Peter Aitken - Academia.edu (original) (raw)

Papers by Peter Aitken

Journal of Military and Veterans' Health, 2009

Discusses the importance of providing postgraduate education for health professionals working in ... more Discusses the importance of providing postgraduate education for health professionals working in the Australian defense forces. The need for a collaborative approach between military and civilian health providers is also highlighted.

Disasters have always occu[r]ed and no civilization in history is immune from their effects. This... more Disasters have always occu[r]ed and no civilization in history is immune from their effects. This thesis examines the major elements of health system preparedness for disaster response in Australia and the issues that impact on this. The thesis aim is to identify factors that can be targeted to improve preparedness for response. A conceptual model is presented as the framework for the thesis, which incorporates the major variables involved. These are the type of disaster, which influences the nature of response; the scale of the disaster, which influences the size of the response; and the components of surge management – space, supplies, staff and system, which enable the response. The thesis is presented in three parts, consistent with the conceptual model. The literature review (Chapter 2) outlines existing work and the current state of knowledge. Separate chapters (Chapter 3-5) for local, national and international response are mapped against examples of the main disaster types (...

Trauma Care Pre-Hospital Manual, 2018

[Extract] Retrieval and transport is an essential element of quality patient care. To be most eff... more [Extract] Retrieval and transport is an essential element of quality patient care. To be most effective there should be seamless transition between care in the prehospital, transport and hospital environments. The usual operating paradigm in patient transport has been to 'bring the patient to care' and enable access to higher levels of care or definitive management. The concept of 'bringing care to the patient' is increasingly important. Highly trained retrieval teams can optimize patient outcomes by earlier introduction of critical care management. This mandates the deployment of appropriately trained staff with essential equipment, and liaison between referring, transporting and receiving staff. Clinical management during transport must aim to at least equal care at the referral point and also prepare the patient for admission to the receiving service. The risk of transport should not exceed any potential benefit the patient may obtain from the receiving centre.

Prehospital and Disaster Medicine

Introduction: General Practitioners (GPs) are inevitably involved when disaster strikes their com... more Introduction: General Practitioners (GPs) are inevitably involved when disaster strikes their communities. Evidence of health care needs in disasters increasingly suggests benefits from greater involvement of GPs, and recent research has clarified key roles. Despite this, GPs continue to be disconnected from disaster health management (DHM) in most countries. Study Objective: The aim of this study was to explore the perspectives of disaster management professionals in two countries, across a range of all-hazard disasters, regarding the roles and contributions of GPs to DHM, and to identify barriers to, and benefits of, more active engagement of GPs in disaster health care systems. Methods: A qualitative research methodology using semi-structured interviews was conducted with a purposive sample of Disaster Managers (DMs) to explore their perspectives arising from experiences and observations of GPs during disasters from 2009 through 2016 in Australia or New Zealand. These involved al...

Improvements in life expectancy and changes in lifestyle have contributed to a "disease tran... more Improvements in life expectancy and changes in lifestyle have contributed to a "disease transition" from communicable to noncommunicable diseases (NCDs). Damage to public health infrastructure (PHI), such as sanitation and water, places people with NCDs at risk of disease exacerbation or even death. We propose the interdisciplinary characteristics of environmental health (EH) and the indirect, but vital, role in maximizing treatment and care for people with NCDs demonstrates the profession is an essential resource for addressing this problem. To explore this proposal, five focus groups were conducted with 55 EH professionals in Queensland, Australia. Relationships were identified between NCD exacerbation and PHI, such as power, sanitation, services, supplies, and water. Preparedness and response activities should focus on this priority PHI, which will require EH professionals to be part of interdisciplinary solutions. Recognizing this role will help protect the health of p...

Prehospital and Disaster Medicine

Background:The aim of this review was to explore hospital socio-natural disaster resilience by id... more Background:The aim of this review was to explore hospital socio-natural disaster resilience by identifying: studies assessing structural and non-structural aspects of building resilience; components required to maintain a safe and functional health facility; and if the checklists used were comprehensive and easily performed.Methods:A review systemic approach using PRISMA was taken to search the literature. The search focused on articles that discuss hospital disaster resilience. This includes assessments and checklists for facility structural and non-structural components.Results:This review identified 22 articles describing hospital assessments using checklists containing structural and non-structural elements of resilience. These studies identified assessments undertaken in ten countries, with eight occurring across Iran. A total of seven differing checklists were identified as containing aspects of structural or non-structural aspects of building resilience. The World Health Orga...

Prehospital and Disaster Medicine

Introduction:When disasters happen, people experience broad environmental, physical, and psychoso... more Introduction:When disasters happen, people experience broad environmental, physical, and psychosocial effects that can last for years. Researchers continue to focus on the acute physical injuries and aspects of patient care without considering the person as a whole. People who experience disasters also experience acute injury, exacerbations of chronic disease, mental and physical health effects, effects on social determinants of health, disruption to usual preventative care, and local community ripple effects. Researchers tend to look at these aspects of care separately, yet an individual can experience them all at once. The focus needs to change to address all the healthcare needs of an individual, rather than the likely needs of groups. Mental and physical care should not be separated, nor the determinants of health. The person, not the population, should be at the center of care. Primary care, poorly integrated into disaster management, can provide that focus with a…

Emergency Medicine Australasia

To estimate the proportion of ED patients in urban Queensland who are potentially suitable for ge... more To estimate the proportion of ED patients in urban Queensland who are potentially suitable for general practitioner (GP) care.

Prehospital and Disaster Medicine

Introduction:First aid, particularly bystander cardiopulmonary resuscitation (CPR), is an importa... more Introduction:First aid, particularly bystander cardiopulmonary resuscitation (CPR), is an important element in the chain of survival. However, little is known about what influences populations to undertake first aid/CPR training, update their training, and use of the training.Objectives:The aim of this study was to explore the characteristics of people who have first aid/CPR training, those who have updated their training, and use of these skills.Methods:As part of the 2011 state-wide, computer-assisted telephone interviewing (CATI) survey of people over 18 years of age living in Queensland, Australia, stratified by gender and age group, three questions about first aid training, re-training, and skill uses were explored.Results:Of the 1,277 respondents, 73.2% reported having undertaken some first aid/CPR training and 39.5% of those respondents had used their first aid/CPR skills. The majority of respondents (56.7%) had not updated their first aid/CPR skills in the past three years, ...

Australasian Journal of Paramedicine

This review discusses the development of trauma care and the retrieval process in Australia, part... more This review discusses the development of trauma care and the retrieval process in Australia, particularly as it impacts on the rural population. In rural and remote settings, trauma is a major cause of death and disability with the death rate from injuries increasing with progressing remoteness. Time is a critical factor in trauma care and the length of time it takes to reach definitive care has a significant impact on patient outcome. In rural areas people have difficulties accessing medical services within a reasonable time period and the delays associated with the provision of trauma care contribute to an unacceptable level of mortality and morbidity. Since it is impractical to provide sophisticated medical services capable of managing severe trauma in rural areas, referral and retrieval form a vital part of the process of rural trauma care. The focus of this review is the management of severe trauma in rural areas. It will discuss the utilisation of clinical guidelines to improv...

Diving and Hyperbaric Medicine Journal

Introduction: Vibration from a helicopter during aeromedical retrieval of divers may increase ven... more Introduction: Vibration from a helicopter during aeromedical retrieval of divers may increase venous gas emboli (VGE) production, evolution or distribution, potentially worsening the patient's condition. Aim: To review the literature surrounding the helicopter transport of injured divers and establish if vibration contributes to increased VGE. Method: A systematic literature search of key databases was conducted to identify articles investigating vibration and bubbles during helicopter retrieval of divers. Level of evidence was graded using the Oxford Centre for Evidence-Based Medicine guidelines. A modified quality assessment tool for studies with diverse designs (QATSDD) was used to assess the overall quality of evidence. Results: Seven studies were included in the review. An in vitro research paper provided some evidence of bubble formation with gas supersaturation and vibration. Only one prospective intervention study was identified which examined the effect of vibration on VGE formation. Bubble duration was used to quantify VGE load with no difference found between the vibration and non-vibration time periods. This study was published in 1980 and technological advances since that time suggest cautious interpretation of the results. The remaining studies were retrospective chart reviews of helicopter retrieval of divers. Mode of transport, altitude exposure, oxygen and intravenous fluids use were examined. Conclusion: There is some physical evidence that vibration leads to bubble formation although there is a paucity of research on the specific effects of helicopter vibration and VGE in divers. Technological advances have led to improved assessment of VGE in divers and will aid in further research.

PLoS Currents

Introduction: Globally, flooding is the most common of all natural disasters and drowning is the ... more Introduction: Globally, flooding is the most common of all natural disasters and drowning is the leading cause of death during floods. In Australia, rivers are the most common location of drowning and experience flooding on a regular basis. Methods: A cross-sectional, total population audit of all known unintentional river flood related fatal drownings in Australia between 1-July-2002 and 30-June-2012 was conducted to identify trends and causal factors. Results: There were 129 (16.8%) deaths involving river flooding, representing a crude drowning rate of 0.06 per 100,000 people per annum. Half (55.8%) were due to slow onset flooding, 27.1% flash flooding and the type of flooding was unknown in 17.1% of cases. Those at an increased risk were males, children, driving (non-aquatic transport) and victims who were swept away (p<0.01). When compared to drownings in major cities, people in remote and very remote locations were 79.6 and 229.1 times respectively more likely to drown in river floods. Common causal factors for falls into flooded rivers included being alone and a blood alcohol content ≥0.05% (for adults). Non-aquatic transport incident victims were commonly the drivers of four wheel drive vehicles and Tweet

Prehospital and Disaster Medicine

s-14th World Congress on Disaster and Emergency Medicine s97 data collection, focusing on syndrom... more s-14th World Congress on Disaster and Emergency Medicine s97 data collection, focusing on syndromes that may represent infections with bioterrorist agents. Conclusion: An emergency department-based, enhanced, bioterrorism, syndrome-surveillance system can be maintained effectively for a short-term period. Additional data sources and accumulation of long-term baseline data are necessary for further system development. The guidelines for early aberration reporting and evaluation of syndrome surveillance systems also requires more research.

PLoS currents, Jan 21, 2016

The exposure of people and infrastructure to flood and storm related disasters across the world i... more The exposure of people and infrastructure to flood and storm related disasters across the world is increasing faster than vulnerability is decreasing. For people with non-communicable diseases this presents a significant risk as traditionally the focus of disaster management systems has been on immediate trauma and communicable diseases. This focus must now be expanded to include the management of non-communicable diseases because these conditions are generating the bulk of ill health, disability and premature death around the globe. When public health service infrastructure is destroyed or damaged access to treatment and care is severely jeopardised, resulting in an increased risk of non-communicable disease exacerbation or even death. This research proposes disaster responders, coordinators and government officials are vital assets to mitigate and eventually prevent these problems from being exacerbated during a disaster. This is due to their role in supporting the public health s...

Scandinavian journal of trauma, resuscitation and emergency medicine, Jan 18, 2016

Patients attending hospital emergency departments (ED) commonly cite the urgency and severity of ... more Patients attending hospital emergency departments (ED) commonly cite the urgency and severity of their condition as the main reason for choosing the ED. However, the patients' perception of urgency and severity may be different to the nurses' perception of their urgency and severity, which is underpinned by their professional experience, knowledge, training and skills. This discordance may be a cause of patient dissatisfaction. The purpose of this study is to understand the extent of agreement/disagreement between the patient's perceived priority and actual triage category and associated factors. A cross-sectional survey of 417 patients attending eight public hospital EDs in Queensland, Australia between March and May 2011 was conducted. The survey included patient's perceived priority and other health-related, socio-demographic and perceptual factors. Patients' triage category data were retrieved from their ED records and linked back to their survey data. Descri...

Prehospital and Disaster Medicine, 2002

Introduction: Emergency departments (ED) often are the first part of the health system to be affe... more Introduction: Emergency departments (ED) often are the first part of the health system to be affected in a disaster. How prepared are they? Methods: This review was a prospective, postal survey distributed to the directors of all adult and mixed (adult and paediatric) Australian Emergency Departments. Those not accredited by the Australasian College for Emergency Medicine (ACEM) were excluded. Surveys were sent to 78 departments. Overall responses were reviewed, as were groupings by state, role delineation, annual attendances, hospital bed numbers, and access block. Actual disaster plan activation also was reviewed. The survey assessed all aspects of disaster preparedness from risk assessment and planning, to staffing, training, education, equipment, and funding. The impact of recent world events on preparedness was reviewed while departments also were asked to assess their own ability to manage disasters using a Likertlike scale. Results: The response rate was 78%. There was no significant difference in response rates between various states or various ACEM role delineations. There was a large variation in levels of disaster preparedness between departments. The majority had a reasonable level of planning, but provided limited education, training, or exercises. Those most prepared were those departments from New South Wales or Victoria with a Major Referral role. The Sydney Olympics had a significant effect on preparedness, but there was little correlation with previous disaster plan activation.

Prehospital and Disaster Medicine, 2002

During the fall of 2000, the United States Centers for Disease Control and Prevention funded the ... more During the fall of 2000, the United States Centers for Disease Control and Prevention funded the initiation of Academic Centers for Public Health Preparedness (the Centers) through a cooperative agreement with the Association of Schools of Public Health. The purpose of the Centers is to link public health practice with academe in order to develop the public health workforce and support the development of a public health emergency / disaster preparedness and response infrastructure in the United States for biological, chemical, mass casualty, nuclear and radiological events. The Centers accomplish this through activities that focus on assisting local and state health departments with developing and implementing emergency preparedness plans, competency-based training curricula, and conducting relevant preparedness research. In addition, narrowing the gaps between the hospital and prehospital sectors and public health are a concern that the Centers are helping to address. This presentation will describe this national network of Centers in detail, and illustrate how the partnering of the academic and practice sectors of public health can serve to build and strengthen the emergency response infrastructure of a nation. Activities by the Columbia University Center at the Mailman School of Public Health in response to the events of 11 September and the anthrax events of autumn 2001 will be discussed. Lessons learned and challenges to achieving efficient, productive partnering also will be discussed.

Prehospital and Disaster Medicine, 2002

Disaster medicine and public health preparedness, Aug 1, 2016

The study aim was to undertake a qualitative research literature review to analyze available data... more The study aim was to undertake a qualitative research literature review to analyze available databases to define, describe, and categorize public health infrastructure (PHI) priorities for tropical cyclone, flood, storm, tornado, and tsunami-related disasters. Five electronic publication databases were searched to define, describe, or categorize PHI and discuss tropical cyclone, flood, storm, tornado, and tsunami-related disasters and their impact on PHI. The data were analyzed through aggregation of individual articles to create an overall data description. The data were grouped into PHI themes, which were then prioritized on the basis of degree of interdependency. Sixty-seven relevant articles were identified. PHI was categorized into 13 themes with a total of 158 descriptors. The highest priority PHI identified was workforce. This was followed by water, sanitation, equipment, communication, physical structure, power, governance, prevention, supplies, service, transport, and surve...

Journal of Military and Veterans' Health, 2009

Discusses the importance of providing postgraduate education for health professionals working in ... more Discusses the importance of providing postgraduate education for health professionals working in the Australian defense forces. The need for a collaborative approach between military and civilian health providers is also highlighted.

Disasters have always occu[r]ed and no civilization in history is immune from their effects. This... more Disasters have always occu[r]ed and no civilization in history is immune from their effects. This thesis examines the major elements of health system preparedness for disaster response in Australia and the issues that impact on this. The thesis aim is to identify factors that can be targeted to improve preparedness for response. A conceptual model is presented as the framework for the thesis, which incorporates the major variables involved. These are the type of disaster, which influences the nature of response; the scale of the disaster, which influences the size of the response; and the components of surge management – space, supplies, staff and system, which enable the response. The thesis is presented in three parts, consistent with the conceptual model. The literature review (Chapter 2) outlines existing work and the current state of knowledge. Separate chapters (Chapter 3-5) for local, national and international response are mapped against examples of the main disaster types (...

Trauma Care Pre-Hospital Manual, 2018

[Extract] Retrieval and transport is an essential element of quality patient care. To be most eff... more [Extract] Retrieval and transport is an essential element of quality patient care. To be most effective there should be seamless transition between care in the prehospital, transport and hospital environments. The usual operating paradigm in patient transport has been to 'bring the patient to care' and enable access to higher levels of care or definitive management. The concept of 'bringing care to the patient' is increasingly important. Highly trained retrieval teams can optimize patient outcomes by earlier introduction of critical care management. This mandates the deployment of appropriately trained staff with essential equipment, and liaison between referring, transporting and receiving staff. Clinical management during transport must aim to at least equal care at the referral point and also prepare the patient for admission to the receiving service. The risk of transport should not exceed any potential benefit the patient may obtain from the receiving centre.

Prehospital and Disaster Medicine

Introduction: General Practitioners (GPs) are inevitably involved when disaster strikes their com... more Introduction: General Practitioners (GPs) are inevitably involved when disaster strikes their communities. Evidence of health care needs in disasters increasingly suggests benefits from greater involvement of GPs, and recent research has clarified key roles. Despite this, GPs continue to be disconnected from disaster health management (DHM) in most countries. Study Objective: The aim of this study was to explore the perspectives of disaster management professionals in two countries, across a range of all-hazard disasters, regarding the roles and contributions of GPs to DHM, and to identify barriers to, and benefits of, more active engagement of GPs in disaster health care systems. Methods: A qualitative research methodology using semi-structured interviews was conducted with a purposive sample of Disaster Managers (DMs) to explore their perspectives arising from experiences and observations of GPs during disasters from 2009 through 2016 in Australia or New Zealand. These involved al...

Improvements in life expectancy and changes in lifestyle have contributed to a "disease tran... more Improvements in life expectancy and changes in lifestyle have contributed to a "disease transition" from communicable to noncommunicable diseases (NCDs). Damage to public health infrastructure (PHI), such as sanitation and water, places people with NCDs at risk of disease exacerbation or even death. We propose the interdisciplinary characteristics of environmental health (EH) and the indirect, but vital, role in maximizing treatment and care for people with NCDs demonstrates the profession is an essential resource for addressing this problem. To explore this proposal, five focus groups were conducted with 55 EH professionals in Queensland, Australia. Relationships were identified between NCD exacerbation and PHI, such as power, sanitation, services, supplies, and water. Preparedness and response activities should focus on this priority PHI, which will require EH professionals to be part of interdisciplinary solutions. Recognizing this role will help protect the health of p...

Prehospital and Disaster Medicine

Background:The aim of this review was to explore hospital socio-natural disaster resilience by id... more Background:The aim of this review was to explore hospital socio-natural disaster resilience by identifying: studies assessing structural and non-structural aspects of building resilience; components required to maintain a safe and functional health facility; and if the checklists used were comprehensive and easily performed.Methods:A review systemic approach using PRISMA was taken to search the literature. The search focused on articles that discuss hospital disaster resilience. This includes assessments and checklists for facility structural and non-structural components.Results:This review identified 22 articles describing hospital assessments using checklists containing structural and non-structural elements of resilience. These studies identified assessments undertaken in ten countries, with eight occurring across Iran. A total of seven differing checklists were identified as containing aspects of structural or non-structural aspects of building resilience. The World Health Orga...

Prehospital and Disaster Medicine

Introduction:When disasters happen, people experience broad environmental, physical, and psychoso... more Introduction:When disasters happen, people experience broad environmental, physical, and psychosocial effects that can last for years. Researchers continue to focus on the acute physical injuries and aspects of patient care without considering the person as a whole. People who experience disasters also experience acute injury, exacerbations of chronic disease, mental and physical health effects, effects on social determinants of health, disruption to usual preventative care, and local community ripple effects. Researchers tend to look at these aspects of care separately, yet an individual can experience them all at once. The focus needs to change to address all the healthcare needs of an individual, rather than the likely needs of groups. Mental and physical care should not be separated, nor the determinants of health. The person, not the population, should be at the center of care. Primary care, poorly integrated into disaster management, can provide that focus with a…

Emergency Medicine Australasia

To estimate the proportion of ED patients in urban Queensland who are potentially suitable for ge... more To estimate the proportion of ED patients in urban Queensland who are potentially suitable for general practitioner (GP) care.

Prehospital and Disaster Medicine

Introduction:First aid, particularly bystander cardiopulmonary resuscitation (CPR), is an importa... more Introduction:First aid, particularly bystander cardiopulmonary resuscitation (CPR), is an important element in the chain of survival. However, little is known about what influences populations to undertake first aid/CPR training, update their training, and use of the training.Objectives:The aim of this study was to explore the characteristics of people who have first aid/CPR training, those who have updated their training, and use of these skills.Methods:As part of the 2011 state-wide, computer-assisted telephone interviewing (CATI) survey of people over 18 years of age living in Queensland, Australia, stratified by gender and age group, three questions about first aid training, re-training, and skill uses were explored.Results:Of the 1,277 respondents, 73.2% reported having undertaken some first aid/CPR training and 39.5% of those respondents had used their first aid/CPR skills. The majority of respondents (56.7%) had not updated their first aid/CPR skills in the past three years, ...

Australasian Journal of Paramedicine

This review discusses the development of trauma care and the retrieval process in Australia, part... more This review discusses the development of trauma care and the retrieval process in Australia, particularly as it impacts on the rural population. In rural and remote settings, trauma is a major cause of death and disability with the death rate from injuries increasing with progressing remoteness. Time is a critical factor in trauma care and the length of time it takes to reach definitive care has a significant impact on patient outcome. In rural areas people have difficulties accessing medical services within a reasonable time period and the delays associated with the provision of trauma care contribute to an unacceptable level of mortality and morbidity. Since it is impractical to provide sophisticated medical services capable of managing severe trauma in rural areas, referral and retrieval form a vital part of the process of rural trauma care. The focus of this review is the management of severe trauma in rural areas. It will discuss the utilisation of clinical guidelines to improv...

Diving and Hyperbaric Medicine Journal

Introduction: Vibration from a helicopter during aeromedical retrieval of divers may increase ven... more Introduction: Vibration from a helicopter during aeromedical retrieval of divers may increase venous gas emboli (VGE) production, evolution or distribution, potentially worsening the patient's condition. Aim: To review the literature surrounding the helicopter transport of injured divers and establish if vibration contributes to increased VGE. Method: A systematic literature search of key databases was conducted to identify articles investigating vibration and bubbles during helicopter retrieval of divers. Level of evidence was graded using the Oxford Centre for Evidence-Based Medicine guidelines. A modified quality assessment tool for studies with diverse designs (QATSDD) was used to assess the overall quality of evidence. Results: Seven studies were included in the review. An in vitro research paper provided some evidence of bubble formation with gas supersaturation and vibration. Only one prospective intervention study was identified which examined the effect of vibration on VGE formation. Bubble duration was used to quantify VGE load with no difference found between the vibration and non-vibration time periods. This study was published in 1980 and technological advances since that time suggest cautious interpretation of the results. The remaining studies were retrospective chart reviews of helicopter retrieval of divers. Mode of transport, altitude exposure, oxygen and intravenous fluids use were examined. Conclusion: There is some physical evidence that vibration leads to bubble formation although there is a paucity of research on the specific effects of helicopter vibration and VGE in divers. Technological advances have led to improved assessment of VGE in divers and will aid in further research.

PLoS Currents

Introduction: Globally, flooding is the most common of all natural disasters and drowning is the ... more Introduction: Globally, flooding is the most common of all natural disasters and drowning is the leading cause of death during floods. In Australia, rivers are the most common location of drowning and experience flooding on a regular basis. Methods: A cross-sectional, total population audit of all known unintentional river flood related fatal drownings in Australia between 1-July-2002 and 30-June-2012 was conducted to identify trends and causal factors. Results: There were 129 (16.8%) deaths involving river flooding, representing a crude drowning rate of 0.06 per 100,000 people per annum. Half (55.8%) were due to slow onset flooding, 27.1% flash flooding and the type of flooding was unknown in 17.1% of cases. Those at an increased risk were males, children, driving (non-aquatic transport) and victims who were swept away (p<0.01). When compared to drownings in major cities, people in remote and very remote locations were 79.6 and 229.1 times respectively more likely to drown in river floods. Common causal factors for falls into flooded rivers included being alone and a blood alcohol content ≥0.05% (for adults). Non-aquatic transport incident victims were commonly the drivers of four wheel drive vehicles and Tweet

Prehospital and Disaster Medicine

s-14th World Congress on Disaster and Emergency Medicine s97 data collection, focusing on syndrom... more s-14th World Congress on Disaster and Emergency Medicine s97 data collection, focusing on syndromes that may represent infections with bioterrorist agents. Conclusion: An emergency department-based, enhanced, bioterrorism, syndrome-surveillance system can be maintained effectively for a short-term period. Additional data sources and accumulation of long-term baseline data are necessary for further system development. The guidelines for early aberration reporting and evaluation of syndrome surveillance systems also requires more research.

PLoS currents, Jan 21, 2016

The exposure of people and infrastructure to flood and storm related disasters across the world i... more The exposure of people and infrastructure to flood and storm related disasters across the world is increasing faster than vulnerability is decreasing. For people with non-communicable diseases this presents a significant risk as traditionally the focus of disaster management systems has been on immediate trauma and communicable diseases. This focus must now be expanded to include the management of non-communicable diseases because these conditions are generating the bulk of ill health, disability and premature death around the globe. When public health service infrastructure is destroyed or damaged access to treatment and care is severely jeopardised, resulting in an increased risk of non-communicable disease exacerbation or even death. This research proposes disaster responders, coordinators and government officials are vital assets to mitigate and eventually prevent these problems from being exacerbated during a disaster. This is due to their role in supporting the public health s...

Scandinavian journal of trauma, resuscitation and emergency medicine, Jan 18, 2016

Patients attending hospital emergency departments (ED) commonly cite the urgency and severity of ... more Patients attending hospital emergency departments (ED) commonly cite the urgency and severity of their condition as the main reason for choosing the ED. However, the patients' perception of urgency and severity may be different to the nurses' perception of their urgency and severity, which is underpinned by their professional experience, knowledge, training and skills. This discordance may be a cause of patient dissatisfaction. The purpose of this study is to understand the extent of agreement/disagreement between the patient's perceived priority and actual triage category and associated factors. A cross-sectional survey of 417 patients attending eight public hospital EDs in Queensland, Australia between March and May 2011 was conducted. The survey included patient's perceived priority and other health-related, socio-demographic and perceptual factors. Patients' triage category data were retrieved from their ED records and linked back to their survey data. Descri...

Prehospital and Disaster Medicine, 2002

Introduction: Emergency departments (ED) often are the first part of the health system to be affe... more Introduction: Emergency departments (ED) often are the first part of the health system to be affected in a disaster. How prepared are they? Methods: This review was a prospective, postal survey distributed to the directors of all adult and mixed (adult and paediatric) Australian Emergency Departments. Those not accredited by the Australasian College for Emergency Medicine (ACEM) were excluded. Surveys were sent to 78 departments. Overall responses were reviewed, as were groupings by state, role delineation, annual attendances, hospital bed numbers, and access block. Actual disaster plan activation also was reviewed. The survey assessed all aspects of disaster preparedness from risk assessment and planning, to staffing, training, education, equipment, and funding. The impact of recent world events on preparedness was reviewed while departments also were asked to assess their own ability to manage disasters using a Likertlike scale. Results: The response rate was 78%. There was no significant difference in response rates between various states or various ACEM role delineations. There was a large variation in levels of disaster preparedness between departments. The majority had a reasonable level of planning, but provided limited education, training, or exercises. Those most prepared were those departments from New South Wales or Victoria with a Major Referral role. The Sydney Olympics had a significant effect on preparedness, but there was little correlation with previous disaster plan activation.

Prehospital and Disaster Medicine, 2002

During the fall of 2000, the United States Centers for Disease Control and Prevention funded the ... more During the fall of 2000, the United States Centers for Disease Control and Prevention funded the initiation of Academic Centers for Public Health Preparedness (the Centers) through a cooperative agreement with the Association of Schools of Public Health. The purpose of the Centers is to link public health practice with academe in order to develop the public health workforce and support the development of a public health emergency / disaster preparedness and response infrastructure in the United States for biological, chemical, mass casualty, nuclear and radiological events. The Centers accomplish this through activities that focus on assisting local and state health departments with developing and implementing emergency preparedness plans, competency-based training curricula, and conducting relevant preparedness research. In addition, narrowing the gaps between the hospital and prehospital sectors and public health are a concern that the Centers are helping to address. This presentation will describe this national network of Centers in detail, and illustrate how the partnering of the academic and practice sectors of public health can serve to build and strengthen the emergency response infrastructure of a nation. Activities by the Columbia University Center at the Mailman School of Public Health in response to the events of 11 September and the anthrax events of autumn 2001 will be discussed. Lessons learned and challenges to achieving efficient, productive partnering also will be discussed.

Prehospital and Disaster Medicine, 2002

Disaster medicine and public health preparedness, Aug 1, 2016

The study aim was to undertake a qualitative research literature review to analyze available data... more The study aim was to undertake a qualitative research literature review to analyze available databases to define, describe, and categorize public health infrastructure (PHI) priorities for tropical cyclone, flood, storm, tornado, and tsunami-related disasters. Five electronic publication databases were searched to define, describe, or categorize PHI and discuss tropical cyclone, flood, storm, tornado, and tsunami-related disasters and their impact on PHI. The data were analyzed through aggregation of individual articles to create an overall data description. The data were grouped into PHI themes, which were then prioritized on the basis of degree of interdependency. Sixty-seven relevant articles were identified. PHI was categorized into 13 themes with a total of 158 descriptors. The highest priority PHI identified was workforce. This was followed by water, sanitation, equipment, communication, physical structure, power, governance, prevention, supplies, service, transport, and surve...