维持和发展适当的建模能力。处理核事故后人类暴露等复杂问题需要实施一套相互关联的模型,如FDMT。FDMT是欧洲两个主要的辐射应急准备决策支持系统中的一个集成模块,ARGOS和JRODOS,模拟放射性核素沿陆地食物链的转移,并预测其在食品中的活性浓度。为了使模块更适合目的,FDMT已在新的建模平台(ECOLEGO)中实施,该平台在进行开发工作方面提供了高度的灵活性。本文提出了通过合并新模型或进一步阐述现有模型来进一步改进FDMT,以及默认参数的更新。通过考虑区域特定参数,模型也更适合目的。具体的改进包括与干沉积相关的建模发展,放射性粒子风化,放射性铯迁移受土壤特性的影响,对于特定地区的情况,动物摄取。此外,本文提出了新的途径和参数(和更新值),以考虑使FDMT更适应挪威的条件。总的来说,在目前的工作中所做的改进应大大减少与FDMT模型的输出相关的不确定性。
    Experience from earlier nuclear accidents has clearly shown the need for maintaining and developing appropriate modelling capabilities. Dealing with complex issues such as human exposure following a nuclear accident necessitates the implementation of a set of interconnected models such as FDMT. FDMT is an integrated module within the two main European decision support systems for radiological emergency preparedness, ARGOS and JRODOS, to simulate the transfer of radionuclides along terrestrial food chains and to predict their activity concentrations in foodstuffs. In order to make the module more fit-for-purpose, FDMT has been implemented in a new modelling platform (ECOLEGO) which provides a high degree of flexibility with regard to conducting developmental work. This paper presents improvements in FDMT further through either the incorporation of new models or further elaboration of existing ones, as well as updates in default parameters. Models have also been made more fit-for-purpose through consideration of regional-specific parameters. Specific improvements include modelling developments related to dry deposition, radioactive particle weathering, radiocaesium transfer influenced by soil characteristics and, for a region-specific case, animal uptake. In addition, the paper presents new pathways and parameters (and updated values) to be considered for making FDMT more adapted for Norwegian conditions. Overall, the improvements made in the present work should significantly reduce the uncertainties associated with the outputs of the FDMT models.
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  • 文章类型: Journal Article
    影响两个美国新生儿筛查(NBS)计划的三起事件突显了应急计划对连续性操作(COOP)的重要性。其他国家统计局计划可能会从这些州计划的经验中受益,以进行自己的应急计划工作。通过事后进行的事后审查,确定了成功管理事件的关键因素。我们详细说明了优势,弱点,需要改进,以及未来的行动,这些行动将有助于为其他事件做好准备,作为经验教训。
    Three incidents that impacted two US newborn screening (NBS) programs highlight the importance of contingency planning for the continuity of operations (COOP). Other NBS programs may benefit from the experience of these state programs for their own contingency planning efforts. Through after-action reviews conducted post-incident, crucial elements for the successful management of an incident were identified. We detailed the strengths, weaknesses, improvements needed, and future actions that will assist in preparing for other incidents as lessons learned.
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  • 文章类型: Journal Article
    实验室响应网络(LRN)由应对突发公共卫生事件的美国和国际实验室组成,如生物反应器。我们使用定性方法评估了LRN在2022年水痘爆发的最初10周内(2022年5月17日至7月31日)的成功和挑战。
    我们进行了9次非结构化访谈,其中包括与疾病控制和预防中心(CDC)主题专家的3次访谈,以及与州和地方公共卫生实验室和流行病学家以及公共卫生实验室协会(APHL)工作人员的6次访谈。我们提出了有关备灾投资的指导性问题,成功,以及最初的水痘反应中的挑战,并要求提出建议,以改善未来LRN对传染病暴发的反应。我们还审查了2022年6月和7月在84个LRN公共卫生实验室进行的两次同期APHL调查的数据。
    显著的成功包括获得美国食品和药物管理局(FDA)批准的检测正痘病毒(非天花正痘病毒[NVO]检测)的检测方法和训练有素的员工队伍;FDA之间的牢固关系,CDC,和LRN;以及LRN实验室和CDC之间的强大沟通。挑战包括LRN实验室在自我报告测试能力方面的差异,为医疗保健提供者访问NVO测定的障碍,以及在测试需求激增期间LRN功能的差距。
    LRN系统在应对美国新出现的传染病暴发中起着至关重要的作用。从LRN对水痘爆发的初始反应中获得的经验教训可以帮助指导改进,以更好地定位LRN,以便将来做出反应。包括与医疗保健提供者的持续接触,商业实验室,和医疗保健环境中的实验室。
    UNASSIGNED: The Laboratory Response Network (LRN) consists of US and international laboratories that respond to public health emergencies, such as biothreats. We used a qualitative approach to assess the successes and challenges of the LRN during the initial 10 weeks of the 2022 mpox outbreak (May 17-July 31, 2022).
    UNASSIGNED: We conducted 9 unstructured interviews, which included 3 interviews with subject matter experts from the Centers for Disease Control and Prevention (CDC) and 6 interviews with state and local public health laboratories and epidemiologists and Association of Public Health Laboratories (APHL) staff. We asked guiding questions on investments in preparedness, successes, and challenges during the initial mpox response and asked for suggestions to improve future LRN responses to infectious disease outbreaks. We also reviewed data from 2 contemporaneous APHL surveys conducted in June and July 2022 in 84 LRN public health laboratories.
    UNASSIGNED: Notable successes included availability of an assay that had received clearance from the US Food and Drug Administration (FDA) for testing orthopoxviruses (non-variola Orthopoxvirus [NVO] assay) and a trained workforce; strong relationships among FDA, CDC, and the LRN; and strong communications between LRN laboratories and CDC. Challenges included variability among LRN laboratories in self-reported testing capacity, barriers to accessing the NVO assay for health care providers, and gaps in LRN function during surges of testing needs.
    UNASSIGNED: The LRN system plays an essential role in the response to emerging infectious disease outbreaks in the United States. Lessons learned from the LRN\'s initial response to the mpox outbreak can help guide improvements to better position the LRN for future responses, including continued engagement with health care providers, commercial laboratories, and laboratories in health care settings.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Case Reports
    在2011年东日本大地震(GEJE)和福岛第一核电站事故之后,向居住在福岛县核电站附近的居民发出了强制疏散命令,包括一些接受家庭氧气治疗的患者。尽管已经注意到接受家庭氧气治疗的患者(最容易遭受灾难的人群之一)的脆弱性,很少有关于辐射灾难事件中疏散对健康的影响的信息。一名90岁的男子从70岁开始被诊断出患有慢性阻塞性肺疾病,住在核电站以南约20公里的城镇,由于健康状况恶化,灾难发生后8个月死亡。这个案例揭示了弱势群体所经历的身体和心理负担的可能性,例如在灾难时期撤离期间接受家庭氧气治疗的患者。虽然只是病例报告,资料有限,需要家庭氧气治疗的严重呼吸窘迫可能是灾难相关死亡的重要风险因素,特别是在疏散时间延长的情况下,比如核灾难。由于灾难发生后立即获得公众支持的挑战,家庭氧气治疗患者可能需要在备灾工作中优先考虑自助和互助。
    Following the Great East Japan Earthquake (GEJE) and the Fukushima Daiichi nuclear power plant accident in 2011, mandatory evacuation orders were issued to residents living near the nuclear power plant in Fukushima prefecture, including some patients receiving home oxygen therapy. Although the vulnerability of patients with home oxygen therapy (one of the population groups most vulnerable to disasters) has been noted, there is little information on the health effects of evacuation in the event of a radiation disaster. A 90-year-old man diagnosed with chronic obstructive pulmonary disease since the age of 70, and lived in a town located approximately 20 km south of the nuclear power plant, died 8 months after the disaster due to worsening health conditions. This case reveals the potential for both physical and psychological burdens experienced by vulnerable groups like patients undergoing home oxygen therapy during evacuations in times of disaster. Although it is only a case report and the information is limited, severe respiratory distress requiring home oxygen therapy may present a significant risk factor for disaster-related deaths, especially in cases where evacuations are prolonged, such as in nuclear disasters. Due to the challenge of obtaining prompt public support immediately after a disaster, home oxygen therapy patients may need to prioritize self-help and mutual assistance in their disaster preparedness efforts.
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  • 文章类型: Journal Article
    目的:了解CSSD应急准备和应急演练的现状,分析其对护士急救态度和能力的影响。
    方法:本研究采用多中心分层抽样方法,2023年1月至6月使用在线调查进行,参与者完成了一般数据,应急准备和演习问卷,公共卫生应急响应问卷和应急能力量表。使用独立样本t检验或Kruskal-Wallis检验来分析护士急救能力和态度的差异。
    结果:数据来自中国15个省55家医院。总的来说,77.58%的参与者机构成立了应急管理小组,85.45%有应急预案并定期修订。92.12%储存应急用品。全体测量人员参加了应急演练,主要由单钻组成(51.52%),90.30%是真正的战斗演习,49.09%的参与者每季度进行演练,91.52%的演习参与者超过50%。受访者的紧急态度得分为(29.346±6.029),他们的应急能力评分为(63.594±10.413),有抢救经验者态度较积极(Z=-2.316,P=0.021)。不同的标题,教育水平,救援经验和应急演练次数对调查对象应急救援能力有影响(P<0.05)。
    结论:大多数医疗机构建立了应急管理体系和计划,然而,内容缺乏地理特异性。应急演练时间长,参与度高,但是演习的效果需要进一步提高,CSSD护士的反应能力和态度较低。建议机关制定全面,有针对性的应急预案,加强对队伍力量的检查和评估,针对应急计划的设备和保障措施,以确保应急计划规定的措施能够在应急响应启动后迅速实施。
    OBJECTIVE: To investigate the current situation of emergency preparation and emergency drill in the CSSD, and analyze its influence on the nurses\' emergency attitude and ability.
    METHODS: This study employed a multicenter stratified sampling method, conducted from January to June 2023 using the online survey, participants completed the general data, emergency preparedness and drill questionnaire, public health emergency response questionnaire and emergency capacity scale. An independent samples t test or Kruskal-Wallis test was used to analyse differences in nurses\' emergency capacity and attitudes.
    RESULTS: The data from 15 provinces 55 hospitals in China. Overall, 77.58% of participants\' institutions set up emergency management teams, 85.45% have an emergency plan and revise it regularly. 92.12% store emergency supplies. All survey staff participated in the emergency drill, which predominantly consisted of individual drills (51.52%), with 90.30% being real combat drills, 49.09% of participants engaging in drills every quarter, and 91.52% of the drill\'s participants exceeding 50%. The respondents\' emergency attitude score was (29.346 ± 6.029), their emergency ability score was (63.594 ± 10.413), and those with rescue experience showed a more positive attitude (Z = -2.316, P = 0.021). Different titles, education levels, rescue experience and the frequency of emergency drill affected the emergency rescue ability of the respondents (P < 0.05).
    CONCLUSIONS: Most medical institutions establish emergency management systems and plans, yet the content lacks geographical specificity.The duration and participation of emergency drills are high, but the effectiveness of the drills needs to be further improved, and the response capacity and attitudes of CSSD nurses are low. It is recommended that agencies develop comprehensive and targeted contingency plans to strengthen the inspection and evaluation of team strength, equipment and safeguards against the contingency plans, so as to ensure that the measures mandated by the contingency plans can be implemented promptly after the emergency response is initiated.
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  • 文章类型: Journal Article
    这项研究评估了护士协助干预对老年人或身体虚弱的社区成员的家庭应急准备水平的影响,采取的行动,和物资聚集。这些社区成员拥有在灾难期间必须满足的访问和功能需求,以减轻他们增加的受伤风险,疾病,因为灾难而死亡。有足够的准备,这些社区成员似乎可以在灾难后幸存下来,而无需灾难救援人员的援助。
    这是非随机的,单组,在美国城市社区环境中与护士干预人员进行一对一的可行性研究(N=31)。我们使用家庭应急准备工具来衡量干预效果,并使用参与者体验调查来评估参与者对干预的满意度。干预包括一本教育手册,向参与者提供如何制定与灾难有关的疏散和沟通计划以及确定社区资源的指导。小册子完成后,参与者获得了免费的灾难补给包。
    平均一般准备分数从干预前的5.5(SD=4.1)增加到干预后的20.2(SD=3.1)(p<.001)。所有分表的准备情况也显著增加(所有ps<.001)。
    研究结果为干预措施的可行性提供了支持,以增加应急准备的所有测量方面(知识,行为,和用品)在灾难期间有出入和功能需求的老年人和身体虚弱的成年人中。
    UNASSIGNED: This research evaluated the effect of a nurse-facilitated intervention on elderly or medically frail community members\' level of household emergency preparedness as measured in knowledge, actions taken, and supplies gathered. These community members had access and functional needs that must be accommodated during disasters to mitigate their increased risk of injury, illness, and death because of the disaster. With adequate preparedness, it is plausible these community members may survive the aftermath of a disaster without needing assistance from disaster responders.
    UNASSIGNED: This was a non-randomized, single group, before-after feasibility study (N = 31) conducted in a one-on-one session with a nurse interventionist in an urban community setting in the United States of America. We used the Household Emergency Preparedness Instrument to measure intervention effectiveness and a Participant Experience Survey to evaluate participant satisfaction with the intervention. The intervention included an educational booklet that provided instruction to participants on how to create a disaster-related evacuation and communication plan and identify community resources. Upon completion of the booklet, participants received a complimentary disaster supply kit.
    UNASSIGNED: Mean general preparedness scores increased from 5.5 (SD = 4.1) pre-intervention to 20.2 (SD = 3.1) post-intervention (p < .001). Preparedness in all sub-scales also increased significantly (all ps < .001).
    UNASSIGNED: Study findings provide support for the feasibility of the intervention to increase all measured aspects of emergency preparedness (knowledge, behaviors, and supplies) among elderly and medically frail adults with access and functional needs during disasters.
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  • 文章类型: Journal Article
    对呼吸保护的有效性缺乏信心可能会导致工人的不确定性,并对工作场所的安全性产生怀疑。迄今为止,没有进行任何研究来研究和了解弹性体半面罩呼吸器(EHMR)的引入-没有呼气阀(EV)或有呼气阀过滤器(EVF),两者都代表了解决工作场所源代码控制的新设计。为了研究这个问题,在COVID-19大流行期间,研究人员与32个医疗服务机构的合作伙伴合作,这些机构从战略国家储备中获得了EHMR。EHMR用户(n=882)在2021年10月至2022年9月之间完成了一项在线调查。分析表明,如果员工接受了健康测试并接受了培训,他们对没有EV/有EVF的EHMR的功效(包括保护用户免受COVID-19伤害的功效)在统计学上更有信心。如果受访者对其组织的安全气候有更积极的看法,他们对EHMR的功效也有统计学上的更自信。随着制造商不断改进呼吸器模型以提高工人的舒适度和使用,结果为定制的配合测试和培训程序提供了见解。结果还表明,即使在突发公共卫生事件中,安全氛围作为支持工人知识的组织因素的作用不容忽视,态度,以及参与呼吸器使用特有的健康和安全行为。
    A lack of confidence in the efficacy of respiratory protection can contribute to uncertainty among workers and cast doubt on workplace safety. To date, no research has been conducted to study and understand the introduction of elastomeric half-mask respirators (EHMRs)-without exhalation valves (EVs) or with exhalation valve filters (EVFs), both representing new designs that address source control-in the workplace. To study this issue, researchers collaborated with partners at 32 health delivery settings that received EHMRs from the Strategic National Stockpile during the COVID-19 pandemic. EHMR users (n = 882) completed an online survey between October 2021 and September 2022. Analyses demonstrated that employees were statistically significantly more confident in the efficacy of EHMRs with no EV/with an EVF (including the efficacy in protecting the user from COVID-19) if they had been fit tested and received training. Respondents were also statistically significantly more confident in the efficacy of their EHMR if they had a more positive perception of their organization\'s safety climate. The results provide insights for tailored fit testing and training procedures as manufacturers continue to improve respirator models to enhance worker comfort and use. Results also show that, even during a public health emergency, the role of safety climate cannot be ignored as an organizational factor to support worker knowledge, attitudes, and participation in health and safety behaviors specific to respirator use.
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