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Sample records for center attack disaster

  1. The World Trade Center Attack: Lessons for disaster management

    PubMed Central

    Simon, Ronald; Teperman, Sheldon

    2001-01-01

    As the largest, and one of the most eclectic, urban center in the United States, New York City felt the need to develop an Office of Emergency Management to coordinate communications and direct resources in the event of a mass disaster. Practice drills were then carried out to assess and improve disaster preparedness. The day of 11 September 2001 began with the unimaginable. As events unfolded, previous plans based on drills were found not to address the unique issues faced and new plans rapidly evolved out of necessity. Heroic actions were commonplace. Much can be learned from the events of 11 September 2001. Natural and unnatural disasters will happen again, so it is critical that these lessons be learned. Proper preparation will undoubtedly save lives and resources. PMID:11737917

  2. The World Trade Center attack. Disaster preparedness: health care is ready, but is the bureaucracy?

    PubMed

    Mattox, K

    2001-12-01

    When a disaster occurs, it is for governments to provide the leadership, civil defense, security, evacuation, and public welfare. The medical aspects of a disaster account for less than 10% of resource and personnel expenditure. Hospitals and health care provider teams respond to unexpected occurrences such as explosions, earthquakes, floods, fires, war, or the outbreak of an infectious epidemic. In some geographic locations where natural disasters are common, such as earthquakes in Japan, such disaster practice drills are common. In other locations, disaster drills become pro forma and have no similarity to real or even projected and predicted disasters. The World Trade Center disaster on 11 September 2001 provides new information, and points out new threats, new information systems, new communication opportunities, and new detection methodologies. It is time for leaders of medicine to re-examine their approaches to disaster preparedness.

  3. The World Trade Center Attack Disaster preparedness: health care is ready, but is the bureaucracy?

    PubMed Central

    Mattox, Kenneth

    2001-01-01

    When a disaster occurs, it is for governments to provide the leadership, civil defense, security, evacuation, and public welfare. The medical aspects of a disaster account for less than 10% of resource and personnel expenditure. Hospitals and health care provider teams respond to unexpected occurrences such as explosions, earthquakes, floods, fires, war, or the outbreak of an infectious epidemic. In some geographic locations where natural disasters are common, such as earthquakes in Japan, such disaster practice drills are common. In other locations, disaster drills become pro forma and have no similarity to real or even projected and predicted disasters. The World Trade Center disaster on 11 September 2001 provides new information, and points out new threats, new information systems, new communication opportunities, and new detection methodologies. It is time for leaders of medicine to re-examine their approaches to disaster preparedness. PMID:11737919

  4. Stress and Well-Being in the Aftermath of the World Trade Center Attack: The Continuing Effects of a Communitywide Disaster

    ERIC Educational Resources Information Center

    Adams, Richard E.; Boscarino, Joseph A.

    2005-01-01

    In this study, we examine the relationship between exposure to the World Trade Center disaster (WTCD) and the well-being of adults living in New York City (NYC) at the time of the attacks by using a stress process model. One year after the attacks, we conducted a telephone survey of a cross-sectional random sample of city residents with an…

  5. Epidemiology of respiratory health outcomes among World Trade Center disaster workers: review of the literature 10 years after the September 11, 2001 terrorist attacks.

    PubMed

    Ekenga, Christine C; Friedman-Jiménez, George

    2011-09-01

    Tens of thousands of workers participated in rescue, recovery, and cleanup activities at the World Trade Center (WTC) site in lower Manhattan after the terrorist attacks on September 11, 2001 (9/11). The collapse of the WTC resulted in the release of a variety of airborne toxicants. To date, respiratory symptoms and diseases have been among the most examined health outcomes in studies of WTC disaster workers. A systematic review of the literature on respiratory health outcomes was undertaken to describe the available information on new onset of respiratory symptoms and diseases among WTC disaster workers after September 11, 2001. Independent risk factors for respiratory health outcomes included being caught in the dust and debris cloud, early arrival at the WTC site, longer duration of work, and delaying mask and respirator use. Methodological challenges in epidemiologic studies of WTC disaster workers involved study design, exposure misclassification, and limited information on potential confounders and effect modifiers. In the 10 years after 9/11, epidemiologic studies of WTC disaster workers have been essential in investigating the respiratory health consequences of WTC exposure. Longitudinal studies along with continued medical surveillance will be vital in understanding the long-term respiratory burden associated with occupational WTC exposure.

  6. The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th.

    PubMed

    Cukor, Judith; Wyka, Katarzyna; Mello, Brittany; Olden, Megan; Jayasinghe, Nimali; Roberts, Jennifer; Giosan, Cezar; Crane, Michael; Difede, Joann

    2011-10-01

    This study examined the long-term mental health outcomes of 2,960 nonrescue disaster workers deployed to the World Trade Center site in New York City following the September 11, 2001 (9/11) terrorist attacks. Semistructured interviews and standardized self-report measures were used to assess the prevalence of posttraumatic stress disorder (PTSD) and other psychopathology 4 and 6 years after the attacks. Clinician-measured rates of PTSD and partial PTSD 4-years posttrauma were 8.4% and 8.9%, respectively, in a subsample of 727 individuals. Rates decreased to 5.8% and 7.7% for full and partial PTSD 6 years posttrauma. For the larger sample, self-report scores revealed probable PTSD and partial PTSD prevalence to be 4.8% and 3.6% at 4 years, and 2.4% and 1.8% at 6 years. Approximately 70% of workers never met criteria for PTSD. Although PTSD rates decreased significantly over time, many workers remained symptomatic, with others showing delayed-onset PTSD. The strongest predictors of ongoing PTSD 6 years following 9/11 were trauma history (odds ratio (OR) = 2.27, 95% confidence interval (CI) [1.06, 4.85]); the presence of major depressive disorder 1-2 years following the trauma (OR = 2.80, 95% CI [1.17, 6.71]); and extent of occupational exposure (OR = 1.31, 95% CI [1.13, 1.51]). The implications of the findings for both screening and treatment of disaster workers are discussed.

  7. HEALTH AND ENVIRONMENTAL CONSEQUENCES OF THE WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyse...

  8. HEALTH AND ENVIRONMENTAL CONSEQUENCES OF THE WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyse...

  9. Conduct of Occupational Health During Major Disasters: A Comparison of Literature on Occupational Health Issues in the World Trade Center Terrorist Attack and the Fukushima Nuclear Power Plant Accident.

    PubMed

    Toyoda, Hiroyuki; Mori, Koji

    Workers who respond to large-scale disasters can be exposed to health hazards that do not exist in routine work. It is assumed that learning from past cases is effective for preparing for and responding to such problems, but published information is still insufficient. Accordingly, we conducted a literature review about the health issues and occupational health activities at the World Trade Center (WTC) terrorist attack and at the Fukushima Nuclear Power Plant accident to investigate how occupational health activities during disasters should be conducted. Seven studies about the WTC attack were extracted and categorized into the following topics: "in relation to emergency systems including occupational health management"; "in relation to improvement and prevention of health effects and occupational hygiene"; and "in relation to care systems aimed at mitigating health effects." Studies about the Fukushima Nuclear Power Plant accident have been used in a previous review. We conclude that, to prevent health effects in workers who respond to large-scale disasters, it is necessary to incorporate occupational health regulations into the national response plan, and to develop practical support functions that enable support to continue for an extended period, training systems for workers with opportunities to report accidents, and care systems to mitigate the health effects.

  10. Psychosocial response to disaster: the attacks on the Stark and the Cole.

    PubMed

    Kootte, Anton F

    2002-01-01

    The terrorist attack on the USS Cole on 12 October 2000 was remarkably similar to the 1987 attack on the USS Stark. This article discusses the psychosocial consequences of the attacks on the families and crews of the ships and the community response of the Navy to the attacks, particularly that of the Navy Family Service Centers. The impact of the attacks is compared to the impact of natural and man-made disasters on communities while the impact on the crew is examined in light of combat psychiatry and post-traumatic stress disorder (PTSD). Events such as these are very likely to produce PTSD despite early intervention efforts. Following the attack on the Stark greater attention was given to the grief of family members than to the trauma of the crew, while the crew of the Cole has received longer-term psychiatric assistance than in previous similar episodes.

  11. The Tokyo subway sarin attack: disaster management, Part 1: Community emergency response.

    PubMed

    Okumura, T; Suzuki, K; Fukuda, A; Kohama, A; Takasu, N; Ishimatsu, S; Hinohara, S

    1998-06-01

    The Tokyo subway sarin attack was the second documented incident of nerve gas poisoning in Japan. Prior to the Tokyo subway sarin attack, there had never been such a large-scale disaster caused by nerve gas in peacetime history. This article provides details related to how the community emergency medical services (EMS) system responded from the viewpoint of disaster management, the problems encountered, and how they were addressed. The authors' assessment was that if EMTs, under Japanese law, had been allowed to maintain an airway with an endotracheal tube or use a laryngeal mask airway without physician oversight, more patients might have been saved during this chemical exposure disaster. Given current legal restrictions, advanced airway control at the scene will require that doctors become more actively involved in out-of-hospital treatment. Other recommendations are: 1) that integration and cooperation of concerned organizations be established through disaster drills; 2) that poison information centers act as regional mediators of all toxicologic information; 3) that a real-time, multidirectional communication system be established; 4) that multiple channels of communication be available for disaster care; 5) that public organizations have access to mobile decontamination facilities; and 6) that respiratory protection and chemical-resistant suits with gloves and boots be available for out-of-hospital providers during chemical disasters.

  12. Mental health issues in disasters and terrorist attacks.

    PubMed

    Schlenger, William E; Jernigan, Nancy E

    2003-01-01

    Recent events make clear that those living in the United States are at risk of exposure to a variety of potentially traumatic events, ranging from sniper and terrorist attacks to a variety of natural disasters. This paper provides a broad overview of the most common psychological reactions that can be expected in the aftermath of such events, how primary care practitioners can identify such reactions in their patients, and actions those practitioners might take.

  13. Center for Integration of Natural Disaster Information

    USGS Publications Warehouse

    ,

    2001-01-01

    The U.S. Geological Survey's Center for Integration of Natural Disaster Information (CINDI) is a research and operational facility that explores methods for collecting, integrating, and communicating information about the risks posed by natural hazards and the effects of natural disasters. The U.S. Geological Survey (USGS) is mandated by the Robert Stafford Act to warn citizens of impending landslides, volcanic eruptions, and earthquakes. The USGS also coordinates with other Federal, State, and local disaster agencies to monitor threats to communities from floods, coastal storms, wildfires, geomagnetic storms, drought, and outbreaks of disease in wildlife populations.

  14. In Time of Emergency. A Citizen's Handbook on Nuclear Attack and Natural Disasters.

    ERIC Educational Resources Information Center

    Office of Civil Defense (DOD), Washington, DC.

    A major emergency affecting a large number of people may occur anytime and any place. Natural disasters such as a flood, tornado, fire, hurricane, blizzard or earthquake, or an enemy nuclear attack on the United States may all constitute a major emergency. In any type of general disaster, lives can be saved if people are prepared for the emergency…

  15. Health and environmental consequences of the world trade center disaster.

    PubMed

    Landrigan, Philip J; Lioy, Paul J; Thurston, George; Berkowitz, Gertrud; Chen, L C; Chillrud, Steven N; Gavett, Stephen H; Georgopoulos, Panos G; Geyh, Alison S; Levin, Stephen; Perera, Frederica; Rappaport, Stephen M; Small, Christopher

    2004-05-01

    The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and

  16. Health and environmental consequences of the world trade center disaster.

    PubMed Central

    Landrigan, Philip J; Lioy, Paul J; Thurston, George; Berkowitz, Gertrud; Chen, L C; Chillrud, Steven N; Gavett, Stephen H; Georgopoulos, Panos G; Geyh, Alison S; Levin, Stephen; Perera, Frederica; Rappaport, Stephen M; Small, Christopher

    2004-01-01

    The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and

  17. The World Trade Center attack. Is critical care prepared for terrorism?

    PubMed

    Kvetan, V

    2001-12-01

    This commentary on the World Trade Center attack is written from the perspective of a New York City critical care service, with a long history of activity in disaster management, which is located at the Montefiore Medical Center/Albert Einstein College of Medicine. The paper describes some of the local concerns of the service in the first hours, the reality of dispersal of victims throughout the New York City hospital system, and some of the resources made available and their utilization. In general, the US Critical Care Medicine System receives massive resources in terms of gross national product expenditure when compared with other developed countries. A large capacity is subsequently in place to provide care to critically ill patients resulting from manmade as well as natural disasters. It was the nature of the World Trade Center attack in terms of the ratio of injured survivors to dead victims that did not allow the full capacity and capability of the system to engage.

  18. The World Trade Center Attack: Helping the helpers: the role of critical incident stress management

    PubMed Central

    Hammond, Jeffrey; Brooks, Jill

    2001-01-01

    Healthcare and prehospital workers involved in disaster response are susceptible to a variety of stress-related psychological and physical sequelae. Critical incident stress management, of which critical incident stress debriefing is a component, can mitigate the response to these stressors. Critical incident stress debriefing is a peer-driven, therapist-guided, structured, group intervention designed to accelerate the recovery of personnel. The attack on the World Trade Center, and the impact it may have on rescue, prehospital, and healthcare workers, should urge us to incorporate critical incident stress management into disaster management plans. PMID:11737916

  19. The World Trade Center attack. Helping the helpers: the role of critical incident stress management.

    PubMed

    Hammond, J; Brooks, J

    2001-12-01

    Healthcare and prehospital workers involved in disaster response are susceptible to a variety of stress-related psychological and physical sequelae. Critical incident stress management, of which critical incident stress debriefing is a component, can mitigate the response to these stressors. Critical incident stress debriefing is a peer-driven, therapist-guided, structured, group intervention designed to accelerate the recovery of personnel. The attack on the World Trade Center, and the impact it may have on rescue, prehospital, and healthcare workers, should urge us to incorporate critical incident stress management into disaster management plans.

  20. Disaster planning: the basics of creating a burn mass casualty disaster plan for a burn center.

    PubMed

    Kearns, Randy D; Conlon, Kathe M; Valenta, Andrea L; Lord, Graydon C; Cairns, Charles B; Holmes, James H; Johnson, Daryhl D; Matherly, Annette F; Sawyer, Dalton; Skarote, Mary Beth; Siler, Sean M; Helminiak, Radm Clare; Cairns, Bruce A

    2014-01-01

    In 2005, the American Burn Association published burn disaster guidelines. This work recognized that local and state assets are the most important resources in the initial 24- to 48-hour management of a burn disaster. Historical experiences suggest there is ample opportunity to improve local and state preparedness for a major burn disaster. This review will focus on the basics of developing a burn surge disaster plan for a mass casualty event. In the event of a disaster, burn centers must recognize their place in the context of local and state disaster plan activation. Planning for a burn center takes on three forms; institutional/intrafacility, interfacility/intrastate, and interstate/regional. Priorities for a burn disaster plan include: coordination, communication, triage, plan activation (trigger point), surge, and regional capacity. Capacity and capability of the plan should be modeled and exercised to determine limitations and identify breaking points. When there is more than one burn center in a given state or jurisdiction, close coordination and communication between the burn centers are essential for a successful response. Burn surge mass casualty planning at the facility and specialty planning levels, including a state burn surge disaster plan, must have interface points with governmental plans. Local, state, and federal governmental agencies have key roles and responsibilities in a burn mass casualty disaster. This work will include a framework and critical concepts any burn disaster planning effort should consider when developing future plans.

  1. Social and psychological resources and health outcomes after the World Trade Center disaster.

    PubMed

    Adams, Richard E; Boscarino, Joseph A; Galea, Sandro

    2006-01-01

    Previous studies on community disasters tend to assess non-representative samples and use nonstandard measures of well-being. Additionally, few of these studies are longitudinal in design. In this report, we examine the consequences of the World Trade Center Disaster (WTCD) within a stress model perspective to assess level of exposure to the disaster and well-being after this event, as measured by the SF12 mental health and physical health scales. Data come from a two-wave panel study of 1681 English or Spanish speaking adults living in New York City on the day of the terrorist attacks and were collected by telephone interviews 1 and 2 years after the disaster. In ordinary least-squares regression models that contained demographic characteristics, stress risk factors, and social psychological resources as independent variables, level of exposure to the disaster was associated with poorer Wave 2 physical well-being, but not psychological health. Level of disaster exposure was not related to Wave 2 physical health, however, once the Wave 1 level of physical health was controlled, suggesting that disaster exposure did not have a lasting impact on variation in physical well-being. Results also indicated that experiencing a panic attack, negative life events, or traumatic events were related to poorer physical health. Respondents who met screening criteria for possible alcohol dependence post-disaster, experienced negative life events, or experienced traumatic events, were more likely to suffer from poorer mental health compared to those who did not meet the criteria, experience negative life events or experience traumas. We discuss these findings relative to community disasters in industrialized and developing countries.

  2. Responding to disasters: academic medical centers' responsibilities and opportunities.

    PubMed

    Sklar, David P; Richards, Michael; Shah, Mark; Roth, Paul

    2007-08-01

    Disaster preparedness and disaster response should be a capability of all academic health centers. The authors explore the potential role and impact of academic medical centers (AMC)s in disaster response. The National Disaster Medical System and the evolution of disaster medical assistance teams (DMAT) are described, and the experience at one AMC with DMAT is reviewed. The recent deployment of a DMAT sponsored by an AMC to the Hurricane Katrina disaster is described, and the experience is used to illustrate the opportunities and challenges of future disaster medical training, research, and practice at AMCs. AMCs are encouraged to identify an appropriate academic unit to house and nurture disaster-preparedness activities, participate in education programs for health professionals and the public, and perform research on disaster epidemiology and response. Networks of AMCs offer the potential of acting as a critical resource for those AMCs stricken by a disaster and for communities needing the infusion of highly trained and motivated health care providers. The Association of American Medical Colleges can play a critical role in assisting and coordinating AMC networks through its relationship with all AMCs and the federal government and by increasing the awareness of medical educators and researchers about this important, emerging area of medical knowledge.

  3. Exposure to the World Trade Center Attack and the Use of Cigarettes and Alcohol Among New York City Public High-School Students

    PubMed Central

    Wu, Ping; Duarte, Cristiane S.; Mandell, Donald J.; Fan, Bin; Liu, Xinhua; Fuller, Cordelia J.; Musa, George; Cohen, Michael; Cohen, Patricia; Hoven, Christina W.

    2006-01-01

    We examined exposure to the World Trade Center attack and changes in cigarette smoking and drinking among 2731 New York City public high-school students evaluated 6 months after the attack. Increased drinking was associated with direct exposure to the World Trade Center attack (P < .05). Increased smoking was not directly associated with exposure to the World Trade Center attack but was marginally significantly associated with posttraumatic stress disorder (P= .06). Our findings suggest that targeted substance-use interventions for youths may be warranted after large-scale disasters. PMID:16571705

  4. The World Trade Center Attack: Doctors in the fire and police services

    PubMed Central

    Martinez, Charles; Gonzalez, Dario

    2001-01-01

    The World Trade Center attack cast some physicians in roles outside their usual hospital practice. The incident required several physicians to function in the dangerous environment of the disaster. Priorities and triage strategies established by the police, emergency medical service and fire departments, while adhered to, required instantaneous modification and upgrading given the vast loss of civilian and rescue personnel lives. Many civilian medical staff presented themselves with good intentions but needed to be placed out of the collapse zone for fear of incurring additional casualties. In addition, problems with re-establishment of command and control, communications, personnel and equipment replacement all impacted on the rescue effort. This article recounts the roles played by the two coauthors during the World Trade Center attack. PMID:11737912

  5. KAMEDO report no. 87: bomb attack in Finnish shopping center, 2002.

    PubMed

    Deverell, Edward; Ortenwall, Per; Almgren, Ola; Riddez, Louis

    2007-01-01

    The detonation of a bomb in a shopping center in Vantaa, Finland, took place on 11 October 2002. Seven people died as a result and > 160 people required medical attention. Because the rescue teams were inadequately trained to respond to terrorist attacks, the event was handled according to protocol. A number of problems arose, including: people from different rescue agencies were difficult to distinguish from each other; there was inadequate communication between the incident site and the main hospital; relatives of victims were not kept informed; and psychiatric problems in the wake of the disaster were not addressed sufficiently.

  6. Aftermath of World Trade Center Attack

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This true-color image was taken by the Enhanced Thematic Mapper Plus (ETM+) aboard the Landsat 7 satellite on September 12, 2001, at roughly 11:30 a.m. Eastern Daylight Savings Time. Visit the NASA home page for photos from the space station and MODIS, and GlobalSecurity.org for images from other satellites. Image courtesy USGS Landsat 7 team, at the EROS Data Center.

  7. Increased rates of asthma among World Trade Center disaster responders.

    PubMed

    Kim, Hyun; Herbert, Robin; Landrigan, Philip; Markowitz, Steven B; Moline, Jacqueline M; Savitz, David A; Todd, Andrew C; Udasin, Iris G; Wisnivesky, Juan P

    2012-01-01

    Studies have documented high rates of asthma symptoms among responders to the World Trade Center (WTC) disaster. However, whether there are increased rates of asthma among responders compared to the general population is unknown. The study population consisted of a prospective cohort of 20,834 responders participating in the WTC Medical Monitoring and Treatment Program between July 2002 and December 2007. We calculated prevalence and standardized morbidity ratios (SMRs) of lifetime asthma and 12-month asthma (defined as ≥1 attacks in the prior 12 months) among WTC responders. The comparison population consisted of >200,000 adults who completed the National Health Interview Survey in 2000 (for pre-9/11 comparisons) and between 2002 and 2007 (for post-9/11 comparisons). WTC responders were on average 43 ± 9 years old, 86% male, 59% white, and 42% had an occupation in protective services. The lifetime prevalence of asthma in the general population was relatively constant at about 10% from 2000 to 2007. However, among WTC responders, lifetime prevalence increased from 3% in 2000, to 13% in 2002, and 19% in 2007. The age-adjusted overall SMR for lifetime asthma among WTC responders was 1.8 (95% CI: 1.8-1.9) for men and 2.0 (95% CI: 1.9-2.1) for women. Twelve-month asthma was also more frequent among WTC responders compared to the general population (SMR 2.4, 95% CI: 2.2-2.5) for men and 2.2 (95% CI: 2.0-2.5) for women. WTC responders are at an increased risk of asthma as measured by lifetime prevalence or active disease. Copyright © 2011 Wiley Periodicals, Inc.

  8. World Trade Center disaster and sensitization to subsequent life stress: A longitudinal study of disaster responders.

    PubMed

    Zvolensky, Michael J; Farris, Samantha G; Kotov, Roman; Schechter, Clyde B; Bromet, Evelyn; Gonzalez, Adam; Vujanovic, Anka; Pietrzak, Robert H; Crane, Michael; Kaplan, Julia; Moline, Jacqueline; Southwick, Steven M; Feder, Adriana; Udasin, Iris; Reissman, Dori B; Luft, Benjamin J

    2015-06-01

    The current study examined the role of World Trade Center (WTC) disaster exposure (hours spent working on the site, dust cloud exposure, and losing friend/loved one) in exacerbating the effects of post-disaster life stress on posttraumatic stress disorder (PTSD) symptoms and overall functioning among WTC responders. Participants were 18,896 responders (8466 police officers and 10,430 non-traditional responders) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and were reassessed an average of two years later. Among police responders, there was a significant interaction, such that the effect of post-disaster life stress on later PTSD symptoms and overall functioning was stronger among police responders who had greater WTC disaster exposure (β's=.029 and .054, respectively, for PTSD symptoms and overall functioning). This moderating effect was absent in non-traditional responders. Across both groups, post-disaster life stress also consistently was related to the dependent variables in a more robust manner than WTC exposure. The present findings suggest that WTC exposure may compound post-disaster life stress, thereby resulting in a more chronic course of PTSD symptoms and reduced functioning among police responders. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. An evaluation of the role played by remote sensing technology following the World Trade Center attack

    NASA Astrophysics Data System (ADS)

    Huyck, Charles K.; Adams, Beverley J.; Kehrlein, David I.

    2003-06-01

    Remote sensing technology has been widely recognized for contributing to emergency response efforts after the World Trade Center attack on September 11th, 2001. The need to coordinate activities in the midst of a dense, yet relatively small area, made the combination of imagery and mapped data strategically useful. This paper reviews the role played by aerial photography, satellite imagery, and LIDAR data at Ground Zero. It examines how emergency managers utilized these datasets, and identifies significant problems that were encountered. It goes on to explore additional ways in which imagery could have been used, while presenting recommendations for more effective use in future disasters and Homeland Security applications. To plan adequately for future events, it was important to capture knowledge from individuals who responded to the World Trade Center attack. In recognition, interviews with key emergency management and geographic information system (GIS) personnel provide the basis of this paper. Successful techniques should not be forgotten, or serious problems dismissed. Although widely used after September 11th, it is important to recognize that with better planning, remote sensing and GIS could have played an even greater role. Together with a data acquisition timeline, an expanded discussion of these issues is available in the MCEER/NSF report “Emergency Response in the Wake of the World Trade Center Attack; The Remote Sensing Perspective” (Huyck and Adams, 2002)

  10. Fear of Terrorism and Preparedness in New York City 2 Years After the Attacks: Implications for Disaster Planning and Research

    PubMed Central

    Boscarino, Joseph A.; Adams, Richard E.; Figley, Charles R.; Galea, Sandro; Foa, Edna B.

    2009-01-01

    Objectives To help improve disaster planning and research, we studied psychosocial predictors of terrorism fear and preparedness among New York City residents after the World Trade Center disaster (WTCD). Method We conducted a random cross-sectional survey of 1,681 adults interviewed 2 years after the WTCD. Participants were living in New York City at the time of the attack and exposed to ongoing terrorist threats. Results We found 44.9 percent (95% confidence interval [CI] = 41.9−47.9) of residents were concerned about future attacks and 16.9 percent (95% CI = 14.7−19.3) reported a fear level of “10” on a 10-point analog scale. Furthermore, 14.8 percent (95% CI = 12.8−17.0) reported they had made some plans for a future attack, a significant increase from the previous year. In addition, although 42.6 percent (95% CI = 39.6−45.7) indicated that they would likely wait for evacuation instructions following a chemical, biological, or nuclear attack, 34.4 percent (95% CI = 31.5−37.3) reported they would evacuate immediately against official advice. Predictors of high terrorism fear in a multivariate model included Hispanic ethnicity (odds ratio [OR] = 2.0, P = .006), lower education (OR = 4.4, P < .001, and OR = 3.7, P < .001, respectively, for nonhigh school and high school graduates, compared with college graduates), being exposed to stressful life events (OR = 1.6, P = .048), having current posttraumatic stress disorder (3.1, P < .001), having a fear of death (OR = 2.5, P = .002), and reporting a likelihood of fleeing an attack against advice (OR = 1.5, P = .034). The best predictors of preparedness in a multivariate model was being between 30 to 64 years old (30−44 years old, OR = 2.6, P = .001; 45−64 yeas old, OR = 1.8, P = .03, respectively, compared with 18−29 years old), having higher exposure to the WTCD (moderate exposure, OR = 1.7, P = .05; high exposure, OR = 2.4, P = .002; very high exposure, OR = 4.1, P < .001), respectively, compared

  11. [The Sino-French emergency and disaster medicine training center].

    PubMed

    Pourriat, Jean-Louis; Dahan, Benjamin; Lapandry, Claude

    2012-01-01

    French (AP-HP) and Chinese (Beijing Health Office) hospitals, with support from the French company Total, collaborated in order to improve Chinese doctors' knowledge of emergency and disaster medicine prior to the Beijing Olympic Games. A Sino-French emergency and disaster medicine training center was subsequently opened in Beijing in 2008, with the aim of providing high-level continuous medical training for Chinese specialists in emergency medicine. Teaching in the management of critical situations was based on the use of a latest-generation simulator (Sim 3G; Laerdal). This collaboration has had both pedagogical and diplomatic benefits.

  12. Injuries and illnesses among New York City Fire Department rescue workers after responding to the World Trade Center attacks.

    PubMed

    2002-09-11

    Within minutes of the terrorist attacks on September 11, 2001, the Fire Department of New York City (FDNY) operated a continuous rescue/recovery effort at the World Trade Center (WTC) site. Medical officers of FDNY Bureau of Health Services (FDNY-BHS) responded to provide emergency medical services (see box). The collapse of the WTC towers and several adjacent structures resulted in a vast, physically dangerous disaster zone. The height of the WTC towers produced extraordinary forces during their collapse, pulverizing considerable portions of the buildings' structural components and exposing first responders and civilians to substantial amounts of airborne particulate matter. Fires burned continuously under the debris until mid-December 2001. Because of ongoing fire activity and the large numbers of civilians and rescue workers who were killed during the attacks, approximately 11,000 FDNY firefighters and many emergency medical service (EMS) personnel worked on or directly adjacent to the rubble and incurred substantial exposures (Figure). This report describes morbidity and mortality in FDNY rescue workers during the 11-month period after the WTC attacks and documents a substantial increase in respiratory and stress-related illness compared with the time period before the WTC attacks. These findings demonstrate the need to provide acute and long-term medical monitoring, treatment, and counseling to FDNY rescue workers exposed to this disaster and to solve supply, compliance, and supervision problems so that respiratory protection can be rapidly provided at future disasters.

  13. Destruction of the World Trade Center Towers. Lessons Learned from an Environmental Health Disaster.

    PubMed

    Reibman, Joan; Levy-Carrick, Nomi; Miles, Terry; Flynn, Kimberly; Hughes, Catherine; Crane, Michael; Lucchini, Roberto G

    2016-05-01

    The assault and subsequent collapse of the World Trade Center towers in New York City on September 11, 2001 (9/11), released more than a million tons of debris and dust into the surrounding area, engulfing rescue workers as they rushed to aid those who worked in the towers, and the thousands of nearby civilians and children who were forced to flee. In December 2015, almost 15 years after the attack, and 5 years after first enactment, Congress reauthorized the James Zadroga 9/11 Health and Compensation Act, a law designed to respond to the adverse health effects of the disaster. This reauthorization affords an opportunity to review human inhalation exposure science in relation to the World Trade Center collapse. In this Special Article, we compile observations regarding the collective medical response to the environmental health disaster with a focus on efforts to address the adverse health effects experienced by nearby community members including local residents and workers. We also analyze approaches to understanding the potential for health risk, characterization of hazardous materials, identification of populations at risk, and shortfalls in the medical response on behalf of the local community. Our overarching goal is to communicate lessons learned from the World Trade Center experience that may be applicable to communities affected by future environmental health disasters. The World Trade Center story demonstrates that communities lacking advocacy and preexisting health infrastructures are uniquely vulnerable to health disasters. Medical and public health personnel need to compensate for these vulnerabilities to mitigate long-term illness and suffering.

  14. Destruction of the World Trade Center Towers. Lessons Learned from an Environmental Health Disaster

    PubMed Central

    Levy-Carrick, Nomi; Miles, Terry; Flynn, Kimberly; Hughes, Catherine; Crane, Michael; Lucchini, Roberto G.

    2016-01-01

    The assault and subsequent collapse of the World Trade Center towers in New York City on September 11, 2001 (9/11), released more than a million tons of debris and dust into the surrounding area, engulfing rescue workers as they rushed to aid those who worked in the towers, and the thousands of nearby civilians and children who were forced to flee. In December 2015, almost 15 years after the attack, and 5 years after first enactment, Congress reauthorized the James Zadroga 9/11 Health and Compensation Act, a law designed to respond to the adverse health effects of the disaster. This reauthorization affords an opportunity to review human inhalation exposure science in relation to the World Trade Center collapse. In this Special Article, we compile observations regarding the collective medical response to the environmental health disaster with a focus on efforts to address the adverse health effects experienced by nearby community members including local residents and workers. We also analyze approaches to understanding the potential for health risk, characterization of hazardous materials, identification of populations at risk, and shortfalls in the medical response on behalf of the local community. Our overarching goal is to communicate lessons learned from the World Trade Center experience that may be applicable to communities affected by future environmental health disasters. The World Trade Center story demonstrates that communities lacking advocacy and preexisting health infrastructures are uniquely vulnerable to health disasters. Medical and public health personnel need to compensate for these vulnerabilities to mitigate long-term illness and suffering. PMID:26872108

  15. Lessons learned for pediatric disaster preparedness from September 11, 2001: New York City trauma centers.

    PubMed

    Stamell, Emily F; Foltin, George L; Nadler, Evan P

    2009-08-01

    The assault on the World Trade Center on September 11, 2001, has mandated that there be improved disaster preparedness for both children and adults in the immediate future. Fortunately, the events of September 11, 2001, spared 3,400 near miss children from substantial harm; however, NYC was not well prepared to handle significant numbers of pediatric patients had they been severely injured. Furthermore, there have been several medical sequelae of the attacks that have manifest long after the immediate postevent period. Both respiratory illness and mental health issues have been suffered by children because of the environmental toxins and the trauma of witnessing the event, respectively. The pediatric practitioners in the area did not feel well prepared to handle the increased demand for services. Also at the time, there was no pediatric-specific plan to either evacuate children in need of specialized care to centers with expertise in handling such patients or to mobilize pediatric practitioners (surgeons, critical care physicians, etc.) to the institutions where the masses of children would have initially been brought. Since then, there have been efforts to create educational materials to better prepare hospitals as well as proposals to create mobile pediatric disaster teams to deploy to hospitals in need of support. This review discusses these recognized and unrecognized issues in pediatric disaster preparedness to hopefully foster discussion for future strategies.

  16. Lessons From the World Trade Center Disaster

    PubMed Central

    Reibman, Joan; Oppenheimer, Beno W.; Vlahos, Ioannis; Harrison, Denise; Goldring, Roberta M.

    2013-01-01

    Background: The present study (1) characterizes a physiologic phenotype of restrictive dysfunction due to airway injury and (2) compares this phenotype to the phenotype of interstitial lung disease (ILD). Methods: This is a retrospective study of 54 persistently symptomatic subjects following World Trade Center (WTC) dust exposure. Inclusion criteria were reduced vital capacity (VC), FEV1/VC > 77%, and normal chest roentgenogram. Measurements included spirometry, plethysmography, diffusing capacity of lung for carbon monoxide (Dlco), impulse oscillometry (IOS), inspiratory/expiratory CT scan, and lung compliance (n = 16). Results: VC was reduced (46% to 83% predicted) because of the reduction of expiratory reserve volume (43% ± 26% predicted) with preservation of inspiratory capacity (IC) (85% ± 16% predicted). Total lung capacity (TLC) was reduced, confirming restriction (73% ± 8% predicted); however, elevated residual volume to TLC ratio (0.35 ± 0.08) suggested air trapping (AT). Dlco was reduced (78% ± 15% predicted) with elevated Dlco/alveolar volume (5.3 ± 0.8 [mL/mm Hg/min]/L). IOS demonstrated abnormalities in resistance and/or reactance in 50 of 54 subjects. CT scan demonstrated bronchial wall thickening and/or AT in 40 of 54 subjects; parenchymal disease was not evident in any subject. Specific compliance at functional residual capacity (FRC) (0.07 ± 0.02 [L/cm H2O]/L) and recoil pressure (Pel) at TLC (27 ± 7 cm H2O) were normal. In contrast to patients with ILD, lung expansion was not limited, since IC, Pel, and inspiratory muscle pressure were normal. Reduced TLC was attributable to reduced FRC, compatible with airway closure in the tidal range. Conclusions: This study describes a distinct physiologic phenotype of restriction due to airway dysfunction. This pattern was observed following WTC dust exposure, has been reported in other clinical settings (eg, asthma), and should be incorporated into the definition of restrictive dysfunction. PMID

  17. Alcohol use disorders and drinking among survivors of the 9/11 attacks on the World Trade Center in New York City.

    PubMed

    North, Carol S; Adinoff, Bryon; Pollio, David E; Kinge, Sagar; Downs, Dana L; Pfefferbaum, Betty

    2013-10-01

    Research on the relationship of alcohol and disasters has yielded mixed conclusions. Some studies investigate alcohol consumption but others examine alcohol use disorders in relation to disaster. Alcohol consumption and alcohol use disorders have not be studied concurrently in relation to specific disaster trauma exposures. A volunteer sample of 379 individuals from New York City agencies affected by the September 11, 2001 (9/11) attacks on World Trade Center were assessed approximately 3years postdisaster for alcohol consumption and alcohol use disorders relative to specific disaster exposures. Increases in alcohol consumption were relatively small, eventually returning to pre-9/11 levels, with few cases of new alcohol use disorders or alcohol relapse. The findings suggest that postdisaster alcohol use has negligible clinical relevance for most of the population. Scarce disaster resources should be focused on those at identified risk of excessive alcohol use, that is, those with pre-existing alcohol or other psychiatric disorders.

  18. The Cooperation Between Poison Control Center and Organized Industrial District for Chemical Disaster Prevention

    DTIC Science & Technology

    2001-09-01

    BETWEEN POISON CONTROL CENTER AND ORGANIZED INDUSTRIAL DISTRICT FOR CHEMICAL DISASTER PREVENTION Ozyurt G. and Tokyay N. Uludag Poison Center; Uludag...UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADP013444 TITLE: The Cooperation Between Poison Control Center and...Organized Industrial District for Chemical Disaster Prevention DISTRIBUTION: Approved for public release, distribution unlimited This paper is part of the

  19. Neuropathic Symptoms in World Trade Center Disaster Survivors and Responders.

    PubMed

    Wilkenfeld, Marc; Fazzari, Melissa; Segelnick, Jacqueline; Stecker, Mark

    2016-01-01

    The objective of this research is to determine whether responders and survivors of the World Trade Center (WTC) disaster experience symptoms of neuropathy at a rate higher than those not exposed. A survey of neuropathic symptoms in patients who were and were not exposed at the WTC based upon the Michigan Neuropathy Screening Instrument (MNSI). Even after correction for medical comorbidities, age, and depression, neuropathic symptoms are much more common in those exposed to WTC dust and increase with increasing exposure. This study provides evidence that exposure to WTC dust is associated with neuropathic symptoms.

  20. Mental health service use among American Red Cross disaster workers responding to the September 11, 2001 U.S. terrorist attacks.

    PubMed

    Elhai, Jon D; Jacobs, Gerard A; Kashdan, Todd B; DeJong, Gary L; Meyer, David L; Frueh, B Christopher

    2006-06-30

    In this article, we explored 1) the extent of mental health (MH) service use by American Red Cross disaster relief workers, both before (lifetime) and 1 year after the September 11, 2001 terrorist attacks, and 2) demographic, disaster and MH variables predicting (1-year) post-September 11 MH service use in this population. A sample of 3015 Red Cross disaster workers was surveyed 1 year after the attacks, regarding demographic characteristics, MH service use before and since the attacks, and posttraumatic stress disorder (PTSD) symptoms. Findings revealed that while 13.5% used MH services before the attacks, 10.7% used services after. Variables increasing the likelihood of MH service use after the attacks included the following: no previous MH treatment, younger age, being divorced/widowed, and higher PTSD intrusion or hyperarousal symptoms. Findings support other recent research on MH service use after the September 11 attacks.

  1. Previous exposure to the World Trade Center terrorist attack and posttraumatic symptoms among older adults following Hurricane Sandy.

    PubMed

    Shrira, Amit; Palgi, Yuval; Hamama-Raz, Yaira; Goodwin, Robin; Ben-Ezra, Menachem

    2014-01-01

    The present study tested the maturation and inoculation hypotheses by examining whether age and previous exposure to the September 11, 2001, World Trade Center (WTC) terrorist attack moderated the relationship between degree of exposure to Hurricane Sandy and related posttraumatic stress disorder (PTSD) symptoms. An online sample of 1,000 participants from affected states completed self-report questionnaires one month after Hurricane Sandy hit the East Coast. Participants reported their degree of exposure to the WTC terrorist attack and to Hurricane Sandy, and their posttraumatic stress disorder (PTSD) symptoms following Hurricane Sandy. The positive relationship between degree of exposure to Hurricane Sandy and level of PTSD symptoms was weaker among older adults. An additional significant three-way interaction suggested that both age and previous exposure to the WTC terrorist attack moderated the relationship between degree of exposure to Hurricane Sandy and level of PTSD symptoms. Previous high degree of exposure to the WTC terrorist attack was related to a weaker effect of current exposure to Hurricane Sandy on PTSD symptoms among older adults. However, among younger adults, previous high degree of exposure to the WTC terrorist attack was related to a stronger effect of current exposure on PTSD symptoms. When confronted by a natural disaster, American older adults are generally resilient. Supporting the inoculation hypothesis, resilience of older adults may be partly related to the strength successfully extracted from previous exposure to adverse events.

  2. Post-disaster stressful life events and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among responders to the World Trade Center disaster.

    PubMed

    Zvolensky, Michael J; Kotov, Roman; Schechter, Clyde B; Gonzalez, Adam; Vujanovic, Anka; Pietrzak, Robert H; Crane, Michael; Kaplan, Julia; Moline, Jacqueline; Southwick, Steven M; Feder, Adriana; Udasin, Iris; Reissman, Dori B; Luft, Benjamin J

    2015-02-01

    The current study examined contributions of post-disaster stressful life events in relation to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning among rescue, recovery, and clean-up workers who responded to the September 11, 2001 World Trade Center (WTC) terrorist attacks. Participants were 18,896 WTC responders, including 8466 police officers and 10,430 non-traditional responders (85.8% male; 86.4% Caucasian; M(age) = 39.5, SD = 8.8) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and who were reassessed, on average, 2.5 years later. Path analyses were conducted to evaluate contributions of life events to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning. These analyses were stratified by police and non-traditional responder groups and adjusted for age, sex, time from 9/11 to initial visit, WTC exposures (three WTC contextual exposures: co-worker, friend, or a relative died in the disaster; co-worker, friend, or a relative injured in the disaster; and responder was exposed to the dust cloud on 9/11), and interval from initial to first follow-up visit. In both groups, WTC-related posttraumatic stress, depressive symptoms, and overall functioning were stable over the follow-up period. WTC exposures were related to these three outcomes at the initial assessment. WTC-related posttraumatic stress, depressive symptoms, and overall functioning, at the initial assessment each predicted the occurrence of post-disaster stressful life events, as measured by Disaster Supplement of the Diagnostic Interview Schedule. Post-disaster stressful life events, in turn, were associated with subsequent mental health, indicating partial mediation of the stability of observed mental health. The present findings suggest a dynamic interplay between exposure, post-disaster stressful life events, and WTC-related posttraumatic stress

  3. Research Methods in Child Disaster Studies: A Review of Studies Generated by the September 11, 2001, Terrorist Attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina

    ERIC Educational Resources Information Center

    Pfefferbaum, Betty; Weems, Carl F.; Scott, Brandon G.; Nitiéma, Pascal; Noffsinger, Mary A.; Pfefferbaum, Rose L.; Varma, Vandana; Chakraburtty, Amarsha

    2013-01-01

    Background: A comprehensive review of the design principles and methodological approaches that have been used to make inferences from the research on disasters in children is needed. Objective: To identify the methodological approaches used to study children's reactions to three recent major disasters--the September 11, 2001, attacks; the…

  4. Research Methods in Child Disaster Studies: A Review of Studies Generated by the September 11, 2001, Terrorist Attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina

    ERIC Educational Resources Information Center

    Pfefferbaum, Betty; Weems, Carl F.; Scott, Brandon G.; Nitiéma, Pascal; Noffsinger, Mary A.; Pfefferbaum, Rose L.; Varma, Vandana; Chakraburtty, Amarsha

    2013-01-01

    Background: A comprehensive review of the design principles and methodological approaches that have been used to make inferences from the research on disasters in children is needed. Objective: To identify the methodological approaches used to study children's reactions to three recent major disasters--the September 11, 2001, attacks; the…

  5. An academic medical center under prolonged rocket attack--organizational, medical, and financial considerations.

    PubMed

    Bar-El, Yaron; Michaelson, Moshe; Hyames, Gila; Skorecki, Karl; Reisner, Shimon A; Beyar, Rafael

    2009-09-01

    The Rambam Medical Center, the major academic health center in northern Israel, serving a population of two million and providing specialized tertiary care, was exposed to an unprecedented experience during the Second Lebanon War in the summer of 2006. For more than one month, it was subjected to continuous rocket attacks, but it continued to provide emergency and routine medical services to the civilian population and also served the military personnel who were evacuated from the battlefront. To accomplish the goals of serving the population while itself being under fire, the Rambam Medical Center had to undertake major organizational decisions, which included maximizing safety within the hospital by shifting patients and departments, ensuring that the hospital was properly fortified, managing the health professional teams' work schedules, and providing needed services for the families of employees. The Rambam Medical Center's Level I trauma center expertise included multidisciplinary teams and extensive collaborations; modern imaging modalities usually reserved for peacetime medical practice were frequently used. The function of the hospital teams during the war was efficient and smooth, based on the long-term actions taken to prepare for disasters and wartime conditions. Routine hospital services continued, although at 60% of normal occupancy. Financial losses incurred were primarily due to the decrease in revenue-generating activity. The two most important components of managing the hospital under these conditions are (1) the ability to arrive at prompt and meaningful decisions with respect to the organizational and medical hospital operations and (2) the leadership and management of the professional staff and teams.

  6. The World Trade Center attack. Observations from New York's Bellevue Hospital.

    PubMed

    Roccaforte, J D

    2001-12-01

    This report describes selected aspects of the response by Bellevue Hospital Center to the World Trade Center attack of 11 September 2001. The hospital is 2.5 miles (4 km) from the site of the attack. These first-hand observations and this analysis may aid in future preparations. Key issues described relate to communication, organization, injuries treated, staffing, and logistics.

  7. To leave an area after disaster: how evacuees from the WTC buildings left the WTC area following the attacks.

    PubMed

    Zimmerman, Rae; Sherman, Martin F

    2011-05-01

    How people leave a devastated area after a disaster is critical to understanding their ability to cope with risks they face while evacuating. Knowledge of their needs for communications about these risks is particularly crucial in planning for emergency responses. A convenience sample of 1,444 persons who survived the World Trade Center (WTC) attacks on September 11, 2001 were surveyed to ascertain their initial and ultimate destinations once they had left the buildings, how they arrived there, the role of types of obstacles they encountered, and the need for information and the seeking of other people as potential factors in influencing the process of leaving immediately. This survey was part of a larger, original survey. Results showed differences in how people traveled by mode to initial and ultimate destinations, how immediately they left the area, and factors associated with when they left. How they traveled and when they left were associated with where people lived, their tendency in times of stress to seek out other people including who they knew in the immediate area (e.g., co-workers or friends), the physical conditions surrounding them, and the importance to some of waiting for more information. Many people indicated they did not leave immediately because they had no information about where to go or what services would be available to them. Perceptions and communications about risks they were facing were reflected in the choices they considered in how and when to leave the area. These findings have numerous ramifications for understanding and guiding personal behavior in catastrophic situations. © 2010 Society for Risk Analysis.

  8. Occupational exposures during the World Trade Center disaster response.

    PubMed

    Wallingford, K M; Snyder, E M

    2001-06-01

    Upon the request of the New York City Department of Health, the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health (NIOSH) monitored occupational exposures among emergency response workers during the rescue and recovery activities at the World Trade Center disaster site from September 18 through 4 October 2001. During this period, over 1,200 bulk and air samples were collected to estimate or characterize workers' occupational exposures. Samples were collected and analyzed for asbestos, carbon monoxide (CO), chlorodifluoromethane (Freon 22), diesel exhaust, hydrogen sulfide, inorganic acids, mercury and other metals, polynuclear aromatic hydrocarbons, respirable particulate not otherwise regulated (PNOR), respirable crystalline silica, total PNOR, and volatile organic compounds. Exposures to most of these potential hazards did not exceed NIOSH Recommended Exposure Limits or Occupational Safety and Health Administration Permissible Exposure Limits. However, one torch cutter was overexposed to cadmium and another worker (and possibly three others) was overexposed to CO. The elevated cadmium and CO levels were the result of workers using oxy-acetylene cutting torches and gasoline-powered cutting saws. Recommendations were made to ensure adequate ventilation and worker understanding when using these tools and, where possible, to substitute rechargeable, battery-powered cutting saws for gasoline-powered ones. Toxicology

  9. The General Public's Attitudes and Beliefs Regarding Resource Management, Collaboration, and Community Assistance Centers During Disasters.

    PubMed

    Charney, Rachel L; Rebmann, Terri; Endrizal, Amy; Dalawari, Preeti

    2017-10-02

    The key to resilience after disasters is the provision of coordinated care and resource distribution to the affected community. Past research indicates that the general public lacks an understanding regarding agencies' roles and responsibilities during disaster response. Study Objectives This study's purpose was to explore the general public's beliefs regarding agencies or organizations' responsibilities related to resource management during disasters. In addition, the public's attitudes towards the management and use of community disaster assistance centers were explored. Qualitative interviews were conducted with members of the general public. Interviews were audio-recorded and transcribed verbatim. Content analysis was used to analyze the data and identify themes that describe the public's expectations of disaster response agencies and the use of community disaster assistance centers. A total of 28 interviews were conducted. Half of the participants (n=14) were black, 57% (n=16) were female, and the mean age was 49 years. The general public has developed trust and distrust toward response organizations and governmental agencies based on past experiences during disasters. The public wishes to have local agencies to help lead disaster response, but expects a collaboration between all response organizations, including the government. The managing agency overseeing community disaster assistance centers was not perceived as important, but the proximity of these centers to community members was considered critical. The general public prefers that local agencies and leaders manage disaster response, and they expect collaboration among response agencies. Community assistance centers need to be located close to those in need, and be managed by agencies trusted by the general public. (Disaster Med Public Health Preparedness. 2017;page 1 of 4).

  10. Rapid assessment of injuries among survivors of the terrorist attack on the World Trade Center--New York City, September 2001.

    PubMed

    2002-01-11

    On September 11, 2001, a jet aircraft crashed into the north tower of the World Trade Center (WTC) in lower Manhattan. Minutes later, a second aircraft crashed into the south tower. The impact, fires, and subsequent collapse of the buildings resulted in the deaths of thousands of persons. The precise number and causes of deaths could not be assessed in the immediate aftermath of the attack; however, data were available on the frequency and type of injuries among survivors (Figure 1). In previous disasters, such information assisted in characterizing type and severity of injuries and the health-care services needed by survivors. To assess injuries and use of health-care services by survivors, the New York City Department of Health (NYCDOH) conducted a field investigation to review emergency department (ED) and inpatient medical records at the four hospitals closest to the crash site and a fifth hospital that served as a burn referral center. This report summarizes findings of that assessment, which indicated that the arrival of injured persons to this sample of hospitals began within minutes of the attack and peaked 2 to 3 hours later. Among 790 injured survivors treated within 48 hours, approximately 50% received care within 7 hours of the attack, most for inhalation or ocular injuries; 18% were hospitalized. Comprehensive surveillance of disaster-related health effects is an integral part of effective disaster planning and response.

  11. School Library Media Center Disaster Response Plan Handbook.

    ERIC Educational Resources Information Center

    Illinois School Library Media Association, Fairfield.

    The best way to deal with a disaster or an emergency is to be prepared. Librarians must be aware of the emergencies which could arise, be ready to respond to them when they occur, and recover from them afterwards. Guidelines are offered by the Illinois School Library Media Association (ISLMA) to assist in the preparation of a disaster plan and the…

  12. School Library Media Center Disaster Response Plan Handbook.

    ERIC Educational Resources Information Center

    Illinois School Library Media Association, Fairfield.

    The best way to deal with a disaster or an emergency is to be prepared. Librarians must be aware of the emergencies which could arise, be ready to respond to them when they occur, and recover from them afterwards. Guidelines are offered by the Illinois School Library Media Association (ISLMA) to assist in the preparation of a disaster plan and the…

  13. Trauma exposure and posttraumatic stress disorder among employees of New York City companies affected by the September 11, 2001 attacks on the World Trade Center.

    PubMed

    North, Carol S; Pollio, David E; Smith, Rebecca P; King, Richard V; Pandya, Anand; Surís, Alina M; Hong, Barry A; Dean, Denis J; Wallace, Nancy E; Herman, Daniel B; Conover, Sarah; Susser, Ezra; Pfefferbaum, Betty

    2011-09-01

    Several studies have provided prevalence estimates of posttraumatic stress disorder (PTSD) related to the September 11, 2001 (9/11) attacks in broadly affected populations, although without sufficiently addressing qualifying exposures required for assessing PTSD and estimating its prevalence. A premise that people throughout the New York City area were exposed to the attacks on the World Trade Center (WTC) towers and are thus at risk for developing PTSD has important implications for both prevalence estimates and service provision. This premise has not, however, been tested with respect to DSM-IV-TR criteria for PTSD. This study examined associations between geographic distance from the 9/11 attacks on the WTC and reported 9/11 trauma exposures, and the role of specific trauma exposures in the development of PTSD. Approximately 3 years after the attacks, 379 surviving employees (102 with direct exposures, including 65 in the towers, and 277 with varied exposures) recruited from 8 affected organizations were interviewed using the Diagnostic Interview Schedule/Disaster Supplement and reassessed at 6 years. The estimated closest geographic distance from the WTC towers during the attacks and specific disaster exposures were compared with the development of 9/11-related PTSD as defined by the Diagnostic and Statistical Manual, Fourth Edition, Text Revision. The direct exposure zone was largely concentrated within a radius of 0.1 mi and completely contained within 0.75 mi of the towers. PTSD symptom criteria at any time after the disaster were met by 35% of people directly exposed to danger, 20% of those exposed only through witnessed experiences, and 35% of those exposed only through a close associate's direct exposure. Outside these exposure groups, few possible sources of exposure were evident among the few who were symptomatic, most of whom had preexisting psychiatric illness. Exposures deserve careful consideration among widely affected populations after large

  14. Long-term posttraumatic stress symptoms among 3,271 civilian survivors of the September 11, 2001, terrorist attacks on the World Trade Center.

    PubMed

    DiGrande, Laura; Neria, Yuval; Brackbill, Robert M; Pulliam, Paul; Galea, Sandro

    2011-02-01

    Although the September 11, 2001, terrorist attacks were the largest human-made disaster in US history, there is little extant research documenting the attacks' consequences among those most directly affected, that is, persons who were in the World Trade Center towers. Data from a cross-sectional survey conducted 2-3 years after the attacks ascertained the prevalence of long-term, disaster-related posttraumatic stress symptoms and probable posttraumatic stress disorder (PTSD) in 3,271 civilians who evacuated World Trade Center towers 1 and 2. Overall, 95.6% of survivors reported at least 1 current posttraumatic stress symptom. The authors estimated the probable rate of PTSD at 15.0% by using the PTSD Checklist. Women and minorities were at an increased risk of PTSD. A strong inverse relation with annual income was observed. Five characteristics of direct exposure to the terrorist attacks independently predicted PTSD: being on a high floor in the towers, initiating evacuation late, being caught in the dust cloud that resulted from the tower collapses, personally witnessing horror, and sustaining an injury. Working for an employer that sustained fatalities also increased risk. Each addition of an experience of direct exposure resulted in a 2-fold increase in the risk of PTSD (odds ratio = 2.09, 95% confidence interval: 1.84, 2.36). Identification of these risk factors may be useful when screening survivors of large-scale terrorist events for long-term psychological sequelae.

  15. Chronic physical health consequences of being injured during the terrorist attacks on World Trade Center on September 11, 2001.

    PubMed

    Brackbill, Robert M; Cone, James E; Farfel, Mark R; Stellman, Steven D

    2014-05-01

    Few studies have focused on injuries from the World Trade Center disaster on September 11, 2001. Severe injury has health consequences, including an increased mortality risk 10 years after injury and the risk of mental health problems, such as posttraumatic stress disorder (PTSD). The World Trade Center Health Registry identified 14,087 persons with none of a selected group of preexisting chronic conditions before 2002 who were present during and soon after the World Trade Center attacks, 1,980 of whom reported sustaining 1 or more types of injury (e.g., a broken bone or burn). Survey data obtained during 2003-2004 and 2006-2007 were used to assess the odds of reporting a diagnosis of chronic conditions (heart disease, respiratory disease, diabetes, cancer) up to 5-6 years after the attacks. Number of injury types and probable PTSD were significantly associated with having any chronic conditions diagnosed in 2002-2007. Persons with multiple injuries and PTSD had a 3-fold higher risk of heart disease than did those with no injury and no PTSD, and persons with multiple injuries and with no PTSD had a 2-fold higher risk of respiratory diseases. The present study shows that injured persons with or without comorbid PTSD have a higher risk of developing chronic diseases. Clinicians should be aware of the heightened risk of chronic heart and respiratory conditions among injured persons.

  16. Chronic Physical Health Consequences of Being Injured During the Terrorist Attacks on World Trade Center on September 11, 2001

    PubMed Central

    Brackbill, Robert M.; Cone, James E.; Farfel, Mark R.; Stellman, Steven D.

    2014-01-01

    Few studies have focused on injuries from the World Trade Center disaster on September 11, 2001. Severe injury has health consequences, including an increased mortality risk 10 years after injury and the risk of mental health problems, such as posttraumatic stress disorder (PTSD). The World Trade Center Health Registry identified 14,087 persons with none of a selected group of preexisting chronic conditions before 2002 who were present during and soon after the World Trade Center attacks, 1,980 of whom reported sustaining 1 or more types of injury (e.g., a broken bone or burn). Survey data obtained during 2003−2004 and 2006−2007 were used to assess the odds of reporting a diagnosis of chronic conditions (heart disease, respiratory disease, diabetes, cancer) up to 5–6 years after the attacks. Number of injury types and probable PTSD were significantly associated with having any chronic conditions diagnosed in 2002–2007. Persons with multiple injuries and PTSD had a 3-fold higher risk of heart disease than did those with no injury and no PTSD, and persons with multiple injuries and with no PTSD had a 2-fold higher risk of respiratory diseases. The present study shows that injured persons with or without comorbid PTSD have a higher risk of developing chronic diseases. Clinicians should be aware of the heightened risk of chronic heart and respiratory conditions among injured persons. PMID:24561992

  17. Availability of a pediatric trauma center in a disaster surge decreases triage time of the pediatric surge population: a population kinetics model

    PubMed Central

    2011-01-01

    Background The concept of disaster surge has arisen in recent years to describe the phenomenon of severely increased demands on healthcare systems resulting from catastrophic mass casualty events (MCEs) such as natural disasters and terrorist attacks. The major challenge in dealing with a disaster surge is the efficient triage and utilization of the healthcare resources appropriate to the magnitude and character of the affected population in terms of its demographics and the types of injuries that have been sustained. Results In this paper a deterministic population kinetics model is used to predict the effect of the availability of a pediatric trauma center (PTC) upon the response to an arbitrary disaster surge as a function of the rates of pediatric patients' admission to adult and pediatric centers and the corresponding discharge rates of these centers. We find that adding a hypothetical pediatric trauma center to the response documented in an historical example (the Israeli Defense Forces field hospital that responded to the Haiti earthquake of 2010) would have allowed for a significant increase in the overall rate of admission of the pediatric surge cohort. This would have reduced the time to treatment in this example by approximately half. The time needed to completely treat all children affected by the disaster would have decreased by slightly more than a third, with the caveat that the PTC would have to have been approximately as fast as the adult center in discharging its patients. Lastly, if disaster death rates from other events reported in the literature are included in the model, availability of a PTC would result in a relative mortality risk reduction of 37%. Conclusions Our model provides a mathematical justification for aggressive inclusion of PTCs in planning for disasters by public health agencies. PMID:21992575

  18. Focus Groups with Children after the World Trade Center Attacks

    ERIC Educational Resources Information Center

    Pfefferbaum, Betty; North, Carol S.; Pollio, David E.; Wallace, Nancy E.; Smith, Rebecca; Jeon-Slaughter, Haekyung

    2007-01-01

    Focus groups with 23 New York City children examined their reactions to the September 11 terrorist attacks, their parents' reactions, and their expectations about the future. We identified an initial set of six topics; these topics were reviewed and assigned to a final set of thematic categories--understanding the events and motives, emotional…

  19. Focus Groups with Children after the World Trade Center Attacks

    ERIC Educational Resources Information Center

    Pfefferbaum, Betty; North, Carol S.; Pollio, David E.; Wallace, Nancy E.; Smith, Rebecca; Jeon-Slaughter, Haekyung

    2007-01-01

    Focus groups with 23 New York City children examined their reactions to the September 11 terrorist attacks, their parents' reactions, and their expectations about the future. We identified an initial set of six topics; these topics were reviewed and assigned to a final set of thematic categories--understanding the events and motives, emotional…

  20. Attacking Al-Qaeda’s Operational Centers of Gravity

    DTIC Science & Technology

    2006-10-23

    Arab world. Many believe that the CIA and Israeli Mossad conspired to conduct the 9-11 attacks to hurt Islam, and that the doctrine of preventative...the West is Losing the War on Terror (Washington, DC: Brassey’s Inc. 2004), xviii; and Ahmed S. Hashim, “The World According to Usama Bin Laden...Global Insurgency, Hurlburt Field, FL, May 2006. Hasenauer, Heike. “Mission: Horn of Africa.” Soldiers. (August 2005): 11-13. Hashim, Ahmed

  1. Evaluation of non-response bias in a cohort study of World Trade Center terrorist attack survivors.

    PubMed

    Yu, Shengchao; Brackbill, Robert M; Stellman, Steven D; Ghuman, Sharon; Farfel, Mark R

    2015-02-15

    Few longitudinal studies of disaster cohorts have assessed both non-response bias in prevalence estimates of health outcomes and in the estimates of associations between health outcomes and disaster exposures. We examined the factors associated with non-response and the possible non-response bias in prevalence estimates and association estimates in a longitudinal study of World Trade Center (WTC) terrorist attack survivors. In 2003-04, 71,434 enrollees completed the WTC Health Registry wave 1 health survey. This study is limited to 67,670 adults who were eligible for both wave 2 and wave 3 surveys in 2006-07 and 2011-12. We first compared the characteristics between wave 3 participants (wave 3 drop-ins and three-wave participants) and non-participants (wave 3 drop-outs and wave 1 only participants). We then examined potential non-response bias in prevalence estimates and in exposure-outcome association estimates by comparing one-time non-participants (wave 3 drop-ins and drop-outs) at the two follow-up surveys with three-wave participants. Compared to wave 3 participants, non-participants were younger, more likely to be male, non-White, non-self enrolled, non-rescue or recovery worker, have lower household income, and less than post-graduate education. Enrollees' wave 1 health status had little association with their wave 3 participation. None of the disaster exposure measures measured at wave 1 was associated with wave 3 non-participation. Wave 3 drop-outs and drop-ins (those who participated in only one of the two follow-up surveys) reported somewhat poorer health outcomes than the three-wave participants. For example, compared to three-wave participants, wave 3 drop-outs had a 1.4 times higher odds of reporting poor or fair health at wave 2 (95% CI 1.3-1.4). However, the associations between disaster exposures and health outcomes were not different significantly among wave 3 drop-outs/drop-ins as compared to three-wave participants. Our results show that

  2. National Disaster Health Consortium: Competency-Based Training and a Report on the American Nurses Credentialing Center Disaster Certification Development.

    PubMed

    Smith, Sherrill J; Farra, Sharon L

    2016-12-01

    As the largest profession of health care providers, nurses are an integral component of disaster response. Having clearly delineated competencies and developing training to acquire those competencies are needed to ensure nurses are ready when disasters occur. This article provides a review of nursing and interprofessional disaster competencies and development of a new interprofessional disaster certification. An overview of a standardized disaster training program, the National Disaster Health Consortium, is provided as an exemplar of a competency-based interprofessional disaster education program.

  3. National Library of Medicine Disaster Information Management Research Center: Establishment and growth, 2008–2010 1

    PubMed Central

    Love, Cynthia B.; Arnesen, Stacey J.; Phillips, Steven J.

    2014-01-01

    In 2008, the National Library of Medicine (NLM) established the Disaster Information Management Research Center (DIMRC). Prior to 2008, NLM had a long history of involvement in providing health information for disaster management. Aware of this legacy and moved by the catastrophic aftermath of Hurricane Katrina, the NLM long range plan (Charting a Course for the 21st Century: NLM’s Long Range Plan 2006–2016) called for creation of a center to show “a strong commitment to disaster remediation and to provide a platform for demonstrating how libraries and librarians can be part of the solution to this national problem”. NLM was urged to “ensure continuous access to health information and effective use of libraries and librarians when disasters occur”. In response to this charge, NLM has undertaken substantial efforts to ensure that medical libraries have plans for the continuity of their operations, librarians are trained to understand their roles in preparedness and response, online disaster health information resources are available for many audiences and in multiple formats, and research is conducted on tools to enhance the exchange of critical information during and following disasters. This paper documents the history, goals, initiatives, accomplishments and future plans of the Center. PMID:25324584

  4. Increased incidence of life-threatening ventricular arrhythmias in implantable defibrillator patients after the World Trade Center attack.

    PubMed

    Steinberg, Jonathan S; Arshad, Aysha; Kowalski, Marcin; Kukar, Atul; Suma, Valentin; Vloka, Margot; Ehlert, Frederick; Herweg, Bengt; Donnelly, Jacqueline; Philip, Julie; Reed, George; Rozanski, Alan

    2004-09-15

    This study was designed to evaluate whether the destruction of the World Trade Center (WTC) on September 11, 2001 (9/11), led to an increased frequency of ventricular arrhythmias among patients fitted with an implantable cardioverter-defibrillator (ICD). The WTC attack induced psychological distress. Because ICDs store all serious arrhythmias for months, the attack provided a unique opportunity to compare pre- and post-9/11 frequencies of potentially lethal arrhythmias among ICD patients. Two hundred consecutive ICD patients who presented for regularly scheduled follow-up to six affiliated clinics were recruited into this observational study. The electrograms stored in the ICDs for the three months before 9/11 and 13 months thereafter were scrutinized in a blinded manner (relative to date) for all ventricular tachyarrhythmias (tachycardia or fibrillation) triggering ICD therapy. The frequency of tachyarrhythmias increased significantly for the 30 days post-9/11 (p = 0.004) relative to all other months between May 2001 and October 2002. In the 30 days post-9/11, 16 patients (8%) demonstrated tachyarrhythmias, compared with only seven (3.5%) in the preceding 30 days, representing a 2.3-fold increase in risk (95% confidence interval 1.1 to 4.9; p = 0.03). The first arrhythmic event did not occur for three days following 9/11, with events accumulating in a progressive non-clustered pattern. Ventricular arrhythmias increased by more than twofold among ICD patients following the WTC attack. The delay in onset and the non-clustered pattern of these events differ sharply from effects following other disasters, suggesting that subacute stress may have served to promote this arrhythmogenesis.

  5. The current state of affairs for disaster planning for a nuclear terrorist attack.

    PubMed

    Goffman, Thomas E

    2009-01-01

    The author presents current thinking on the effects of an atomic bomb blast from a medical point of view and will argue that current US Federal plans for a nuclear disaster are simply crude, insufficient, disarticulated, and principally relies on martial law as a means of crowd control. The simple physics of a fusion reaction bomb is discussed along with the plans of other countries, apparently "secret"American plans, which show a poor knowledge of the physics of nuclear bombs as well as poor insight into what will be needed to help the maximum number of citizens. An alternative plan involving computer modeling and educating the public to the effects of a fission explosion are presented. The key issue of statewide planning is discussed, as the Federal government has dumped medical problems on "the local level."

  6. Paresthesias Among Community Members Exposed to the World Trade Center Disaster.

    PubMed

    Marmor, Michael; Shao, Yongzhao; Bhatt, D Harshad; Stecker, Mark M; Berger, Kenneth I; Goldring, Roberta M; Rosen, Rebecca L; Caplan-Shaw, Caralee; Kazeros, Angeliki; Pradhan, Deepak; Wilkenfeld, Marc; Reibman, Joan

    2017-04-01

    Paresthesias can result from metabolic disorders, nerve entrapment following repetitive motions, hyperventilation pursuant to anxiety, or exposure to neurotoxins. We analyzed data from community members exposed to the World Trade Center (WTC) disaster of September 11, 2001, to evaluate whether exposure to the disaster was associated with paresthesias. Analysis of data from 3141 patients of the WTC Environmental Health Center. Fifty-six percent of patients reported paresthesias at enrollment 7 to 15 years following the WTC disaster. After controlling for potential confounders, paresthesias were associated with severity of exposure to the WTC dust cloud and working in a job requiring cleaning of WTC dust. This study suggests that paresthesias were commonly associated with WTC-related exposures or post-WTC cleaning work. Further studies should objectively characterize these paresthesias and seek to identify relevant neurotoxins or paresthesia-inducing activities.

  7. Paresthesias Among Community Members Exposed to the World Trade Center Disaster

    PubMed Central

    Marmor, Michael; Shao, Yongzhao; Bhatt, D. Harshad; Stecker, Mark M.; Berger, Kenneth I.; Goldring, Roberta M.; Rosen, Rebecca L.; Caplan-Shaw, Caralee; Kazeros, Angeliki; Pradhan, Deepak; Wilkenfeld, Marc; Reibman, Joan

    2017-01-01

    Objective: Paresthesias can result from metabolic disorders, nerve entrapment following repetitive motions, hyperventilation pursuant to anxiety, or exposure to neurotoxins. We analyzed data from community members exposed to the World Trade Center (WTC) disaster of September 11, 2001, to evaluate whether exposure to the disaster was associated with paresthesias. Methods: Analysis of data from 3141 patients of the WTC Environmental Health Center. Results: Fifty-six percent of patients reported paresthesias at enrollment 7 to 15 years following the WTC disaster. After controlling for potential confounders, paresthesias were associated with severity of exposure to the WTC dust cloud and working in a job requiring cleaning of WTC dust. Conclusions: This study suggests that paresthesias were commonly associated with WTC-related exposures or post-WTC cleaning work. Further studies should objectively characterize these paresthesias and seek to identify relevant neurotoxins or paresthesia-inducing activities. PMID:28157767

  8. National Library of Medicine Disaster Information Management Research Center: Achieving the vision, 2010–2013

    PubMed Central

    Love, Cynthia B.; Arnesen, Stacey J.; Phillips, Steven J.; Windom, Robert E.

    2016-01-01

    From 2010 to 2013, the National Library of Medicine (NLM) Disaster Information Management Research Center (DIMRC) continued to build its programs and services on the foundation laid in its starting years, 2008–2010. Prior to 2008, NLM had a long history of providing health information, training, and tools in response to disasters. Aware of this legacy, the NLM long range plan (Charting a Course for the 21st Century: NLM’s Long Range Plan 2006–2016) called for creation of a center to show “a strong commitment to disaster remediation and to provide a platform for demonstrating how libraries and librarians can be part of the solution to this national problem”. NLM is continuing efforts to ensure that medical libraries have plans for the continuity of their operations, librarians are trained to understand their roles in preparedness and response, online disaster health information resources are available for many audiences and in multiple formats, and research is conducted on tools to enhance the exchange of critical information during and following disasters. This paper describes the 2010–2013 goals and activities of DIMRC and its future plans. PMID:27570333

  9. Posttraumatic stress disorder and new-onset diabetes among adult survivors of the World Trade Center disaster.

    PubMed

    Miller-Archie, Sara A; Jordan, Hannah T; Ruff, Ryan R; Chamany, Shadi; Cone, James E; Brackbill, Robert M; Kong, Joanne; Ortega, Felix; Stellman, Steven D

    2014-09-01

    To explore the temporal relationship between 9/11-related posttraumatic stress disorder (PTSD) and new-onset diabetes in World Trade Center (WTC) survivors up to 11 years after the attack in 2001. Three waves of surveys (conducted from 2003 to 2012) from the WTC Health Registry cohort collected data on physical and mental health status, sociodemographic characteristics, and 9/11-related exposures. Diabetes was defined as self-reported, physician-diagnosed diabetes reported after enrollment. After excluding prevalent cases, there were 36,899 eligible adult enrollees. Logistic regression and generalized multilevel growth models were used to assess the association between PTSD measured at enrollment and subsequent diabetes. We identified 2143 cases of diabetes. After adjustment, we observed a significant association between PTSD and diabetes in the logistic model [adjusted odds ratio (AOR) 1.28, 95% confidence interval (CI) 1.14-1.44]. Results from the growth model were similar (AOR 1.37, 95% CI 1.23-1.52). This exploratory study found that PTSD, a common 9/11-related health outcome, was a risk factor for self-reported diabetes. Clinicians treating survivors of both the WTC attacks and other disasters should be aware that diabetes may be a long-term consequence. Copyright © 2014. Published by Elsevier Inc.

  10. Implications of the World Trade Center Attack for the Public Health and Health Care Infrastructures

    PubMed Central

    Klitzman, Susan; Freudenberg, Nicholas

    2003-01-01

    The September 11, 2001, attack on the World Trade Center had profound effects on the well-being of New York City. The authors describe and assess the strengths and weaknesses of the city’s response to the public health, environmental/ occupational health, and mental health dimensions of the attack in the first 6 months after the event. They also examine the impact on the city’s health care and social service system. The authors suggest lessons that can inform the development of a post–September 11th agenda for strengthening urban health infrastructures. PMID:12604481

  11. Implications of the World Trade Center attack for the public health and health care infrastructures.

    PubMed

    Klitzman, Susan; Freudenberg, Nicholas

    2003-03-01

    The September 11, 2001, attack on the World Trade Center had profound effects on the well-being of New York City. The authors describe and assess the strengths and weaknesses of the city's response to the public health, environmental/ occupational health, and mental health dimensions of the attack in the first 6 months after the event. They also examine the impact on the city's health care and social service system. The authors suggest lessons that can inform the development of a post-September 11th agenda for strengthening urban health infrastructures.

  12. [Disaster medicine].

    PubMed

    Carli, Pierre; Telionri, Caroline

    2015-01-01

    For over 30 years, the French hospital and pre-hospital medical teams are trained in disaster medicine. In fact, they are regularly confronted with the management of multiple casualties in accidents or even terrorist attacks, and more rarely to large-scale disasters. The intervention of physicians of the EMS system (SAMU-SMUR) in the field allows an original healthcare organization: in an advanced medical post, the victims are triaged according to their severity and benefit if needed of initial resuscitation. SAMU medical regulating center then organize their transport and repartition in several hospitals put on alert. To cope with a mass casualty situation, the hospital also has a specific organization, the White Plan. This plan, initiated by the director, assisted by a medico-administrative cell crisis can mobilize all the resources of the institution. Personnel are recalled and the ability of emergency units is increased. Care, less urgent, other patients are postponed. There are many plans for responding to disasters. ORSEC plans of the ministry of Interior articulate with the ORSAN plans of the ministry of Health. This complementarity allows a global mobilization of public services in disasters or exceptional medical situations.

  13. Epidemiologic Methods Lessons Learned from Environmental Public Health Disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina

    PubMed Central

    Svendsen, Erik R.; Runkle, Jennifer R.; Dhara, Venkata Ramana; Lin, Shao; Naboka, Marina; Mousseau, Timothy A.; Bennett, Charles

    2012-01-01

    Background: Environmental public health disasters involving hazardous contaminants may have devastating effects. While much is known about their immediate devastation, far less is known about long-term impacts of these disasters. Extensive latent and chronic long-term public health effects may occur. Careful evaluation of contaminant exposures and long-term health outcomes within the constraints imposed by limited financial resources is essential. Methods: Here, we review epidemiologic methods lessons learned from conducting long-term evaluations of four environmental public health disasters involving hazardous contaminants at Chernobyl, the World Trade Center, Bhopal, and Graniteville (South Carolina, USA). Findings: We found several lessons learned which have direct implications for the on-going disaster recovery work following the Fukushima radiation disaster or for future disasters. Interpretation: These lessons should prove useful in understanding and mitigating latent health effects that may result from the nuclear reactor accident in Japan or future environmental public health disasters. PMID:23066404

  14. Epidemiologic methods lessons learned from environmental public health disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina.

    PubMed

    Svendsen, Erik R; Runkle, Jennifer R; Dhara, Venkata Ramana; Lin, Shao; Naboka, Marina; Mousseau, Timothy A; Bennett, Charles

    2012-08-01

    Environmental public health disasters involving hazardous contaminants may have devastating effects. While much is known about their immediate devastation, far less is known about long-term impacts of these disasters. Extensive latent and chronic long-term public health effects may occur. Careful evaluation of contaminant exposures and long-term health outcomes within the constraints imposed by limited financial resources is essential. Here, we review epidemiologic methods lessons learned from conducting long-term evaluations of four environmental public health disasters involving hazardous contaminants at Chernobyl, the World Trade Center, Bhopal, and Graniteville (South Carolina, USA). We found several lessons learned which have direct implications for the on-going disaster recovery work following the Fukushima radiation disaster or for future disasters. These lessons should prove useful in understanding and mitigating latent health effects that may result from the nuclear reactor accident in Japan or future environmental public health disasters.

  15. Smoke Plume Dispersal from the World Trade Center Disaster

    NASA Image and Video Library

    2006-09-06

    The collapse of the World Trade Center on September 11, 2001, and the fires that followed produced a noxious smoke plume, a complex mixture of tiny airborne particles and gases as seen by NASA Terra spacecraft.

  16. Low Compliance of Urgent Care Centers in the United States With Recommendations for Office-Based Disaster Preparedness.

    PubMed

    Dunnick, Jennifer; Olympia, Robert P; Wilkinson, Robert; Brady, Jodi

    2016-05-01

    The aim of the study was to determine the compliance of urgent care centers in the United States with published recommendations for office-based disaster preparedness. An electronic questionnaire was distributed to urgent care center administrators as identified by the American Academy of Urgent Care Medicine directory. One hundred twenty-two questionnaires of the 872 distributed were available for analysis (14% usable response rate). Twenty-seven percent of centers have an established disaster plan for events that involve their establishment and surrounding community; 49% practice the plan at least once a year, 19% less frequent than once a year, and 32% never practice. Forty-seven percent of centers are familiar with designated emergency shelters and community evacuation plans. Seventeen percent of centers function as part of a surveillance system to provide early detection of any biologic/chemical/nuclear agents. Twenty-two percent of centers take part in local community and hospital disaster planning, exercises, and drills through emergency medical services and public health systems. Five percent of centers aid schools, child care centers, camps, and other child congregate facilities in disaster planning. Twenty-eight percent of centers have an assembled emergency/disaster kit, containing such items as water, first aid supplies, radios, flashlights, batteries, heavy-duty gloves, food, and sanitation supplies. Areas for improvement in urgent care center disaster preparedness were identified, such as developing an office disaster plan that is practiced at least yearly, becoming familiar with designated emergency shelters and community evacuation plans, providing surveillance to detect potential acts of terrorism, assisting community organizations (hospitals, schools, child care centers, etc) in disaster planning, and assembling office emergency/disaster kits.

  17. Disability and posttraumatic stress disorder in disaster relief workers responding to September 11, 2001 World Trade Center disaster.

    PubMed

    Evans, Susan; Patt, Ivy; Giosan, Cezar; Spielman, Lisa; Difede, JoAnn

    2009-07-01

    Empirical evidence suggests that social and occupational disability plays a significant role in posttraumatic stress disorder (PTSD). The purpose of this study was to assess the role of social/occupational disability and to identify predictors of the development of PTSD in a group of disaster relief workers (DRWs) who had been deployed to the World Trade Center (WTC) following September 11, 2001. Eight hundred forty-two utility workers completed a battery of comprehensive tests measuring PTSD and social occupational functioning. Results indicated a significant association between PTSD symptoms and impaired social/occupational functioning. Symptomatic workers were also more likely to have a history of trauma, panic disorder, and depression. Those with a history of trauma, depression, generalized anxiety disorder or panic reported significantly more disability than those without a psychiatric history. Careful screening of PTSD and social/occupational functioning in DRWs following a disaster is warranted so that early treatment can be undertaken to prevent a chronic and disabling course.

  18. Can burn centers evacuate in response to disasters?

    PubMed

    Gallagher, James J; Jaco, Mary; Marvin, Janet; Herndon, David N

    2006-01-01

    On August 29, 2005, the Gulf Coast was hit by Hurricane Katrina, a category 4 storm. The storm was responsible for more than 1000 deaths and the displacement of hundreds of thousands of people. Hospitals in the city of New Orleans evacuated because of the complete collapse of infrastructure. This event influenced the decisions and actions taken to protect patients, families, and staff of a 30-bed pediatric burn center in the projected path of a second catastrophic hurricane 3 weeks later. Approximately 80 hours before projected landfall, the local government announced that a mandatory evacuation of the community surrounding the burn center would occur. A coordinated decision was made by administration, nursing, and medical staff to cancel upcoming clinics and elective surgery and to evacuate all 14 inpatients, 52 outpatients, and 66 guardians to other facilities. The evacuation plan was successfully completed in 32 hours. The eye wall of the hurricane passed 65 miles east of the burn center. No significant damage to the physical plant was noted. Repopulation of the hospital by patients and acceptance of new acute burn referrals began approximately 40 hours after the local government permitted the population to return to the area. No morbidity or mortality was attributed to the evacuation. Emergent evacuation of threatened burn centers can be safely accomplished with adequate prior planning of evacuation sites, and modes of transportation. An established communication command center plays a key role in this process.

  19. Operation of emergency operating centers during mass casualty incidents in taiwan: a disaster management perspective.

    PubMed

    Wen, Jet-Chau; Tsai, Chia-Chou; Chen, Mei-Hsuan; Chang, Wei-Ta

    2014-10-01

    On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation. This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan's Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems. Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms. To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6).

  20. Adolescent behavior and PTSD 6-7 years after the World Trade Center terrorist attacks of September 11, 2001.

    PubMed

    Mann, Mana; Li, Jiehui; Farfel, Mark R; Maslow, Carey B; Osahan, Sukhminder; Stellman, Steven D

    2014-01-01

    Behavioral problems and psychopathologies were reported in children exposed to the World Trade Center (WTC) attacks in New York City within 2-3 y post-disaster. Little is known of subsequent 9/11 related behavioral and emotional problems. We assessed risk factors for behavioral difficulties and probable posttraumatic stress disorder (PTSD) in 489 adolescent enrollees ages 11-18 y of age in the World Trade Center Health Registry cohort using the Strengths and Difficulties Questionnaire (SDQ) and DISC Predictive Scales (DPS), respectively, as reported by the adolescents. Associations between parental PTSD and adolescent PTSD and behavioral problems were studied in a subset of 166 adolescent-parent pairs in which the parent was also a Registry enrollee. Nearly one-fifth (17.4%) of the adolescents, all of whom were 5-12 y old at the time of the attacks, scored in the abnormal (5.7%) or borderline (11.7%) range of total SDQ. Problems were more frequent in minority, low-income, and single-parent adolescents. Abnormal and borderline SDQ scores were significantly associated with direct WTC exposures and with WTC-related injury or death of a family member. Adolescent PTSD was significantly associated with WTC exposure and with fear of one's own injury or death, and with PTSD in the parent (OR = 5.6; 95% CI 1.1-28.4). This adolescent population should be monitored for persistence or worsening of these problems. Co-occurrence of parent and child mental health symptoms following a disaster may have implications for healthcare practitioners and for disaster response planners.

  1. Adolescent behavior and PTSD 6–7 years after the World Trade Center terrorist attacks of September 11, 2001

    PubMed Central

    Mann, Mana; Li, Jiehui; Farfel, Mark R; Maslow, Carey B; Osahan, Sukhminder; Stellman, Steven D

    2014-01-01

    Behavioral problems and psychopathologies were reported in children exposed to the World Trade Center (WTC) attacks in New York City within 2–3 y post-disaster. Little is known of subsequent 9/11 related behavioral and emotional problems. We assessed risk factors for behavioral difficulties and probable posttraumatic stress disorder (PTSD) in 489 adolescent enrollees ages 11–18 y of age in the World Trade Center Health Registry cohort using the Strengths and Difficulties Questionnaire (SDQ) and DISC Predictive Scales (DPS), respectively, as reported by the adolescents. Associations between parental PTSD and adolescent PTSD and behavioral problems were studied in a subset of 166 adolescent-parent pairs in which the parent was also a Registry enrollee. Nearly one-fifth (17.4%) of the adolescents, all of whom were 5–12 y old at the time of the attacks, scored in the abnormal (5.7%) or borderline (11.7%) range of total SDQ. Problems were more frequent in minority, low-income, and single-parent adolescents. Abnormal and borderline SDQ scores were significantly associated with direct WTC exposures and with WTC-related injury or death of a family member. Adolescent PTSD was significantly associated with WTC exposure and with fear of one's own injury or death, and with PTSD in the parent (OR = 5.6; 95% CI 1.1–28.4). This adolescent population should be monitored for persistence or worsening of these problems. Co-occurrence of parent and child mental health symptoms following a disaster may have implications for healthcare practitioners and for disaster response planners. PMID:28229007

  2. Risk factors for persistence of lower respiratory symptoms among community members exposed to the 2001 World Trade Center terrorist attacks

    PubMed Central

    Jordan, Hannah T; Friedman, Stephen M; Reibman, Joan; Goldring, Roberta M; Miller Archie, Sara A; Ortega, Felix; Alper, Howard; Shao, Yongzhao; Maslow, Carey B; Cone, James E; Farfel, Mark R; Berger, Kenneth I

    2017-01-01

    Objectives We studied the course of lower respiratory symptoms (LRS; cough, wheeze or dyspnoea) among community members exposed to the 9/11/2001 World Trade Center (WTC) attacks during a period of 12–13 years following the attacks, and evaluated risk factors for LRS persistence, including peripheral airway dysfunction and post-traumatic stress disorder (PTSD). Methods Non-smoking adult participants in a case-control study of post-9/11-onset LRS (exam 1, 2008–2010) were recruited for follow-up (exam 2, 2013–2014). Peripheral airway function was assessed with impulse oscillometry measures of R5 and R5-20. Probable PTSD was a PTSD checklist score ≥44 on a 2006–2007 questionnaire. Results Of 785 exam 1 participants, 545 (69%) completed exam 2. Most (321, 59%) were asymptomatic at all assessments. Among 192 participants with initial LRS, symptoms resolved for 110 (57%) by exam 2, 55 (29%) had persistent LRS and 27 (14%) had other patterns. The proportion with normal spirometry increased from 65% at exam 1 to 85% at exam 2 in the persistent LRS group (p<0.01) and was stable among asymptomatic participants and those with resolved LRS. By exam 2, spirometry results did not differ across symptom groups; however, R5 and R5-20 abnormalities were more common among participants with persistent LRS (56% and 46%, respectively) than among participants with resolved LRS (30%, p<0.01; 27%, p=0.03) or asymptomatic participants (20%, p<0.001; 8.2%, p<0.001). PTSD, R5 at exam 1, and R5-20 at exam 1 were each independently associated with persistent LRS. Conclusions Peripheral airway dysfunction and PTSD may contribute to LRS persistence. Assessment of peripheral airway function detected pulmonary damage not evident on spirometry. Mental and physical healthcare for survivors of complex environmental disasters should be coordinated carefully. PMID:28341697

  3. Research Methods in Child Disaster Studies: A Review of Studies Generated by the September 11, 2001, Terrorist Attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina

    PubMed Central

    Weems, Carl F.; Scott, Brandon G.; Nitiéma, Pascal; Noffsinger, Mary A.; Pfefferbaum, Rose L.; Varma, Vandana; Chakraburtty, Amarsha

    2013-01-01

    Background A comprehensive review of the design principles and methodological approaches that have been used to make inferences from the research on disasters in children is needed. Objective To identify the methodological approaches used to study children’s reactions to three recent major disasters—the September 11, 2001, attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina. Methods This review was guided by a systematic literature search. Results A total of 165 unduplicated empirical reports were generated by the search and examined for this review. This included 83 references on September 11, 29 on the 2004 Tsunami, and 53 on Hurricane Katrina. Conclusions A diversity of methods has been brought to bear in understanding children’s reactions to disasters. While cross-sectional studies predominate, pre-event data for some investigations emerged from archival data and data from studies examining non-disaster topics. The nature and extent of the influence of risk and protective variables beyond disaster exposure are not fully understood due, in part, to limitations in the study designs used in the extant research. Advancing an understanding of the roles of exposure and various individual, family, and social factors depends upon the extent to which measures and assessment techniques are valid and reliable, as well as on data sources and data collection designs. Comprehensive assessments that extend beyond questionnaires and checklists to include interviews and cognitive and biological measures to elucidate the negative and positive effects of disasters on children also may improve the knowledge base. PMID:24443635

  4. Improvement of Coordination in the Multi-National Military Coordination Center of the Nepal Army in Respond to Disasters

    DTIC Science & Technology

    2017-06-09

    hour per response , including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and...duplication 15. SUBJECT TERMS Disaster Response , Coordination Center, Multi-national, Coordination Challenges, National Disaster Response ...Framework 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON a. REPORT b. ABSTRACT c

  5. Bioinformatics and human identification in mass fatality incidents: the world trade center disaster.

    PubMed

    Leclair, Benoît; Shaler, Robert; Carmody, George R; Eliason, Kristilyn; Hendrickson, Brant C; Judkins, Thad; Norton, Michael J; Sears, Christopher; Scholl, Tom

    2007-07-01

    Victim identification initiatives undertaken in the wake of Mass Fatality Incidents (MFIs) where high-body fragmentation has been sustained are often dependent on DNA typing technologies to complete their mandate. The success of these endeavors is linked to the choice of DNA typing methods and the bioinformatic tools required to make the necessary associations. Several bioinformatic tools were developed to assist with the identification of the victims of the World Trade Center attacks, one of the most complex incidents to date. This report describes one of these tools, the Mass Disaster Kinship Analysis Program (MDKAP), a pair-wise comparison software designed to handle large numbers of complete or partial Short Tandem Repeats (STR) genotypes, and infer identity of, or biological relationships between tested samples. The software performs all functions required to take full advantage of the information content of processed genotypic data sets from large-scale MFIs, including the collapse of victims data sets, remains re-association, virtual genotype generation through gap-filling, parentage trio searching, and a consistency check of reported/inferred biological relationships within families. Although very few WTC victims were genetically related, the software can detect parentage trios from within a victim's genotype data set through a nontriangulated approach that screens all possible parentage trios. All software-inferred relationships from WTC data were confirmed by independent statistical analysis. With a 13 STR loci complement, a fortuitous parentage trio (FPT) involving nonrelated individuals was detected. Additional STR loci would be required to reduce the risk of an FPT going undetected in large-scale MFIs involving related individuals among the victims. Kinship analysis has proven successful in this incident but its continued success in larger scale MFIs is contingent on the use of a sufficient number of STR loci to reduce the risk of undetected FPTs, the

  6. The World Trade Center attack. Eye witness: observations of a physician on the outside looking in.

    PubMed

    Chalfin, D B

    2001-12-01

    Having personally witnessed the destruction at the World Trade Center on 11 September 2001, this paper presents my personal feelings and observations as an observer of both disaster and terror. Aside from the unimaginable horror as a result of the carnage, a feeling of helplessness was particularly prominent due to the inability to be able to care for casualties since most victims were fatalities. The passage of time has enabled a return to normalcy, however 'normalcy' carries a new definition due to the vastness of the tragedy and the sudden threat of bioterrorism and other weapons of mass destruction.

  7. Exposure and Human Health Evaluation of Airborne Pollution from the World Trade Center Disaster

    EPA Science Inventory

    In the days following the September 11, 2001, terrorist attack on New York City's World Trade Center (WTC) towers, many Federal agencies, including the U.S. Environmental Protection Agency (EPA), were called upon to bring their technical and scientific expertise to the national e...

  8. EXPOSURE AND HUMAN HEALTH EVALUATION OF AIRBORNE POLLUTION FROM THE WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    In the days following the September 11, 2001, terrorist attack on New York City's World Trade Center (WTC) towers, many Federal agencies, including the U.S. Environmental Protection Agency (EPA), were called upon to bring their technical and scientific expertise to the national e...

  9. Exposure and Human Health Evaluation of Airborne Pollution from the World Trade Center Disaster

    EPA Science Inventory

    In the days following the September 11, 2001, terrorist attack on New York City's World Trade Center (WTC) towers, many Federal agencies, including the U.S. Environmental Protection Agency (EPA), were called upon to bring their technical and scientific expertise to the national e...

  10. The postdisaster prevalence of major depression relative to PTSD in survivors of the 9/11 attacks on the World Trade Center selected from affected workplaces.

    PubMed

    North, Carol S; Pollio, David E; Hong, Barry A; Pandya, Anand; Smith, Rebecca P; Pfefferbaum, Betty

    2015-07-01

    Studies of survivors of the September 11, 2001 attacks on the World Trade Center in New York City suggest that postdisaster depressive disorders may be at least as prevalent, or even more prevalent, than posttraumatic stress disorder (PTSD), unlike findings from most other disaster studies. The relative prevalence and incidence of major depressive disorder (MDD) and PTSD were examined after the 9/11 attacks relative to trauma exposures. This study used full diagnostic assessment methods and careful categorization of exposure groups based on DSM-IV-TR criteria for PTSD to examine 373 employees of 9/11-affected New York City workplaces. Postdisaster new MDD episode (26%) in the entire sample was significantly more prevalent (p<.001) than 9/11-related PTSD (14%). Limiting the comparison to participants with 9/11 trauma exposures, the prevalence of postdisaster new MDD episode and 9/11-related PTSD did not differ (p=.446). The only 9/11 trauma exposure group with a significant difference in relative prevalence of MDD and PTSD were those with a 9/11 trauma-exposed close associate, for whom postdisaster new MDD episode (45%) was more prevalent (p=.046) than 9/11-related PTSD (31%). Because of the conditional definition of PTSD requiring trauma exposure that is not part of MDD criteria, prevalence comparisons of these two disorders must be limited to groups with qualifying trauma exposures to be meaningful. Findings from this study suggest distinct mechanisms underlying these two disorders that differentially relate to direct exposure to trauma vs. the magnitude of the disaster and personal connectedness to disaster and community-wide effects. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Anger and posttraumatic stress disorder in disaster relief workers exposed to the September 11, 2001 World Trade Center disaster: one-year follow-up study.

    PubMed

    Jayasinghe, Nimali; Giosan, Cezar; Evans, Susan; Spielman, Lisa; Difede, JoAnn

    2008-11-01

    Although anger is an important feature of posttraumatic stress disorder (PTSD) it is unclear whether it is simply concomitant or plays a role in maintaining symptoms. A previous study of disaster workers responding to the terrorist attacks of September 11, 2001 () indicated that those with PTSD evidenced more severe anger than those without. The purpose of this study was to conduct a 1-year follow-up to assess the role of anger in maintaining PTSD. Workers with PTSD continued to report more severe anger than those without; there were statistically significant associations between changes in anger, PTSD severity, depression, and psychiatric distress. Multiple regression analysis indicated initial anger severity to be a significant predictor of PTSD severity at follow-up, which is consistent with the notion that anger maintains PTSD. One implication is that disaster workers with high anger may benefit from early intervention to prevent chronic PTSD.

  12. The World Trade Center Disaster and the Health of Workers: Five-Year Assessment of a Unique Medical Screening Program

    PubMed Central

    Herbert, Robin; Moline, Jacqueline; Skloot, Gwen; Metzger, Kristina; Baron, Sherry; Luft, Benjamin; Markowitz, Steven; Udasin, Iris; Harrison, Denise; Stein, Diane; Todd, Andrew; Enright, Paul; Stellman, Jeanne Mager; Landrigan, Philip J.; Levin, Stephen M.

    2006-01-01

    Background Approximately 40,000 rescue and recovery workers were exposed to caustic dust and toxic pollutants following the 11 September 2001 attacks on the World Trade Center (WTC). These workers included traditional first responders, such as firefighters and police, and a diverse population of construction, utility, and public sector workers. Methods To characterize WTC-related health effects, the WTC Worker and Volunteer Medical Screening Program was established. This multicenter clinical program provides free standardized examinations to responders. Examinations include medical, mental health, and exposure assessment questionnaires; physical examinations; spirometry; and chest X rays. Results Of 9,442 responders examined between July 2002 and April 2004, 69% reported new or worsened respiratory symptoms while performing WTC work. Symptoms persisted to the time of examination in 59% of these workers. Among those who had been asymptomatic before September 11, 61% developed respiratory symptoms while performing WTC work. Twenty-eight percent had abnormal spirometry; forced vital capacity (FVC) was low in 21%; and obstruction was present in 5%. Among nonsmokers, 27% had abnormal spirometry compared with 13% in the general U.S. population. Prevalence of low FVC among nonsmokers was 5-fold greater than in the U.S. population (20% vs. 4%). Respiratory symptoms and spirometry abnormalities were significantly associated with early arrival at the site. Conclusion WTC responders had exposure-related increases in respiratory symptoms and pulmonary function test abnormalities that persisted up to 2.5 years after the attacks. Long-term medical monitoring is required to track persistence of these abnormalities and identify late effects, including possible malignancies. Lessons learned should guide future responses to civil disasters. PMID:17185275

  13. Emergency Preparedness Safety Climate and Other Factors Associated With Mental Health Outcomes Among World Trade Center Disaster Evacuees.

    PubMed

    Sherman, Martin F; Gershon, Robyn R; Riley, Halley E M; Zhi, Qi; Magda, Lori A; Peyrot, Mark

    2017-06-01

    We examined psychological outcomes in a sample of participants who evacuated from the World Trade Center towers on September 11, 2011. This study aimed to identify risk factors for psychological injury that might be amenable to change, thereby reducing adverse impacts associated with emergency high-rise evacuation. We used data from a cross-sectional survey conducted 2 years after the attacks to classify 789 evacuees into 3 self-reported psychological outcome categories: long-term psychological disorder diagnosed by a physician, short-term psychological disorder and/or memory problems, and no known psychological disorder. After nonmodifiable risk factors were controlled for, diagnosed psychological disorder was more likely for evacuees who reported lower "emergency preparedness safety climate" scores, more evacuation challenges (during exit from the towers), and evacuation-related physical injuries. Other variables associated with increased risk of psychological disorder outcome included gender (female), lower levels of education, preexisting physical disability, preexisting psychological disorder, greater distance to final exit, and more information sources during egress. Improving the "emergency preparedness safety climate" of high-rise business occupancies and reducing the number of egress challenges are potential strategies for reducing the risk of adverse psychological outcomes of high-rise evacuations. Focused safety training for individuals with physical disabilities is also warranted. (Disaster Med Public Health Preparedness. 2017;11:326-336).

  14. Emergency care centers--an efficient method for mitigation of consequences after a dirty bomb attack.

    PubMed

    Miska, Horst

    2012-08-01

    For emergency preparedness and response with respect to nuclear power plant accidents, the concept of Emergency Care Centers has been developed in Germany. This setup aims at monitoring contamination, to decontaminate if needed, assess the dose, and perform an initial medical evaluation of people who might have been affected by the accident. The concept has been tested in many exercises. In response to a terrorist attack involving a dirty bomb, this concept may prove useful for attending contaminated people who are not severely injured.

  15. Mixed lateral preference and peritraumatic reactions to the World Trade Center attacks.

    PubMed

    Chemtob, Claude M; Wang, Yanping; Dugan, Kelly L; Abramovitz, Robert; Marmar, Charles

    2006-11-01

    There is evidence that mixed lateral preference is a risk factor for developing more intense posttraumatic stress disorder symptoms. However, no research has examined whether mixed-handed persons experience greater threat of loss of life and physical injury and more intense emotional reactions (terror, helplessness, horror) during peritraumatic exposure. This study compared the intensity of ratings of perceived threat to life and physical injury and emotional reactions among mixed-handed and fully right-handed mothers directly exposed to the World Trade Center attacks. Controlling for exposure, mixed-handed mothers reported more intense ratings, indicating that mixed lateral preference may be associated with greater peritraumatic emotional distress.

  16. Volunteerism and Well-Being in the Context of the World Trade Center Terrorist Attacks

    PubMed Central

    Adams, Richard E.; Boscarino, Joseph A.

    2015-01-01

    Using a community sample of New York City residents (N=1681) interviewed 1 and 2 years after the World Trade Center Disaster (WTCD), we estimated several logistic regression equations to assess predictors of volunteerism and the relationship between volunteerism and later well-being. Multivariate results show that those with more education, higher exposure to WTCD events, many life-time traumatic events, and pre-WTCD mental health problems were more likely to report volunteerism post-WTCD. African Americans and Latinos were less likely to volunteer, compared to Whites. Respondents scoring high on the Srole Anomie scale and reporting physical disabilities were also less likely to report volunteering in the aftermath of the WTCD. Multivariate results with volunteerism as an independent variable suggest that people who engaged in this activity were less likely to have poor well-being as measured by the SF-12 physical and mental health scales. We discuss these results as they relate to identity theory, the stress process model, and resilience and how community disaster researchers need to pay closer attention to how people interpret and give meaning to traumatic events. PMID:25774097

  17. Volunteerism and Well-Being in the Context of the World Trade Center Terrorist Attacks.

    PubMed

    Adams, Richard E; Boscarino, Joseph A

    Using a community sample of New York City residents (N=1681) interviewed 1 and 2 years after the World Trade Center Disaster (WTCD), we estimated several logistic regression equations to assess predictors of volunteerism and the relationship between volunteerism and later well-being. Multivariate results show that those with more education, higher exposure to WTCD events, many life-time traumatic events, and pre-WTCD mental health problems were more likely to report volunteerism post-WTCD. African Americans and Latinos were less likely to volunteer, compared to Whites. Respondents scoring high on the Srole Anomie scale and reporting physical disabilities were also less likely to report volunteering in the aftermath of the WTCD. Multivariate results with volunteerism as an independent variable suggest that people who engaged in this activity were less likely to have poor well-being as measured by the SF-12 physical and mental health scales. We discuss these results as they relate to identity theory, the stress process model, and resilience and how community disaster researchers need to pay closer attention to how people interpret and give meaning to traumatic events.

  18. Protecting worker and public health during responses to catastrophic disasters-learning from the World Trade Center experience.

    PubMed

    Newman, David M

    2014-11-01

    Despite incremental lessons learned since 9/11, responder and community health remain at unnecessary risk during responses to catastrophic disasters, as evidenced during the BP Deepwater Horizon spill and Hurricanes Katrina, Rita, and Sandy. Much of the health harm that occurs during disaster response, as distinct from during the disaster event itself, is avoidable. Protection of public health should be an integral component of disaster response, which should "do no additional harm." This commentary examines how challenges and gaps the World Trade Center response resulted in preventable occupational and environmental health harm. It proposes changes in disaster response policies to better protect the health of rescue and recovery workers, volunteers, and impacted worker and residential communities.

  19. Model for determining logistic distribution center: case study of Mount Merapi eruption disaster

    NASA Astrophysics Data System (ADS)

    Ai, T. J.; Wigati, S. S.

    2017-01-01

    As one of the most active volcano in the earth, Mount Merapi is periodically erupted and it is considered as a natural disaster for the surrounding area. Kabupaten Sleman as one of the nearest location to this mount has to be always prepared to this disaster. The local government already set three different groups of region, in which potentially affected by Mount Merapi eruption, called KRB I, KRB II, and KRB III. Region KRB III is the closest area to the mount crater and most often affected by the eruption disaster. Whenever KRB III is affected, people live in that area usually being transfer to the next region set that is KRB II. The case presented in this paper is located at the KRB II region, which is the second closest region to the mount crater. A humanitarian distribution system has to be set in this region, since usually this region is became the location of shelters for KRB III population whenever a ‘big’ eruption is happened. A mathematical model is proposed in this paper, for determining the location of distribution center, vehicle route, and the amount of goods delivered to each customer. Some numerical illustration are presented in order to know the behavior of the proposed model.

  20. Risk factors for persistence of lower respiratory symptoms among community members exposed to the 2001 World Trade Center terrorist attacks.

    PubMed

    Jordan, Hannah T; Friedman, Stephen M; Reibman, Joan; Goldring, Roberta M; Miller Archie, Sara A; Ortega, Felix; Alper, Howard; Shao, Yongzhao; Maslow, Carey B; Cone, James E; Farfel, Mark R; Berger, Kenneth I

    2017-06-01

    We studied the course of lower respiratory symptoms (LRS; cough, wheeze or dyspnoea) among community members exposed to the 9/11/2001 World Trade Center (WTC) attacks during a period of 12-13 years following the attacks, and evaluated risk factors for LRS persistence, including peripheral airway dysfunction and post-traumatic stress disorder (PTSD). Non-smoking adult participants in a case-control study of post-9/11-onset LRS (exam 1, 2008-2010) were recruited for follow-up (exam 2, 2013-2014). Peripheral airway function was assessed with impulse oscillometry measures of R5 and R5-20. Probable PTSD was a PTSD checklist score ≥44 on a 2006-2007 questionnaire. Of 785 exam 1 participants, 545 (69%) completed exam 2. Most (321, 59%) were asymptomatic at all assessments. Among 192 participants with initial LRS, symptoms resolved for 110 (57%) by exam 2, 55 (29%) had persistent LRS and 27 (14%) had other patterns. The proportion with normal spirometry increased from 65% at exam 1 to 85% at exam 2 in the persistent LRS group (p<0.01) and was stable among asymptomatic participants and those with resolved LRS. By exam 2, spirometry results did not differ across symptom groups; however, R5 and R5-20 abnormalities were more common among participants with persistent LRS (56% and 46%, respectively) than among participants with resolved LRS (30%, p<0.01; 27%, p=0.03) or asymptomatic participants (20%, p<0.001; 8.2%, p<0.001). PTSD, R5 at exam 1, and R5-20 at exam 1 were each independently associated with persistent LRS. Peripheral airway dysfunction and PTSD may contribute to LRS persistence. Assessment of peripheral airway function detected pulmonary damage not evident on spirometry. Mental and physical healthcare for survivors of complex environmental disasters should be coordinated carefully. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly

  1. An HIT Solution for Clinical Care and Disaster Planning: How One health Center in Joplin, MO Survived a Tornado and Avoided a Health Information Disaster.

    PubMed

    Shin, Peter; Jacobs, Feygele

    2012-01-01

    Since taking office, President Obama has made substantial investments in promoting the diffusion of health information technology (IT). The objective of the national health IT program is, generally, to enable health care providers to better manage patient care through secure use and sharing of health information. Through the use of technologies including electronic health records, providers can better maintain patient care information and facilitate communication, often improving care outcomes. The recent tornado in Joplin, MO highlights the importance of health information technology in the health center context, and illustrates the importance of secure electronic health information systems as a crucial element of disaster and business continuity planning. This article examines the experience of a community health center in the aftermath of the major tornado that swept through the American Midwest in the spring of 2011, and provides insight into the planning for disaster survival and recovery as it relates to patient records and health center data.

  2. Applications of tactical mobile robot technology to urban search and rescue: lessons learned at the World Trade Center disaster

    NASA Astrophysics Data System (ADS)

    Pratt, S. S.; Alibozek, Fred; Frost, Thomas; Norman, Christopher O.; Shein, Andrew M.; Smith, Christopher

    2002-07-01

    In the wake of the World Trade Center tragedy on Sept. 11th 2001, robots developed for the Defense Advanced Research Projects Agency's Tactical Mobile Robot program were used under the direction of CRASAR, the Center for Robot-Assisted Search and Rescue, to provide technical support to the relief effort. The TMR's (Tactical Mobile Robots) were used to search the disaster scene for casualties, locate victims, and assess building integrity. During the effort the Tactical Mobile Robots were presented with unprecedented obstacles and challenges. This paper serves to outline lessons learned at the WTC (World Trade Center) disaster and provide information for the development of more capable search and rescue robots.

  3. Mental health status of World Trade Center tower survivors compared to other survivors a decade after the September 11, 2001 terrorist attacks.

    PubMed

    Gargano, Lisa M; Nguyen, Angela; DiGrande, Laura; Brackbill, Robert M

    2016-09-01

    Studies of individuals directly exposed to the World Trade Center (WTC) terrorist attacks of September 11, 2001 have found increased risk for post-traumatic stress disorder (PTSD) and binge drinking (BD). No long-term studies have been conducted on one highly exposed group, WTC tower evacuees. The study sample included 7,695 adult civilians in the WTC Health Registry. Logistic regression was used to examine the odds of PTSD and BD in 1,946 towers evacuees compared to 5,749 others in nearby buildings or on the street. WTC tower survivors were at increased risk for PTSD and BD compared to the others. Infrastructure and behavioral barriers experienced during evacuation were significantly associated with PTSD. WTC tower evacuees are at increased risk for PTSD and BD. Understanding the effects of disaster-related evacuation barriers on the long-term mental health status of survivors can help in the planning of continuing post-disaster treatment. Am. J. Ind. Med. 59:742-751, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Exposure to the World Trade Center Disaster and 9/11-Related Post-Traumatic Stress Disorder and Household Disaster Preparedness.

    PubMed

    Gargano, Lisa M; Caramanica, Kimberly; Sisco, Sarah; Brackbill, Robert M; Stellman, Steven D

    2015-12-01

    In a population with prior exposure to the World Trade Center disaster, this study sought to determine the subsequent level of preparedness for a new disaster and how preparedness varied with population characteristics that are both disaster-related and non-disaster-related. The sample included 4496 World Trade Center Health Registry enrollees who completed the Wave 3 (2011-2012) and Hurricane Sandy (2013) surveys. Participants were considered prepared if they reported possessing at least 7 of 8 standard preparedness items. Logistic regression was used to determine associations between preparedness and demographic and medical factors, 9/11-related post-traumatic stress disorder (PTSD) assessed at Wave 3, 9/11 exposure, and social support. Over one-third (37.5%) of participants were prepared with 18.8% possessing all 8 items. The item most often missing was an evacuation plan (69.8%). Higher levels of social support were associated with being prepared. High levels of 9/11 exposure were associated with being prepared in both the PTSD and non-PTSD subgroups. Our findings indicate that prior 9/11 exposure favorably impacted Hurricane Sandy preparedness. Future preparedness messaging should target people with low social support networks. Communications should include information on evacuation zones and where to find information about how to evacuate.

  5. Cardiometabolic profiles of adolescents and young adults exposed to the World Trade Center Disaster.

    PubMed

    Trasande, Leonardo; Koshy, Tony T; Gilbert, Joseph; Burdine, Lauren K; Marmor, Michael; Han, Xiaoxia; Shao, Yongzhao; Chemtob, Claude; Attina, Teresa M; Urbina, Elaine M

    2017-09-30

    Few studies have examined the possible cardiometabolic consequences of World Trade Center-related exposures on children who lived and/or attended school near the disaster site. Our objective was to compare cardiometabolic profiles of participants in the World Trade Center Health Registry (WTCHR) with a matched comparison group. We evaluated WTCHR enrollees who resided in New York City and were born between September 11, 1993 and September 10, 2001, and a matched comparison group. We assessed exposure to dust cloud, home dust, as well as traumatic exposure, and associations with blood pressure, arterial wall stiffness, body mass index (BMI), total cholesterol, triglycerides, HDL, and LDL. A total of 402 participants completed the study, 222 in the comparison group and 180 in the WTCHR group. In multivariable regression analysis, after adjusting for relevant confounders we detected a weak association between participation in the WTCHR group and lower BMI (-1.12kg/m(2), 95% CI -2.11, -0.12; p = 0.03), which became non-significant after adjusting for multiple comparisons. With respect to traumatic and psychosocial exposures, the only association that persisted in our multivariable model, below our predefined level of significance, was between post-traumatic stress disorder and higher BMI (2.06kg/m2, 95% CI 0.37, 3.74; p = 0.02). Our findings do not support an association between self-reported exposures to the WTC disaster and adverse cardiometabolic profile. However, further longitudinal studies may better inform the full extent of WTC-related conditions associated with exposure to the disaster. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. The impact of the World Trade Center attack on FDNY firefighter retirement, disabilities, and pension benefits.

    PubMed

    Niles, J K; Webber, M P; Gustave, J; Zeig-Owens, R; Lee, R; Glass, L; Weiden, M D; Kelly, K J; Prezant, D J

    2011-09-01

    Our goal was to examine the effect of the World Trade Center (WTC) attack and subsequent New York City Fire Department (FDNY) rescue/recovery activities on firefighter retirements. We also analyzed the financial impact associated with the increased number and proportion of service-connected "accidental" disability retirements on the FDNY pension system. A total of 7,763 firefighters retired between 9/11/1994 and 9/10/2008. We compared the total number of retirements and the number and proportion of accidental disability retirements 7 years before and 7 years after the WTC attack. We categorized WTC-related accidental disability retirements by medical cause and worked with the New York City Office of the Actuary to approximate the financial impact by cause. In the 7 years before 9/11 there were 3,261 retirements, 48% (1,571) of which were accidental disability retirements. In the 7 years after 9/11, there were 4,502 retirements, 66% (2,970) were accidental disability retirements, of which 47% (1,402) were associated with WTC-related injuries or illnesses. After 9/11, the increase in accidental disability retirements was, for the most part, due to respiratory-related illnesses. Additional increases were attributed to psychological-related illnesses and musculoskeletal injuries incurred at the WTC site. Pension benefits associated with WTC-related accidental disability retirements have produced an increased financial burden of over $826 million on the FDNY pension system. The WTC attacks affected the health of the FDNY workforce resulting in more post-9/11 retirements than expected, and a larger proportion of these retirees with accidental disability pensions. Copyright © 2011 Wiley-Liss, Inc.

  7. Prevalence and predictors of posttraumatic stress symptoms in utility workers deployed to the World Trade Center following the attacks of September 11, 2001.

    PubMed

    Cukor, Judith; Wyka, Katarzyna; Jayasinghe, Nimali; Weathers, Frank; Giosan, Cezar; Leck, Pamela; Roberts, Jennifer; Spielman, Lisa; Crane, Michael; Difede, JoAnn

    2011-03-01

    Recent attention has begun to be focused on the effects of disaster recovery work on nonrescue workers. The goal of this study was to assess the prevalence and predictors of posttraumatic stress disorder (PTSD) and related symptoms in a population of utility workers deployed to the World Trade Center (WTC) site in the aftermath of 9/11. Utility workers deployed to the WTC site were screened at their place of employment between 10 and 34 months following the WTC attacks, utilizing both structured interviews and self-report measures. PTSD symptoms were assessed by the CAPS and the PCL; co-morbid disorders were also assessed. 2,960 individuals with complete CAPS and PCL data were included in the analyses. Eight percent of participants had symptoms consistent with full PTSD, 9.3% with subthreshold PTSD, 6% with MDD, 3.5% with GAD, and 2.5% with panic disorder. Although risk factors included psychiatric and trauma history, 51% of individuals with probable PTSD had neither; subjective perception of threat to one's life was the best predictor of probable PTSD. Extent of exposure predicted 89% of PTSD cases in those without a psychiatric or trauma history, but only 67% of cases among those with both. Nonrescue workers deployed to a disaster site are at risk for PTSD and depression. Extent of exposure affected the most vulnerable workers differently than the least vulnerable ones. These results suggest that the relationship among predictors of PTSD may be different for different vulnerability groups, and underscore the importance of screening, education, and prevention programs for disaster workers. © 2010 Wiley-Liss, Inc.

  8. NASA Involvement in National Priority Support for Disasters

    NASA Technical Reports Server (NTRS)

    McGregor, Lloyd

    2002-01-01

    This viewgraph presentation provides an overview of the role NASA remote sensing played in planning recovery operations in the aftermath of the September 11, 2001 terrorist attacks on the World Trade Center and the Pentagon. The presentation includes AVIRIS and satellite imagery of the attack sites, and photographs taken on the ground after the attacks. One page of the presentation addresses NASA's role in disaster management of the 2002 Winter Olympics.

  9. NASA Involvement in National Priority Support for Disasters

    NASA Technical Reports Server (NTRS)

    McGregor, Lloyd

    2002-01-01

    This viewgraph presentation provides an overview of the role NASA remote sensing played in planning recovery operations in the aftermath of the September 11, 2001 terrorist attacks on the World Trade Center and the Pentagon. The presentation includes AVIRIS and satellite imagery of the attack sites, and photographs taken on the ground after the attacks. One page of the presentation addresses NASA's role in disaster management of the 2002 Winter Olympics.

  10. Enhancing Disaster Management: Development of a Spatial Database of Day Care Centers in the USA

    SciTech Connect

    Singh, Nagendra; Tuttle, Mark A.; Bhaduri, Budhendra L.

    2015-07-30

    Children under the age of five constitute around 7% of the total U.S. population and represent a segment of the population, which is totally dependent on others for day-to-day activities. A significant proportion of this population spends time in some form of day care arrangement while their parents are away from home. Accounting for those children during emergencies is of high priority, which requires a broad understanding of the locations of such day care centers. As concentrations of at risk population, the spatial location of day care centers is critical for any type of emergency preparedness and response (EPR). However, until recently, the U.S. emergency preparedness and response community did not have access to a comprehensive spatial database of day care centers at the national scale. This paper describes an approach for the development of the first comprehensive spatial database of day care center locations throughout the USA utilizing a variety of data harvesting techniques to integrate information from widely disparate data sources followed by geolocating for spatial precision. In the context of disaster management, such spatially refined demographic databases hold tremendous potential for improving high resolution population distribution and dynamics models and databases.

  11. Enhancing Disaster Management: Development of a Spatial Database of Day Care Centers in the USA

    DOE PAGES

    Singh, Nagendra; Tuttle, Mark A.; Bhaduri, Budhendra L.

    2015-07-30

    Children under the age of five constitute around 7% of the total U.S. population and represent a segment of the population, which is totally dependent on others for day-to-day activities. A significant proportion of this population spends time in some form of day care arrangement while their parents are away from home. Accounting for those children during emergencies is of high priority, which requires a broad understanding of the locations of such day care centers. As concentrations of at risk population, the spatial location of day care centers is critical for any type of emergency preparedness and response (EPR). However,more » until recently, the U.S. emergency preparedness and response community did not have access to a comprehensive spatial database of day care centers at the national scale. This paper describes an approach for the development of the first comprehensive spatial database of day care center locations throughout the USA utilizing a variety of data harvesting techniques to integrate information from widely disparate data sources followed by geolocating for spatial precision. In the context of disaster management, such spatially refined demographic databases hold tremendous potential for improving high resolution population distribution and dynamics models and databases.« less

  12. Attachment and psychological adaptation in high exposure survivors of the September 11th attack on the World Trade Center.

    PubMed

    Fraley, R Chris; Fazzari, David A; Bonanno, George A; Dekel, Sharon

    2006-04-01

    This study examined the relationship between individual differences in adult attachment and psychological adaptation in a sample of high-exposure survivors of the terrorist attacks on the World Trade Center on September 11, 2001. Symptoms of posttraumatic stress disorder (PTSD) and depression were assessed via self-report 7 and 18 months after the attacks. In addition, friends and relatives were asked to provide evaluations of participants' adjustment before and after the attacks. Findings indicate that securely attached individuals exhibited fewer symptoms of PTSD and depression than insecurely attached individuals and were viewed by friends and relatives as showing an increase in adjustment following the attacks. Highly dismissing adults were viewed by their friends and family as showing neither increments nor decrements in adjustment, despite the fact that highly dismissing people self-reported relatively high levels of PTSD and depression.

  13. Disasters and Perinatal Health: A Systematic Review

    PubMed Central

    Harville, EW; Xiong, X; Buekens, P

    2012-01-01

    Background The empirical literature on the effects of disaster on pregnancy and the postpartum period is limited. The objective of this review was to examine the existing evidence on the effect of disasters on perinatal health. Methods A systematic review was conducted by searching electronic databases (MEDLINE, EMBASE, Cinahl, PsycInfo), including literature on disasters and pregnancy outcomes (e.g., preterm birth, low birthweight, congenital anomalies), mental health, and child development. 110 articles were identified, but many published reports were anecdotes or recommendations rather than systematic studies. The final review included 49 peer-reviewed studies that met inclusion criteria. Results Studies addressing the World Trade Center disaster of September 11th and other terrorist attacks, environmental/chemical disasters, and natural disasters such as hurricanes and earthquakes were identified. Disasters of various types may reduce fetal growth in some women, though there does not appear to be an effect on gestational age at birth. Severity of exposure is the major predictor of mental health issues among pregnant and postpartum women. The mother's mental health after a disaster may more strongly influence on child development than any direct effect of disaster-related prenatal stress. Conclusions There is evidence that disaster impacts maternal mental health and some perinatal health outcomes, particular among highly-exposed women. Future research should focus on under-studied outcomes such as spontaneous abortion. Relief workers and clinicians should concentrate on the most exposed women, particularly with respect to mental health. PMID:21375788

  14. Geochemical Fingerprinting of the World Trade Center Attack in New York Harbor Sediments

    NASA Astrophysics Data System (ADS)

    Brabander, D. J.; Oktay, S.; Smith, J.; Kada, J.; Bullen, T.; Olsen, C.

    2002-12-01

    By comparing the textural, chemical, and isotopic composition of World Trade Center (WTC) ash samples (collected near Ground Zero one week after the terrorist attack) with sediment samples from cores taken on October 12, 2001 in known deposition areas in New York Harbor (NYH), we characterized a unique suite of geochemical-textural tracers that allow us to both identify and quantify the input of WTC derived material to adjacent areas in the Hudson River estuary. Scanning electron microscopy coupled with energy dispersive spectroscopy revealed two chemically distinct (Si-rich and Ca-rich) rod-like features (40-200 æm in length) in both ash and sediment samples. The Si-rich rods are consistent with a fiberglass parent material while the Ca-rich rods originate from gypsum. An 87Sr/86Sr ratio for the ash material of 0.7088 (n=2) coupled with Ca/Sr (wt. ratio) ranging from 260-300 suggest that the ash material analyzed is approximately 70% gypsum. As a function of depth within the sediment core, correlations exist between the measured activities of 7Be (a naturally occurring short-lived radionuclide), elemental weight-percent ratios of Ca/Sr, and the isotopic ratios of 87Sr/86Sr ratios. . These combined isotopic approaches allow us to constrain the timing (via 7Be), and the composition and amount (via 87Sr/86Sr and Ca/Sr) of WTC material input into the NYH sediments. These down-core isotope-ratio profiles can be described by a mixing line between background NYH 87Sr/86Sr ratios (>0.724) and the WTC derived ash material. The geochemical-textural tracers associated with the WTC terrorist attack may provide a potential tool for assessing the fate and transport of WTC material in the Lower Hudson River and aid in assessing the environmental and human health impacts of the WTC catastrophe.

  15. Impact of 9/11-related chronic conditions and PTSD comorbidity on early retirement and job loss among World Trade Center disaster rescue and recovery workers.

    PubMed

    Yu, Shengchao; Brackbill, Robert M; Locke, Sean; Stellman, Steven D; Gargano, Lisa M

    2016-09-01

    The economic impact of the 9/11 terrorist attacks has rarely been studied. We examined the association between 9/11-related chronic health conditions with or without post-traumatic stress disorder (PTSD) and one important aspect of the economic impact, retirement, and job loss before age 60. A total of 7,662 workers who participated in the World Trade Center Health Registry surveys were studied. Logistic regression models examined the association of 9/11-related health and labor force exit. Workers with chronic conditions were more likely to experience early retirement and job loss, and the association was stronger in the presence of PTSD comorbidity: the odds ratios for reporting early retirement or job loss were increased considerably when chronic conditions were comorbid with PTSD. Disaster-related health burden directly impacts premature labor force exit and income. Future evaluation of disaster outcome should include its long-term impact on labor force. Am. J. Ind. Med. 59:731-741, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. Neurologic Evaluations of Patients Exposed to the World Trade Center Disaster.

    PubMed

    Stecker, Mark M; Yu, Huiying; Barlev, Renee; Marmor, Michael; Wilkenfeld, Marc

    2016-11-01

    The aim of this study was to describe the clinical phenotype of a limited group of responders and survivors of the World Trade Center (WTC) disaster who were referred for the evaluation of neuropathic symptoms. Sixteen patients with WTC exposure were referred to a neurologist for evaluation. All had a neurologic examination. Most had electromyogram and nerve conduction testing/nerve conduction studies as well as appropriate imaging and blood tests. There was a higher probability of a neuropathy diagnosis in WTC-exposed patients than other patients referred for EMG testing. Two WTC-exposed patients had motor neuron disease and not neuropathy. This study provides objective evidence of neuropathy in a relatively high fraction of WTC-exposed patients with neuropathic symptoms. It also emphasizes that the scope of neurologic problems following WTC exposure may include other diagnoses such as motor neuron disease.

  17. Exposure and Human Health Evaluation of Airborne Pollution from the World Trade Center Disaster (External Review Draft)

    EPA Science Inventory

    Following the collapse of the World Trade Center towers on September 11, 2001, New York State and Federal agencies initiated numerous air monitoring activities to better understand the ongoing impact of emissions from the disaster. This report focuses on these air measurement da...

  18. Exposure and Human Health Evaluation of Airborne Pollution from the World Trade Center Disaster (External Review Draft)

    EPA Science Inventory

    Following the collapse of the World Trade Center towers on September 11, 2001, New York State and Federal agencies initiated numerous air monitoring activities to better understand the ongoing impact of emissions from the disaster. This report focuses on these air measurement da...

  19. EXPOSURE AND HUMAN HEALTH EVALUATION OF AIRBORNE POLLUTION FROM THE WORLD TRADE CENTER DISASTER (EXTERNAL REVIEW DRAFT)

    EPA Science Inventory

    Following the collapse of the World Trade Center towers on September 11, 2001, New York State and Federal agencies initiated numerous air monitoring activities to better understand the ongoing impact of emissions from the disaster. This report focuses on these air measurement da...

  20. A slow “catch and release” process prolongs immune attack on cancer cells | Center for Cancer Research

    Cancer.gov

    Center for Cancer Research investigators have discovered that some cancer cells catch immune signaling molecules called cytokines on their surfaces then slowly release the molecules. The results suggest that the immune system may exploit this weak spot to mount a prolonged attack on the tumor. Read more...

  1. Preparing for Disaster: Taking the Lead

    ERIC Educational Resources Information Center

    Colber, Judith

    2008-01-01

    In this article, Irwin Redlener, director of the National Center for Disaster Preparedness describes disasters in relation to five phases that may serve as a helpful framework for planning disaster response: (1) before the disaster (pre-disaster); (2) during the disaster (intra-disaster); (3) immediately after the disaster (immediate…

  2. PTSD and alcohol use after the World Trade Center attacks: a longitudinal study.

    PubMed

    Boscarino, Joseph A; Kirchner, H Lester; Hoffman, Stuart N; Sartorius, Jennifer; Adams, Richard E

    2011-10-01

    Research suggests that posttraumatic stress disorder (PTSD) is associated with increased alcohol use, but the findings have not been consistent. We assessed alcohol use, binge drinking, and psychotropic medication use longitudinally in 1,681 New York City adults, representative of the 2000 census, 2 years after the World Trade Center attacks. We found that, with the exception of a modified CAGE Questionnaire index for alcohol, alcohol use showed a modest increase over time and was related to PTSD symptoms, with an increase of about 1 more drink per month for those with PTSD, even though overall levels appeared to be within the National Institute on Alcohol Abuse and Alcoholism's safe range. Psychotropic medication use followed a similar trend; those with PTSD used psychotropics about 20 more days over the past year than those without. Because the study analyses adjusted for key psychosocial variables and confounders, it is not clear if the increased alcohol use following trauma exposure is associated with self-medication of PTSD symptoms, whether increased alcohol use prior to exposure is a risk for delayed-onset PTSD, or whether a third unmeasured variable is involved. Further research is warranted.

  3. PTSD and Alcohol Use After the World Trade Center Attacks: A Longitudinal Study

    PubMed Central

    Boscarino, Joseph A.; Kirchner, H. Lester; Hoffman, Stuart N.; Sartorius, Jennifer; Adams, Richard E.

    2013-01-01

    Research suggests that posttraumatic stress disorder (PTSD) is associated with increased alcohol use, but the findings have not been consistent. We assessed alcohol use, binge drinking, and psychotropic medication use longitudinally in 1,681 New York City adults, representative of the 2000 census, 2 years after the World Trade Center attacks. We found that, with the exception of a modified CAGE Questionnaire index for alcohol, alcohol use showed a modest increase over time and was related to PTSD symptoms, with an increase of about 1 more drink per month for those with PTSD, even though overall levels appeared to be within the National Institute on Alcohol Abuse and Alcoholism’s safe range. Psychotropic medication use followed a similar trend; those with PTSD used psychotropics about 20 more days over the past year than those without. Because the study analyses adjusted for key psychosocial variables and confounders, it is not clear if the increased alcohol use following trauma exposure is associated with self-medication of PTSD symptoms, whether increased alcohol use prior to exposure is a risk for delayed-onset PTSD, or whether a third unmeasured variable is involved. Further research is warranted. PMID:21882246

  4. Air levels of carcinogenic polycyclic aromatic hydrocarbons after the World Trade Center disaster.

    PubMed

    Pleil, Joachim D; Vette, Alan F; Johnson, Brent A; Rappaport, Stephen M

    2004-08-10

    The catastrophic collapse of the World Trade Center (WTC) on September 11, 2001, created an immense dust cloud followed by fires that emitted soot into the air of New York City (NYC) well into December. The subsequent cleanup used diesel equipment that further polluted the air until the following June. The particulate air pollutants contained mutagenic and carcinogenic polycyclic aromatic hydrocarbons (PAHs). By using an assay developed for archived samples of fine particles, we measured nine PAHs in 243 samples collected at or near Ground Zero from September 23, 2001, to March 27, 2002. Based on temporal trends of individual PAH levels, we differentiated between fire and diesel sources and predicted PAH levels between 3 and 200 d after the disaster. Predicted PAH air concentrations on September 14, 2001, ranged from 1.3 to 15 ng/m(3); these values are among the highest reported from outdoor sources. We infer that these high initial air concentrations resulted from fires that rapidly diminished over 100 d. Diesel sources predominated for the next 100 d, during which time PAH levels declined slowly to background values. Because elevated PAH levels were transient, any elevation in cancer risk from PAH exposure should be very small among nonoccupationally exposed residents of NYC. However, the high initial levels of PAHs may be associated with reproductive effects observed in the offspring of women who were (or became) pregnant shortly after September 11, 2001. Because no PAH-specific air sampling was conducted, this work provides the only systematic measurements, to our knowledge, of ambient PAHs after the WTC disaster.

  5. Disasters; the 2010 Haitian earthquake and the evacuation of burn victims to US burn centers.

    PubMed

    Kearns, Randy D; Holmes, James H; Skarote, Mary Beth; Cairns, Charles B; Strickland, Samantha Cooksey; Smith, Howard G; Cairns, Bruce A

    2014-09-01

    Response to the 2010 Haitian earthquake included an array of diverse yet critical actions. This paper will briefly review the evacuation of a small group of patients with burns to burn centers in the southeastern United States (US). This particular evacuation brought together for the first time plans, groups, and organizations that had previously only exercised this process. The response to the Haitian earthquake was a glimpse at what the international community working together can do to help others, and relieve suffering following a catastrophic disaster. The international response was substantial. This paper will trace one evacuation, one day for one unique group of patients with burns to burn centers in the US and review the lessons learned from this process. The patient population with burns being evacuated from Haiti was very small compared to the overall operation. Nevertheless, the outcomes included a better understanding of how a larger event could challenge the limited resources for all involved. This paper includes aspects of the patient movement, the logistics needed, and briefly discusses reimbursement for the care provided. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  6. Elements of resilience after the World Trade Center disaster: reconstituting New York City's Emergency Operations Centre.

    PubMed

    Kendra, James M; Wachtendorf, Tricia

    2003-03-01

    In this paper we examine the reconstitution of the Emergency Operations Centre (EOC) after its destruction in the World Trade Center attack, using that event to highlight several features of resilience. The paper summarises basic EOC functions, and then presents conceptions of resilience as understood from several disciplinary perspectives, noting that work in these fields has sought to understand how a natural or social system that experiences disturbance sustains its functional processes. We observe that, although the physical EOC facility was destroyed, the organisation that had been established to manage crises in New York City continued, enabling a response that drew on the resources of New York City and neighbouring communities, states and the federal government. Availability of resources--which substituted for redundancy of personnel, equipment and space--pre-existing relationships that eased communication challenges as the emergency developed and the continuation of organisational patterns of response integration and role assignments were among the factors that contributed to resilience following the attack.

  7. Hospitalizations for asthma among adults exposed to the September 11, 2001 World Trade Center terrorist attack.

    PubMed

    Miller-Archie, Sara A; Jordan, Hannah T; Alper, Howard; Wisnivesky, Juan P; Cone, James E; Friedman, Stephen M; Brackbill, Robert M

    2017-06-06

    We described the patterns of asthma hospitalization among persons exposed to the 2001 World Trade Center (WTC) attacks, and assessed whether 9/11-related exposures or comorbidities, including posttraumatic stress disorder (PTSD) and gastroesophageal reflux symptoms (GERS), were associated with an increased rate of hospitalization. Data for adult enrollees in the WTC Health Registry, a prospective cohort study, with self-reported physician-diagnosed asthma who resided in New York State on 9/11 were linked to administrative hospitalization data to identify asthma hospitalizations during September 11, 2001-December 31, 2010. Multivariable zero-inflated Poisson regression was used to examine associations among 9/11 exposures, comorbid conditions, and asthma hospitalizations. Of 11 471 enrollees with asthma, 406 (3.5%) had ≥1 asthma hospitalization during the study period (721 total hospitalizations). Among enrollees diagnosed before 9/11 (n = 6319), those with PTSD or GERS had over twice the rate of hospitalization (adjusted rate ratio (ARR) = 2.5, 95% CI = 1.4-4.1; ARR = 2.1, 95% CI = 1.3-3.2, respectively) compared to those without. This association was not statistically significant in enrollees diagnosed after 9/11. Compared to higher educational attainment, completing less than college was associated with an increased hospitalization rate among participants with both pre-9/11- and post-9/11-onset asthma (ARR = 1.9, 95% CI = 1.2-2.9; ARR = 2.6, 95% CI = 1.6-4.1, respectively). Sinus symptoms, exposure to the dust cloud, and having been a WTC responder were not associated with asthma hospitalization. Among enrollees with pre-9/11 asthma, comorbid PTSD and GERS were associated with an increase in asthma hospitalizations. Management of these comorbidities may be an important factor in preventing hospitalization.

  8. Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS): Psychometric Testing of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool

    ERIC Educational Resources Information Center

    Hansel, Tonya Cross; Osofsky, Joy D.; Osofsky, Howard J.

    2015-01-01

    Background: Post disaster psychosocial surveillance procedures are important for guiding effective and efficient recovery. The Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS) is a model designed with the goal of assisting recovering communities in understanding the needs of and targeting services…

  9. Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS): Psychometric Testing of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool

    ERIC Educational Resources Information Center

    Hansel, Tonya Cross; Osofsky, Joy D.; Osofsky, Howard J.

    2015-01-01

    Background: Post disaster psychosocial surveillance procedures are important for guiding effective and efficient recovery. The Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS) is a model designed with the goal of assisting recovering communities in understanding the needs of and targeting services…

  10. The World Trade Center Attacks and Post-Traumatic Stress Disorder.

    ERIC Educational Resources Information Center

    Reynolds, Glenda Phillips

    2003-01-01

    Describes the symptoms of posttraumatic stress disorder (PTSD). Analyzes reports from five newspapers during the first 10 days after the September 11 attacks in relation to manifestations of PTSD, especially in children. (Contains 42 references.) (SK)

  11. Disaster Preparedness Information Needs of Individuals Attending an Adult Literacy Center: An Exploratory Study

    ERIC Educational Resources Information Center

    Friedman, Daniela; Tanwar, Manju; Yoho, Deborah W.; Richter, Jane V. E.

    2009-01-01

    Being prepared with accurate, credible, and timely information during a disaster can help individuals make informed decisions about taking appropriate actions. Unfortunately, many people have difficulty understanding health and risk-related resources. This exploratory, mixed methods study assessed disaster information seeking behaviors and…

  12. Disaster Preparedness Information Needs of Individuals Attending an Adult Literacy Center: An Exploratory Study

    ERIC Educational Resources Information Center

    Friedman, Daniela; Tanwar, Manju; Yoho, Deborah W.; Richter, Jane V. E.

    2009-01-01

    Being prepared with accurate, credible, and timely information during a disaster can help individuals make informed decisions about taking appropriate actions. Unfortunately, many people have difficulty understanding health and risk-related resources. This exploratory, mixed methods study assessed disaster information seeking behaviors and…

  13. Tritium in the World Trade Center September 11, 2001 Terrorist Attack: It's Possible Sources and Fate

    SciTech Connect

    Parekh, P; Semkow, T; Husain, L; Haines, D; Woznial, G; Williams, P; Hafner, R; Rabun, R

    2002-05-03

    Traces of tritiated water (HTO) were determined at World Trade Center (WTC) ground zero after the 9/11/01 terrorist attack. A method of ultralow-background liquid scintillation counting was used after distilling HTO from the samples. A water sample from the WTC sewer, collected on 9/13/01, contained 0.174{plus_minus}0.074 (2{sigma}) nCi/L of HTO. A split water sample, collected on 9/21/01 from the basement of WTC Building 6, contained 3.53{plus_minus}0.17 and 2.83{plus_minus}0.15 nCi/L, respectively. Several water and vegetation samples were analyzed from areas outside the ground zero, located in Manhattan, Brooklyn, Queens, and Kensico Reservoir. No HTO above the background was found in those samples. All these results are well below the levels of concern to human exposure. Several tritium radioluminescent (RL) devices were investigated as possible sources of the traces of tritium at ground zero. Tritium is used in self-luminescent emergency EXIT signs. No such signs were present inside the WTC buildings. However, it was determined that Boeing 767-222 aircraft operated by the United Airlines that hit WTC Tower 2 as well as Boeing 767-223ER operated by the American Airlines, that hit WTC Tower 1, had a combined 34.3 Ci of tritium at the time of impact. Other possible sources of tritium include dials and lights of fire and emergency equipment, sights and scopes in weaponry, as well as time devices equipped with tritium dials. It was determined that emergency equipment was not a likely source. However, WTC hosted several law-enforcement agencies such as ATF, CIA, US Secret Service and US Customs. The ATF office had two weapon vaults in WTC Building 6. Also 63 Police Officers, possibly carrying handguns with tritium sights, died in the attack. The weaponry containing tritium was therefore a likely and significant source of tritium. It is possible that some of the 2830 victims carried tritium watches, however this source appears to be less significant that the other

  14. Sarcoidosis diagnosed after September 11, 2001, among adults exposed to the World Trade Center disaster.

    PubMed

    Jordan, Hannah T; Stellman, Steven D; Prezant, David; Teirstein, Alvin; Osahan, Sukhminder S; Cone, James E

    2011-09-01

    Explore relationships between World Trade Center (WTC) exposures and sarcoidosis. Sarcoidosis has been reported after exposure to the WTC disaster. We ascertained biopsy-proven post-9/11 sarcoidosis among WTC Health Registry enrollees. Cases diagnosed after Registry enrollment were included in a nested case-control study. Controls were matched to cases on age, sex, race or ethnicity, and eligibility group (eg, rescue or recovery worker). We identified 43 cases of post-9/11 sarcoidosis. Twenty-eight incident cases and 109 controls were included in the case-control analysis. Working on the WTC debris pile was associated with sarcoidosis (odds ratio 9.1, 95% confidence interval 1.1 to 74.0), but WTC dust cloud exposure was not (odds ratio 1.0, 95% confidence interval 0.4 to 2.8). Working on the WTC debris pile was associated with an elevated risk of post-9/11 sarcoidosis. Occupationally exposed workers may be at increased risk. (C)2011The American College of Occupational and Environmental Medicine

  15. Posttraumatic stress symptoms and smoking among World Trade Center disaster responders: A longitudinal investigation.

    PubMed

    Zvolensky, Michael J; Farris, Samantha G; Kotov, Roman; Schechter, Clyde B; Bromet, Evelyn; Gonzalez, Adam; Vujanovic, Anka; Pietrzak, Robert H; Crane, Michael; Kaplan, Julia; Moline, Jacqueline; Southwick, Steven M; Feder, Adriana; Udasin, Iris; Reissman, Dori B; Luft, Benjamin J

    2015-11-01

    The current longitudinal study examined posttraumatic stress disorder (PTSD) symptom severity in relation to smoking abstinence and reduction over time among responders to the World Trade Center (WTC) disaster. Participants were 763 police and 1881 non-traditional (e.g., construction workers) WTC responders who reported being smokers at an initial examination obtained between July 2002 and July 2011 at the WTC Health Program (WTC-HP). WTC responders were reassessed, on average, 2.5 years later. For police WTC responders, higher levels of WTC-related PTSD symptoms at the initial visit were associated with a decreased likelihood of smoking abstinence (OR=0.98, p=.002) and with decreased smoking reduction (β=-.06, p=.012) at the follow-up visit. WTC-related PTSD symptom severity was not related to likelihood of smoking abstinence or change in number of cigarettes smoked among non-traditional responders. Post hoc analyses suggested that for police, hyperarousal PTSD symptoms were predictive of decreased abstinence likelihood at the follow-up visit (OR=0.56, p=.006). The present findings suggest that PTSD symptoms may be differentially related to smoking behavior among police and non-traditional WTC responders in a naturalistic, longitudinal investigation. Future work may benefit from exploring further which aspects of PTSD (as compared to each other and to common variance) explain smoking maintenance. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Trends in probable PTSD in firefighters exposed to the World Trade Center disaster, 2001-2010.

    PubMed

    Soo, Jackie; Webber, Mayris P; Gustave, Jackson; Lee, Roy; Hall, Charles B; Cohen, Hillel W; Kelly, Kerry J; Prezant, David J

    2011-09-01

    We present the longest follow-up, to date, of probable posttraumatic stress disorder (PTSD) after the 2001 terrorist attacks on the World Trade Center (WTC) in New York City firefighters who participated in the rescue/recovery effort. We examined data from 11,006 WTC-exposed firefighters who completed 40,672 questionnaires and reported estimates of probable PTSD by year from serial cross-sectional analyses. In longitudinal analyses, we used separate Cox models with data beginning from October 2, 2001, to identify variables associated with recovery from or delayed onset of probable PTSD. The prevalence of probable PTSD was 7.4% by September 11, 2010, and continued to be associated with early arrival at the WTC towers during every year of analysis. An increasing number of aerodigestive symptoms (hazard ratio [HR] 0.89 per symptom, 95% confidence interval [CI] 0.86-.93) and reporting a decrease in exercise, whether the result of health (HR 0.56 vs no change in exercise, 95% CI 0.41-.78) or other reasons (HR 0.76 vs no change in exercise, 95% CI 0.63-.92), were associated with a lower likelihood of recovery from probable PTSD. Arriving early at the WTC (HR 1.38 vs later WTC arrival, 95% CI 1.12-1.70), an increasing number of aerodigestive symptoms (HR 1.45 per symptom, 95% CI 1.40-1.51), and reporting an increase in alcohol intake since September 11, 2001 (HR 3.43 vs no increase in alcohol intake, 95% CI 2.67-4.43) were associated with delayed onset of probable PTSD. Probable PTSD continues to be associated with early WTC arrival even 9 years after the terrorist attacks. Concurrent conditions and behaviors, such as respiratory symptoms, exercise, and alcohol use also play important roles in contributing to PTSD symptoms.

  17. Serum perfluoroalkyl substances in children exposed to the world trade center disaster.

    PubMed

    Trasande, Leonardo; Koshy, Tony T; Gilbert, Joseph; Burdine, Lauren K; Attina, Teresa M; Ghassabian, Akhgar; Honda, Masato; Marmor, Michael; Chu, Dinh Binh; Han, Xiaoxia; Shao, Yongzhao; Kannan, Kurunthachalam

    2017-04-01

    The World Trade Center (WTC) disaster released large amounts of various chemical substances into the environment, including perfluoroalkyl substances (PFASs). Yet, no studies have examined exposures in children living or attending schools near the disaster site. We measured serum PFASs in WTC Health Registry (WTCHR) respondents who were ≤8 years of age on September 11, 2001 and a sociodemographically-matched comparison group. We also examined the relationship of PFASs levels with dust cloud exposure; home dust exposure, and with traumatic exposure, the latter to take into account differences related to possible mental health consequences and associated behavioral problems. Serum samples, collected between 2014 and 2016, were analyzed from 123 WTCHR participants and from 185 participants in the comparison group. In the WTCHR group, median perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) levels were 1.81ng/mL and 3.72ng/mL, respectively. Controlling for sex, caloric intake, race/ethnicity, and date of birth, significant increases among WTCHR participants compared with the matched comparison group were detected for perfluorohexanesulfonate (0.23ng/mL increase or 0.24log unit increase, p=0.006); PFOS (0.86ng/mL increase or 0.16log unit increase, p=0.011); PFOA (0.35ng/mL increase or 0.18log unit increase, p<0.001); perfluorononanoic acid (0.12ng/mL increase or 0.17log unit increase, p=0.003); perfluorodecanoic acid (0.06ng/mL increase or 0.42log unit increase, p<0.001); and perfluoroundecanoic acid (0.03ng/mL increase or 0.32log unit increase, p=0.019). Stronger associations were identified for home dust exposures and traumatic exposures than dust cloud. These findings highlight the importance of conducting longitudinal studies in this population to assess possible cardiometabolic and renal consequences related to these exposures. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. The Mental Health Consequences of Disaster-Related Loss: Findings from Primary Care One Year After the 9/11 Terrorist Attacks

    PubMed Central

    Neria, Yuval; Olfson, Mark; Gameroff, Marc J.; Wickramaratne, Priya; Gross, Raz; Pilowsky, Daniel J.; Blanco, Carlos; Manetti-Cusa, Julián; Lantigua, Rafael; Shea, Steven; Weissman, Myrna M.

    2013-01-01

    This study examines the long-term psychiatric consequences, pain interference in daily activities, work loss, and functional impairment associated with 9/11-related loss among low-income, minority primary care patients in New York City. A systematic sample of 929 adult patients completed a survey that included a sociodemographic questionnaire, the PTSD Checklist, the PRIME-MD Patient Health Questionnaire, and the Medical Outcomes Study Short Form-12 (SF-12). Approximately one-quarter of the sample reported knowing someone who was killed in the attacks of 9/11, and these patients were sociodemographically similar to the rest of the sample. Compared to patients who had not experienced 9/11-related loss, patients who experienced loss were roughly twice as likely (OR = 1.97, 95%; CI = 1.40, 2.77) to screen positive for at least one mental disorder, including major depressive disorder (MDD; 29.2%), generalized anxiety disorder (GAD; 19.4%), and posttraumatic stress disorder (PTSD; 17.1%). After controlling for pre-9/11 trauma, 9/11-related loss was significantly related to extreme pain interference, work loss, and functional impairment. The results suggest that disaster-related mental health care in this clinical population should emphasize evidence-based treatments for mood and anxiety disorders. PMID:19152283

  19. The mental health consequences of disaster-related loss: findings from primary care one year after the 9/11 terrorist attacks.

    PubMed

    Neria, Yuval; Olfson, Mark; Gameroff, Marc J; Wickramaratne, Priya; Gross, Raz; Pilowsky, Daniel J; Blanco, Carlos; Manetti-Cusa, Julián; Lantigua, Rafael; Shea, Steven; Weissman, Myrna M

    2008-01-01

    This study examines the long-term psychiatric consequences, pain interference in daily activities, work loss, and functional impairment associated with 9/11-related loss among low-income, minority primary care patients in New York City. A systematic sample of 929 adult patients completed a survey that included a sociodemographic questionnaire, the PTSD Checklist, the PRIME-MD Patient Health Questionnaire, and the Medical Outcomes Study Short Form-12 (SF-12). Approximately one-quarter of the sample reported knowing someone who was killed in the attacks of 9/11, and these patients were sociodemographically similar to the rest of the sample. Compared to patients who had not experienced 9/11-related loss, patients who experienced loss were roughly twice as likely (OR = 1.97, 95%; CI = 1.40, 2.77) to screen positive for at least one mental disorder, including major depressive disorder (MDD; 29.2%), generalized anxiety disorder (GAD; 19.4%), and posttraumatic stress disorder (PTSD; 17.1%). After controlling for pre-9/11 trauma, 9/11-related loss was significantly related to extreme pain interference, work loss, and functional impairment. The results suggest that disaster-related mental health care in this clinical population should emphasize evidence-based treatments for mood and anxiety disorders.

  20. Combined external and internal hospital disaster: impact and response in a Houston trauma center intensive care unit.

    PubMed

    Nates, Joseph L

    2004-03-01

    To increase awareness of specific risks to healthcare systems during a natural or civil disaster. We describe the catastrophic disruption of essential services and the point-by-point response to the crisis in a major medical center. Case report, review of the literature, and discussion. A 28-bed intensive care unit in a level I trauma center in the largest medical center in the world. In June 2001, tropical storm Allison caused >3 feet of rainfall and catastrophic flooding in Houston, TX. Memorial Hermann Hospital, one of only two level I trauma centers in the community, lost electrical power, communications systems, running water, and internal transportation. All essential hospital services were rendered nonfunctional. Life-saving equipment such as ventilators, infusion pumps, and monitors became useless. Patients were triaged to other medical facilities based on acuity using ground and air ambulances. No patients died as result of the internal disaster. Adequate training, teamwork, communication, coordination with other healthcare professionals, and strong leadership are essential during a crisis. Electricity is vital when delivering care in today's healthcare system, which depends on advanced technology. It is imperative that hospitals take the necessary measures to preserve electrical power at all times. Hospitals should have battery-operated internal and external communication systems readily available in the event of a widespread disaster and communication outage. Critical services such as pharmacy, laboratories, blood bank, and central supply rooms should be located at sites more secure than the ground floors, and these services should be prepared for more extensive performances. Contingency plans to maintain protected water supplies and available emergency kits with batteries, flashlights, two-way radios, and a nonelectronic emergency system for patient identification are also very important. Rapid adaptation to unexpected adverse conditions is critical to

  1. Planning and Implementing a Disaster Recovery Capability for a Mainframe-Based Hospital Information System: Duke University Medical Center's Experience

    PubMed Central

    Kirby, J. David; Walker, L. Phillip; Aaron, Walter H.; Whitesell, Judy J.; Stead, William W.

    1988-01-01

    Since October 1986, the Medical Center Information Systems Department at Duke University Medical Center (DUMC) has been developing and implementing a plan to provide for the continuation of the functions performed by Duke Hospital's central computing system in the event of a disaster that would disable the central hardware configuration for an extended amount of time. The key characteristic of the plan is that it provides for the full function and performance of the system to be returned to the end users within twenty four hours of the primary system's failure.

  2. Asthma control in adolescents 10 to 11 y after exposure to the World Trade Center disaster.

    PubMed

    Gargano, Lisa M; Thomas, Pauline A; Stellman, Steven D

    2017-01-01

    Little is known about asthma control in adolescents who were exposed to the World Trade Center (WTC) attacks of 11 September 2001 and diagnosed with asthma after 9/11. This report examines asthma and asthma control 10-11 y after 9/11 among exposed adolescents. The WTC Health Registry adolescent Wave 3 survey (2011-2012) collected data on asthma diagnosed by a physician after 11 September 2001, extent of asthma control based on modified National Asthma Education and Prevention Program criteria, probable mental health conditions, and behavior problems. Parents reported healthcare needs and 9/11-exposures. Logistic regression was used to evaluate associations between asthma and level of asthma control and 9/11-exposure, mental health and behavioral problems, and unmet healthcare needs. Poorly/very poorly controlled asthma was significantly associated with a household income of ≤$75,000 (adjusted odds ratio (AOR): 3.0; 95% confidence interval (CI): 1.1-8.8), having unmet healthcare needs (AOR: 6.2; 95% CI: 1.4-27.1), and screening positive for at least one mental health condition (AOR: 5.0; 95% CI: 1.4-17.7), but not with behavioral problems. The impact of having at least one mental health condition on the level of asthma control was substantially greater in females than in males. Comprehensive care of post-9/11 asthma in adolescents should include management of mental health-related comorbidities.

  3. Providing Crisis Counseling to New Yorkers after the Terrorist Attack on the World Trade Center.

    ERIC Educational Resources Information Center

    Jordan, Karin

    2002-01-01

    This article provides an overview of two crisis intervention techniques used by a marriage and family counselor who served as a crisis counselor in New York City after the September 11th terrorist attack. The intervention techniques described are Critical Incident Stress Debriefing and one-on-one crisis counseling. An overview of both techniques…

  4. Not so close but still extremely loud: recollection of the World Trade Center terror attack and previous hurricanes moderates the association between exposure to hurricane Sandy and posttraumatic stress symptoms.

    PubMed

    Palgi, Yuval; Shrira, Amit; Hamama-Raz, Yaira; Palgi, Sharon; Goodwin, Robin; Ben-Ezra, Menachem

    2014-05-01

    The present study examined whether recollections of the World Trade Center (WTC) terror attack and previous hurricanes moderated the relationship between exposure to Hurricane Sandy and related posttraumatic stress disorder (PTSD) symptoms. An online sample of 1000 participants from affected areas completed self-report questionnaires a month after Hurricane Sandy hit the East Coast of the United States. Participants reported their exposure to Hurricane Sandy, their PTSD symptoms, and recollections of the WTC terror attack and previous hurricanes elicited due to Hurricane Sandy. Exposure to Hurricane Sandy was related to PTSD symptoms among those with high level of recollections of the WTC terror attack and past hurricanes, but not among those with low level of recollections. The aftermath of exposure to Hurricane Sandy is related not only to exposure, but also to its interaction with recollections of past traumas. These findings have theoretical and practical implications for practitioners and health policy makers in evaluating and interpreting the impact of past memories on future natural disasters. This may help in intervention plans of social and psychological services. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Post-disaster reproductive health outcomes.

    PubMed

    Zotti, Marianne E; Williams, Amy M; Robertson, McKaylee; Horney, Jennifer; Hsia, Jason

    2013-07-01

    We examined methodological issues in studies of disaster-related effects on reproductive health outcomes and fertility among women of reproductive age and infants in the United States (US). We conducted a systematic literature review of 1,635 articles and reports published in peer-reviewed journals or by the government from January 1981 through December 2010. We classified the studies using three exposure types: (1) physical exposure to toxicants; (2) psychological trauma; and (3) general exposure to disaster. Fifteen articles met our inclusion criteria concerning research focus and design. Overall studies pertained to eight different disasters, with most (n = 6) focused on the World Trade Center attack. Only one study examined pregnancy loss, i.e., occurrence of spontaneous abortions post-disaster. Most studies focused on associations between disaster and adverse birth outcomes, but two studies pertained only to post-disaster fertility while another two examined it in addition to adverse birth outcomes. In most studies disaster-affected populations were assumed to have experienced psychological trauma, but exposure to trauma was measured in only four studies. Furthermore, effects of both physical exposure to toxicants and psychological trauma on disaster-affected populations were examined in only one study. Effects on birth outcomes were not consistently demonstrated, and study methodologies varied widely. Even so, these studies suggest an association between disasters and reproductive health and highlight the need for further studies to clarify associations. We postulate that post-disaster surveillance among pregnant women could improve our understanding of effects of disaster on the reproductive health of US pregnant women.

  6. Post-Disaster Reproductive Health Outcomes

    PubMed Central

    Zotti, Marianne E.; Williams, Amy M.; Robertson, McKaylee; Horney, Jennifer; Hsia, Jason

    2015-01-01

    We examined methodological issues in studies of disaster-related effects on reproductive health outcomes and fertility among women of reproductive age and infants in the United States (US). We conducted a systematic literature review of 1,635 articles and reports published in peer-reviewed journals or by the government from January 1981 through December 2010. We classified the studies using three exposure types: (1) physical exposure to toxicants; (2) psychological trauma; and (3) general exposure to disaster. Fifteen articles met our inclusion criteria concerning research focus and design. Overall studies pertained to eight different disasters, with most (n = 6) focused on the World Trade Center attack. Only one study examined pregnancy loss, i.e., occurrence of spontaneous abortions post-disaster. Most studies focused on associations between disaster and adverse birth outcomes, but two studies pertained only to post-disaster fertility while another two examined it in addition to adverse birth outcomes. In most studies disaster-affected populations were assumed to have experienced psychological trauma, but exposure to trauma was measured in only four studies. Furthermore, effects of both physical exposure to toxicants and psychological trauma on disaster-affected populations were examined in only one study. Effects on birth outcomes were not consistently demonstrated, and study methodologies varied widely. Even so, these studies suggest an association between disasters and reproductive health and highlight the need for further studies to clarify associations. We postulate that post-disaster surveillance among pregnant women could improve our understanding of effects of disaster on the reproductive health of US pregnant women. PMID:22752348

  7. An Air Campaign for a Second Korean War: A Strategy for Attacking the Centers of Gravity

    DTIC Science & Technology

    1992-05-18

    for a Second Korean War. The author argues that North Korea has three concentric centers of gravity--one each at the strategic, operational, and...tactical level. The strategic center is the national and military leadership; the operational center is the North Korean Integrated Air Defense System; the...Second Korean War. The author argues that North Korea has three concentric centers of gravity--one each at the strategic, operational, and tactical

  8. Asthma control in adolescents 10 to 11 y after exposure to the World Trade Center disaster

    PubMed Central

    Gargano, Lisa M.; Thomas, Pauline A.; Stellman, Steven D.

    2017-01-01

    Background: Little is known about asthma control in adolescents who were exposed to the World Trade Center (WTC) attacks of 11 September 2001 and diagnosed with asthma after 9/11. This report examines asthma and asthma control 10–11 y after 9/11 among exposed adolescents. Methods: The WTC Health Registry adolescent Wave 3 survey (2011–2012) collected data on asthma diagnosed by a physician after 11 September 2001, extent of asthma control based on modified National Asthma Education and Prevention Program criteria, probable mental health conditions, and behavior problems. Parents reported healthcare needs and 9/11-exposures. Logistic regression was used to evaluate associations between asthma and level of asthma control and 9/11-exposure, mental health and behavioral problems, and unmet healthcare needs. Results: Poorly/very poorly controlled asthma was significantly associated with a household income of ≤$75,000 (adjusted odds ratio (AOR): 3.0; 95% confidence interval (CI): 1.1–8.8), having unmet healthcare needs (AOR: 6.2; 95% CI: 1.4–27.1), and screening positive for at least one mental health condition (AOR: 5.0; 95% CI: 1.4–17.7), but not with behavioral problems. The impact of having at least one mental health condition on the level of asthma control was substantially greater in females than in males. Conclusions: Comprehensive care of post-9/11 asthma in adolescents should include management of mental health-related comorbidities. PMID:27656769

  9. Temporal Movement of the Geochemical "Fingerprint" of the World Trade Center Terrorist Attack in New York Harbor Sediments

    NASA Astrophysics Data System (ADS)

    Smith, J. P.; Oktay, S. D.; Brabander, D. J.; Olsen, C. R.; Kada, J.

    2002-12-01

    The September 11, 2001 terrorist attack on the World Trade Center (WTC) in New York City introduced large amounts of ash and debris over a wide area including New York Harbor (NYH) and the Lower Hudson River Estuary. Previous results, based on data from ash/debris collected after the event and from sediment cores taken on October 12, 2001 in inactive harbor slips along the lower west side of Manhattan, have identified a textural and elemental "fingerprint" for the ash/debris, and have documented a stratigraphic horizon for the event in New York Harbor sediments. On July 24 and July 25, 2002, almost eleven months after the attack, the same sample sites were revisited and new sediment cores collected. Sediment samples were analyzed using radionuclide tracers (Be-7, Cs-137, I-131) and textural and elemental (major- and trace-element) characterizations were made in order to: 1) document the temporal progression of the fingerprint as a distinct horizon preserved in the sediments of New York Harbor; and 2) investigate how short-to-medium term sediment dynamics (supply, deposition, re-suspension, and net accumulation) may affect the preservation of a sedimentological record associated with the event. These results will be used to evaluate whether the WTC geochemical fingerprint may serve as a tool to help assess the impact of the attack and as a tracer for short to medium term sediment dynamics in the Lower Hudson River Estuary.

  10. Routine High-Resolution Forecasts/Analyses for the Pacific Disaster Center: User Manual

    NASA Technical Reports Server (NTRS)

    Roads, John; Han, J.; Chen, S.; Burgan, R.; Fujioka, F.; Stevens, D.; Funayama, D.; Chambers, C.; Bingaman, B.; McCord, C.; Paylor, Earnest (Technical Monitor)

    2001-01-01

    Enclosed herein is our HWCMO user manual. This manual constitutes the final report for our NASA/PDC grant, NASA NAG5-8730, "Routine High Resolution Forecasts/Analysis for the Pacific Disaster Center". Since the beginning of the grant, we have routinely provided experimental high resolution forecasts from the RSM/MSM for the Hawaii Islands, while working to upgrade the system to include: (1) a more robust input of NCEP analyses directly from NCEP; (2) higher vertical resolution, with increased forecast accuracy; (3) faster delivery of forecast products and extension of initial 1-day forecasts to 2 days; (4) augmentation of our basic meteorological and simplified fireweather forecasts to firedanger and drought forecasts; (5) additional meteorological forecasts with an alternate mesoscale model (MM5); and (6) the feasibility of using our modeling system to work in higher-resolution domains and other regions. In this user manual, we provide a general overview of the operational system and the mesoscale models as well as more detailed descriptions of the models. A detailed description of daily operations and a cost analysis is also provided. Evaluations of the models are included although it should be noted that model evaluation is a continuing process and as potential problems are identified, these can be used as the basis for making model improvements. Finally, we include our previously submitted answers to particular PDC questions (Appendix V). All of our initially proposed objectives have basically been met. In fact, a number of useful applications (VOG, air pollution transport) are already utilizing our experimental output and we believe there are a number of other applications that could make use of our routine forecast/analysis products. Still, work still remains to be done to further develop this experimental weather, climate, fire danger and drought prediction system. In short, we would like to be a part of a future PDC team, if at all possible, to further

  11. ENVIRONMENTAL MONITORING AND MODELING ASSOCIATED WITH NATIONAL EMERGENCIES - EXPERIENCES GAINED FROM THE WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    A workshop was held in Research Triangle Park, NC on November 18-19, 2002 to discuss scientific issues associated with measuring, modeling, and assessing exposure and risk to air containing contaminants generated as a result of national emergencies and disasters. Participants wer...

  12. ENVIRONMENTAL MONITORING AND MODELING ASSOCIATED WITH NATIONAL EMERGENCIES - EXPERIENCES GAINED FROM THE WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    A workshop was held in Research Triangle Park, NC on November 18-19, 2002 to discuss scientific issues associated with measuring, modeling, and assessing exposure and risk to air containing contaminants generated as a result of national emergencies and disasters. Participants wer...

  13. Development of the University Center for Disaster Preparedness and Emergency Response (UCDPER)

    DTIC Science & Technology

    2011-09-30

    become robust over the course of the project. Follow-up projects are being planned 15 . SUBJECT TERMS Disaster preparedness, emergency response. 16...three projects expected to be concluded by February 15 , 2011. The research projects conducted under the UCDPER umbrella have produced...operations conducted by Jafari concluded that real time information on patient tracking and resource availability can significantly improve patient flow

  14. Kinematic Analysis of Volleyball Attack in the Net Center with Various Types of Take-Off

    PubMed Central

    Zahálka, František; Malý, Tomáš; Malá, Lucia; Ejem, Miloslav; Zawartka, Marek

    2017-01-01

    Abstract The aim of the study was to describe and compare kinematics in two types of execution of attack hit, the goofy approach and regular approach. The research group consisted of players from the Czech Republic’s top league (n = 12, age 28.0 ± 4.3 years, body height 196.6 ± 5.6 cm, body mass 89.7 ± 6.7 kg) divided into two groups according to the individual type of approach in the attack. Analysis of movement was performed by 3D kinematics video analysis, space coordinates were calculated by the DLT (Direct Linear Transformation) method together with interpretation software TEMA Bio 2.3 (Image Systems AB, Sweden). The players started their run-up from a distance of about 4 – 4.5 m from the net with similar maximal vertical velocity (2.91 – 2.96 m⋅s-1). The trajectory of players with goofy approach seemed to be convenient for the rotation of shoulders and hips in the moment of ball contact. Differences between both groups were observed. Players with a goofy approach had a longer flight phase compared to regularly approaching players. PMID:28828096

  15. Applications of NASA and NOAA Satellite Observations by NASA's Short-term Prediction Research and Transition (SPoRT) Center in Response to Natural Disasters

    NASA Technical Reports Server (NTRS)

    Molthan, Andrew L.; Burks, Jason E.; McGrath, Kevin M.; Jedlovec, Gary J.

    2012-01-01

    NASA s Short-term Prediction Research and Transition (SPoRT) Center supports the transition of unique NASA and NOAA research activities to the operational weather forecasting community. SPoRT emphasizes real-time analysis and prediction out to 48 hours. SPoRT partners with NOAA s National Weather Service (NWS) Weather Forecast Offices (WFOs) and National Centers to improve current products, demonstrate future satellite capabilities and explore new data assimilation techniques. Recently, the SPoRT Center has been involved in several activities related to disaster response, in collaboration with NOAA s National Weather Service, NASA s Applied Sciences Disasters Program, and other partners.

  16. Cost analysis of a disaster facility at an apex tertiary care trauma center of India

    PubMed Central

    Singh, Sheetal; Gupta, Shakti; Daga, Anoop; Siddharth, Vijaydeep; Wundavalli, LaxmiTej

    2016-01-01

    Introduction: For the Commonwealth Games 2010, Jai Prakash Narayan Apex Trauma Centre (JPNATC) of India had been directed by the Director General Health Services and Ministry of Health and Family Welfare, Government of India, to set up a specialized unit for the definitive management of the injured/unwell athletes, officials, and related personnel coming for the Commonwealth Games in October 2010. The facility included a 20-bedded fully equipped ward, six ICU beds with ventilator capacity, one very very important person observation area, one perioperative management cubicle, and one fully modular and integrated operating room. Objective: The objective of this study was to calculate the cost of disaster facility at JPNATC, All India Institute of Medical Sciences, New Delhi. Methodology: Traditional (average or gross) costing methodology was used to arrive at the cost for the provisioning of these services by this facility. Results: The annual cost of providing services at disaster facility at JPNATC, New Delhi, was calculated to be INR 61,007,334.08 (US$ 983,989.258) while the per hour cost was calculated to be INR 7061.03 of the total cost toward the provisioning of services by disaster facility where 26% was the capital cost and 74% was the operating cost. Human resource caters to maximum chunk of the expenditures (47%). Conclusion: The results of this costing study will help in the future planning of resource allocation within the financial constraints (US$ 1 = INR 62 in the year 2013). PMID:27904258

  17. Cost analysis of a disaster facility at an apex tertiary care trauma center of India.

    PubMed

    Singh, Sheetal; Gupta, Shakti; Daga, Anoop; Siddharth, Vijaydeep; Wundavalli, LaxmiTej

    2016-01-01

    For the Commonwealth Games 2010, Jai Prakash Narayan Apex Trauma Centre (JPNATC) of India had been directed by the Director General Health Services and Ministry of Health and Family Welfare, Government of India, to set up a specialized unit for the definitive management of the injured/unwell athletes, officials, and related personnel coming for the Commonwealth Games in October 2010. The facility included a 20-bedded fully equipped ward, six ICU beds with ventilator capacity, one very very important person observation area, one perioperative management cubicle, and one fully modular and integrated operating room. The objective of this study was to calculate the cost of disaster facility at JPNATC, All India Institute of Medical Sciences, New Delhi. Traditional (average or gross) costing methodology was used to arrive at the cost for the provisioning of these services by this facility. The annual cost of providing services at disaster facility at JPNATC, New Delhi, was calculated to be INR 61,007,334.08 (US$ 983,989.258) while the per hour cost was calculated to be INR 7061.03 of the total cost toward the provisioning of services by disaster facility where 26% was the capital cost and 74% was the operating cost. Human resource caters to maximum chunk of the expenditures (47%). The results of this costing study will help in the future planning of resource allocation within the financial constraints (US$ 1 = INR 62 in the year 2013).

  18. Community Disasters, Psychological Trauma, and Crisis Intervention

    PubMed Central

    Boscarino, Joseph A.

    2015-01-01

    The current issue of International Journal of Emergency Mental Health and Human Resilience is focused on community disasters, the impact of trauma exposure, and crisis intervention. The articles incorporated include studies ranging from the World Trade Center disaster to Hurricane Sandy. These studies are related to public attitudes and beliefs about disease outbreaks, the impact of volunteerism following the World Trade Center attacks, alcohol misuse among police officers after Hurricane Katrina, posttraumatic stress disorder after Hurricane Sandy among those exposed to the Trade Center disaster, compassion fatigue and burnout among trauma workers, crisis interventions in Eastern Europe, and police officers' use of stress intervention services. While this scope is broad, it reflects the knowledge that has emerged since the Buffalo Creek and Chernobyl catastrophes, to the more recent Hurricane Katrina and Sandy disasters. Given the current threat environment, psychologists, social workers, and other providers need to be aware of these developments and be prepared to mitigate the impact of psychological trauma following community disasters, whether natural or man-made. PMID:25983663

  19. Community Disasters, Psychological Trauma, and Crisis Intervention.

    PubMed

    Boscarino, Joseph A

    The current issue of International Journal of Emergency Mental Health and Human Resilience is focused on community disasters, the impact of trauma exposure, and crisis intervention. The articles incorporated include studies ranging from the World Trade Center disaster to Hurricane Sandy. These studies are related to public attitudes and beliefs about disease outbreaks, the impact of volunteerism following the World Trade Center attacks, alcohol misuse among police officers after Hurricane Katrina, posttraumatic stress disorder after Hurricane Sandy among those exposed to the Trade Center disaster, compassion fatigue and burnout among trauma workers, crisis interventions in Eastern Europe, and police officers' use of stress intervention services. While this scope is broad, it reflects the knowledge that has emerged since the Buffalo Creek and Chernobyl catastrophes, to the more recent Hurricane Katrina and Sandy disasters. Given the current threat environment, psychologists, social workers, and other providers need to be aware of these developments and be prepared to mitigate the impact of psychological trauma following community disasters, whether natural or man-made.

  20. Cumulative trauma and posttraumatic stress disorder among children exposed to the 9/11 World Trade Center attack.

    PubMed

    Mullett-Hume, Elizabeth; Anshel, Daphne; Guevara, Vivianne; Cloitre, Marylene

    2008-01-01

    Two and one-half years after the September 11, 2001 World Trade Center attack, 204 middle school students in an immigrant community located near Ground Zero were assessed for posttraumatic stress disorder (PTSD) symptoms as influenced by "dose" of exposure to the attack and accumulated lifetime traumas. Ninety percent of students reported at least one traumatic event other than 9/11 (e.g., community violence) with an average of 4 lifetime events reported. An interaction was obtained such that the dose-response effect depended on presence of other traumas. Among students with the lowest number of additional traumas, the usual dose-response pattern of increasing PTSD symptoms with increasing 9/11 exposure was observed; among those with medium to high cumulative life trauma, PTSD symptoms were substantially higher and uniformly so regardless of 9/11 exposure dose. Results suggest that traumas that precede or follow mass violence often have as much as if not greater impact on long-term symptom severity than high-dose exposure to the event. Implications regarding the presence of continuing or previous trauma exposure for postdisaster and early intervention policies are discussed.

  1. Considerations in Identifying and Attacking the Enemy’s Center of Gravity,

    DTIC Science & Technology

    1986-05-14

    1941 Crusader and 1942 Bustard Hunt operations - in order to identify insights and lessons applicable to center of gravity at the operational level...I II. ANALYSIS OF OPERATION CRUSADER ................. 9 III. ANALYSIS OF OPERATION BUSTARD HUNT ............ 19 S, IV. CONCLUSIONS...28 APPENDIX A (MAPS FOR CRUSADER) ................. 31 APPENDIX B (MAPS FOR BUSTARD HUNT) ............. 35 ENDNOTES

  2. Injury, intense dust exposure, and chronic disease among survivors of the World Trade Center terrorist attacks of September 11, 2001.

    PubMed

    Alper, Howard E; Yu, Shengchao; Stellman, Steven D; Brackbill, Robert M

    2017-12-01

    The World Trade Center attack of September 11, 2001 in New York City (9/11) exposed thousands of people to intense concentrations of hazardous materials that have resulted in reports of increased levels of asthma, heart disease, diabetes, and other chronic diseases along with psychological illnesses such as post-traumatic stress disorder (PTSD). Few studies have discriminated between health consequences of immediate (short-term or acute) intense exposures versus chronic residential or workplace exposures. We used proportional hazards methods to determine adjusted hazard ratios (AHRs) for associations between several components of acute exposures (e.g., injury, immersion in the dust cloud) and four chronic disease outcomes: asthma, other non-neoplastic lung diseases, cardiovascular disease, and diabetes, in 8701 persons free of those conditions prior to exposure and who were physically present during or immediately after the World Trade Center attacks. Participants were followed prospectively up to 11 years post-9/11. Heart disease exhibited a dose-response association with sustaining injury (1 injury type: AHR =2.0, 95% CI (Confidence Interval) 1.1-3.6; 2 injury types: AHR = 3.1, 95% CI 1.2-7.9; 3 or more injury types: AHR = 6.8, 95% CI 2.0-22.6), while asthma and other lung diseases were both significantly associated with dust cloud exposure (AHR = 1.3, 95% CI 1.0-1.6). Diabetes was not associated with any of the predictors assessed in this study. In this study we demonstrated that the acute exposures of injury and dust cloud that were sustained on 9/11/2001 had significant associations with later heart and respiratory diseases. Continued monitoring of 9/11 exposed persons' health by medical providers is warranted for the foreseeable future.

  3. Environmental studies of the World Trade Center area after the September 11, 2001 attack

    USGS Publications Warehouse

    Clark, Roger N.; Green, Robert O.; Swayze, Gregg A.; Meeker, Greg; Sutley, Steve; Hoefen, Todd M.; Livo, K. Eric; Plumlee, Geoff; Pavri, Betina; Sarture, Chuck; Wilson, Steve; Hageman, Phil; Lamothe, Paul; Vance, J. Sam; Boardman, Joe; Brownfield, Isabelle; Gent, Carol; Morath, Laurie C.; Taggart, Joseph; Theodorakos, Peter M.; Adams, Monique

    2001-01-01

    This web site describes the results of an interdisciplinary environmental characterization of the World Trade Center (WTC) area after September 11, 2001.Information presented in this site was first made available to the World Trade Center emergency response teams on September 18, 2001 (Thermal hot spot information), and September 27, 2001 (maps and compositional results).The Airborne Visible / Infrared Imaging Spectrometer (AVIRIS), a hyperspectral remote sensing instrument, was flown by JPL/NASA over the World Trade Center (WTC) area on September 16, 18, 22, and 23, 2001 ( Link to the AVIRIS JPL data facility). A 2-person USGS crew collected samples of dusts and airfall debris from more than 35 localities within a 1-km radius of the World trade Center site on the evenings of September 17 and 18, 2001. Two samples were collected of indoor locations that were presumably not affected by rainfall (there was a rainstorm on September 14). Two samples of material coating a steel beam in the WTC debris were also collected. The USGS ground crew also carried out on-the-ground reflectance spectroscopy measurements during daylight hours to field calibrate AVIRIS remote sensing data. Radiance calibration and rectification of the AVIRIS data were done at JPL/NASA. Surface reflectance calibration, spectral mapping, and interpretation were done at the USGS Imaging Spectroscopy Lab in Denver. The dust/debris and beam-insulation samples were analyzed for a variety of mineralogical and chemical parameters using Reflectance Spectroscopy (RS), Scanning Electron Microscopy (SEM), X-Ray Diffraction (XRD), chemical analysis, and chemical leach test techniques in U.S. Geological Survey laboratories in Denver, Colorado.

  4. Revised and updated recommendations for the establishment of primary stroke centers: a summary statement from the brain attack coalition.

    PubMed

    Alberts, Mark J; Latchaw, Richard E; Jagoda, Andy; Wechsler, Lawrence R; Crocco, Todd; George, Mary G; Connolly, E S; Mancini, Barbara; Prudhomme, Stephen; Gress, Daryl; Jensen, Mary E; Bass, Robert; Ruff, Robert; Foell, Kathy; Armonda, Rocco A; Emr, Marian; Warren, Margo; Baranski, Jim; Walker, Michael D

    2011-09-01

    The formation and certification of Primary Stroke Centers has progressed rapidly since the Brain Attack Coalition's original recommendations in 2000. The purpose of this article is to revise and update our recommendations for Primary Stroke Centers to reflect the latest data and experience. We conducted a literature review using MEDLINE and PubMed from March 2000 to January 2011. The review focused on studies that were relevant for acute stroke diagnosis, treatment, and care. Original references as well as meta-analyses and other care guidelines were also reviewed and included if found to be valid and relevant. Levels of evidence were added to reflect current guideline development practices. Based on the literature review and experience at Primary Stroke Centers, the importance of some elements has been further strengthened, and several new areas have been added. These include (1) the importance of acute stroke teams; (2) the importance of Stroke Units with telemetry monitoring; (3) performance of brain imaging with MRI and diffusion-weighted sequences; (4) assessment of cerebral vasculature with MR angiography or CT angiography; (5) cardiac imaging; (6) early initiation of rehabilitation therapies; and (7) certification by an independent body, including a site visit and disease performance measures. Based on the evidence, several elements of Primary Stroke Centers are particularly important for improving the care of patients with an acute stroke. Additional elements focus on imaging of the brain, the cerebral vasculature, and the heart. These new elements may improve the care and outcomes for patients with stroke cared for at a Primary Stroke Center.

  5. Longitudinal study of probable post-traumatic stress disorder in firefighters exposed to the World Trade Center disaster.

    PubMed

    Berninger, Amy; Webber, Mayris P; Niles, Justin K; Gustave, Jackson; Lee, Roy; Cohen, Hillel W; Kelly, Kerry; Corrigan, Malachy; Prezant, David J

    2010-12-01

    Symptoms of post-traumatic stress disorder (PTSD) have been reported even years after the terrorist attacks of September 11, 2001 (9/11). We used screening tools to assess the prevalence of probable PTSD in 9/11-exposed firefighters at two time points, within 6 months of 9/11 (baseline) and 3-4 years post-disaster (follow-up). Five thousand six hundred fifty-six individuals completed assessments at both times. 15.5% reported probable PTSD post-9/11, 8.6% at baseline and 11.1% at follow-up, on average 2.9 (SD 0.5) years later. Analyses revealed that nearly half of all probable PTSD occurred as delayed onset (absent baseline, present follow-up). Compared with the resilient group (no probable PTSD at either time), probable PTSD at baseline, and delayed onset at follow-up were each associated with concomitant functional impairment (OR 19.5 and 18.9), respectively. Similar percentages of firefighters met criteria for baseline and delayed onset probable PTSD at follow-up, years later. Both were associated with substantial functional impairment. Early risk identification could provide opportunities for mental health interventions before symptoms compromise work and social relationships.

  6. Management of patients with transient ischemic attack (TIA) at Sestre milosrdnice University Hospital Center.

    PubMed

    Lovrencić-Huzjan, Arijana; Strineka, Maja; Simicević, Darja Sodec; Azman, Drazen; Strbe, Sanja; Vuković-Cvetković, Vlasta; Martinić-Popović, Irena; Demarin, Vida

    2011-09-01

    Improved outcomes were observed in transient ischemic attack (TIA) patients after implementation of recommendations for stroke management and after multiple interventions such as public campaigns focused on raising awareness of stroke and reorganization of health services. The aim of this study was to describe reorganization of in-hospital services to improve the management of patients suspected of having TIA or stroke, and to validate these measures with patient outcomes. Data on 5219 patients examined between January 1 and December 31, 2008 at emergency neurology outpatient department were analyzed. Patients were referred by general practitioners, emergency physicians, or were brought by relatives without being previously seen by health services staff. The emergency services department is intended to improve care for TIA patients, providing a short standardized clinical assessment followed by initiation of a comprehensive stroke prevention program. Demographic data, risk factors, stroke type, previous TIA history, ABCD2 scores and admission rates were analyzed. A total of 1057 patients suspected of having stroke or TIA were examined. There were 447 patients with ischemic stroke (mean age 73 +/- 11 years, 196 males) and 99 patients with TIA (mean age 67 +/- 14 years, 55 males). Parenchymal hemorrhage was diagnosed in 56 and subarachnoid hemorrhage in 49 patients, while 406 patients had nonspecific symptoms or other systemic or neurologic diseases. TIA preceded stroke in 29 (6.5%) patients and 197 (44%) patients were examined for worsening of stroke symptoms (133 within 24 hours, 47 within 48 hours, and 17 within 7 days). The mean ABCD2 score was 2.95. In all examined patients, a comprehensive stroke prevention program was started; 427/447 (95%) strokes and 31/99 (31%) TIAs were hospitalized at neurology department. Four (4%) TIA patients developed stroke and were hospitalized, three of them after 2 days (ABCD2 score 3.4 and 5) and one after 7 days (ABCD2 score 5

  7. Surviving Disasters

    ERIC Educational Resources Information Center

    Henke, Karen Greenwood

    2008-01-01

    Schools play a unique role in communities when disaster strikes. They serve as shelter for evacuees and first responders; they are a trusted source of information; and once danger has passed, the district, as employer and community center, often serves as a foundation for recovery. Technology plays a key role in a school district's ability to…

  8. Surviving Disasters

    ERIC Educational Resources Information Center

    Henke, Karen Greenwood

    2008-01-01

    Schools play a unique role in communities when disaster strikes. They serve as shelter for evacuees and first responders; they are a trusted source of information; and once danger has passed, the district, as employer and community center, often serves as a foundation for recovery. Technology plays a key role in a school district's ability to…

  9. Building a Student-Centered Culture in Times of Natural Disaster: A Case Study

    ERIC Educational Resources Information Center

    Hlinka, Karen Ramey

    2013-01-01

    Increased rates of student success and persistence have been positively linked to community colleges with student-centered cultures. A student-centered culture is one in which policies and practices promote a consistent message of concern and respect while expecting high standards of academic accomplishment. Developing a student-centered culture…

  10. Building a Student-Centered Culture in Times of Natural Disaster: A Case Study

    ERIC Educational Resources Information Center

    Hlinka, Karen Ramey

    2013-01-01

    Increased rates of student success and persistence have been positively linked to community colleges with student-centered cultures. A student-centered culture is one in which policies and practices promote a consistent message of concern and respect while expecting high standards of academic accomplishment. Developing a student-centered culture…

  11. Terrorist attacks in Paris: Surgical trauma experience in a referral center.

    PubMed

    Gregory, Thomas M; Bihel, Thomas; Guigui, Pierre; Pierrart, Jérôme; Bouyer, Benjamin; Magrino, Baptiste; Delgrande, Damien; Lafosse, Thibault; Al Khaili, Jaber; Baldacci, Antoine; Lonjon, Guillaume; Moreau, Sébastien; Lantieri, Laurent; Alsac, Jean-Marc; Dufourcq, Jean-Baptiste; Mantz, Jean; Juvin, Philippe; Halimi, Philippe; Douard, Richard; Mir, Olivier; Masmejean, Emmanuel

    2016-10-01

    On November 13th, 2015, terrorist bomb explosions and gunshots occurred in Paris, France, with 129 people immediately killed, and more than 300 being injured. This article describes the staff organization, surgical management, and patterns of injuries in casualties who were referred to the Teaching European Hospital Georges Pompidou. This study is a retrospective analysis of the pre-hospital response and the in-hospital response in our referral trauma center. Data for patient flow, resource use, patterns of injuries and outcomes were obtained by the review of electronic hospital records. Forty-one patients were referred to our center, and 22 requiring surgery were hospitalized for>24h. From November 14th at 0:41 A.M. to November 15th at 1:10 A.M., 23 surgical interventions were performed on 22 casualties. Gunshot injuries and/or shrapnel wounds were found in 45%, fractures in 45%, head trauma in 4.5%, and abdominal injuries in 14%. Soft-tissue and musculoskeletal injuries predominated in 77% of cases, peripheral nerve injury was identified in 30%. The mortality rate was 0% at last follow up. Rapid staff and logistical response, immediate access to operating rooms, and multidisciplinary surgical care delivery led to excellent short-term outcomes, with no in-hospital death and only one patient being still hospitalized 45days after the initial event. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Development and Verification of a Mobile Shelter Assessment System "Rapid Assessment System of Evacuation Center Condition Featuring Gonryo and Miyagi (RASECC-GM)" for Major Disasters.

    PubMed

    Ishii, Tadashi; Nakayama, Masaharu; Abe, Michiaki; Takayama, Shin; Kamei, Takashi; Abe, Yoshiko; Yamadera, Jun; Amito, Koichiro; Morino, Kazuma

    2016-10-01

    Introduction There were 5,385 deceased and 710 missing in the Ishinomaki medical zone following the Great East Japan Earthquake that occurred in Japan on March 11, 2011. The Ishinomaki Zone Joint Relief Team (IZJRT) was formed to unify the relief teams of all organizations joining in support of the Ishinomaki area. The IZJRT expanded relief activity as they continued to manually collect and analyze assessments of essential information for maintaining health in all 328 shelters using a paper-type survey. However, the IZJRT spent an enormous amount of time and effort entering and analyzing these data because the work was vastly complex. Therefore, an assessment system must be developed that can tabulate shelter assessment data correctly and efficiently. The objective of this report was to describe the development and verification of a system to rapidly assess evacuation centers in preparation for the next major disaster. Report Based on experiences with the complex work during the disaster, software called the "Rapid Assessment System of Evacuation Center Condition featuring Gonryo and Miyagi" (RASECC-GM) was developed to enter, tabulate, and manage the shelter assessment data. Further, a verification test was conducted during a large-scale Self-Defense Force (SDF) training exercise to confirm its feasibility, usability, and accuracy. The RASECC-GM comprises three screens: (1) the "Data Entry screen," allowing for quick entry on tablet devices of 19 assessment items, including shelter administrator, living and sanitary conditions, and a tally of the injured and sick; (2) the "Relief Team/Shelter Management screen," for registering information on relief teams and shelters; and (3) the "Data Tabulation screen," which allows tabulation of the data entered for each shelter, as well as viewing and sorting from a disaster headquarters' computer. During the verification test, data of mock shelters entered online were tabulated quickly and accurately on a mock disaster

  13. Chemical contamination assessment of the Hudson-Raritan Estuary as a result of the attacks on the World Trade Center: analysis of trace elements.

    PubMed

    Kimbrough, K L; Commey, S; Apeti, D A; Lauenstein, G G

    2010-12-01

    The attack on the World Trade Center (WTC) resulted in the destruction of buildings, and the release of tons of dust and debris into the environment. As part of the effort to characterize the environmental impact of the WTC collapse, Mussel Watch Program trace element measurements from the Hudson-Raritan Estuary (HRE) were assessed for the years before (1986-2001) and after (2001-2005) the attack. Trace element measurements in the HRE were significantly higher than Mussel Watch measurements taken elsewhere in the Nation. Post-attack trace element measurements were not significantly different from pre-attack measurements. The impacts of WTC collapse may have been obscured by high ambient levels of trace elements in the HRE. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Asthma among Staten Island fresh kills landfill and barge workers following the September 11, 2001 World Trade Center terrorist attacks.

    PubMed

    Cone, James E; Osahan, Sukhminder; Ekenga, Christine C; Miller-Archie, Sara A; Stellman, Steven D; Fairclough, Monique; Friedman, Stephen M; Farfel, Mark R

    2016-09-01

    Although airborne respiratory irritants at the World Trade Center (WTC) site have been associated with asthma among WTC Ground Zero workers, little is known about asthma associated with work at the Staten Island landfill or barges. To evaluate the risk of asthma first diagnosed among Staten Island landfill and barge workers, we conducted a survey and multivariable logistic regression analysis regarding the association between Staten Island landfill and barge-related work exposures and the onset of post-9/11 asthma. Asthma newly diagnosed between September 11, 2001 and December 31, 2004 was reported by 100/1,836 (5.4%) enrollees. Jobs involving sifting, digging, welding, and steel cutting, enrollees with high landfill/barge exposure index scores or who were police and sanitation workers, and enrollees with probable posttraumatic stress disorder all had increased odds ratios for new-onset asthma. Post-9/11 asthma cumulative incidence among Staten Island landfill/barge workers was similar to that of other WTC disaster rescue and recovery workers. Am. J. Ind. Med. 59:795-804, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Serum perfluoroalkyl substances and cardiometabolic consequences in adolescents exposed to the World Trade Center disaster and a matched comparison group.

    PubMed

    Koshy, Tony T; Attina, Teresa M; Ghassabian, Akhgar; Gilbert, Joseph; Burdine, Lauren K; Marmor, Michael; Honda, Masato; Chu, Dinh Binh; Han, Xiaoxia; Shao, Yongzhao; Kannan, Kurunthachalam; Urbina, Elaine M; Trasande, Leonardo

    2017-09-07

    Large amounts of various chemical contaminants, including perfluoroalkyl substances (PFASs), were released at the time of the World Trade Center (WTC) disaster. Thousands of children who lived and/or attended school near the disaster site were exposed to these substances but few studies have examined the possible consequences related to these exposures. To examine the relationship of PFASs serum levels with cardiometabolic profile in children and adolescents enrolled in the World Trade Center Health Registry (WTCHR) and a matched comparison group. We evaluated WTCHR enrollees who resided in New York City and were born between September 11, 1993 and September 10, 2001, and a matched comparison group consisting of individuals who were ineligible for WTCHR participation upon distance of their home, school or work from the WTC and lack of participation in rescue and recovery activities. Matching was based on date of birth, sex, race, ethnicity, and income. We assessed exposure to PFASs, as measured by serum levels and association with cardiometabolic profile as measured by arterial wall stiffness, body mass index, insulin resistance, fasting total cholesterol, HDL, LDL and triglycerides. A total of 402 participants completed the study and serum samples were analyzed from 308 participants, 123 in the WTCHR group and 185 in the comparison group. In multivariable regression analysis, after adjusting for relevant confounders, we observed a significant, positive association of perfluorooctanoic acid (PFOA) with triglycerides (beta coefficient=0.14, 95% CI: 0.02, 0.27, 15.1% change), total cholesterol (beta coefficient=0.09, 95% CI: 0.04, 0.14, 9.2% change), and LDL cholesterol (beta coefficient=0.11, 95% CI: 0.03, 0.19, 11.5% change). Perfluorohexanesulfonic acid levels were associated with decreased insulin resistance (beta coefficient=-0.09, 95% CI: -0.18, -0.003, -8.6% change); PFOA and perfluorononanoic acid were associated with increased brachial artery distensibility

  16. Elevated C-reactive protein and posttraumatic stress pathology among survivors of the 9/11 World Trade Center attacks.

    PubMed

    Rosen, Rebecca L; Levy-Carrick, Nomi; Reibman, Joan; Xu, Ning; Shao, Yongzhao; Liu, Mengling; Ferri, Lucia; Kazeros, Angeliki; Caplan-Shaw, Caralee E; Pradhan, Deepak R; Marmor, Michael; Galatzer-Levy, Isaac R

    2017-06-01

    Systemic inflammation has emerged as a promising marker and potential mechanism underlying post-traumatic stress disorder (PTSD). The relationship between posttraumatic stress pathology and systemic inflammation has not, however, been consistently replicated and is potentially confounded by comorbid illness or injury, common complications of trauma exposure. We analyzed a large naturalistic cohort sharing a discrete physical and mental health trauma from the destruction of the World Trade Center (WTC) towers on September 11, 2001 (n = 641). We evaluated the relationship between multiple physical and mental health related indices collected through routine evaluations at the WTC Environmental Health Center (WTC EHC), a treatment program for community members exposed to the disaster. C-Reactive Protein (CRP), a marker of systemic inflammation, was examined in relation to scores for PTSD, PTSD symptom clusters (re-experiencing, avoidance, negative cognitions/mood, arousal), depression and anxiety, while controlling for WTC exposures, lower respiratory symptoms, age, sex, BMI and smoking as potential risks or confounders. CRP was positively associated with PTSD severity (p < 0.001), trending toward association with depression (p = 0.06), but not with anxiety (p = 0.27). CRP was positively associated with re-experiencing (p < 0.001) and avoidance (p < 0.05) symptom clusters, and trended toward associations with negative cognitions/mood (p = 0.06) and arousal (p = 0.08). In this large study of the relationship between CRP and posttraumatic stress pathology, we demonstrated an association between systemic inflammation and stress pathology (PTSD; trending with depression), which remained after adjusting for potentially confounding variables. These results contribute to research findings suggesting a salient relationship between inflammation and posttraumatic stress pathology. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Psychological trauma associated with the World Trade Center attacks and its effect on pregnancy outcome.

    PubMed

    Engel, Stephanie Mulherin; Berkowitz, Gertrud S; Wolff, Mary S; Yehuda, Rachel

    2005-09-01

    The destruction of the World Trade Center (WTC) on 11 September 2001 was a source of enormous psychological trauma that may have consequences for the health of pregnant women and their fetuses. In this report, we describe the impact of extreme trauma on the birth outcomes of women highly exposed to the WTC. We enrolled 187 women who were pregnant and living or working within close proximity to the WTC on 11 September. Among women with singleton pregnancies, 52 completed at least one psychological assessment prior to delivery. In adjusted multivariable models, both post-traumatic stress symptomatology (PTSS) and moderate depression were associated with longer gestational durations, although only PTSS was associated with decrements in infant head circumference at birth (beta=-0.07, SE=0.03, P=0.01). The impact of stress resulting from extreme trauma may be different from that which results from ordinary life experiences, particularly with respect to cortisol production. As prenatal PTSS was associated with decrements in head circumference, this may influence subsequent neurocognitive development. Long-term follow-up of infants exposed to extreme trauma in utero is needed to evaluate the persistence of these effects.

  18. Development of a quality, high throughput DNA analysis procedure for skeletal samples to assist with the identification of victims from the World Trade Center attacks.

    PubMed

    Holland, Mitchell M; Cave, Christopher A; Holland, Charity A; Bille, Todd W

    2003-06-01

    The attacks on the World Trade Center (WTC) Towers on September 11, 2001, represented the single largest terrorist-related mass fatality incident in the history of the United States. More than 2,700 individuals of varied racial and ethnic background lost their lives that day. Through the efforts of thousands of citizens, including recovery workers, medical examiners, and forensic scientists, the identification of approximately 1,500 victims had been accomplished through June 2003 (the majority of these identifications were made within the first 8-12 months). The principal role of The Bode Technology Group (Bode) in this process was to develop a quality, high throughput DNA extraction and short tandem repeat (STR) analysis procedure for skeletal elements, and to provide STR profiles to the Office of the Chief Medical Examiner (OCME) in New York City to be used for identification of the victims. A high throughput process was developed to include electronic accessioning of samples, so that the numbering system of the OCME was maintained; rapid preparation and sampling of skeletal fragments to allow for the processing of more than 250 fragments per day; use of a 96-well format for sample extraction, DNA quantification, and STR analysis; and use of the Applied Biosystems 3100 and 3700 instrumentation to develop STR profiles. Given the highly degraded nature of the skeletal remains received by Bode, an advanced DNA extraction procedure was developed to increase the quantity of DNA recovery and reduce the co-purification of polymerase chain reaction (PCR) amplification inhibitors. In addition, two new STR multiplexes were developed specifically for this project, which reduced the amplicon size of the STR loci, and therefore, enhanced the ability to obtain results from the most challenged of samples. In all, the procedures developed allowed for the analysis of more than 1,000 skeletal samples each week. Approximately 13,000 skeletal fragments were analyzed at least once

  19. The first 24 hours of the World Trade Center attacks of 2001--the Centers for Disease Control and Prevention emergency phase response.

    PubMed

    Cruz, Miguel A; Burger, Ronald; Keim, Mark

    2007-01-01

    On 11 September 2001, terrorists hijacked two passenger planes and crashed them into the two towers of the World Trade Center (WTC) in New York City. These synchronized attacks were the largest act of terrorism ever committed on US soil. The impacts, fires, and subsequent collapse of the towers killed and injured thousands of people. Within minutes after the first plane crashed into the WTC, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, initiated one of the largest public health responses in its history. Staff of the CDC provided technical assistance on several key public health issues. During the acute phase of the event, CDC personnel assisted with: (1) assessing hospital capacity; (2) establishing injury and disease surveillance activities; (3) deploying emergency coordinators/liaisons to facilitate inter-agency coordination with the affected jurisdictions; and (4) arranging rapid delivery of emergency medical supplies, therapeutics, and personal protective equipment. This incident highlighted the need for adequate planning for all potential hazards and the importance of interagency and interdepartmental coordination in preparing for and responding to public health emergencies.

  20. Changing clinical characteristics of thyroid carcinoma at a single center from Turkey: before and after the Chernobyl disaster.

    PubMed

    Ozdemir, D; Dagdelen, S; Kiratli, P; Tuncel, M; Erbas, B; Erbas, T

    2012-09-01

    The aim of the study was to determine the possible role of Chernobyl disaster on changing clinical features of thyroid carcinoma (TC) in a moderately iodine deficient region. We retrospectively reviewed demographical features, presenting symptoms, tumor size, histopathological diagnosis and distant metastates in 160 patients with TC diagnosed between 1990-2007. We compared our findings with the database of 118 TC patients diagnosed between 1970-1990 in the same center. There were 123 female (76.9%) and 37 (23.1%) male patients with a mean age of 44.89±14.84. Sex distribution and age at diagnosis were similar between 1970-1990 and 1990-2007 (P=0.77 and P=0.42, respectively). Histopathological diagnoses were papillary in 114 (73.1%), follicular in 22 (14.1%), medullary in 9 (5.8%), hurthle cell in 7 (4.5%) and anaplastic TC in 4 (2.6%) patients. We observed a marked increase in papillary TC (P<0.001) and marked decreases in follicular (P<0.001) and anaplastic TC (P=0.01) compared to the period between 1970-1990. Thyroid microcarcinomas accounted for 27.1% and 37.1% of carcinomas in 1970-1990 and 1990-2007, respectively (P<0.05). We showed that incidence of papillary TC increased and incidences of follicular and anaplastic TC decreased in a period that might be affected by Chernobyl fallout in a moderately iodine deficient area. Presenting symptoms of TC have changed and microcarcinomas are diagnosed more frequently compared to past. Further large scale trials are needed to find out whether Chernobyl disaster has role on changing characteristic of TC in countries that are not very near but also not very far from Chernobyl such as Turkey.

  1. A high-quality high-fidelity visualization of the September 11 attack on the World Trade Center.

    PubMed

    Rosen, Paul; Popescu, Voicu; Hoffmann, Christoph; Irfanoglu, Ayhan

    2008-01-01

    In this application paper, we describe the efforts of a multidisciplinary team towards producing a visualization of the September 11 Attack on the North Tower of New York's World Trade Center. The visualization was designed to meet two requirements. First, the visualization had to depict the impact with high fidelity, by closely following the laws of physics. Second, the visualization had to be eloquent to a nonexpert user. This was achieved by first designing and computing a finite-element analysis (FEA) simulation of the impact between the aircraft and the top 20 stories of the building, and then by visualizing the FEA results with a state-of-the-art commercial animation system. The visualization was enabled by an automatic translator that converts the simulation data into an animation system 3D scene. We built upon a previously developed translator. The translator was substantially extended to enable and control visualization of fire and of disintegrating elements, to better scale with the number of nodes and number of states, to handle beam elements with complex profiles, and to handle smoothed particle hydrodynamics liquid representation. The resulting translator is a powerful automatic and scalable tool for high-quality visualization of FEA results.

  2. The prevalence of metabolic syndrome among law enforcement officers who responded to the 9/11 World Trade Center attacks.

    PubMed

    Moline, Jacqueline M; McLaughlin, Mary Ann; Sawit, Simonette T; Maceda, Cynara; Croft, Lori B; Goldman, Martin E; Garcia, Mario J; Iyengar, Rupa L; Woodward, Mark

    2016-09-01

    Law enforcement officers (LEOs) experience high rates of cardiovascular events compared with the general US population. Metabolic syndrome (MetS) confers an increased risk of cardiovascular disease and all-cause mortality. Data regarding MetS among LEOs are limited. We sought to determine the prevalence of MetS and its associated risk factors as well as gender differences among LEOs who participated in the World Trade Center (WTC) Law Enforcement Cardiovascular Screening (LECS) Program from 2008 to 2010. We evaluated a total of 2,497 participants, 40 years and older, who responded to the 9/11 WTC attacks. The prevalence of MetS was 27%, with abdominal obesity and hypertension being the most frequently occurring risk factors. MetS and its risk factors were significantly higher among male compared to female LEOs, except for reduced HDL-cholesterol levels. MetS is a rising epidemic in the United States, and importantly, approximately one in four LEOs who worked at the WTC site after 9/11 are affected. Am. J. Ind. Med. 59:752-760, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. AIR LEVELS OF CARCINOGENIC POLYCYCLIC AROMATIC HYDROCARBONS FOLLOWING THE WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    The catastrophic collapse of the World Trade Center (WTC) on September 11, 2001, created an immense dust cloud followed by fires that emitted soot into the air of New York City (NYC) well into December. The subsequent cleanup used diesel equipment that further polluted the air un...

  4. AIR LEVELS OF CARCINOGENIC POLYCYCLIC AROMATIC HYDROCARBONS FOLLOWING THE WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    The catastrophic collapse of the World Trade Center (WTC) on September 11, 2001, created an immense dust cloud followed by fires that emitted soot into the air of New York City (NYC) well into December. The subsequent cleanup used diesel equipment that further polluted the air un...

  5. Mass casualty following unprecedented tornadic events in the Southeast: natural disaster outcomes at a Level I trauma center.

    PubMed

    Hartmann, Elizabeth H; Creel, Nathan; Lepard, Jacob; Maxwell, Robert A

    2012-07-01

    On April 27, 2011, an EF4 (enhanced Fujita scale) tornado struck a 48-mile path across northwest Georgia and southeast Tennessee. Traumatic injuries sustained during this tornado and others in one of the largest tornado outbreaks in history presented to the regional Level I trauma center, Erlanger Health System, in Chattanooga, TN. Patients were triaged per mass casualty protocols through an incident command center and triage officer. Medical staffing was increased to anticipate a large patient load. Records of patients admitted as a result of tornado-related injury were retrospectively reviewed and characterized by the injury patterns, demographics, procedures performed, length of stay, and complications. One hundred four adult patients were treated in the emergency department; of these, 28 (27%) patients required admission to the trauma service. Of those admitted, 16 (57%) were male with an age range of 21 to 87 years old and an average length of stay of 10.9 ± 11.8 days. Eleven (39%) patients required intensive care unit admissions. The most common injuries seen were those of soft tissue, bony fractures, and the chest. Interventions included tube thoracostomies, exploratory laparotomies, orthopedic fixations, soft tissue reconstructions, and craniotomy. All 28 patients admitted survived to discharge. Nineteen (68%) patients were discharged home, six (21%) went to a rehabilitation hospital, and three (11%) were transferred to skilled nursing facilities. Emergency preparedness and organization are key elements in effectively treating victims of natural disasters. Those victims who survive the initial tornadic event and present to a Level I trauma center have low mortality. Like in our experience, triage protocols need to be implemented to quickly and effectively manage mass injuries.

  6. Unmet need for counseling services by children in New York City after the September 11th attacks on the World Trade Center: implications for pediatricians.

    PubMed

    Fairbrother, Gerry; Stuber, Jennifer; Galea, Sandro; Pfefferbaum, Betty; Fleischman, Alan R

    2004-05-01

    The objectives of this study were to describe the prevalence of counseling services, contrasted with the need after the terrorist attacks of September 11, 2001, the types of counseling received, and the predictors of receipt of counseling services. A cross-sectional, random-digit-dial survey was conducted in New York City (NYC) of parents (N = 434) of children who were 4 to 17 years of age 4 months after the September 11th terrorist attacks on the World Trade Center. Overall, 10% of NYC children received some type of counseling after the September 11th attacks, according to parental report. Among these, 44% received counseling in schools, 36% received counseling from medical or professional providers, and 20% received counseling from other sources. However, only 27% of the children who had severe/very severe posttraumatic stress reactions (PTSR) after the attacks received counseling services. In a multivariate model, receipt of counseling before the September 11th attacks (odds ratio: 4.44) and having severe/very severe PTSR (odds ratio: 3.59) were the most important predictors of use of counseling services after the September 11th attacks. Minority status and having a parent who experienced the loss of a friend or a relative were also associated with receipt of services. There was substantial disparity between apparent need (as indicated by severe/very severe PTSR) for and receipt of mental health services for children after the September 11th attacks. There is need for intensified efforts to identify, refer, and treat children in need, especially for children who are not already in a therapeutic relationship. An enhanced role for pediatricians is indicated.

  7. World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder among Responders and Civilians: A Meta-Analysis

    PubMed Central

    Liu, Bian; Tarigan, Lukman H.; Bromet, Evelyn J.; Kim, Hyun

    2014-01-01

    The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e.g. police, firefighters, rescue/recovery workers and volunteers) had a lower probable PTSD risk (OR = 1.61; 95% CI: 1.39, 1.87) compared to civilians (e.g. residents, office workers, and passersby; OR = 2.71, 95% CI: 2.35, 3.12). The differences in ORs between responders and civilians were larger for physical compared to psychosocial exposure types. We also found that injury, lost someone, and witnessed horror were the three (out of six) most pernicious exposures. These findings suggest that these three exposures should be a particular focus in psychological evaluation and treatment programs in WTC intervention and future emergency preparedness efforts. PMID:25047411

  8. World Trade Center disaster exposure-related probable posttraumatic stress disorder among responders and civilians: a meta-analysis.

    PubMed

    Liu, Bian; Tarigan, Lukman H; Bromet, Evelyn J; Kim, Hyun

    2014-01-01

    The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e.g. police, firefighters, rescue/recovery workers and volunteers) had a lower probable PTSD risk (OR = 1.61; 95% CI: 1.39, 1.87) compared to civilians (e.g. residents, office workers, and passersby; OR = 2.71, 95% CI: 2.35, 3.12). The differences in ORs between responders and civilians were larger for physical compared to psychosocial exposure types. We also found that injury, lost someone, and witnessed horror were the three (out of six) most pernicious exposures. These findings suggest that these three exposures should be a particular focus in psychological evaluation and treatment programs in WTC intervention and future emergency preparedness efforts.

  9. Natural disaster, unnatural deaths: the killings on the life care floors at Tenet's Memorial Medical Center after Hurricane Katrina.

    PubMed

    Lugosi, Charles I

    2007-01-01

    This article examines the meaning of the killing of four patients with disabilities on the Life Care ward of Tenet's Memorial Medical Center in New Orleans in anticipation of hurricane Katrina. None were terminally ill. None were in pain. None knew their lives were about to end. None were evacuated. The victims had one thing in common: they all had chosen to be designated as Do Not Resuscitate (DNR) patients. All were killed with overdoses of medications that had not been prescribed for them. Dr. Daniel Nuss of the Louisiana State University School of Medicine and Dr. Floyd Burras, President of the Louisiana Medical Society defend the doctor's actions as involuntary euthanasia or mercy killing. Was this euthanasia, or homicide? At Memorial, the term DNR took on a new meaning--Do Not Rescue. In this new Memorial model, patient autonomy to control and choose one's medical treatment, yields to the physician's unilateral power to arbitrarily decide who lives and who dies. The author concludes that doctors and hospitals must observe the rule of law, even in times of natural disaster.

  10. Disaster Response on September 11, 2001 Through the Lens of Statistical Network Analysis

    PubMed Central

    Schweinberger, Michael; Petrescu-Prahova, Miruna; Vu, Duy Quang

    2014-01-01

    The rescue and relief operations triggered by the September 11, 2001 attacks on the World Trade Center in New York City demanded collaboration among hundreds of organisations. To shed light on the response to the September 11, 2001 attacks and help to plan and prepare the response to future disasters, we study the inter-organisational network that emerged in response to the attacks. Studying the inter-organisational network can help to shed light on (1) whether some organisations dominated the inter-organisational network and facilitated communication and coordination of the disaster response; (2) whether the dominating organisations were supposed to coordinate disaster response or emerged as coordinators in the wake of the disaster; and (3) the degree of network redundancy and sensitivity of the inter-organisational network to disturbances following the initial disaster. We introduce a Bayesian framework which can answer the substantive questions of interest while being as simple and parsimonious as possible. The framework allows organisations to have varying propensities to collaborate, while taking covariates into account, and allows to assess whether the inter-organisational network had network redundancy—in the form of transitivity—by using a test which may be regarded as a Bayesian score test. We discuss implications in terms of disaster management. PMID:24707073

  11. Forensic Archaeological Recovery of a Large-Scale Mass Disaster Scene: Lessons Learned from Two Complex Recovery Operations at the World Trade Center Site.

    PubMed

    Warnasch, Scott C

    2016-05-01

    In 2006, unexpected discoveries of buried World Trade Center (WTC) debris and human remains were made at the World Trade Center mass disaster site. New York City's Office of Chief Medical Examiner (OCME) was given the task of systematically searching the site for any remaining victims' remains. The subsequent OCME assessment and archaeological excavation conducted from 2006 until 2013, resulted in the recovery of over 1,900 victims' remains. In addition, this operation demonstrated the essential skills archaeologists can provide in a mass disaster recovery operation. The OCME excavation data illustrates some of the challenges encountered during the original recovery effort of 2001/2002. It suggests that when understood within the larger site recovery context, certain fundamental components of the original recovery effort, such as operational priorities and activities in effect during the original recovery, directly or indirectly resulted in unsearched deposits that contained human remains. © 2016 American Academy of Forensic Sciences.

  12. Symptoms, respirator use, and pulmonary function changes among New York City firefighters responding to the World Trade Center disaster.

    PubMed

    Feldman, Debra M; Baron, Sherry L; Bernard, Bruce P; Lushniak, Boris D; Banauch, Gisela; Arcentales, Nicole; Kelly, Kerry J; Prezant, David J

    2004-04-01

    New York City firefighters responding to the World Trade Center (WTC) disaster on September 11, 2001, were exposed to numerous hazards. A medical screening program was conducted 3 weeks after the disaster on a sample of firefighters. To determine whether arrival time at the WTC and other exposure variables (including respirator use) were associated with symptoms and changes in pulmonary function (after exposure - before exposure). A cross-sectional comparison of firefighters representing the following groups: (1) firefighters who arrived before/during the WTC collapse, (2) firefighters who arrived 1 to 2 days after the collapse, (3) firefighters who arrived 3 to 7 days after the collapse, and (4) unexposed firefighters. Fire Department of New York City (FDNY) Bureau of Health Services on October 1 to 5, 2001. A stratified random sample of 362 of 398 recruited working firefighters (91%). Of these, 149 firefighters (41%) were present at the WTC collapse, 142 firefighters (39%) arrived after the collapse but within 48 h, 28 firefighters (8%) arrived 3 to 7 days after the collapse, and 43 firefighters (12%) were unexposed. New/worsening symptoms involving the eyes, skin, respiratory system, and nose and throat (NT), and changes in spirometry from before to after exposure. During the first 2 weeks at the WTC site, 19% of study firefighters reported not using a respirator; 50% reported using a respirator but only rarely. Prevalence ratios (PRs) for skin, eye, respiratory, and NT symptoms showed a dose-response pattern between exposure groups based on time of arrival at the WTC site, with PRs between 2.6 and 11.4 with 95% confidence intervals (CIs) excluding 1.0 for all but skin symptoms. For those spending > 7 days at the site, the PR for respiratory symptoms was 1.32 (95% CI, 1.13 to 1.55), compared with those who were exposed for < 7 days. Mean spirometry results before and after exposure were within normal limits. The change in spirometry findings (after exposure

  13. DNA preservation in skeletal elements from the World Trade Center disaster: recommendations for mass fatality management.

    PubMed

    Mundorff, Amy Z; Bartelink, Eric J; Mar-Cash, Elaine

    2009-07-01

    The World Trade Center (WTC) victim identification effort highlights taphonomic influences on the degradation of DNA from victims of mass fatality incidents. This study uses a subset of the WTC-Human Remains Database to evaluate differential preservation of DNA by skeletal element. Recovery location, sex, and victim type (civilian, firefighter, or plane passenger) do not appear to influence DNA preservation. Results indicate that more intact elements, as well as elements encased in soft tissue, produced slightly higher identification rates than more fragmented remains. DNA identification rates by element type conform to previous findings, with higher rates generally found in denser, weight-bearing bones. However, smaller bones including patellae, metatarsals, and foot phalanges yielded rates comparable to both femora and tibiae. These elements can be easily sampled with a disposable scalpel, and thus reduce potential DNA contamination. These findings have implications for DNA sampling guidelines in future mass fatality incidents.

  14. PRIORITIZATION OF PEDIATRIC CBRNE DISASTER PREPAREDNESS EDUCATION AND TRAINING NEEDS.

    PubMed

    Siegel, David; Strauss-Riggs, Kandra; Needle, Scott

    2014-12-01

    Children are the members of our population who are most vulnerable to the effects of a chemical, biological, radiological, nuclear or explosive (CBRNE) attack. It has been over 12 years since 9/11 and the majority of clinicians who would be providing care to children in the event of another attack still lack the requisite disaster preparedness training. The purpose of this report is to provide an overview of the recent developments that will enable the affordable creation of key CBRNE educational and just in time material. In 2011, the National Center for Disaster Medicine and Public Health (NCDMPH) convened a pediatric disaster preparedness conference. Much of the initial groundwork for development of a pediatric disaster preparedness curriculum, including the identification of target audiences and requisite role specific CBRNE curriculum content, was the product of this conference. Much of the needed pediatric education and training content for the diagnosis and treatment of the injurious effects of CBRNE has recently been both developed and well vetted. Bringing together these efforts in an educational program will result in a workforce that is better trained and prepared to address the needs of children impacted by these types of disasters.

  15. PRIORITIZATION OF PEDIATRIC CBRNE DISASTER PREPAREDNESS EDUCATION AND TRAINING NEEDS

    PubMed Central

    Siegel, David; Strauss-Riggs, Kandra; Needle, Scott

    2014-01-01

    Children are the members of our population who are most vulnerable to the effects of a chemical, biological, radiological, nuclear or explosive (CBRNE) attack. It has been over 12 years since 9/11 and the majority of clinicians who would be providing care to children in the event of another attack still lack the requisite disaster preparedness training. The purpose of this report is to provide an overview of the recent developments that will enable the affordable creation of key CBRNE educational and just in time material. In 2011, the National Center for Disaster Medicine and Public Health (NCDMPH) convened a pediatric disaster preparedness conference. Much of the initial groundwork for development of a pediatric disaster preparedness curriculum, including the identification of target audiences and requisite role specific CBRNE curriculum content, was the product of this conference. Much of the needed pediatric education and training content for the diagnosis and treatment of the injurious effects of CBRNE has recently been both developed and well vetted. Bringing together these efforts in an educational program will result in a workforce that is better trained and prepared to address the needs of children impacted by these types of disasters. PMID:25587241

  16. Respiratory health of 985 children exposed to the World Trade Center disaster: report on world trade center health registry wave 2 follow-up, 2007-2008.

    PubMed

    Stellman, Steven D; Thomas, Pauline A; S Osahan, Sukhminder; Brackbill, Robert M; Farfel, Mark R

    2013-05-01

    The World Trade Center (WTC) disaster of September 11, 2001, has been associated with early respiratory problems including asthma in workers, residents, and children. Studies on adults have documented persistence of longer term, 9/11-related respiratory symptoms. There are no comparable reports on children. We surveyed 985 children aged 5-17 years who enrolled in the WTC Health Registry in 2003-04, and who were re-surveyed in 2007-08. Health data were provided by parents in both surveys and focused on respiratory symptoms suggestive of reactive airway impairment (wheezing or the combination of cough and shortness of breath) in the preceding 12 months. At follow-up, adolescents aged 11-17 years completed separate surveys that screened for post-traumatic stress symptoms and behavior problems (Strengths and Difficulties Questionnaire, SDQ). Associations between respiratory symptoms in the prior 12 months with 9/11 exposures and behavioral outcomes were evaluated with univariate and multivariate methods. Of the 985 children, 142 (14.4%) children reported respiratory symptoms in the prior 12 months; 105 (73.9%) children with respiratory symptoms had previously been diagnosed with asthma. Among children aged 5-10 years, respiratory symptoms were significantly elevated among African-Americans (adjusted odds ratio, (aOR) 3.8; 95% confidence interval (CI) 1.2-11.5) and those with household income below $75,000 (aOR 1.9; CI 1.0-3.7), and was more than twice as great in children with dust cloud exposure (aOR 2.2; CI 1.2-3.9). Among adolescents aged 11-17 years, respiratory symptoms were significantly associated with household income below $75,000 (aOR 2.4; CI 1.2-4.6), and with a borderline or abnormal SDQ score (aOR 2.7, 95% CI 1.4-5.2). Symptoms were reported more than twice as often by adolescents with vs. without dust cloud exposure (24.8% vs. 11.5%) but the adjusted odds ratio was not statistically significant (aOR 1.7; CI 0.9-3.2), Most Registry children exposed to the

  17. Health effects of World Trade Center (WTC) Dust: An unprecedented disaster's inadequate risk management.

    PubMed

    Lippmann, Morton; Cohen, Mitchell D; Chen, Lung-Chi

    2015-07-01

    The World Trade Center (WTC) twin towers in New York City collapsed on 9/11/2001, converting much of the buildings' huge masses into dense dust clouds of particles that settled on the streets and within buildings throughout Lower Manhattan. About 80-90% of the settled WTC Dust, ranging in particle size from ∼2.5 μm upward, was a highly alkaline mixture of crushed concrete, gypsum, and synthetic vitreous fibers (SVFs) that was readily resuspendable by physical disturbance and low-velocity air currents. High concentrations of coarse and supercoarse WTC Dust were inhaled and deposited in the conductive airways in the head and lungs, and subsequently swallowed, causing both physical and chemical irritation to the respiratory and gastroesophageal epithelia. There were both acute and chronic adverse health effects in rescue/recovery workers; cleanup workers; residents; and office workers, especially in those lacking effective personal respiratory protective equipment. The numerous health effects in these people were not those associated with the monitored PM2.5 toxicants, which were present at low concentrations, that is, asbestos fibers, transition and heavy metals, polyaromatic hydrocarbons or PAHs, and dioxins. Attention was never directed at the very high concentrations of the larger-sized and highly alkaline WTC Dust particles that, in retrospect, contained the more likely causal toxicants. Unfortunately, the initial focus of the air quality monitoring and guidance on exposure prevention programs on low-concentration components was never revised. Public agencies need to be better prepared to provide reliable guidance to the public on more appropriate means of exposure assessment, risk assessment, and preventive measures.

  18. Health effects of World Trade Center (WTC) Dust: An unprecedented disaster with inadequate risk management

    PubMed Central

    Lippmann, Morton; Cohen, Mitchell D.; Chen, Lung-Chi

    2015-01-01

    The World Trade Center (WTC) twin towers in New York City collapsed on 9/11/2001, converting much of the buildings’ huge masses into dense dust clouds of particles that settled on the streets and within buildings throughout Lower Manhattan. About 80–90% of the settled WTC Dust, ranging in particle size from ~2.5 μm upward, was a highly alkaline mixture of crushed concrete, gypsum, and synthetic vitreous fibers (SVFs) that was readily resuspendable by physical disturbance and low-velocity air currents. High concentrations of coarse and supercoarse WTC Dust were inhaled and deposited in the conductive airways in the head and lungs, and subsequently swallowed, causing both physical and chemical irritation to the respiratory and gastroesophageal epithelia. There were both acute and chronic adverse health effects in rescue/recovery workers; cleanup workers; residents; and office workers, especially in those lacking effective personal respiratory protective equipment. The numerous health effects in these people were not those associated with the monitored PM2.5 toxicants, which were present at low concentrations, that is, asbestos fibers, transition and heavy metals, polyaromatic hydrocarbons or PAHs, and dioxins. Attention was never directed at the very high concentrations of the larger-sized and highly alkaline WTC Dust particles that, in retrospect, contained the more likely causal toxicants. Unfortunately, the initial focus of the air quality monitoring and guidance on exposure prevention programs on low-concentration components was never revised. Public agencies need to be better prepared to provide reliable guidance to the public on more appropriate means of exposure assessment, risk assessment, and preventive measures. PMID:26058443

  19. Heart attack

    MedlinePlus

    ... infarction; Non-ST - elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attack ... made up of cholesterol and other cells. A heart attack may occur when: A tear in the ...

  20. Analysis of XXI Century Disasters in the National Geophysical Data Center Historical Natural Hazard Event Databases

    NASA Astrophysics Data System (ADS)

    Dunbar, P. K.; McCullough, H. L.

    2011-12-01

    The National Geophysical Data Center (NGDC) maintains a global historical event database of tsunamis, significant earthquakes, and significant volcanic eruptions. The database includes all tsunami events, regardless of intensity, as well as earthquakes and volcanic eruptions that caused fatalities, moderate damage, or generated a tsunami. Event date, time, location, magnitude of the phenomenon, and socio-economic information are included in the database. Analysis of the NGDC event database reveals that the 21st century began with earthquakes in Gujarat, India (magnitude 7.7, 2001) and Bam, Iran (magnitude 6.6, 2003) that killed over 20,000 and 31,000 people, respectively. These numbers were dwarfed by the numbers of earthquake deaths in Pakistan (magnitude 7.6, 2005-86,000 deaths), Wenchuan, China (magnitude 7.9, 2008-87,652 deaths), and Haiti (magnitude 7.0, 2010-222,000 deaths). The Haiti event also ranks among the top ten most fatal earthquakes. The 21st century has observed the most fatal tsunami in recorded history-the 2004 magnitude 9.1 Sumatra earthquake and tsunami that caused over 227,000 deaths and 10 billion damage in 14 countries. Six years later, the 2011 Tohoku, Japan earthquake and tsunami, although not the most fatal (15,000 deaths and 5,000 missing), could cost Japan's government in excess of 300 billion-the most expensive tsunami in history. Volcanic eruptions can cause disruptions and economic impact to the airline industry, but due to their remote locations, fatalities and direct economic effects are uncommon. Despite this fact, the second most expensive eruption in recorded history occurred in the 21st century-the 2010 Merapi, Indonesia volcanic eruption that resulted in 324 deaths, 427 injuries, and $600 million in damage. NGDC integrates all natural hazard event datasets into one search interface. Users can find fatal tsunamis generated by earthquakes or volcanic eruptions. The user can then link to information about the related runup

  1. Trajectories of PTSD Among Lower Manhattan Residents and Area Workers Following the 2001 World Trade Center Disaster, 2003-2012.

    PubMed

    Welch, Alice E; Caramanica, Kimberly; Maslow, Carey B; Brackbill, Robert M; Stellman, Steven D; Farfel, Mark R

    2016-04-01

    Group-based trajectory modeling was used to explore empirical trajectories of symptoms of posttraumatic stress disorder (PTSD) among 17,062 adult area residents/workers (nonrescue/recovery workers) enrolled in the World Trade Center (WTC) Health Registry using 3 administrations of the PTSD Checklist (PCL) over 9 years of observation. Six trajectories described PTSD over time: low-stable (48.9%), moderate-stable (28.3%), moderate-increasing (8.2%), high-stable (6.0%), high-decreasing (6.6 %), and very high-stable (2.0%). To examine factors associated with improving or worsening PTSD symptoms, groups with similar intercepts, but different trajectories were compared using bivariate analyses and logistic regression. The adjusted odds of being in the moderate-increasing relative to the moderate-stable group were significantly greater among enrollees reporting low social integration (OR = 2.18), WTC exposures (range = 1.34 to 1.53), job loss related to the September 11, 2001 disaster (OR = 1.41), or unmet mental health need/treatment (OR = 4.37). The odds of being in the high-stable relative to the high-decreasing group were significantly greater among enrollees reporting low social integration (OR = 2.23), WTC exposures (range = 1.39 to 1.45), or unmet mental health need/treatment (OR = 3.42). The influence of severe exposures, scarce personal/financial resources, and treatment barriers on PTSD trajectories suggest a need for early and ongoing PTSD screening postdisaster. Copyright © 2016 International Society for Traumatic Stress Studies.

  2. Estimating the Time Interval Between Exposure to the World Trade Center Disaster and Incident Diagnoses of Obstructive Airway Disease

    PubMed Central

    Glaser, Michelle S.; Webber, Mayris P.; Zeig-Owens, Rachel; Weakley, Jessica; Liu, Xiaoxue; Ye, Fen; Cohen, Hillel W.; Aldrich, Thomas K.; Kelly, Kerry J.; Nolan, Anna; Weiden, Michael D.; Prezant, David J.; Hall, Charles B.

    2014-01-01

    Respiratory disorders are associated with occupational and environmental exposures. The latency period between exposure and disease onset remains uncertain. The World Trade Center (WTC) disaster presents a unique opportunity to describe the latency period for obstructive airway disease (OAD) diagnoses. This prospective cohort study of New York City firefighters compared the timing and incidence of physician-diagnosed OAD relative to WTC exposure. Exposure was categorized by WTC arrival time as high (on the morning of September 11, 2001), moderate (after noon on September 11, 2001, or on September 12, 2001), or low (during September 13–24, 2001). We modeled relative rates and 95% confidence intervals of OAD incidence by exposure over the first 5 years after September 11, 2001, estimating the times of change in the relative rate with change point models. We observed a change point at 15 months after September 11, 2001. Before 15 months, the relative rate for the high- versus low-exposure group was 3.96 (95% confidence interval: 2.51, 6.26) and thereafter, it was 1.76 (95% confidence interval: 1.26, 2.46). Incident OAD was associated with WTC exposure for at least 5 years after September 11, 2001. There were higher rates of new-onset OAD among the high-exposure group during the first 15 months and, to a lesser extent, throughout follow-up. This difference in relative rate by exposure occurred despite full and free access to health care for all WTC-exposed firefighters, demonstrating the persistence of WTC-associated OAD risk. PMID:24980522

  3. Estimating the time interval between exposure to the World Trade Center disaster and incident diagnoses of obstructive airway disease.

    PubMed

    Glaser, Michelle S; Webber, Mayris P; Zeig-Owens, Rachel; Weakley, Jessica; Liu, Xiaoxue; Ye, Fen; Cohen, Hillel W; Aldrich, Thomas K; Kelly, Kerry J; Nolan, Anna; Weiden, Michael D; Prezant, David J; Hall, Charles B

    2014-08-01

    Respiratory disorders are associated with occupational and environmental exposures. The latency period between exposure and disease onset remains uncertain. The World Trade Center (WTC) disaster presents a unique opportunity to describe the latency period for obstructive airway disease (OAD) diagnoses. This prospective cohort study of New York City firefighters compared the timing and incidence of physician-diagnosed OAD relative to WTC exposure. Exposure was categorized by WTC arrival time as high (on the morning of September 11, 2001), moderate (after noon on September 11, 2001, or on September 12, 2001), or low (during September 13-24, 2001). We modeled relative rates and 95% confidence intervals of OAD incidence by exposure over the first 5 years after September 11, 2001, estimating the times of change in the relative rate with change point models. We observed a change point at 15 months after September 11, 2001. Before 15 months, the relative rate for the high- versus low-exposure group was 3.96 (95% confidence interval: 2.51, 6.26) and thereafter, it was 1.76 (95% confidence interval: 1.26, 2.46). Incident OAD was associated with WTC exposure for at least 5 years after September 11, 2001. There were higher rates of new-onset OAD among the high-exposure group during the first 15 months and, to a lesser extent, throughout follow-up. This difference in relative rate by exposure occurred despite full and free access to health care for all WTC-exposed firefighters, demonstrating the persistence of WTC-associated OAD risk. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

  4. The epidemiology of disasters.

    PubMed Central

    Lechat, M. F.

    1976-01-01

    Over the last few years there has been an increasing awareness that some kind of disaster management should be possible. The emphasis is now moving from post-disaster improvisation to predisaster preparedness. The League of Red Cross Societies has increasingly encouraged predisaster planning in countries at risk. A new United Nations agency - United Nations Disaster Relief Office (UNDRO)- has been set up with headquarters in Geneva. Coordination and exchange of information between agencies engaged in disaster relief are becoming the rule rather than the exception, and a number of groups have started with the specific objective of making professional expertise available to disaster management. A number of private initiatives have been taken, meetings have been organized, research centers set up, and research projects launched. The study of disasters needs to be approached on a multidisciplinary basis, the more so since the health component is only one part of the broad disaster problem and, perhaps not the major one. Social scientists, psychologists, administrators, economists, geographers, have been or are conducting a number of studies on natural disasters. These studies have provided new insights and have proved most useful in preparing for disasters and increasing the effectiveness and acceptance of relief operations. This is a vital and challenging field, wide open for research. It is now time for epidemiologists and community health scientists to enter the fray and provide much needed information on which a rational, effective and flexible policy for the management of disasters can be based. PMID:959212

  5. The epidemiology of disasters.

    PubMed

    Lechat, M F

    1976-06-01

    Over the last few years there has been an increasing awareness that some kind of disaster management should be possible. The emphasis is now moving from post-disaster improvisation to predisaster preparedness. The League of Red Cross Societies has increasingly encouraged predisaster planning in countries at risk. A new United Nations agency - United Nations Disaster Relief Office (UNDRO)- has been set up with headquarters in Geneva. Coordination and exchange of information between agencies engaged in disaster relief are becoming the rule rather than the exception, and a number of groups have started with the specific objective of making professional expertise available to disaster management. A number of private initiatives have been taken, meetings have been organized, research centers set up, and research projects launched. The study of disasters needs to be approached on a multidisciplinary basis, the more so since the health component is only one part of the broad disaster problem and, perhaps not the major one. Social scientists, psychologists, administrators, economists, geographers, have been or are conducting a number of studies on natural disasters. These studies have provided new insights and have proved most useful in preparing for disasters and increasing the effectiveness and acceptance of relief operations. This is a vital and challenging field, wide open for research. It is now time for epidemiologists and community health scientists to enter the fray and provide much needed information on which a rational, effective and flexible policy for the management of disasters can be based.

  6. Definition and functions of health unified command and emergency operations centers for large-scale bioevent disasters within the existing ICS.

    PubMed

    Burkle, Frederick M; Hsu, Edbert B; Loehr, Michael; Christian, Michael D; Markenson, David; Rubinson, Lewis; Archer, Frank L

    2007-11-01

    The incident command system provides an organizational structure at the agency, discipline, or jurisdiction level for effectively coordinating response and recovery efforts during most conventional disasters. This structure does not have the capacity or capability to manage the complexities of a large-scale health-related disaster, especially a pandemic, in which unprecedented decisions at every level (eg, surveillance, triage protocols, surge capacity, isolation, quarantine, health care staffing, deployment) are necessary to investigate, control, and prevent transmission of disease. Emerging concepts supporting a unified decision-making, coordination, and resource management system through a health-specific emergency operations center are addressed and the potential structure, function, roles, and responsibilities are described, including comparisons across countries with similar incident command systems.

  7. Performance of Self-Report to Establish Cancer Diagnoses in Disaster Responders and Survivors, World Trade Center Health Registry, New York, 2001-2007.

    PubMed

    Li, Jiehui; Cone, James E; Alt, Abigail K; Wu, David R; Liff, Jonathan M; Farfel, Mark R; Stellman, Steven D

    2016-01-01

    Large-scale disasters may disrupt health surveillance systems, depriving health officials and researchers of timely and accurate information needed to assess disaster-related health effects and leading to use of less reliable self-reports of health outcomes. In particular, ascertainment of cancer in a population is ordinarily obtained through linkage of self-reported data with regional cancer registries, but exclusive reliance on these sources following a disaster may result in lengthy delays or loss of critical data. To assess the impact of such reliance, we validated self-reported cancer in a cohort of 59,340 responders and survivors of the World Trade Center disaster against data from 11 state cancer registries (SCRs). We focused on residents of the 11 states with SCRs and on cancers diagnosed from September 11, 2001, to the date of their last survey participation. Medical records were also sought in a subset of 595 self-reported cancer patients who were not recorded in an SCR. Overall sensitivity and specificity of self-reported cancer were 83.9% (95% confidence interval [CI] 81.9, 85.9) and 98.5% (95% CI 98.4, 98.6), respectively. Site-specific sensitivities were highest for pancreatic (90.9%) and testicular (82.4%) cancers and multiple myeloma (84.6%). Compared with enrollees with true-positive reports, enrollees with false-negative reports were more likely to be non-Hispanic black (adjusted odds ratio [aOR] = 1.8, 95% CI 1.2, 2.9) or Asian (aOR=2.2, 95% CI 1.2, 4.1). Among the 595 cases not recorded in an SCR, 13 of 62 (21%) cases confirmed through medical records were reportable to SCRs. Self-report of cancer had relatively high sensitivity among adults exposed to the World Trade Center disaster, suggesting that self-reports of other disaster-related conditions less amenable to external validation may also be reasonably valid.

  8. Performance of Self-Report to Establish Cancer Diagnoses in Disaster Responders and Survivors, World Trade Center Health Registry, New York, 2001–2007

    PubMed Central

    Cone, James E.; Alt, Abigail K.; Wu, David R.; Liff, Jonathan M.; Farfel, Mark R.; Stellman, Steven D.

    2016-01-01

    Objective Large-scale disasters may disrupt health surveillance systems, depriving health officials and researchers of timely and accurate information needed to assess disaster-related health effects and leading to use of less reliable self-reports of health outcomes. In particular, ascertainment of cancer in a population is ordinarily obtained through linkage of self-reported data with regional cancer registries, but exclusive reliance on these sources following a disaster may result in lengthy delays or loss of critical data. To assess the impact of such reliance, we validated self-reported cancer in a cohort of 59,340 responders and survivors of the World Trade Center disaster against data from 11 state cancer registries (SCRs). Methods We focused on residents of the 11 states with SCRs and on cancers diagnosed from September 11, 2001, to the date of their last survey participation. Medical records were also sought in a subset of 595 self-reported cancer patients who were not recorded in an SCR. Results Overall sensitivity and specificity of self-reported cancer were 83.9% (95% confidence interval [CI] 81.9, 85.9) and 98.5% (95% CI 98.4, 98.6), respectively. Site-specific sensitivities were highest for pancreatic (90.9%) and testicular (82.4%) cancers and multiple myeloma (84.6%). Compared with enrollees with true-positive reports, enrollees with false-negative reports were more likely to be non-Hispanic black (adjusted odds ratio [aOR] = 1.8, 95% CI 1.2, 2.9) or Asian (aOR=2.2, 95% CI 1.2, 4.1). Among the 595 cases not recorded in an SCR, 13 of 62 (21%) cases confirmed through medical records were reportable to SCRs. Conclusion Self-report of cancer had relatively high sensitivity among adults exposed to the World Trade Center disaster, suggesting that self-reports of other disaster-related conditions less amenable to external validation may also be reasonably valid. PMID:27252562

  9. The Role of Epidemiology in Disaster Response Policy Development

    PubMed Central

    Thorpe, Lorna E; Assari, Shervin; Deppen, Stephen; Glied, Sherry; Lurie, Nicole; Mauer, Matthew P; Mays, Vickie M.; Trapido, Edward

    2015-01-01

    Purpose Disasters expose the general population and responders to a range of potential contaminants and stressors which may harm physical and mental health. This article addresses the role of epidemiology in informing policies after a disaster to mitigate ongoing exposures, provide care and compensation, and improve preparedness for future disasters. Methods The World Trade Center (WTC) disaster response is used as a case study. We examine how epidemiologic evidence was used to shape post-disaster policy and identify important gaps in early research. Results In the wake of WTC attacks, epidemiologic research played a key role in identifying and characterizing affected populations, assessing environmental exposures, quantifying physical and mental health impacts, and producing evidence to ascribe causation. However, most studies suffered from methodological challenges, including delays, selection biases, poor exposure measurement, and nonstandardized outcomes. Gaps included measuring unmet health needs and financing coverage, as well as coordination across longitudinal cohorts of studies for rare conditions with long latency, such as cancer. Conclusions Epidemiologists can increase their impact on evidence-based policymaking by ensuring core mechanisms are in place prior to a disaster to mount monitoring of responders and other affected populations, improve early exposure assessment efforts, identify critical gaps in scientific knowledge, and coordinate communication of scientific findings to policymakers and the public. PMID:25150446

  10. Epidemiologic research on man-made disasters: strategies and implications of cohort definition for World Trade Center worker and volunteer surveillance program.

    PubMed

    Savitz, David A; Oxman, Rachael T; Metzger, Kristina B; Wallenstein, Sylvan; Stein, Diane; Moline, Jacqueline M; Herbert, Robin

    2008-01-01

    Studies of long-term health consequences of disasters face unique methodologic challenges. The authors focused on studies of the health of cleanup and recovery workers, who are often poorly enumerated at the outset and difficult to follow over time. Comparison of the experience at the World Trade Center disaster with 4 past incidents of chemical and radiation releases at Seveso, Italy; Bhopal, India; Chernobyl, Ukraine; and Three Mile Island, USA, provided useful contrasts. Each event had methodologic advantages and disadvantages that depended on the nature of the disaster and the availability of records on area residents, and the emergency-response and cleanup protocol. The World Trade Center Worker Monitoring Program has well-defined eligibility criteria but lacks information on the universe of eligible workers to characterize response proportions or the potential for distortion of reported health effects. Nonparticipation may result from lack of interest, lack of awareness of the program, availability of another source of medical care, medical conditions precluding participation, inability to take time off from work, moving out of the area, death, or shift from initially ineligible to eligible status. Some of these considerations suggest selective participation by the sickest individuals, whereas others favor participation by the healthiest. The greatest concern with the validity of inferences regarding elevated health risks relative to external populations is the potential for selective enrollment among those who are affected. If there were a large pool of nonparticipating workers and those who suffered ill health were most motivated to enroll, the rates of disease among participants would be substantially higher than among all those eligible for the program. Future disaster follow-up studies would benefit substantially by having access to accurate estimates of the number of workers and information on the individuals who contributed to the cleanup and recovery

  11. Workplace response of companies exposed to the 9/11 World Trade Center attack: a focus-group study

    PubMed Central

    North, Carol S.; Pfefferbaum, Betty; Hong, Barry A.; Gordon, Mollie R.; Kim, You-Seung; Lind, Lisa; Pollio, David E.

    2014-01-01

    The terrorist attacks of 11 September 2001 (9/11) left workplaces in pressing need of a mental health response capability. Unaddressed emotional sequelae may be devastating to the productivity and economic stability of a company’s workforce. In the second year after the attacks, 85 employees of five highly affected agencies participated in 12 focus groups to discuss workplace mental health issues. Managers felt ill prepared to manage the magnitude and the intensity of employees’ emotional responses. Rapid return to work, provision of workplace mental health services, and peer support were viewed as contributory to emotional recovery. Formal mental health services provided were perceived as insufficient. Drawing on their post-9/11 workplace experience, members of these groups identified practical measures that they found helpful in promoting healing outside of professional mental health services. These measures, consistent with many principles of psychological first aid, may be applied by workplace leaders who are not mental health professionals. PMID:23066661

  12. Workplace response of companies exposed to the 9/11 World Trade Center attack: a focus-group study.

    PubMed

    North, Carol S; Pfefferbaum, Betty; Hong, Barry A; Gordon, Mollie R; Kim, You-Seung; Lind, Lisa; Pollio, David E

    2013-01-01

    The terrorist attacks of 11 September 2001 (9/11) left workplaces in pressing need of a mental health response capability. Unaddressed emotional sequelae may be devastating to the productivity and economic stability of a company's workforce. In the second year after the attacks, 85 employees of five highly affected agencies participated in 12 focus groups to discuss workplace mental health issues. Managers felt ill prepared to manage the magnitude and the intensity of employees' emotional responses. Rapid return to work, provision of workplace mental health services, and peer support were viewed as contributory to emotional recovery. Formal mental health services provided were perceived as insufficient. Drawing on their post-9/11 workplace experience, members of these groups identified practical measures that they found helpful in promoting healing outside of professional mental health services. These measures, consistent with many principles of psychological first aid, may be applied by workplace leaders who are not mental health professionals.

  13. Using exterior building surface films to assess human exposure and health risks from PCDD/Fs in New York City, USA, after the World Trade Center attacks.

    PubMed

    Rayne, Sierra

    2005-12-09

    Concentrations of tetra- through octa-chlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were determined in exterior window films from Manhattan and Brooklyn in New York City (NYC), USA, 6 weeks after the World Trade Center (WTC) attacks of 11 September 2001. High concentrations of the 2,3,7,8-substituted congeners (P(2378)CDD/Fs) were observed, at levels up to 6600 pg-TEQ g(-1) nearest the WTC site. An equilibrium partitioning model was developed to reconstruct total gas + particle-phase atmospheric concentrations of P(2378)CDD/Fs at each site. The reconstructed atmospheric and window film concentrations were subsequently used in a preliminary human health risk assessment to estimate the potential cancer and non-cancer risks posed to residents of lower Manhattan from these contaminants over the 6 week exposure period between the WTC attacks and sampling dates. Residents of lower Manhattan appear to have a slightly elevated cancer risk (up to 1.6% increase over background) and increased P(2378)CDD/F body burden (up to 8.0% increase over background) because of above-background exposure to high concentrations of P(2378)CDD/Fs produced from the WTC attacks during the short period between 11 September 2001, and window film sampling 6 weeks later.

  14. Organizational Behavior in Disasters and Implications for Disaster Planning. Volume 1, Number 2

    DTIC Science & Technology

    1986-07-01

    Disaster Research Center Ohio State University National Emergency Training Center Emmitsburg, Maryland MONOGRAPH SERIES 1984 A VoIu’c NMober 2 "UIO ns1~e A... emergency . Disaster planning can be effective, if done properly. A disaster plan, when implemented, will reflect what was put into it. Thus, if such a...applicable to all disaster types. This monograph is designed for emergency management professionals having disaster preparedness planning

  15. An academic medical center's response to widespread computer failure.

    PubMed

    Genes, Nicholas; Chary, Michael; Chason, Kevin W

    2013-01-01

    As hospitals incorporate information technology (IT), their operations become increasingly vulnerable to technological breakdowns and attacks. Proper emergency management and business continuity planning require an approach to identify, mitigate, and work through IT downtime. Hospitals can prepare for these disasters by reviewing case studies. This case study details the disruption of computer operations at Mount Sinai Medical Center (MSMC), an urban academic teaching hospital. The events, and MSMC's response, are narrated and the impact on hospital operations is analyzed. MSMC's disaster management strategy prevented computer failure from compromising patient care, although walkouts and time-to-disposition in the emergency department (ED) notably increased. This incident highlights the importance of disaster preparedness and mitigation. It also demonstrates the value of using operational data to evaluate hospital responses to disasters. Quantifying normal hospital functions, just as with a patient's vital signs, may help quantitatively evaluate and improve disaster management and business continuity planning.

  16. Neural and genetic markers of vulnerability to post-traumatic stress symptoms among survivors of the World Trade Center attacks.

    PubMed

    Olsson, Andreas; Kross, Ethan; Nordberg, Samuel S; Weinberg, Anna; Weber, Jochen; Schmer-Galunder, Sonja; Fossella, John; Wager, Tor D; Bonanno, George A; Ochsner, Kevin N

    2015-06-01

    Although recent research has begun to describe the neural and genetic processes underlying variability in responses to trauma, less is known about how these processes interact. We addressed this issue by using functional magnetic resonance imaging to examine the relationship between posttraumatic stress symptomatology (PTSS), a common genetic polymorphism of the serotonin transporter [5-HTT (5-hydroxy tryptamine)] gene and neural activity in response to viewing images associated with the 9/11 terrorist attack among a rare sample of high-exposure 9/11 survivors (n = 17). Participants varied in whether they carried a copy of the short allele in the promoter region of the 5-HTT gene. During scanning, participants viewed images of the 9/11 attack, non-9/11 negative and neutral images. Three key findings are reported. First, carriers of the short allele displayed higher levels of PTSS. Second, both PTSS and the presence of the short allele correlated negatively with activity in a network of cortical midline regions (e.g. the retrosplenal and more posterior cingulate cortices (PCCs)) implicated in episodic memories and self-reflection when viewing 9/11 vs non-9/11 negative control images. Finally, exploratory analyses indicated that PCC activity mediated the relationship between genotype and PTSS. These results highlight the role of PCC in distress following trauma. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  17. Meaning reconstruction in the face of terror: An examination of recovery and posttraumatic growth among victims of the 9/11 World Trade Center attacks.

    PubMed

    Richardson, Katherine M

    2015-01-01

    This study examines the relationship between meaning reconstruction with posttraumatic growth and depreciation in the aftermath of terrorist trauma and loss. A group of individuals (n=118) who were personally affected by the September 11, 2001 terrorist attacks were surveyed about their experiences and administered the Posttraumatic Growth Inventory and Impact of Event scales. Subjects were volunteer docents at the Tribute World Trade Center Visitor Center. Results revealed that ability to make sense of one's 9/11 experience was related to recovery but not to posttraumatic growth, whereas ability to find some benefit in the experience was related to growth. In addition, location in downtown Manhattan on September 11, 2001 was related to higher levels of posttraumatic depreciation. Findings suggest that two aspects of meaning reconstruction are differentially related to recovery and posttraumatic growth.

  18. Television images and psychological symptoms after the September 11 terrorist attacks.

    PubMed

    Ahern, Jennifer; Galea, Sandro; Resnick, Heidi; Kilpatrick, Dean; Bucuvalas, Michael; Gold, Joel; Vlahov, David

    2002-01-01

    Exposure to graphic television images may exacerbate psychological symptoms in disaster situations. We tested the hypotheses that (1) more frequent viewing of television images of the September 11 terrorist attacks was associated with posttraumatic stress disorder (PTSD) and depression, and that (2) direct exposure to disaster events had an interactive effect with media viewing. We recruited 1,008 adult residents of the borough of Manhattan in New York City through a random-digit-dial telephone survey conducted between October 16 and November 15, 2001. Respondents who repeatedly saw "people falling or jumping from the towers of the World Trade Center" had higher prevalence of PTSD (17.4%) and depression (14.7%) than those who did not (6.2% and 5.3%, respectively). Among respondents who were directly affected by the attacks (e.g., had a friend killed), those who watched this television image frequently were more likely to have PTSD and depression than those who did not. Among respondents not directly affected by the attacks, prevalence of PTSD and depression was not associated with frequency of television image viewing. Specific disaster-related television images were associated with PTSD and depression among persons who were directly exposed to a disaster. Future research should address causal directionality of this association.

  19. The Center for Excellence in Disaster Management and Humanitarian Assistance (CFE-DMHA): An Assessment of Roles and Missions

    DTIC Science & Technology

    2016-01-01

    for Excellence in Disaster Management and Humanitarian Assistance problem for CFE-DMHA and is a central element of the current director’s plans to...hiring authority for recruiting SMEs to support its programs, but this proposal was not endorsed by PACOM. U.S. Office of Personnel Management ...global community , as well as to prepare to manage DoD’s Civil-Military Emergency Preparedness Program (CMEP).47 Assuming responsibility for CMEP, a

  20. Disaster Recovery: Courting Disaster

    ERIC Educational Resources Information Center

    O'Hanlon, Charlene

    2007-01-01

    An inadequate or nonexistent disaster recovery plan can have dire results. Fire, power outage, and severe weather all can brin down the best of networks in an instant. This article draws on the experiences of the Charlotte County Public Schools (Port Charlotte, Florida), which were able to lessen the damage caused by Hurricane Charley when it hit…

  1. Disaster Recovery: Courting Disaster

    ERIC Educational Resources Information Center

    O'Hanlon, Charlene

    2007-01-01

    An inadequate or nonexistent disaster recovery plan can have dire results. Fire, power outage, and severe weather all can brin down the best of networks in an instant. This article draws on the experiences of the Charlotte County Public Schools (Port Charlotte, Florida), which were able to lessen the damage caused by Hurricane Charley when it hit…

  2. A person-centered analysis of posttraumatic stress disorder symptoms following a natural disaster: predictors of latent class membership.

    PubMed

    Rosellini, Anthony J; Coffey, Scott F; Tracy, Melissa; Galea, Sandro

    2014-01-01

    The present study applied latent class analysis to a sample of 810 participants residing in southern Mississippi at the time of Hurricane Katrina to determine if people would report distinct, meaningful PTSD symptom classes following a natural disaster. We found a four-class solution that distinguished persons on the basis of PTSD symptom severity/pervasiveness (Severe, Moderate, Mild, and Negligible Classes). Multinomial logistic regression models demonstrated that membership in the Severe and Moderate Classes was associated with potentially traumatic hurricane-specific experiences (e.g., being physically injured, seeing dead bodies), pre-hurricane traumatic events, co-occurring depression symptom severity and suicidal ideation, certain religious beliefs, and post-hurricane stressors (e.g., social support). Collectively, the findings suggest that more severe/pervasive typologies of natural disaster PTSD may be predicted by the frequency and severity of exposure to stressful/traumatic experiences (before, during, and after the disaster), co-occurring psychopathology, and specific internal beliefs.

  3. A Person-Centered Analysis of Posttraumatic Stress Disorder Symptoms Following a Natural Disaster: Predictors of Latent Class Membership

    PubMed Central

    Rosellini, Anthony J.; Coffey, Scott F.; Tracy, Melissa; Galea, Sandro

    2014-01-01

    The present study applied latent class analysis to a sample of 810 participants residing in southern Mississippi at the time of Hurricane Katrina to determine if people would report distinct, meaningful PTSD symptom classes following a natural disaster. We found a four-class solution that distinguished persons on the basis of PTSD symptom severity/pervasiveness (Severe, Moderate, Mild, and Negligible Classes). Multinomial logistic regression models demonstrated that membership in the Severe and Moderate Classes was associated with potentially traumatic hurricane-specific experiences (e.g., being physically injured, seeing dead bodies), pre-hurricane traumatic events, co-occurring depression symptom severity and suicidal ideation, certain religious beliefs, and post-hurricane stressors (e.g., social support). Collectively, the findings suggest that more severe/pervasive typologies of natural disaster PTSD may be predicted by the frequency and severity of exposure to stressful/traumatic experiences (before, during, and after the disaster), co-occurring psychopathology, and specific internal beliefs. PMID:24334161

  4. Preparation for disaster.

    PubMed

    CHESBRO, W

    1958-08-01

    Standardization of county medical society plans for dealing with casualties in disasters would greatly facilitate integration with the state Civil Defense organization. Without such plans there can be no hope of coping with the great number of casualties that would come should this area be attacked. The plan of the Alameda-Contra Costa County Medical Association herein described, has been tested in actual emergency and has been found effective.

  5. In the Shadows of Terror: A Community Neighboring the World Trade Center Disaster Uses Art Therapy To Process Trauma.

    ERIC Educational Resources Information Center

    Gonzalez-Dolginko, Beth

    2002-01-01

    Discusses the work the author did at the Children's Museum of the Arts with a parents' group with the intention of creating a healing place within the SoHo community after the September 11th attacks. Examples of the art produced, comments made by participants, and suggestions made to these parents concerning their own healing and that of their…

  6. Unmet mental health care need 10–11 years after the 9/11 terrorist attacks: 2011–2012 results from the World Trade Center Health Registry

    PubMed Central

    2014-01-01

    Background There is little current information about the unmet mental health care need (UMHCN) and reasons for it among those exposed to the World Trade Center (WTC) terrorist attacks. The purpose of this study was to assess the level of UMHCN among symptomatic individuals enrolled in the WTC Health Registry (WTCHR) in 2011–2012, and to analyze the relationship between UMHCN due to attitudinal, cost, and access factors and mental health symptom severity, mental health care utilization, health insurance availability, and social support. Methods The WTCHR is a prospective cohort study of individuals with reported exposure to the 2001 WTC attacks. This study used data from 9,803 adults who completed the 2003–2004 (Wave 1) and 2011–2012 (Wave 3) surveys and had posttraumatic stress disorder (PTSD) or depression in 2011–2012. We estimated logistic regression models relating perceived attitudinal, cost and access barriers to symptom severity, health care utilization, a lack of health insurance, and social support after adjusting for sociodemographic characteristics. Results Slightly more than one-third (34.2%) of study participants reported an UMHCN. Symptom severity was a strong predictor of UMHCN due to attitudinal and perceived cost and access reasons. Attitudinal UMHCN was common among those not using mental health services, particularly those with relatively severe mental health symptoms. Cost-related UMHCN was significantly associated with a lack of health insurance but not service usage. Access-related barriers were significantly more common among those who did not use any mental health services. A higher level of social support served as an important buffer against cost and access UMHCN. Conclusions A significant proportion of individuals exposed to the WTC attacks with depression or PTSD 10 years later reported an UMHCN, and individuals with more severe and disabling conditions, those who lacked health insurance, and those with low levels of social

  7. The chemical disaster response system in Japan.

    PubMed

    Okumura, Tetsu; Ninomiya, Norifumi; Ohta, Muneo

    2003-01-01

    During the last decade, Japan has experienced the largest burden of chemical terrorism-related events in the world, including the: (1) 1994 Matsumoto sarin attack; (2) 1995 Tokyo subway sarin attack; (3) 1998 Wakayama arsenic incident; (4) 1998 Niigata sodium-azide incident; and (5) 1998 Nagano cyanide incident. Two other intentional cyanide releases in Tokyo subway and railway station restrooms were thwarted in 1995. These events spurred Japan to improve the following components of its chemical disaster-response system: (1) scene demarcation; (2) emergency medical care; (3) mass decontamination; (4) personal protective equipment; (5) chemical detection; (6) information-sharing and coordination; and (7) education and training. Further advances occurred as result of potential chemical terrorist threats to the 2000 Kyushu-Okinawa G8 Summit, which Japan hosted. Today, Japan has an integrated system of chemical disaster response that involves local fire and police services, local emergency medical services (EMS), local hospitals, Japanese Self-Defense Forces, and the Japanese Poison Information Center.

  8. Natural disasters.

    PubMed

    Cullen, J M

    1980-09-01

    This presentation covers the various types of natural disasters which are faced by investigators throughout the world. Each geophysical substance is discussed, including earth, air and water, and secondary effects including fire. Additionally, four myths associated with disasters are reviewed.

  9. Are you ready. Your guide to disaster preparedness. Handbook

    SciTech Connect

    Not Available

    1990-09-01

    The handbook outlines basic steps to take in case of natural disasters (such as floods or tornadoes), man-made disasters (such as a nuclear power plant incident or industrial fire) and national security emergencies (such as an attack on the country). Each chapter ends with a list of publications one can get to find out more about disaster planning.

  10. Disaster Preparedness.

    ERIC Educational Resources Information Center

    Brooks, Constance

    Most librarians know the importance of disaster preparedness. Many disasters could have been prevented altogether or have had reduced impact if institutions had been better prepared. This resource guide suggests how disaster preparedness can be achieved at cultural institutions. Twenty-three basic resource articles are presented to introduce…

  11. Dissociation versus posttraumatic stress: cortisol and physiological correlates in adults highly exposed to the World Trade Center attack on 9/11.

    PubMed

    Simeon, Daphne; Yehuda, Rachel; Knutelska, Margaret; Schmeidler, James

    2008-12-15

    Nine months on average after the World Trade Center (WTC) attack, 21 highly exposed adults and 10 healthy controls without major exposure did not differ in cortisol and physiologic measures. Dissociation and posttraumatic stress symptoms were quantified in the exposed group. Dissociation was associated with greater peritraumatic dissociation and, marginally, childhood trauma, lower plasma cortisol levels at 08.00h, and blunted heart rate reactivity to psychosocial stress. Posttraumatic stress was associated with exposure, peritraumatic distress, and early posttraumatic stress, and marginally associated with peritraumatic dissociation; it was not associated with cortisol or physiologic measures. Urinary cortisol differed significantly in its relationship to dissociation versus posttraumatic stress. This small study emphasizes the importance of dissecting the neurobiology of posttraumatic stress versus dissociative traumatic responses.

  12. Posttraumatic stress symptoms and body mass index among World Trade Center disaster-exposed smokers: A preliminary examination of the role of anxiety sensitivity.

    PubMed

    Farris, Samantha G; Paulus, Daniel J; Gonzalez, Adam; Mahaffey, Brittain L; Bromet, Evelyn J; Luft, Benjamin J; Kotov, Roman; Zvolensky, Michael J

    2016-07-30

    Among individuals exposed to the World Trade Center (WTC) disaster on September 11, 2001, posttraumatic stress disorder (PTSD) and symptoms are both common and associated with increased cigarette smoking and body mass. However, there is little information on the specific processes underlying the relationship of PTSD symptoms with body mass. The current study is an initial exploratory test of anxiety sensitivity, the fear of internal bodily sensations, as a possible mechanism linking PTSD symptom severity and body mass index (BMI). Participants were 147 adult daily smokers (34.0% female) exposed to the WTC disaster (via rescue/recovery work or direct witness). The direct and indirect associations between PTSD symptom severity and BMI via anxiety sensitivity (total score and subscales of physical, cognitive, and social concerns) were examined. PTSD symptom severity was related to BMI indirectly via anxiety sensitivity; this effect was specific to physical concerns about the meaning of bodily sensations. Interventions focusing on anxiety sensitivity reduction (specifically addressing physical concerns about bodily sensations) may be useful in addressing elevated BMI among trauma-exposed persons. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Mental health of those directly exposed to the World Trade Center disaster: unmet mental health care need, mental health treatment service use, and quality of life.

    PubMed

    Brackbill, Robert M; Stellman, Steven D; Perlman, Sharon E; Walker, Deborah J; Farfel, Mark R

    2013-03-01

    Mental health service utilization several years following a man-made or natural disaster can be lower than expected, despite a high prevalence of mental health disorders among those exposed. This study focused on factors associated with subjective unmet mental health care need (UMHCN) and its relationship to a combination of diagnostic history and current mental health symptoms, 5-6 years after the 9-11-01 World Trade Center (WTC) disaster in New York City, USA. Two survey waves of the WTC Health Registry, after exclusions, provided a sample of 36,625 enrollees for this analysis. Important differences were found among enrollees who were categorized according to the presence or absence of a self-reported mental health diagnosis and symptoms indicative of post-traumatic stress disorder or serious psychological distress. Persons with diagnoses and symptoms had the highest levels of UMHCN, poor mental health days, and mental health service use. Those with symptoms only were a vulnerable group much less likely to use mental health services yet reporting UMHCN and poor mental health days. Implications for delivering mental health services include recognizing that many persons with undiagnosed but symptomatic mental health symptoms are not using mental health services, despite having perceived need for mental health care. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Disaster and sexuality.

    PubMed

    Gilbert, Arthur N; Barkun, Michael

    1981-08-01

    The hypothesis presented in this article is that fear of disaster and fear of certain modes of sexuality are intimately linked. Throughout most of human history, disaster was, in essence, the result of the actions of God or nature; either gratuitous or as a punishment for a sinning mankind. Sodom and Gommorah was the classic biblical example of this interrelationship. With the coming of the French and the Industrial Revolutions, man-caused disaster came to the center of the stage and this brought in its wake changing attitudes towards sexual deviant behavior. By examining the changing images of disaster the authors seek to explain the concern with sodomy and masturbation in the early and mid-nineteenth century.

  15. Nationwide program of education for undergraduates in the field of disaster medicine: development of a core curriculum centered on blended learning and simulation tools.

    PubMed

    Ingrassia, Pier Luigi; Ragazzoni, Luca; Tengattini, Marco; Carenzo, Luca; Della Corte, Francesco

    2014-10-01

    In recent years, effective models of disaster medicine curricula for medical schools have been established. However, only a small percentage of medical schools worldwide have considered at least basic disaster medicine teaching in their study program. In Italy, disaster medicine has not yet been included in the medical school curriculum. Perceiving the lack of a specific course on disaster medicine, the Segretariato Italiano Studenti in Medicina (SISM) contacted the Centro di Ricerca Interdipartimentale in Medicina di Emergenza e dei Disastri ed Informatica applicata alla didattica e alla pratica Medica (CRIMEDIM) with a proposal for a nationwide program in this field. Seven modules (introduction to disaster medicine, prehospital disaster management, definition of triage, characteristics of hospital disaster plans, treatment of the health consequences of different disasters, psychosocial care, and presentation of past disasters) were developed using an e-learning platform and a 12-hour classroom session which involved problem-based learning (PBL) activities, table-top exercises, and a computerized simulation (Table 1). The modules were designed as a framework for a disaster medicine curriculum for undergraduates and covered the three main disciplines (clinical and psychosocial, public health, and emergency and risk management) of the core of "Disaster Health" according to the World Association for Disaster and Emergency Medicine (WADEM) international guidelines for disaster medicine education. From January 2011 through May 2013, 21 editions of the course were delivered to 21 different medical schools, and 524 students attended the course. The blended approach and the use of simulation tools were appreciated by all participants and successfully increased participants' knowledge of disaster medicine and basic competencies in performing mass-casualty triage. This manuscript reports on the designing process and the initial outcomes with respect to learners

  16. Disaster Preparedness

    PubMed Central

    Achora, Susan; Kamanyire, Joy K.

    2016-01-01

    With the increasing global frequency of disasters, the call for disaster preparedness training needs to be reinforced. Nurses form the largest group of the healthcare workforce and are often on the frontline in disaster management. Therefore, nurses should be adequately equipped with the knowledge and skills to respond to disasters, starting from their pre-service training to their in-service professional training. However, the inclusion of disaster preparedness education in undergraduate nursing curricula is minimal in most countries. The purpose of this article is to highlight the current state of nursing education and training in disaster management, both generally and in Oman. The significance of disaster preparedness training and recommendations for its inclusion in nursing practice and education are also discussed. PMID:26909207

  17. Implementation of CBT for youth affected by the World Trade Center disaster: matching need to treatment intensity and reducing trauma symptoms.

    PubMed

    2010-12-01

    An implementation study of cognitive-behavioral therapies (CBT) was conducted for traumatized youth in a postdisaster context. Headed by the New York State Office of Mental Health, the study targeted youth (N = 306) ages 5-21 affected by the World Trade Center disaster. They received either trauma-specific CBT or brief CBT skills depending upon the severity of trauma symptoms. Clinicians were trained to deliver these interventions and received monthly consultation. A regression discontinuity design was used to assess optimal strategies for matching need to service intensity. At 6-months postbaseline, both groups had improved. Rate of change was similar despite differences in severity of need. The implications for the implementation of evidence-based treatments postdisaster are discussed. Copyright © 2010 International Society for Traumatic Stress Studies.

  18. Heart Attack

    MedlinePlus

    ... test your blood several times during the first 24 hours to 48 hours after yours symptoms start.Other ... do to help prevent heart attack?A healthy lifestyle can help prevent heart attack. This ... your stress.Controlling your blood pressure.Managing your ...

  19. Heart Attack

    MedlinePlus

    ... a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get ... It's important to know the symptoms of a heart attack and call 9-1-1 if someone ...

  20. Environmental Mapping with Imaging Spectroscopy of the World Trade Center Area After the September 11, 2001 Attack

    NASA Astrophysics Data System (ADS)

    Clark, R. N.; Swayze, G. A.; Hoefen, T.; Livo, E.; Sutley, S.; Meeker, G.; Plumlee, G.; Brownfield, I.; Hageman, P.; Lamothe, P.; Gent, C.; Morath, L.; Taggart, J.; Theodorakos, T.; Adams, M.; Green, R.; Pavri, B.; Sarture, C.; Vance, S.; Boardman, J.

    2002-12-01

    The Airborne Visible / Infrared Imaging Spectrometer (AVIRIS), a hyperspectral remote sensing instrument, was flown by JPL/NASA over the World Trade Center (WTC) area on September 16, 18, 22, and 23, 2001. A 2-person USGS crew collected samples of dusts and airfall debris from more than 35 localities within a 1-km radius of the World trade Center site on the evenings of September 17 and 18, 2001. The AVIRIS data, field spectrometer data collected in areas away from the WTC, and information derived from field samples in and around the WTC were used to calibrate, provide ground truth, and map the debris and its composition in the lower Manhattan area with 2x4-meter sampling. Laboratory analyses and the AVIRIS mapping results indicate the dusts are variable in composition, both on a fine scale within individual samples and on a coarser spatial scale based on direction and distance from the WTC. Replicate mineralogical and chemical analyses of material from the same sample reveal variability that presumably is due to the heterogeneous mixture of different materials comprising the dusts. The spatial variability is observed at large scales of tens of meters to centimeter and smaller scales. AVIRIS mapping suggests that materials with higher iron content settled to the south-southeast of the building 2 collapse center. Chrysotile may occur primarily (but not exclusively) in a discontinuous pattern radially in west, north, and easterly directions, perhaps at distances greater than 3/4 kilometer from ground zero. Although only trace levels of chrysotile asbestos have been detected in the dust and airfall samples studied to date, the presence of up to 20 volume % chrysotile asbestos in material coating steel beams in the WTC debris, and the potential areas indicated in the AVIRIS mineral maps, indicate that asbestos can be found in localized concentrations.

  1. DSM-IV post-traumatic stress disorder among World Trade Center responders 11-13 years after the disaster of 11 September 2001 (9/11).

    PubMed

    Bromet, E J; Hobbs, M J; Clouston, S A P; Gonzalez, A; Kotov, R; Luft, B J

    2016-03-01

    Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11-13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being. Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit. In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life. This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.

  2. Are human made disasters different?

    PubMed

    Sederer, L I

    2012-03-01

    The author distinguishes natural from human made disasters, and identifies their traumatic effects. He stresses the impact on both individuals and communities. Lessons learned from the NYC World Trade Center bombings are offered. He concludes with a universal prescription for responding to disasters.

  3. Co-occurring Lower Respiratory Symptoms and Posttraumatic Stress Disorder 5 to 6 Years After the World Trade Center Terrorist Attack

    PubMed Central

    Nair, Hemanth P.; Ekenga, Christine C.; Cone, James E.; Brackbill, Robert M.; Farfel, Mark R.

    2012-01-01

    Objectives. We have described the epidemiology of co-occurring lower respiratory symptoms (LRS) and probable posttraumatic stress disorder (PTSD) 5 to 6 years after exposure to the 9/11 disaster. Methods. We analyzed residents, office workers, and passersby (n = 16 363) in the World Trade Center Health Registry. Using multivariable logistic regression, we examined patterns of reported respiratory symptoms, treatment sought for symptoms, diagnosed respiratory conditions, mental health comorbidities, quality of life, and unmet health care needs in relation to comorbidity. Results. Among individuals with either LRS or PTSD, 24.6% had both conditions. The odds of comorbidity was significantly higher among those with more severe 9/11 exposures. Independent of 9/11 exposures, participants with LRS had 4 times the odds of those without it of meeting criteria for PTSD, and those with PTSD had 4 times the odds of those without it of meeting criteria for LRS. Participants with comorbidity had worse quality of life and more unmet mental health care needs than did all other outcome groups. Conclusions. Respiratory and mental illness are closely linked in individuals exposed to 9/11 and should be considered jointly in public health outreach and treatment programs. PMID:22897552

  4. Environmental mapping of the World Trade Center area with imaging spectroscopy after the September 11, 2001 attack

    USGS Publications Warehouse

    Clark, Roger N.; Swayze, Gregg A.; Hoefen, Todd M.; Green, Robert O.; Livo, Keith E.; Meeker, Gregory P.; Sutley, Stephen J.; Plumlee, Geoffrey S.; Pavri, Betina; Sarture, Charles M.; Boardman, Joe; Brownfield, Isabelle; Morath, Laurie C.

    2009-01-01

    The Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) was flown over the World Trade Center area on September 16, 18, 22, and 23, 2001. The data were used to map the WTC debris plume and its contents, including the spectral signatures of asbestiform minerals. Samples were collected and used as ground truth for the AVARIS mapping. A number of thermal hot spots were observed with temperatures greater than 700 °C. The extent and temperatures of the fires were mapped as a function of time. By September 23, most of the fires observed by AVIRIS had been eliminated or reduced in intensity. The mineral absorption features mapped by AVARIS only indicated the presence of serpentine mineralogy and not if the serpentine has asbestiform.

  5. The role of the plastic surgeon in disaster relief.

    PubMed

    Thakar, Hema J; Pepe, Paul E; Rohrich, Rod J

    2009-09-01

    Awareness of large-scale disasters among members of the medical community and the public at large has been heightened by recent events such as the 1995 Oklahoma City bombing incident, the 2001 World Trade Center attack, and the 2005 London Underground bombings. Experience with these events has highlighted the critical role of surgical specialists, including plastic surgeons. As part of their residency, plastic surgeons are trained in acute trauma management. In addition, they also are required to demonstrate expertise in the assessment and treatment of soft-tissue injuries, upper extremity trauma, facial fractures, and both operative and nonoperative burn management. Accordingly, the plastic surgeon is among the most qualified of physicians to provide specialized injury care, especially in the disaster medicine setting. In turn, training programs should include key elements of incident command and catastrophe relief.

  6. Planning for biological disasters. Occupational health nurses as "first responders".

    PubMed

    Salazar, Mary K; Kelman, Betty

    2002-04-01

    1. As a result of recent terrorist events, there is an immediate need for occupational nurses to review their disaster plans and to develop strategies to cope with bioterrorism in their workplaces. 2. The Centers for Disease Control and Prevention has identified three major categories of biological weapons. Category A, which is the highest priority category (and the focus of this article), includes smallpox, anthrax, botulism, plague, tularemia, filoviruses, and adenoviruses. Dealing with bioterrorism requires occupational health nurses to be familiar with these organisms, including their pathophysiology and methods of prevention, detection, and treatment. 3. Five principles can be used to guide responses to a biological attack. Incorporation of these principles into disaster planning will increase the effectiveness of responses to bioterrorism, if and when it occurs. Developing a plan of action before an event occurs will greatly enhance the likelihood that the repercussions of such an event are minimized.

  7. Heart Attack Recovery FAQs

    MedlinePlus

    ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure ... a Heart Attack • Treatment of a Heart Attack • Life After a Heart Attack Lifestyle Changes Recovery FAQs • Heart ...

  8. About Heart Attacks

    MedlinePlus

    ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure ... a Heart Attack • Treatment of a Heart Attack • Life After a Heart Attack Lifestyle Changes Recovery FAQs • Heart ...

  9. Impact of September 11 attacks on workers in the vicinity of the World Trade Center--New York City.

    PubMed

    2002-09-11

    In January 2002, CDC's National Institute for Occupational Safety and Health received requests for Health Hazard Evaluations from labor unions representing workers employed in buildings in the vicinity of the World Trade Center (WTC). Workers reported persistent physical and mental health symptoms that they associated with exposures from the WTC collapse and ensuing fires. To address these concerns, CDC conducted surveys of workers at four workplaces in New York City (NYC), a high school (high school A) and college (college A) near the WTC site, and a high school (comparison high school B) and college (comparison college B) > or = 5 miles from the WTC site to determine rates of physical and mental health symptoms. This report summarizes the preliminary results of the employee surveys, which indicated that workers employed near the WTC site had significantly higher rates of physical and mental health symptoms than workers employed > or = 5 miles from the site. Intervention programs should be tailored to address the needs of these workers, and the effectiveness of these programs should be evaluated. Further assessment is warranted to describe the nature and extent of illness in specific working groups and individual medical follow-up in those with persistent symptoms.

  10. Setting Up an Efficient Therapeutic Hypothermia Team in Conscious ST Elevation Myocardial Infarction Patients: A UK Heart Attack Center Experience.

    PubMed

    Islam, Shahed; Hampton-Till, James; MohdNazri, Shah; Watson, Noel; Gudde, Ellie; Gudde, Tom; Kelly, Paul A; Tang, Kare H; Davies, John R; Keeble, Thomas R

    2015-12-01

    Patients presenting with ST elevation myocardial infarction (STEMI) are routinely treated with percutaneous coronary intervention to restore blood flow in the occluded artery to reduce infarct size (IS). However, there is evidence to suggest that the restoration of blood flow can cause further damage to the myocardium through reperfusion injury (RI). Recent research in this area has focused on minimizing damage to the myocardium caused by RI. Therapeutic hypothermia (TH) has been shown to be beneficial in animal models of coronary artery occlusion in reducing IS caused by RI if instituted early in an ischemic myocardium. Data in humans are less convincing to date, although exploratory analyses suggest that there is significant clinical benefit in reducing IS if TH can be administered at the earliest recognition of ischemia in anterior myocardial infarction. The Essex Cardiothoracic Centre is the first UK center to have participated in administering TH in conscious patients presenting with STEMI as part of the COOL-AMI case series study. In this article, we outline our experience of efficiently integrating conscious TH into our primary percutaneous intervention program to achieve 18 minutes of cooling duration before reperfusion, with no significant increase in door-to-balloon times, in the setting of the clinical trial.

  11. Setting Up an Efficient Therapeutic Hypothermia Team in Conscious ST Elevation Myocardial Infarction Patients: A UK Heart Attack Center Experience

    PubMed Central

    Islam, Shahed; Hampton-Till, James; MohdNazri, Shah; Watson, Noel; Gudde, Ellie; Gudde, Tom; Kelly, Paul A.; Tang, Kare H.

    2015-01-01

    Patients presenting with ST elevation myocardial infarction (STEMI) are routinely treated with percutaneous coronary intervention to restore blood flow in the occluded artery to reduce infarct size (IS). However, there is evidence to suggest that the restoration of blood flow can cause further damage to the myocardium through reperfusion injury (RI). Recent research in this area has focused on minimizing damage to the myocardium caused by RI. Therapeutic hypothermia (TH) has been shown to be beneficial in animal models of coronary artery occlusion in reducing IS caused by RI if instituted early in an ischemic myocardium. Data in humans are less convincing to date, although exploratory analyses suggest that there is significant clinical benefit in reducing IS if TH can be administered at the earliest recognition of ischemia in anterior myocardial infarction. The Essex Cardiothoracic Centre is the first UK center to have participated in administering TH in conscious patients presenting with STEMI as part of the COOL-AMI case series study. In this article, we outline our experience of efficiently integrating conscious TH into our primary percutaneous intervention program to achieve 18 minutes of cooling duration before reperfusion, with no significant increase in door-to-balloon times, in the setting of the clinical trial. PMID:26154447

  12. Treatise of World Trade Center (WTC) Dust generated during the September 2001 terrorist attacks on the WTC towers

    NASA Astrophysics Data System (ADS)

    Badger, Steven R.

    The initial devastation created by the collapse of the World Trade Center (WTC) Towers resulting from the September 11, 2001 bombings was followed by the dissemination of newly formed toxic dust throughout Lower Manhattan. The ensuing fires that burned within the six-story high debris pile produced a continuous stream of hazardous combustion products. Emphasis on this research was placed on the characterization, the extent of contamination, remediation procedures, and the potential for recontamination by dusts produced by the events of 9/11/2001. A detailed characterization of the WTC Dust was performed using a wide variety of methods. Through the analyses of known WTC Dust, WTC Dust Markers were identified using the composition and morphology of the particles present. Buildings throughout Lower Manhattan were tested for WTC Dust Markers and the radial extent of the WTC Dust was identified. Case studies of buildings located in close proximity to the WTC Site were undertaken to determine the pervasiveness of the WTC Dust into various building systems and components. Testing was conducted on all major building systems/spaces including: occupied spaces, perimeter induction units, structural steel, interior wall cavities, curtain walls, IT raceways, HVAC, and MEP systems. The analytical results indicated that all systems contained WTC Dust and that reservoirs were present. The feasibility of remediation of the WTC Dust from surfaces was evaluated in order to determine if it is possible for the dusts and contaminants to be eradicated. Utilizing standard remediation methods specific to surface type and contaminate type, surfaces throughout the studied buildings were cleaned. Results of post-remediation analyses indicated that remediation efforts in a building contaminated with WTC Dust were ineffective in returning the building to its state prior to the WTC Event. Recontamination studies were also performed in buildings that had been previously cleaned to determine if

  13. Risk Communication Strategies: Lessons Learned from Previous Disasters with a Focus on the Fukushima Radiation Accident.

    PubMed

    Svendsen, Erik R; Yamaguchi, Ichiro; Tsuda, Toshihide; Guimaraes, Jean Remy Davee; Tondel, Martin

    2016-12-01

    It has been difficult to both mitigate the health consequences and effectively provide health risk information to the public affected by the Fukushima radiological disaster. Often, there are contrasting public health ethics within these activities which complicate risk communication. Although no risk communication strategy is perfect in such disasters, the ethical principles of risk communication provide good practical guidance. These discussions will be made in the context of similar lessons learned after radiation exposures in Goiania, Brazil, in 1987; the Chernobyl nuclear power plant accident, Ukraine, in 1986; and the attack at the World Trade Center, New York, USA, in 2001. Neither of the two strategies is perfect nor fatally flawed. Yet, this discussion and lessons from prior events should assist decision makers with navigating difficult risk communication strategies in similar environmental health disasters.

  14. Heart Attack

    MedlinePlus

    ... it as instructed while awaiting emergency help. Take aspirin, if recommended . Taking aspirin during a heart attack could reduce heart damage by helping to keep your blood from clotting. Aspirin can interact with other medications, however, so don' ...

  15. Initial estimates of the temperature and fractional areas of fires at the World Trade Center Disaster from AVIRIS

    NASA Technical Reports Server (NTRS)

    Green, R. O.; Clark, R. N.; Boardman, J.; Pavri, B.; Sarture, C.

    2003-01-01

    This paper reports the measurements, algorithms, analyses, and results of the fire temperature and fractional area determinations with AVIRIS calibrated spectra at the World Trade Center site in September 2001.

  16. Initial estimates of the temperature and fractional areas of fires at the World Trade Center Disaster from AVIRIS

    NASA Technical Reports Server (NTRS)

    Green, R. O.; Clark, R. N.; Boardman, J.; Pavri, B.; Sarture, C.

    2003-01-01

    This paper reports the measurements, algorithms, analyses, and results of the fire temperature and fractional area determinations with AVIRIS calibrated spectra at the World Trade Center site in September 2001.

  17. A Geographic Simulation Model for the Treatment of Trauma Patients in Disasters.

    PubMed

    Carr, Brendan G; Walsh, Lauren; Williams, Justin C; Pryor, John P; Branas, Charles C

    2016-08-01

    Though the US civilian trauma care system plays a critical role in disaster response, there is currently no systems-based strategy that enables hospital emergency management and local and regional emergency planners to quantify, and potentially prepare for, surges in trauma care demand that accompany mass-casualty disasters. A proof-of-concept model that estimates the geographic distributions of patients, trauma center resource usage, and mortality rates for varying disaster sizes, in and around the 25 largest US cities, is presented. The model was designed to be scalable, and its inputs can be modified depending on the planning assumptions of different locales and for different types of mass-casualty events. To demonstrate the model's potential application to real-life planning scenarios, sample disaster responses for 25 major US cities were investigated using a hybrid of geographic information systems and dynamic simulation-optimization. In each city, a simulated, fast-onset disaster epicenter, such as might occur with a bombing, was located randomly within one mile of its population center. Patients then were assigned and transported, in simulation, via the new model to Level 1, 2, and 3 trauma centers, in and around each city, over a 48-hour period for disaster scenario sizes of 100, 500, 5000, and 10,000 casualties. Across all 25 cities, total mean mortality rates ranged from 26.3% in the smallest disaster scenario to 41.9% in the largest. Out-of-hospital mortality rates increased (from 21.3% to 38.5%) while in-hospital mortality rates decreased (from 5.0% to 3.4%) as disaster scenario sizes increased. The mean number of trauma centers involved ranged from 3.0 in the smallest disaster scenario to 63.4 in the largest. Cities that were less geographically isolated with more concentrated trauma centers in their surrounding regions had lower total and out-of-hospital mortality rates. The nine US cities listed as being the most likely targets of terrorist attacks

  18. The environmental and medical geochemistry of potentially hazardous materials produced by disasters

    USGS Publications Warehouse

    Plumlee, Geoffrey S.; Morman, Suzette A.; Meeker, G.P.; Hoefen, Todd M.; Hageman, Philip L.; Wolf, Ruth E.

    2014-01-01

    Many natural or human-caused disasters release potentially hazardous materials (HM) that may pose threats to the environment and health of exposed humans, wildlife, and livestock. This chapter summarizes the environmentally and toxicologically significant physical, mineralogical, and geochemical characteristics of materials produced by a wide variety of recent disasters, such as volcanic eruptions, hurricanes and extreme storms, spills of mining/mineral-processing wastes or coal extraction by-products, and the 2001 attacks on and collapse of the World Trade Center towers. In describing these characteristics, this chapter also illustrates the important roles that geochemists and other earth scientists can play in environmental disaster response and preparedness. In addition to characterizing in detail the physical, chemical, and microbial makeup of HM generated by the disasters, these roles also include (1) identifying and discriminating potential multiple sources of the materials; (2) monitoring, mapping, and modeling dispersal and evolution of the materials in the environment; (3) understanding how the materials are modified by environmental processes; (4) identifying key characteristics and processes that influence the materials' toxicity to exposed humans and ecosystems; (5) estimating shifts away from predisaster environmental baseline conditions; and (6) using geochemical insights learned from past disasters to help estimate, prepare for, and increase societal resilience to the environmental and related health impacts of future disasters.

  19. Role of a database-driven web site in the immediate disaster response and recovery of Academic Health Center: the Katrina experience.

    PubMed

    Fordis, Michael; Alexander, J Douglas; McKellar, Julie

    2007-08-01

    In the wake of Hurricane Katrina's landfall on August 29, 2005, and the subsequent levee failures, operations of Tulane University School of Medicine became unsustainable. As New Orleans collapsed, faculty, students, residents, and staff were scattered nationwide. In response, four Texas medical schools created an alliance to assist Tulane in temporarily relocating operations to south Texas. Resuming operations in a three- to four-week time span required developing and implementing a coordinated communication plan in the face of widespread communication infrastructure disruptions. A keystone of the strategy involved rapidly creating a "recovery Web site" to provide essential information on immediate recovery plans, mechanisms for reestablishing communications with displaced persons, housing relocation options (over 200 students, faculty, and staff were relocated using Web site resources), classes and residency training, and other issues (e.g., financial services, counseling support) vitally important to affected individuals. The database-driven Web site was launched in four days on September 11, 2005, by modifying an existing system and completing new programming. Additional functions were added during the next week, and the site operated continuously until March 2006, providing about 890,000 pages of information in over 100,000 visitor sessions. The site proved essential in disseminating announcements, reestablishing communications among the Tulane family, and supporting relocation and recovery. This experience shows the importance of information technology in collaborative efforts of academic health centers in early disaster response and recovery, reinforcing recommendations published recently by the Association of Academic Health Centers and the National Academy of Sciences.

  20. Disaster: would your community bounce back?

    SciTech Connect

    Sims, Benjamin H

    2011-01-12

    What makes some communities or organizations able to quickly bounce back from a disaster, while others take a long time to recover? This question has become very important for emergency planners in federal, state, and local government - particularly since the 9/11 attacks and Hurricane Katrina, which nearly destroyed New Orleans five years ago. These events have made people aware that we can't always prevent disasters, but might be able to improve the ability of communities and regions to respond to and bounce back from major disruptions. Social scientists have found that most communities are, in fact, quite resilient to most disasters. People tend to work together, overcome divisions, identify problems, and develop improvised solutions. This often leads to a greater sense of community and a sense of personal accomplishment. Long-term recovery can be harder, but rebuilding can create jobs and stimulate economies. Communities may even end up better than they were before. But there are some disturbing exceptions to this trend, including Hurricane Katrina. The hurricane killed many people, the federal and local emergency response was not effective, people who could not evacuate were housed in the Superdome and Convention Center in terrible conditions, crime was prevalent, and local government did not appear to have control over the situation. A significant portion of the population was eventually evacuated to other cities. Even five years later, many people have not returned, and large parts of the city have not been rebuilt. Clearly, New Orleans lacked sufficient resilience to overcome a disaster of the magnitude of Katrina. There are four factors that social scientists are beginning to agree are important for community resilience: (1) A strong, diverse economy - Stable jobs, good incomes, diversity of industries, personal savings; (2) Robust social networks - Community members know each other, help each other, and have connections outside the community; (3

  1. Natural Disaster & Crisis Management in School Districts and Community Colleges.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee. Office of Educational Facilities.

    This document provides school districts and community colleges in Florida with guidance on disaster preparedness planning and management for all types of disasters. Procedures include those for insurance coverage, emergency shelters, command centers and disaster team organization, emergency communications, security, preparation prior to disaster,…

  2. Cognitive impairment among World Trade Center responders: Long-term implications of re-experiencing the 9/11 terrorist attacks.

    PubMed

    Clouston, Sean A P; Kotov, Roman; Pietrzak, Robert H; Luft, Benjamin J; Gonzalez, Adam; Richards, Marcus; Ruggero, Camilo J; Spiro, Avron; Bromet, Evelyn J

    2016-01-01

    During the World Trade Center (WTC) attacks, responders who helped in search, rescue, and recovery endured multiple traumatic and toxic exposures. One-fifth subsequently developed post-traumatic stress disorder (PTSD). PTSD has been linked to dementia in veterans. This study examined the association between WTC-related PTSD and cognitive impairment (CI) in WTC responders. A one-third sample of responders (N = 818) reporting for annual monitoring visits were screened for cognitive impairment and dementia using the Montreal Cognitive Assessment from January 2014-April 2015. Concurrent diagnoses of PTSD and major depressive disorder (MDD), as well as serial PTSD and depressive symptom inventories, collected since 2002, were examined in relation to current CI. Approximately 12.8% and 1.2% of responders in this sample respectively had scores indicative of CI and possible dementia. Current PTSD and MDD were associated with CI. Longitudinal results revealed that re-experiencing symptoms were consistently associated with CI (aRR = 2.88, 95% confidence interval = 1.35-6.22), whereas longitudinal increases in other PTSD and depressive symptoms in the years before screening were evident only among those with CI. Analyses replicated results from Veterans studies and further highlighted the importance of re-experiencing symptoms, a major component of PTSD that was consistently predictive of CI 14 years later. Clinicians should monitor CI when treating individuals with chronic PTSD.

  3. Was there unmet mental health need after the September 11, 2001 terrorist attacks?

    PubMed

    Stuber, Jennifer; Galea, Sandro; Boscarino, Joseph A; Schlesinger, Mark

    2006-03-01

    This study examined the use of professionals for mental health problems among New York City residents who were directly affected by the September 11, 2001 terrorist attacks on the World Trade Center (WTC) or had a probable diagnosis of post-traumatic stress disorder (PTSD) or depression in its aftermath. Correlates of help seeking from professionals for mental health problems after the attacks and barriers to care were also assessed. Data were from a random digit dial telephone survey of 2,752 adults representative of the Greater New York Metropolitan area conducted 6 months after the September 11 terrorist attacks. Fifteen percent of those directly affected and 36% of those with probable PTSD or depression sought help from a professional for a mental health problem after the attacks. There was little new utilization of professionals for mental health problems after the attacks among persons who were not already receiving care prior to September 11. Barriers that prevented people from seeking help for mental health problems 6 months after the September 11 attacks included traditional barriers to care (e.g., cost) and barriers that are unique to the post-disaster context (e.g., the belief that others need the services more than oneself). This study suggests that there was potential unmet mental health need in New York City 6 months after the September 11 attacks on the WTC, but these findings should be tempered by research showing an apparent decrease in population-rates of PTSD. In the aftermath of a disaster, interventions should target persons with mental health needs who were not previously seeking help from a professional for a mental health problem.

  4. In the Shadows of Terror: A Community Neighboring the World Trade Center Disaster Uses Art Therapy to Process Trauma

    ERIC Educational Resources Information Center

    Gonzalez-Dolginko, Beth

    2002-01-01

    The Children's Museum of the Arts, located in SoHo, is a community center where children and families create together through involvement with the visual and performing arts. The families that participate in the programming offered by the Museum are living, and perhaps working and going to school, in the shadows of what used to be the World Trade…

  5. ASSESSING CARCINOGENIC POLYCYCLIC AROMATIC HYDROCARBONS (PAH) LEVELS IN THE AFTERMATH OF THE NEW YORK WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    The catastrophic destruction of the World Trade Center (WTC) on Sept. 11, 2001 (9/11) created an immense dust cloud followed by fires that emitted smoke and soot into the air of New York City (NYC) well into December. Outdoor pollutant levels in lower Manhattan returned to urban...

  6. Chronic and acute exposures to the world trade center disaster and lower respiratory symptoms: area residents and workers.

    PubMed

    Maslow, Carey B; Friedman, Stephen M; Pillai, Parul S; Reibman, Joan; Berger, Kenneth I; Goldring, Roberta; Stellman, Steven D; Farfel, Mark

    2012-06-01

    We assessed associations between new-onset (post-September 11, 2001 [9/11]) lower respiratory symptoms reported on 2 surveys, administered 3 years apart, and acute and chronic 9/11-related exposures among New York City World Trade Center-area residents and workers enrolled in the World Trade Center Health Registry. World Trade Center-area residents and workers were categorized as case participants or control participants on the basis of lower respiratory symptoms reported in surveys administered 2 to 3 and 5 to 6 years after 9/11. We created composite exposure scales after principal components analyses of detailed exposure histories obtained during face-to-face interviews. We used multivariate logistic regression models to determine associations between lower respiratory symptoms and composite exposure scales. Both acute and chronic exposures to the events of 9/11 were independently associated, often in a dose-dependent manner, with lower respiratory symptoms among individuals who lived and worked in the area of the World Trade Center. Study findings argue for detailed assessments of exposure during and after events in the future from which potentially toxic materials may be released and for rapid interventions to minimize exposures and screen for potential adverse health effects.

  7. ASSESSING CARCINOGENIC POLYCYCLIC AROMATIC HYDROCARBONS (PAH) LEVELS IN THE AFTERMATH OF THE NEW YORK WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    The catastrophic destruction of the World Trade Center (WTC) on Sept. 11, 2001 (9/11) created an immense dust cloud followed by fires that emitted smoke and soot into the air of New York City (NYC) well into December. Outdoor pollutant levels in lower Manhattan returned to urban...

  8. Trends in respiratory diagnoses and symptoms of firefighters exposed to the World Trade Center disaster: 2005-2010.

    PubMed

    Weakley, Jessica; Webber, Mayris P; Gustave, Jackson; Kelly, Kerry; Cohen, Hillel W; Hall, Charles B; Prezant, David J

    2011-12-01

    To compare the prevalence of self-reported respiratory diagnoses in World Trade Center-exposed Fire Department of New York City firefighters to the prevalence in demographically similar National Health Interview Survey participants by year; and, 2) to describe the prevalence of World Trade Center-related symptoms up to 9 years post-9/11. We analyzed 45,988 questionnaires completed by 10,999 firefighters from 10/2/2001 to 9/11/2010. For comparison of diagnosis rates, we calculated 95% confidence intervals around yearly firefighter prevalence estimates and generated odds ratios and confidence intervals to compare the odds of diagnoses in firefighters to the National Health Interview Survey prevalence, by smoking status. Overall, World Trade Center-exposed firefighters had higher respiratory diagnosis rates than the National Health Interview Survey; Fire Department of New York City rates also varied less by smoking status. In 2009, bronchitis rates in firefighters aged 45-65 were 13.3 in smokers versus 13.1 in never-smokers while in the National Health Interview Survey, bronchitis rates were doubled for smokers: 4.3 vs. 2.1. In serial cross-sectional analyses, the prevalence of most symptoms stabilized by 2005, at ~10% for cough to ~48% for sinus. We found generally higher rates of respiratory diagnoses in World Trade Center-exposed firefighters compared to US males, regardless of smoking status. This underscores the impact of World Trade Center exposure and the need for continued monitoring and treatment of this population. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. The San Bernardino, California, Terror Attack: Two Emergency Departments’ Response

    PubMed Central

    Lee, Carol; Walters, Elizabeth; Borger, Rodney; Clem, Kathleen; Fenati, Gregory; Kiemeney, Michael; Seng, Sakona; Yuen, Ho-Wang; Neeki, Michael; Smith, Dustin

    2016-01-01

    On December 2, 2015, a terror attack in the city of San Bernardino, California killed 14 Americans and injured 22 in the deadliest attack on U.S. soil since September 11, 2001. Although emergency personnel and law enforcement officials frequently deal with multi-casualty incidents (MCIs), what occurred that day required an unprecedented response. Most of the severely injured victims were transported to either Loma Linda University Medical Center (LLUMC) or Arrowhead Regional Medical Center (ARMC). These two hospitals operate two designated trauma centers in the region and played crucial roles during the massive response that followed this attack. In an effort to shed a light on our response to others, we provide an account of how these two teaching hospitals prepared for and coordinated the medical care of these victims. In general, both centers were able to quickly mobilize large number of staff and resources. Prior disaster drills proved to be invaluable. Both centers witnessed excellent teamwork and coordination involving first responders, law enforcement, administration, and medical personnel from multiple specialty services. Those of us working that day felt safe and protected. Although we did identify areas we could have improved upon, including patchy communication and crowd-control, they were minor in nature and did not affect patient care. MCIs pose major challenges to emergency departments and trauma centers across the country. Responding to such incidents requires an ever-evolving approach as no two incidents will present exactly alike. It is our hope that this article will foster discussion and lead to improvements in management of future MCIs. PMID:26823922

  10. The San Bernardino, California, Terror Attack: Two Emergency Departments' Response.

    PubMed

    Lee, Carol; Walters, Elizabeth; Borger, Rodney; Clem, Kathleen; Fenati, Gregory; Kiemeney, Michael; Seng, Sakona; Yuen, Ho-Wang; Neeki, Michael; Smith, Dustin

    2016-01-01

    On December 2, 2015, a terror attack in the city of San Bernardino, California killed 14 Americans and injured 22 in the deadliest attack on U.S. soil since September 11, 2001. Although emergency personnel and law enforcement officials frequently deal with multi-casualty incidents (MCIs), what occurred that day required an unprecedented response. Most of the severely injured victims were transported to either Loma Linda University Medical Center (LLUMC) or Arrowhead Regional Medical Center (ARMC). These two hospitals operate two designated trauma centers in the region and played crucial roles during the massive response that followed this attack. In an effort to shed a light on our response to others, we provide an account of how these two teaching hospitals prepared for and coordinated the medical care of these victims. In general, both centers were able to quickly mobilize large number of staff and resources. Prior disaster drills proved to be invaluable. Both centers witnessed excellent teamwork and coordination involving first responders, law enforcement, administration, and medical personnel from multiple specialty services. Those of us working that day felt safe and protected. Although we did identify areas we could have improved upon, including patchy communication and crowd-control, they were minor in nature and did not affect patient care. MCIs pose major challenges to emergency departments and trauma centers across the country. Responding to such incidents requires an ever-evolving approach as no two incidents will present exactly alike. It is our hope that this article will foster discussion and lead to improvements in management of future MCIs.

  11. PSYCHOLOGICAL ASPECTS OF ATOMIC DISASTER

    PubMed Central

    Adams, Edward C.

    1954-01-01

    Increasing attention to the psychological aspects of atomic disaster will help improve the ability of the citizens of this country to withstand attack and survive as a free people. Since an enemy may be expected to exploit any internal weaknesses it can find, preparation must be made against the onslaught. The ability to deal effectively with any situation, even the most awesome, depends on knowledge of what to expect, and there is no reason to believe that facts about atomic disaster are an exception to this time proven truth. The psychological aspects need to be considered from two points of view, namely, the effect on masses of people and on individuals. PMID:13182616

  12. Heart disease among adults exposed to the September 11, 2001 World Trade Center disaster: results from the World Trade Center Health Registry.

    PubMed

    Jordan, Hannah T; Miller-Archie, Sara A; Cone, James E; Morabia, Alfredo; Stellman, Steven D

    2011-12-01

    To examine associations between 9/11-related exposures, posttraumatic stress disorder (PTSD), and subsequent development of heart disease (HD). We prospectively followed 39,324 WTC Health Registry participants aged ≥18 on 9/11 for an average of 2.9 years. HD was defined as self-reported physician-diagnosed angina, heart attack, and/or other HD reported between study enrollment (2003-2004) and a follow-up survey (2006-2008) in enrollees without previous HD. A PTSD Checklist (PCL) score ≥44 was considered PTSD. We calculated adjusted hazard ratios (AHR) and 95% confidence intervals (CI) to examine relationships between 9/11-related exposures and HD. We identified 1162 HD cases (381 women, 781 men). In women, intense dust cloud exposure was significantly associated with HD (AHR 1.28, 95% CI 1.02-1.61). Injury on 9/11 was significantly associated with HD in women (AHR 1.46, 95% CI 1.19-1.79) and in men (AHR 1.33, 95% CI 1.15-1.53). Participants with PTSD at enrollment had an elevated HD risk (AHR 1.68, 95% CI 1.33-2.12 in women, AHR 1.62, 95% CI 1.34-1.96 in men). A dose-response relationship was observed between PCL score and HD risk. This exploratory study suggests that exposure to the WTC dust cloud, injury on 9/11 and 9/11-related PTSD may be risk factors for HD. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Pre-Attack Stress-Load, Appraisals, and Coping in Children's Responses to the 9/11 Terrorist Attacks

    ERIC Educational Resources Information Center

    Lengua, Liliana J.; Long, Anna C.; Meltzoff, Andrew N.

    2006-01-01

    Background: Appraisal and coping following a disaster are important factors in children's post-traumatic stress (PTS) symptoms. However, little is known about predictors of disaster coping responses. This study examined stress-load, appraisals and coping styles measured prior to the September 11 terrorist attacks as predictors of 9/11-specific…

  14. Pre-Attack Stress-Load, Appraisals, and Coping in Children's Responses to the 9/11 Terrorist Attacks

    ERIC Educational Resources Information Center

    Lengua, Liliana J.; Long, Anna C.; Meltzoff, Andrew N.

    2006-01-01

    Background: Appraisal and coping following a disaster are important factors in children's post-traumatic stress (PTS) symptoms. However, little is known about predictors of disaster coping responses. This study examined stress-load, appraisals and coping styles measured prior to the September 11 terrorist attacks as predictors of 9/11-specific…

  15. Chemical contamination of the Hudson-Raritan Estuary as a result of the attack on the World Trade Center: analysis of polycyclic aromatic hydrocarbons and polychlorinated biphenyls in mussels and sediment.

    PubMed

    Lauenstein, G G; Kimbrough, K L

    2007-03-01

    The September 11, 2001 attack on the World Trade Center (WTC) resulted in a massive plume of dust and smoke that blanketed lower Manhattan and part of the Hudson-Raritan Estuary (HRE). The NOAA National Status and Trends Mussel Watch Program has long-term monitoring sites in the area and thus had an opportunity to assess the effect of the WTC attack on PAH and PCB contamination of the surrounding estuary. Seven additional sites were added in the Upper HRE to attain higher sampling resolution for comparison with regularly sampled Mussel Watch Project HRE sites. Elevated background levels of PCBs and PAHs in mussel tissue and sediments were high enough before the WTC attack that concentrations were not measurably changed by WTC derived contaminant input.

  16. The BEYOND center of excellence for the effective exploitation of satellite time series towards natural disasters monitoring and assessment

    NASA Astrophysics Data System (ADS)

    Kontoes, Charalampos; Papoutsis, Ioannis; Amiridis, Vassilis; Balasis, George; Keramitsoglou, Iphigenia; Herekakis, Themistocles; Christia, Eleni

    2014-05-01

    BEYOND project (2013-2016, 2.3Meuro) funded under the FP7-REGPOT scheme is an initiative which aims to build a Centre of Excellence for Earth Observation (EO) based monitoring of natural disasters in south-eastern Europe (http://beyond-eocenter.eu/), established at the National Observatory of Athens (NOA). The project focuses on capacity building on top of the existing infrastructure, aiming at unlocking the institute's potential through the systematic interaction with high-profile partners across Europe, and at consolidating state-of-the-art equipment and technological know-how that will allow sustainable cutting-edge interdisciplinary research to take place with an impact on the regional and European socioeconomic welfare. The vision is to set up innovative integrated observational solutions to allow a multitude of space borne and ground-based monitoring networks to operate in a complementary and cooperative manner, create archives and databases of long series of observations and higher level products, and make these available for exploitation with the involvement of stakeholders. In BEYOND critical infrastructural components are being procured for fostering access, use, retrieval and analysis of long EO data series and products. In this framework NOA has initiated activities for the development, installation and operation of important acquisition facilities and hardware modules, including space based observational infrastructures as the X-/L-band acquisition station for receiving EOS Aqua/Terra, NPP, JPSS, NOAA, Metop, Feng Yun data in real time, the setting up of an ESA's Mirror Site of Sentinel missions to be operable from 2014 onwards, an advanced Raman Lidar portable station, a spectrometer facility, several ground magnetometer stations. All these are expected to work in synergy with the existing capacity resources and observational networks including the MSG/SEVIRI acquisition station, nationwide seismographic, GPS, meteo and atmospheric networks. The

  17. Chronic and Acute Exposures to the World Trade Center Disaster and Lower Respiratory Symptoms: Area Residents and Workers

    PubMed Central

    Friedman, Stephen M.; Pillai, Parul S.; Reibman, Joan; Berger, Kenneth I.; Goldring, Roberta; Stellman, Steven D.; Farfel, Mark

    2012-01-01

    Objectives. We assessed associations between new-onset (post–September 11, 2001 [9/11]) lower respiratory symptoms reported on 2 surveys, administered 3 years apart, and acute and chronic 9/11-related exposures among New York City World Trade Center–area residents and workers enrolled in the World Trade Center Health Registry. Methods. World Trade Center–area residents and workers were categorized as case participants or control participants on the basis of lower respiratory symptoms reported in surveys administered 2 to 3 and 5 to 6 years after 9/11. We created composite exposure scales after principal components analyses of detailed exposure histories obtained during face-to-face interviews. We used multivariate logistic regression models to determine associations between lower respiratory symptoms and composite exposure scales. Results. Both acute and chronic exposures to the events of 9/11 were independently associated, often in a dose-dependent manner, with lower respiratory symptoms among individuals who lived and worked in the area of the World Trade Center. Conclusions. Study findings argue for detailed assessments of exposure during and after events in the future from which potentially toxic materials may be released and for rapid interventions to minimize exposures and screen for potential adverse health effects. PMID:22515865

  18. Disastrous assumptions about community disasters

    SciTech Connect

    Dynes, R.R.

    1995-12-31

    Planning for local community disasters is compounded with erroneous assumptions. Six problematic models are identified: agent facts, big accident, end of the world, media, command and control, administrative. Problematic assumptions in each of them are identified. A more adequate model centered on problem solving is identified. That there is a discrepancy between disaster planning efforts and the actual response experience seems rather universal. That discrepancy is symbolized by the graffiti which predictably surfaces on many walls in post disaster locations -- ``First the earthquake, then the disaster.`` That contradiction is seldom reduced as a result of post disaster critiques, since the most usual conclusion is that the plan was adequate but the ``people`` did not follow it. Another explanation will be provided here. A more plausible explanation for failure is that most planning efforts adopt a number of erroneous assumptions which affect the outcome. Those assumptions are infrequently changed or modified by experience.

  19. Visualizing disaster attitudes resulting from terrorist activities.

    PubMed

    Khalid, Halimahtun M; Helander, Martin G; Hood, Nilwan A

    2013-09-01

    The purpose of this study was to analyze people's attitudes to disasters by investigating how people feel, behave and think during disasters. We focused on disasters induced by humans, such as terrorist attacks. Two types of textual information were collected - from Internet blogs and from research papers. The analysis enabled forecasting of attitudes for the design of proactive disaster advisory scheme. Text was analyzed using a text mining tool, Leximancer. The outcome of this analysis revealed core themes and concepts in the text concerning people's attitudes. The themes and concepts were sorted into three broad categories: Affect, Behaviour, and Cognition (ABC), and the data was visualized in semantic maps. The maps reveal several knowledge pathways of ABC for developing attitudinal ontologies, which describe the relations between affect, behaviour and cognition, and the sequence in which they develop. Clearly, terrorist attacks induced trauma and people became highly vulnerable.

  20. Node Survival in Networks under Correlated Attacks

    PubMed Central

    Hao, Yan; Armbruster, Dieter; Hütt, Marc-Thorsten

    2015-01-01

    We study the interplay between correlations, dynamics, and networks for repeated attacks on a socio-economic network. As a model system we consider an insurance scheme against disasters that randomly hit nodes, where a node in need receives support from its network neighbors. The model is motivated by gift giving among the Maasai called Osotua. Survival of nodes under different disaster scenarios (uncorrelated, spatially, temporally and spatio-temporally correlated) and for different network architectures are studied with agent-based numerical simulations. We find that the survival rate of a node depends dramatically on the type of correlation of the disasters: Spatially and spatio-temporally correlated disasters increase the survival rate; purely temporally correlated disasters decrease it. The type of correlation also leads to strong inequality among the surviving nodes. We introduce the concept of disaster masking to explain some of the results of our simulations. We also analyze the subsets of the networks that were activated to provide support after fifty years of random disasters. They show qualitative differences for the different disaster scenarios measured by path length, degree, clustering coefficient, and number of cycles. PMID:25932635

  1. Node Survival in Networks under Correlated Attacks.

    PubMed

    Hao, Yan; Armbruster, Dieter; Hütt, Marc-Thorsten

    2015-01-01

    We study the interplay between correlations, dynamics, and networks for repeated attacks on a socio-economic network. As a model system we consider an insurance scheme against disasters that randomly hit nodes, where a node in need receives support from its network neighbors. The model is motivated by gift giving among the Maasai called Osotua. Survival of nodes under different disaster scenarios (uncorrelated, spatially, temporally and spatio-temporally correlated) and for different network architectures are studied with agent-based numerical simulations. We find that the survival rate of a node depends dramatically on the type of correlation of the disasters: Spatially and spatio-temporally correlated disasters increase the survival rate; purely temporally correlated disasters decrease it. The type of correlation also leads to strong inequality among the surviving nodes. We introduce the concept of disaster masking to explain some of the results of our simulations. We also analyze the subsets of the networks that were activated to provide support after fifty years of random disasters. They show qualitative differences for the different disaster scenarios measured by path length, degree, clustering coefficient, and number of cycles.

  2. Spatial Distributions of Iodine-131 and the Geochemical "Fingerprint" from the World Trade Center Terrorist Attack in New York Harbor Sediments

    NASA Astrophysics Data System (ADS)

    Oktay, S. D.; Smith, J. P.; Brabander, D. J.; Kada, J.; Olsen, C. R.

    2002-12-01

    The September 11, 2001 terrorist attack on the World Trade Center (WTC) in New York City introduced large amounts of ash and debris over an extensive area including New York Harbor (NYH) and the Lower Hudson Estuary. Previous results have identified a textural and elemental "fingerprint" for this ash/debris that can be seen as a quantifiable event horizon in NYH surface sediments. In addition, the short-lived radioisotope, I-131 (half-life, 8.04 days), was unexpectedly identified in the surface sediments, which corroborated that this sediment was recently deposited and anthropogenically influenced. On July 24-25, 2002, additional sediment cores were collected in the sites occupied in 2001 and in various locations throughout NYH (on both the Manhattan and New Jersey sides of the Hudson river) in order to determine the spatial extent of both the WTC "fingerprint" and the I-131 signal. Gamma spectrometric measurements of I-131 in surface sediments were used to determine its spatial distribution in NYH sediments and its potential use as an indicator of rapid sedimentary processes (days to weeks) initiated by urban input. Potential sources for the I-131 were evaluated, with initial evidence pointing to traces of human waste discharge related to medical treatments as the most likely source. The short-lived radionuclide, Be-7 (half-life, 53.12 days), and textural and elemental characterizations originally identified in the earlier research were examined in order to document the spatial distribution of the geochemical WTC "fingerprint" and investigate how short-to-medium term sediment dynamics (supply, deposition, re-suspension, and net accumulation) in New York Harbor may affect the spatial distribution and preservation of a sedimentological record associated with this event. This research should help delineate the geographical extent of the debris created from the WTC catastrophe and may predict where urban inputs of material such as I-131 can accumulate in NYH.

  3. Polychlorinated dioxins and furans from the World Trade Center attacks in exterior window films from lower Manhattan in New York City.

    PubMed

    Rayne, Sierra; Ikonomou, Michael G; Butt, Craig M; Diamond, Miriam L; Truong, Jennifer

    2005-04-01

    Samples of ambient organic films deposited on exterior window surfaces from lower Manhattan and Brooklyn in New York City were collected six weeks after the terrorist attacks at the World Trade Center (WTC) on September 11, 2001 and analyzed for polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). Total tetra- through octa-CDD/F concentrations in window films within 1 km of the WTC site in lower Manhattan ranged up to 630,000 pg/m2 (estimated as a mass concentration of ca. 1,300,000 pg/ g) and a maximum toxic equivalent (TEQ) concentration of 4700 TEQ/m2 (ca. 10 000 pg TEQ/g). Measurements at a background site 3.5 km away in Brooklyn showed lower concentrations at 130 pg TEQ/m2 (260 pg TEQ/g). Ambient gas-phase PCDD/F concentrations estimated for each site using an equilibrium partitioning model suggested concentrations ranging from ca. 2700 fg-TEQ/m3 near the WTC site to the more typical urban concentration of 20 fg-TEQ/m3 atthe Brooklyn site. Multivariate analyses of 2,3,7,8-substitued congeners and homologue group profiles suggested unique patterns in films near the WTC site compared to that observed at background sites in the study area and in other literature-derived combustion source profiles. Homologue profiles near the WTC site were dominated by tetra-, penta-, and Hexa-CDD/Fs, and 2,3,7,8-substituted profiles contained mostly octa- and hexachlorinated congeners. In comparison, profiles in Brooklyn and near mid-Manhattan exhibited congener and homologue patterns comprised mainly of hepta- and octa-CDDs, similar to that commonly reported in background air and soil.

  4. Factors associated with poor control of 9/11-related asthma 10-11 years after the 2001 World Trade Center terrorist attacks.

    PubMed

    Jordan, Hannah T; Stellman, Steven D; Reibman, Joan; Farfel, Mark R; Brackbill, Robert M; Friedman, Stephen M; Li, Jiehui; Cone, James E

    2015-01-01

    To identify key factors associated with poor asthma control among adults in the World Trade Center (WTC) Health Registry, a longitudinal study of rescue/recovery workers and community members who were directly exposed to the 2001 WTC terrorist attacks and their aftermath. We studied incident asthma diagnosed by a physician from 12 September 2001 through 31 December 2003 among participants aged ≥18 on 11 September 2001, as reported on an enrollment (2003-2004) or follow-up questionnaire. Based on modified National Asthma Education and Prevention Program criteria, asthma was considered controlled, poorly-controlled, or very poorly-controlled at the time of a 2011-2012 follow-up questionnaire. Probable post-traumatic stress disorder, depression, and generalized anxiety disorder were defined using validated scales. Self-reported gastroesophageal reflux symptoms (GERS) and obstructive sleep apnea (OSA) were obtained from questionnaire responses. Multinomial logistic regression was used to examine factors associated with poor or very poor asthma control. Among 2445 participants, 33.7% had poorly-controlled symptoms and 34.6% had very poorly-controlled symptoms in 2011-2012. Accounting for factors including age, education, body mass index, and smoking, there was a dose-response relationship between the number of mental health conditions and poorer asthma control. Participants with three mental health conditions had five times the odds of poor control and 13 times the odds of very poor control compared to participants without mental health comorbidities. GERS and OSA were significantly associated with poor or very poor control. Rates of poor asthma control were very high in this group with post-9/11 diagnosed asthma. Comprehensive care of 9/11-related asthma should include management of mental and physical health comorbidities.

  5. Factors associated with poor control of 9/11-related asthma 10–11 years after the 2001 World Trade Center terrorist attacks

    PubMed Central

    Jordan, Hannah T.; Stellman, Steven D.; Reibman, Joan; Farfel, Mark R.; Brackbill, Robert M.; Friedman, Stephen M.; Li, Jiehui; Cone, James E.

    2015-01-01

    Abstract Objective: To identify key factors associated with poor asthma control among adults in the World Trade Center (WTC) Health Registry, a longitudinal study of rescue/recovery workers and community members who were directly exposed to the 2001 WTC terrorist attacks and their aftermath. Methods: We studied incident asthma diagnosed by a physician from 12 September 2001 through 31 December 2003 among participants aged ≥18 on 11 September 2001, as reported on an enrollment (2003–2004) or follow-up questionnaire. Based on modified National Asthma Education and Prevention Program criteria, asthma was considered controlled, poorly-controlled, or very poorly-controlled at the time of a 2011–2012 follow-up questionnaire. Probable post-traumatic stress disorder, depression, and generalized anxiety disorder were defined using validated scales. Self-reported gastroesophageal reflux symptoms (GERS) and obstructive sleep apnea (OSA) were obtained from questionnaire responses. Multinomial logistic regression was used to examine factors associated with poor or very poor asthma control. Results: Among 2445 participants, 33.7% had poorly-controlled symptoms and 34.6% had very poorly-controlled symptoms in 2011–2012. Accounting for factors including age, education, body mass index, and smoking, there was a dose–response relationship between the number of mental health conditions and poorer asthma control. Participants with three mental health conditions had five times the odds of poor control and 13 times the odds of very poor control compared to participants without mental health comorbidities. GERS and OSA were significantly associated with poor or very poor control. Conclusions: Rates of poor asthma control were very high in this group with post-9/11 diagnosed asthma. Comprehensive care of 9/11-related asthma should include management of mental and physical health comorbidities. PMID:25539137

  6. Cardiovascular disease hospitalizations in relation to exposure to the September 11, 2001 World Trade Center disaster and posttraumatic stress disorder.

    PubMed

    Jordan, Hannah T; Stellman, Steven D; Morabia, Alfredo; Miller-Archie, Sara A; Alper, Howard; Laskaris, Zoey; Brackbill, Robert M; Cone, James E

    2013-10-24

    A cohort study found that 9/11-related environmental exposures and posttraumatic stress disorder increased self-reported cardiovascular disease risk. We attempted to replicate these findings using objectively defined cardiovascular disease hospitalizations in the same cohort. Data for adult World Trade Center Health Registry enrollees residing in New York State on enrollment and no cardiovascular disease history (n = 46,346) were linked to a New York State hospital discharge-reporting system. Follow-up began at Registry enrollment (2003-2004) and ended at the first cerebrovascular or heart disease (HD) hospitalization, death, or December 31, 2010, whichever was earliest. We used proportional hazards models to estimate adjusted hazard ratios (AHRs) for HD (n = 1151) and cerebrovascular disease (n = 284) hospitalization during 302,742 person-years of observation (mean follow-up, 6.5 years per person), accounting for other factors including age, race/ethnicity, smoking, and diabetes. An elevated risk of HD hospitalization was observed among women (AHR 1.32, 95% CI 1.01 to 1.71) but not men (AHR 1.16, 95% CI 0.97 to 1.40) with posttraumatic stress disorder at enrollment. A high overall level of World Trade Center rescue and recovery-related exposure was associated with an elevated HD hospitalization risk in men (AHR 1.82, 95% CI 1.06 to 3.13; P for trend = 0.05), but findings in women were inconclusive (AHR 3.29, 95% CI 0.85 to 12.69; P for trend = 0.09). Similar associations were observed specifically with coronary artery disease hospitalization. Posttraumatic stress disorder increased the cerebrovascular disease hospitalization risk in men but not in women. 9/11-related exposures and posttraumatic stress disorder appeared to increase the risk of subsequent hospitalization for HD and cerebrovascular disease. This is consistent with findings based on self-reported outcomes.

  7. Disaster Management: Mental Health Perspective

    PubMed Central

    Math, Suresh Bada; Nirmala, Maria Christine; Moirangthem, Sydney; Kumar, Naveen C.

    2015-01-01

    Disaster mental health is based on the principles of ‘preventive medicine’ This principle has necessitated a paradigm shift from relief centered post-disaster management to a holistic, multi-dimensional integrated community approach of health promotion, disaster prevention, preparedness and mitigation. This has ignited the paradigm shift from curative to preventive aspects of disaster management. This can be understood on the basis of six ‘R’s such as Readiness (Preparedness), Response (Immediate action), Relief (Sustained rescue work), Rehabilitation (Long term remedial measures using community resources), Recovery (Returning to normalcy) and Resilience (Fostering). Prevalence of mental health problems in disaster affected population is found to be higher by two to three times than that of the general population. Along with the diagnosable mental disorders, affected community also harbours large number of sub-syndromal symptoms. Majority of the acute phase reactions and disorders are self-limiting, whereas long-term phase disorders require assistance from mental health professionals. Role of psychotropic medication is very limited in preventing mental health morbidity. The role of cognitive behaviour therapy (CBT) in mitigating the mental health morbidity appears to be promising. Role of Psychological First Aid (PFA) and debriefing is not well-established. Disaster management is a continuous and integrated cyclical process of planning, organising, coordinating and implementing measures to prevent and to manage disaster effectively. Thus, now it is time to integrate public health principles into disaster mental health. PMID:26664073

  8. Cardiovascular Disease Hospitalizations in Relation to Exposure to the September 11, 2001 World Trade Center Disaster and Posttraumatic Stress Disorder

    PubMed Central

    Jordan, Hannah T.; Stellman, Steven D.; Morabia, Alfredo; Miller‐Archie, Sara A.; Alper, Howard; Laskaris, Zoey; Brackbill, Robert M.; Cone, James E.

    2013-01-01

    Background A cohort study found that 9/11‐related environmental exposures and posttraumatic stress disorder increased self‐reported cardiovascular disease risk. We attempted to replicate these findings using objectively defined cardiovascular disease hospitalizations in the same cohort. Methods and Results Data for adult World Trade Center Health Registry enrollees residing in New York State on enrollment and no cardiovascular disease history (n=46 346) were linked to a New York State hospital discharge–reporting system. Follow‐up began at Registry enrollment (2003–2004) and ended at the first cerebrovascular or heart disease (HD) hospitalization, death, or December 31, 2010, whichever was earliest. We used proportional hazards models to estimate adjusted hazard ratios (AHRs) for HD (n=1151) and cerebrovascular disease (n=284) hospitalization during 302 742 person‐years of observation (mean follow‐up, 6.5 years per person), accounting for other factors including age, race/ethnicity, smoking, and diabetes. An elevated risk of HD hospitalization was observed among women (AHR 1.32, 95% CI 1.01 to 1.71) but not men (AHR 1.16, 95% CI 0.97 to 1.40) with posttraumatic stress disorder at enrollment. A high overall level of World Trade Center rescue and recovery–related exposure was associated with an elevated HD hospitalization risk in men (AHR 1.82, 95% CI 1.06 to 3.13; P for trend=0.05), but findings in women were inconclusive (AHR 3.29, 95% CI 0.85 to 12.69; P for trend=0.09). Similar associations were observed specifically with coronary artery disease hospitalization. Posttraumatic stress disorder increased the cerebrovascular disease hospitalization risk in men but not in women. Conclusions 9/11‐related exposures and posttraumatic stress disorder appeared to increase the risk of subsequent hospitalization for HD and cerebrovascular disease. This is consistent with findings based on self‐reported outcomes. PMID:24157650

  9. MEDICAL PREPAREDNESS FOR DISASTER

    PubMed Central

    Stein, Justin J.

    1959-01-01

    The Federal Civil Defense Administration has been consolidated under the President's Reorganization Plan No. 1 of 1958 with the Office of Defense Mobilization. The new organization, the Office of Civil and Defense Mobilization, should be able to deal more efficiently with the problem of mobilization and management of all resources and production of the nation in time of disaster. As preparation for possible enemy attack, organized plans entailing training, supplies, equipment and communications for use in major peacetime disasters—floods, earthquakes, tornado damage—should be carried forward vigorously. Apathy must be overcome. From the local to the highest level all civil defense and disaster plans must be developed and kept flexible enough to be operable during any kind of emergency. Physicians must learn as much as they can about the mass care of casualties, how to survive under the most trying of circumstances. Drills in dealing with simulated disaster are of utmost importance for finding out ahead of time what must be done and the personnel and supplies needed for doing it. PMID:13651962

  10. Occupational exposures to air contaminants at the World Trade Center disaster site--New York, September-October, 2001.

    PubMed

    2002-05-31

    Amid concerns about the fires and suspected presence of toxic materials in the rubble pile following the collapse of the World Trade Center (WTC) buildings on September 11, 2001, the New York City Department of Health (NYCDOH) asked CDC for assistance in evaluating occupational exposures at the site. CDC's National Institute for Occupational Safety and Health (NIOSH) collected general area (GA) and personal breathing zone (PBZ) air samples for numerous potential air contaminants. This report summarizes the results of the assessment, which indicate that most exposures, including asbestos, did not exceed NIOSH recommended exposure limits (RELs) or Occupational Safety and Health Administration (OSHA) permissible exposure limits (PELs). One torch cutter was overexposed to cadmium; another worker was overexposed to carbon monoxide (CO) while cutting metal beams with an oxyacetylene torch or a gasoline-powered saw, and two more were possibly overexposed to CO. NIOSH recommended that workers ensure adequate on-site ventilation when using gas-powered equipment and use rechargeable, battery-powered equipment when possible.

  11. Disaster Preparedness Among University Students in Guangzhou, China: Assessment of Status and Demand for Disaster Education.

    PubMed

    Tan, Yibing; Liao, Xiaolan; Su, Haihao; Li, Chun; Xiang, Jiagen; Dong, Zhaoyang

    2017-06-01

    This study had 2 aims. First, we evaluated the current levels of disaster preparedness among university students in southern China. Second, we assessed students' demands for future disaster education. In addition, we examined the influence of demographic factors on current disaster preparedness status and demand. A cross-sectional design was used. The data were collected from 1893 students in 10 universities in the Guangzhou Higher Education Mega (GHEM) center. A self-administered questionnaire developed for this study was administered to assess the current status and demand for disaster education. The results are based on 1764 valid questionnaires. Among the participants, 77.8% reported having had disaster education experiences before, 85.5% indicated their desire for a systematic disaster course, and 75.4% expressed their willingness to take such a course upon its availability. The total mean score for demand for disaster course content (5-point Likert scale) was 4.17±0.84, with items relating to rescue skills given the highest scores. These results suggested that students had high desires for disaster preparedness knowledge, especially knowledge concerning rescue skills. We observed significant differences in disaster education experiences between male and female students and across programs, school years, and home locations. Furthermore, we observed significant differences in demand for disaster course content between male and female students and across universities, student programs, years of school, and students' majors. A systematic disaster course focused on rescue skills is needed by all types of universities. To improve the disaster education system in universities, disaster drills should be performed on a semester basis as a refresher and to enhance disaster preparedness. The government and universities should support building a simulated disaster rescue center and recruit faculty from the emergency department, especially those who have had disaster

  12. [Current organization of disaster medicine].

    PubMed

    Julien, Henri

    2013-12-01

    The concept of disaster medicine, derivedfrom medical management of casualties caused by terrorist attacks or earthquakes, began to be taught in medical school in 1982. It adapts military intervention tactics to civilian practices, and differentiates major disasters (in which preformed teams are sent to the scene) from disasters with limited effects (predefined plans form the backbone of the rescue organization). Management of blast and crush syndromes, triage, care of numerous burn victims, on-site amputation, necrotomy, medicopsychological support, mass decontamination, and rescue management are some of the aspects with which physicians should be familiar. Predefined intervention teams and ad hoc materials have been created to provide autonomous logistic support. Regulations, ethical aspects and managerial methods still need to be refined, and research and teaching must be given a new impetus.

  13. Biomonitoring of perfluorochemicals in plasma of New York State personnel responding to the World Trade Center disaster.

    PubMed

    Tao, Lin; Kannan, Kurunthachalam; Aldous, Kenneth M; Mauer, Matthew P; Eadon, George A

    2008-05-01

    The collapse of the World Trade Center (WTC) on September 11, 2001 resulted in the release of several airborne pollutants in and around the site. Perfluorochemicals including perfluorooctanesulfonate (PFOS) and perfluorooctanoic acid (PFOA), which are used in soil- and stain-resistant coatings on upholstery, carpets, leather, floor waxes, polishes, and in fire-fighting foams were potentially released during the collapse of the WTC. In this pilot study, we analyzed 458 plasma samples of New York State (NYS) employees and National Guard personnel assigned to work in the vicinity of the WTC between September 11 and December 23, 2001, to assess exposure to perfluorochemicals released in dust and smoke. The plasma samples collected from NYS WTC responders were grouped based on estimated levels of exposure to dust and smoke, as follows: more dust exposure (MDE), less dust exposure (LDE), more smoke exposure (MSE), and less smoke exposure (LSE). Furthermore, samples were grouped, based on self-reported symptoms at the time of sampling, as symptomatic and asymptomatic. Eight perfluorochemicals were measured in 458 plasma samples. PFOS, PFOA, perfluorohexanesulfonate (PFHxS), and perfluorononanoic acid (PFNA), were consistently detected in almost all samples. PFOA and PFHxS concentrations were approximately 2-fold higher in WTC responders than the concentrations reported for the U.S. general population. No significant difference was observed in the concentrations of perfluorochemicals between symptomatic and asymptomatic groups. Concentrations of PFHxS were significantly (p < or = 0.05) higher in the MDE group than in the LDE group. Concentrations of PFNA were significantly higher in the MSE group than in the LSE group. Significantly higher concentrations of PFOA and PFHxS were found in individuals exposed to smoke than in individuals exposed to dust. A significant negative correlation existed between plasma lipid content and concentrations of certain perfluorochemicals

  14. Infectious diseases in disaster areas/catastrophes.

    PubMed

    Benca, J; Kalavsky, E; Miklosko, Jozef; Rudinsky, B; Taziarova, M; McKenzie, F

    2007-06-01

    There is very little data and no prospective research possible in the field of catastrophic medicine (disaster medicine) including infectious diseases. This minireview tries to contribute to the pathogenesis and outcome of infectious diseases in areas after anthropogenic (war, genocide, terrorist attack, industrial disasters) and non anthropogenic (natural) catastrophes (earthquake, floods, tsunamis, hurricanes, volcano eruptions). Therefore ISC received a proposal to create a working group on infectious diseases in areas after catastrophes, better to understand epidemiology, prevention and therapy of infectious diseases occurring in conjunction to various anthropogenic and non anthropogenic (natural) disasters.

  15. [Disaster Control and Civil Protection in Germany].

    PubMed

    Kippnich, Maximilian; Kowalzik, Barbara; Cermak, Rudolf; Kippnich, Uwe; Kranke, Peter; Wurmb, Thomas

    2017-09-01

    The train crash of Bad Aibling/Germany in February 2016 and the terrorist attacks of the recent years in Europe have demonstrated the urgent need to be prepared for such disastrous events. Disaster preparedness and disaster control are very important governmental duties, as are civil protection and civil defense. In Germany the responsibility for those tasks are divided between the 16 "Länder" and the Federation. While the Federation takes care of the civil protection and disaster assistance, the Länder are responsible for disaster control. The presented article focuses on these issues and gives valuable insights into the German system of disaster control and civil protection with a focus on health protection. Georg Thieme Verlag KG Stuttgart · New York.

  16. [Perspectives on researches in disaster psychiatry].

    PubMed

    Tomita, Hiroaki

    2014-01-01

    After experiencing the catastrophic Great East Japan Earthquake and Tsunami disaster in 2011, Tohoku University founded the International Research Institute of Disaster Science (IRIDeS) in April, 2012. IRIDeS, comprising 7 divisions and 36 laboratories with broad areas of specialization, from the humanities to natural sciences, aims to become a global center for the study of disasters and disaster mitigation, learning from and building upon past lessons in disaster management from Japan and around the world. In IRIDeS, the Department of Disaster Psychiatry is in charge of dealing with issues related to disaster psychiatry, including the psychosocial impact of disasters. Now, at more than 2 and a half years after the catastrophic disaster, the psychological impact actually seems to be getting stronger and wider, whereas the memory of the disaster seems to be waning in other areas of the country. In such a situation, where a number of problems need to be resolved, what can/should we do as psychiatrists? On the other hand, other natural disasters, such as storms and floods, have kept hitting Japan, and catastrophes seem to strike somewhere in the world every year. In addition, we need to prepare for the possibility of a Nankai Trough Quake and an earthquake directly hitting the Tokyo area, which may occur sometime in the future. Considering the situation, we need to establish an education system for disaster psychiatry, and proceed with research to collect useful information to prepare for coming disasters. The aim of our department is to integrate multi-faceted basic and clinical research approaches to investigate the following topics: 1) to identify social, psychological, and biological factors involved in the pathophysiology of and recovery from disaster-related mental health problems; 2) to develop systems for disaster prevention, disaster response, and recovery, considering disaster-related psychiatric and psychological issues; 3) to develop useful tools for the

  17. Monitoring Disasters by Use of Instrumented Robotic Aircraft

    NASA Technical Reports Server (NTRS)

    Wegener, Steven S.; Sullivan, Donald V.; Dunagan, Steven E.; Brass, James A.; Ambrosia, Vincent G.; Buechel, Sally W.; Stoneburner, Jay; Schoenung, Susan M.

    2009-01-01

    Efforts are under way to develop data-acquisition, data-processing, and data-communication systems for monitoring disasters over large geographic areas by use of uninhabited aerial systems (UAS) robotic aircraft that are typically piloted by remote control. As integral parts of advanced, comprehensive disaster- management programs, these systems would provide (1) real-time data that would be used to coordinate responses to current disasters and (2) recorded data that would be used to model disasters for the purpose of mitigating the effects of future disasters and planning responses to them. The basic idea is to equip UAS with sensors (e.g., conventional video cameras and/or multispectral imaging instruments) and to fly them over disaster areas, where they could transmit data by radio to command centers. Transmission could occur along direct line-of-sight paths and/or along over-the-horizon paths by relay via spacecraft in orbit around the Earth. The initial focus is on demonstrating systems for monitoring wildfires; other disasters to which these developments are expected to be applicable include floods, hurricanes, tornadoes, earthquakes, volcanic eruptions, leaks of toxic chemicals, and military attacks. The figure depicts a typical system for monitoring a wildfire. In this case, instruments aboard a UAS would generate calibrated thermal-infrared digital image data of terrain affected by a wildfire. The data would be sent by radio via satellite to a data-archive server and image-processing computers. In the image-processing computers, the data would be rapidly geo-rectified for processing by one or more of a large variety of geographic-information- system (GIS) and/or image-analysis software packages. After processing by this software, the data would be both stored in the archive and distributed through standard Internet connections to a disaster-mitigation center, an investigator, and/or command center at the scene of the fire. Ground assets (in this case

  18. Anxiety sensitivity mediates the association between post-traumatic stress symptom severity and interoceptive threat-related smoking abstinence expectancies among World Trade Center disaster-exposed smokers.

    PubMed

    Farris, Samantha G; Paulus, Daniel J; Gonzalez, Adam; Mahaffey, Brittain L; Bromet, Evelyn J; Luft, Benjamin J; Kotov, Roman; Zvolensky, Michael J

    2015-12-01

    Anxiety sensitivity (fear of internal anxiety-relevant bodily sensations) is an individual difference variable that is associated with the development and maintenance of posttraumatic stress disorder (PTSD) and is also involved in the maintenance/relapse of smoking. Abstinence expectancies are crucial to smoking maintenance, yet, past work has not explored how PTSD symptom severity and anxiety sensitivity contribute to them. Participants were 122 treatment-seeking daily smokers (36.1% female; Mage=49.2, SD=9.7; cigarettes per day: M=18.3, SD=15.2) who were exposed to the World Trade Center disaster on September 11, 2001 and responded to an advertisement for a clinical smoking cessation trial. The indirect effect of anxiety sensitivity was tested in terms of the effect of PTSD symptom severity on smoking abstinence expectancies (i.e., anxiety sensitivity as a statistical mediator). PTSD symptom severity was positively associated with interoceptive threat-related smoking abstinence expectancies: expecting harmful consequences (β=.33, p<.001) and somatic symptoms (β=.26, p=.007). PTSD symptom severity was also significantly associated with anxiety sensitivity (β=.27, p=.003). Anxiety sensitivity mediated the association between PTSD symptom severity and expectancies about the harmful consequences (β=.09, CI95%=.02-.21; ΔR(2)=.076) and somatic symptoms (β=.11, CI95%=.02-.24; ΔR(2)=.123) from smoking abstinence, with medium effect sizes (Κ(2)=.08 and .10, respectively). These data document the role of PTSD symptoms in threat-based expectancies about smoking abstinence and suggest anxiety sensitivity may underlie the associations between PTSD symptom severity and abstinence expectancies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Cortisol metabolic predictors of response to psychotherapy for symptoms of PTSD in survivors of the World Trade Center attacks on September 11, 2001.

    PubMed

    Yehuda, Rachel; Bierer, Linda M; Sarapas, Casey; Makotkine, Iouri; Andrew, Ruth; Seckl, Jonathan R

    2009-10-01

    A proportion of subjects with symptoms of posttraumatic stress disorder (PTSD) are unresponsive to specialized psychotherapy, but a biological basis for this has not been described. To observe whether differences in cortisol or its metabolites predict or correlate with response to therapy for PTSD symptoms, cortisol and its metabolites were measured from urine samples at pre-treatment, at the conclusion of psychotherapy, and at 3-month follow-up. 28 survivors of the World Trade Center attacks on September 11, 2001 seeking psychological treatment for PTSD symptoms received four sessions of either exposure therapy or supportive counseling, followed by up to 10 sessions of prolonged exposure in a specialized PTSD treatment program at a private hospital serving the New York City metropolitan area. 24-h mean integrated cortisol excretion was assessed by radioimmunoassay (RIA); urinary free cortisol and metabolites cortisone, 5alpha-tetrahydrocortisol (5alpha-THF), 5beta-tetrahydrocortisol, and tetrahydrocortisone were assessed by gas chromatography-mass spectrometry (GC-MS); and indices of enzyme activity for 5alpha- and 5beta-reductase and for the 11beta-hydroxysteroid dehydrogenases were derived from the metabolite and glucocorticoid measures. 5alpha-Reductase activity was significantly lower at pre-treatment among non-responders, whereas there were no significant pre-treatment differences between responders and non-responders in any other hormone or metabolite level. In repeated measures analyses across the three time points, 5alpha-reductase activity, as well as 5alpha-THF and total glucocorticoids, significantly differed between responders and non-responders. For urinary cortisol measured by RIA, there was a significant groupxtime interaction indicating that, although not different at pre-treatment, urinary cortisol levels declined over time in the non-responder group, such that by follow-up, lowered cortisol significantly distinguished non-responders from

  20. Reductions in Circulating Endocannabinoid Levels in Individuals with Post-Traumatic Stress Disorder Following Exposure to the World Trade Center Attacks

    PubMed Central

    Hill, Matthew N.; Bierer, Linda M.; Makotkine, Iouri; Golier, Julia A.; Galea, Sandro; McEwen, Bruce S.; Hillard, Cecilia J.; Yehuda, Rachel

    2013-01-01

    Endocannabinoid (eCB) signaling has been identified as a modulator of adaptation to stress, and is integral to basal and stress-induced glucocorticoid regulation. Furthermore, interactions between eCBs and glucocorticoids have been shown to be necessary for the regulation of emotional memories, suggesting that eCB function may relate to the development of post-traumatic stress disorder (PTSD). To examine this, plasma eCBs were measured in a sample (n=46) drawn from a population-based cohort selected for physical proximity to the World Trade Center (WTC) at the time of the 9/11 attacks. Participants received a structured diagnostic interview and were grouped according to whether they met diagnostic criteria for PTSD (no PTSD, n=22; lifetime diagnosis of PTSD = 24). eCB content (2-arachidonoylglycerol (2-AG) and anandamide (AEA)) and cortisol were measured from 8 a.m. plasma samples. Circulating 2-AG content was significantly reduced among individuals meeting diagnostic criteria for PTSD. The effect of reduced 2-AG content in PTSD remained significant after controlling for the stress of exposure to the WTC collapse, gender, depression and alcohol abuse. There were no significant group differences for AEA or cortisol levels; however, across the whole sample AEA levels positively correlated with circulating cortisol, and AEA levels exhibited a negative relationship with the degree of intrusive symptoms within the PTSD sample. This report shows that PTSD is associated with a reduction in circulating levels of the eCB 2-AG. Given the role of 2-AG in the regulation of the stress response, these data support the hypothesis that deficient eCB signaling may be a component of the glucocorticoid dysregulation associated with PTSD. The negative association between AEA levels and intrusive symptoms is consistent with animal data indicating that reductions in AEA promote retention of aversive emotional memories. Future work will aim to replicate these findings and extend their

  1. Reductions in circulating endocannabinoid levels in individuals with post-traumatic stress disorder following exposure to the World Trade Center attacks.

    PubMed

    Hill, Matthew N; Bierer, Linda M; Makotkine, Iouri; Golier, Julia A; Galea, Sandro; McEwen, Bruce S; Hillard, Cecilia J; Yehuda, Rachel

    2013-12-01

    Endocannabinoid (eCB) signaling has been identified as a modulator of adaptation to stress, and is integral to basal and stress-induced glucocorticoid regulation. Furthermore, interactions between eCBs and glucocorticoids have been shown to be necessary for the regulation of emotional memories, suggesting that eCB function may relate to the development of post-traumatic stress disorder (PTSD). To examine this, plasma eCBs were measured in a sample (n=46) drawn from a population-based cohort selected for physical proximity to the World Trade Center (WTC) at the time of the 9/11 attacks. Participants received a structured diagnostic interview and were grouped according to whether they met diagnostic criteria for PTSD (no PTSD, n=22; lifetime diagnosis of PTSD=24). eCB content (2-arachidonoylglycerol (2-AG) and anandamide (AEA)) and cortisol were measured from 8 a.m. plasma samples. Circulating 2-AG content was significantly reduced among individuals meeting diagnostic criteria for PTSD. The effect of reduced 2-AG content in PTSD remained significant after controlling for the stress of exposure to the WTC collapse, gender, depression and alcohol abuse. There were no significant group differences for AEA or cortisol levels; however, across the whole sample AEA levels positively correlated with circulating cortisol, and AEA levels exhibited a negative relationship with the degree of intrusive symptoms within the PTSD sample. This report shows that PTSD is associated with a reduction in circulating levels of the eCB 2-AG. Given the role of 2-AG in the regulation of the stress response, these data support the hypothesis that deficient eCB signaling may be a component of the glucocorticoid dysregulation associated with PTSD. The negative association between AEA levels and intrusive symptoms is consistent with animal data indicating that reductions in AEA promote retention of aversive emotional memories. Future work will aim to replicate these findings and extend their

  2. Approaches to Climate Change & Health in Cuba: Guillermo Mesa MD MPhil, Director, Disasters & Health, National School of Public Health. Paulo Ortiz MS PhD, Senior Researcher, Climate Center, Cuban Meteorology Institute.

    PubMed

    Mesa, Guillermo; Ortiz, Paulo; Gorry, Conner

    2015-04-01

    The US National Institutes of Health predict climate change will cause an additional 250,000 deaths between 2030 and 2050, with damages to health costing US$2-$4 billion by 2030. Although much debate still surrounds climate change, island ecosystems-such as Cuba's-in the developing world are arguably among the most vulnerable contexts in which to confront climate variability. Beginning in the 1990s, Cuba launched research to develop the evidence base, set policy priorities, and design mitigation and adaptation actions specifically to address climate change and its effects on health. Two researchers at the forefront of this interdisciplinary, intersectoral effort are epidemiologist Dr Guillermo Mesa, who directed design and implementation of the nationwide strategy for disaster risk reduction in the Cuban public health system as founding director of the Latin American Center for Disaster Medicine (CLAMED) and now heads the Disasters and Health department at the National School of Public Health; and Dr Paulo Ortiz, a biostatistician and economist at the Cuban Meteorology Institute's Climate Center (CENCLIM), who leads the research on Cuba's Climate and Health project and is advisor on climate change and health for the UN Economic Commission for Latin America and the Caribbean (ECLAC).

  3. Quantitative bias analysis in an asthma study of rescue-recovery workers and volunteers from the 9/11 World Trade Center attacks.

    PubMed

    Jurek, Anne M; Maldonado, George

    2016-11-01

    When learning bias analysis, epidemiologists are taught to quantitatively adjust for multiple biases by correcting study results in the reverse order of the error sequence. To understand the error sequence for a particular study, one must carefully examine the health study's epidemiologic data-generating process. In this article, we describe the unique data-generating process of a man-made disaster epidemiologic study. We described the data-generating process and conducted a bias analysis for a study associating September 11, 2001 dust cloud exposure and self-reported newly physician-diagnosed asthma among rescue-recovery workers and volunteers. We adjusted an odds ratio (OR) estimate for the combined effect of missing data, outcome misclassification, and nonparticipation. Under our assumptions about systematic error, the ORs adjusted for all three biases ranged from 1.33 to 3.84. Most of the adjusted estimates were greater than the observed OR of 1.77 and were outside the 95% confidence limits (1.55, 2.01). Man-made disasters present some situations that are not observed in other areas of epidemiology. Future epidemiologic studies of disasters could benefit from a proactive approach that focuses on the technical aspect of data collection and gathers information on bias parameters to provide more meaningful interpretations of results. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Planning for burn disasters: lessons learned from one hundred years of history.

    PubMed

    Barillo, David J; Wolf, Steven

    2006-01-01

    The terrorist attacks of September 11th have prompted interest in developing plans to manage thousands of burn casualties. There is little actual experience in the United States in managing disasters of this magnitude. As an alternative, lessons may be learned from the historical experiences of previous civilian burn or fire disasters occurring in this country. A review of relevant medical, fire service, and popular literature pertaining to civilian burn or fire disasters occurring in the United States between the years 1900 and 2000 was performed. In the 20th century, 73 major U.S. fire or burn disasters have occurred. With each disaster prompting a strengthening of fire regulations or building codes, the number of fatalities per incident has steadily decreased. Detailed examination of several landmark fires demonstrated that casualty counts were great but that most victims had fatal injuries and died on the scene or within 24 hours. A second large cohort comprised the walking wounded, who required minimal outpatient treatment. Patients requiring inpatient burn care comprise a small percentage of the total casualty figure but consume enormous resources during hospitalization. Burn mass casualty incidents are uncommon. The number of casualties per incident decreased over time. In most fire disasters, the majority of victims either rapidly die or have minimal injuries and can be treated and released. As a result, most disasters produce fewer than 25 to 50 patients requiring inpatient burn care. This would be a rational point to begin burn center preparations for mass casualty incidents. A robust outpatient capability to manage the walking wounded is also desirable.

  5. Pre-attack symptomatology and temperament as predictors of children's responses to the September 11 terrorist attacks.

    PubMed

    Lengua, Liliana J; Long, Anna C; Smith, Kimberlee I; Meltzoff, Andrew N

    2005-06-01

    The aims of this study were to assess the psychological response of children following the September 11, 2001 terrorist attacks in New York and Washington, DC and to examine prospective predictors of children's post-attack responses. Children's responses were assessed in a community sample of children in Seattle, Washington, participating in an ongoing study. Symptomatology and temperament assessed prior to the attacks were examined as prospective predictors of post-attack post-traumatic stress (PTS), anxiety, depression and externalizing problems. Children demonstrated PTS symptoms and worries at levels comparable to those in children directly experiencing disasters, with 77% of children reporting being worried, 68% being upset by reminders, and 39% having upsetting thoughts. The most common PTS symptom cluster was re-experiencing, and 8% of children met criteria consistent with PTSD. African-American children reported more avoidant PTS symptoms and being more upset by the attacks than European-American children. Girls reported being more upset than boys. Prior internalizing, externalizing, social competence and self-esteem were related to post-attack PTS; and child inhibitory control, assessed prior to the 9/11 attacks, demonstrated a trend towards an association with post-attack PTS symptoms controlling for prior levels of symptomatology. PTS predicted child-report anxiety and conduct problem symptoms at follow-up, approximately 6 months after 9/11. Children experiencing a major disaster at a distance or indirectly through media exposure demonstrated worries and PTS symptoms suggesting that communities need to attend to children's mental health needs in response to national or regional disasters. Pre-disaster symptomatology or low self-regulation may render children more vulnerable in response to a disaster, and immediate post-disaster responses predict subsequent symptomatology. These variables might be used in the identification of children in need of

  6. Effects of the World Trade Center Attack on NYC Public School Students: Initial Report to the New York City Board of Education.

    ERIC Educational Resources Information Center

    2002

    This study investigated the mental health needs of New York City (NYC) public school students 6 months after the September 11, 2001 attack. A needs assessment survey was conducted on 8,266 students in grades 4-12 from 94 schools in the Ground Zero area, other presumed high risk areas, and the remainder of NYC. The survey assessed such factors as…

  7. Disaster Master

    MedlinePlus

    ... and earn points to unlock new levels. But watch out! The wrong choice could end the game. Survive all 7 levels plus a turn in the hot seat and become a Disaster Master! ... 5: Winter Storm/Extreme Cold Level 6 - ...

  8. Disaster Drill.

    ERIC Educational Resources Information Center

    Jones, Rebecca

    1998-01-01

    Bus disaster drills have been held all over country for years. A drill in Blairsville, Pennsylvania, taught officials important lessons: (1) keep roster of students and stops in designated area on bus, and ensure emergency workers know where location; (2) send at least three school officials to accident scene; (3) provide school officials with…

  9. Can a pediatric trauma center improve the response to a mass casualty incident?

    PubMed

    Barthel, Erik R; Pierce, James R; Goodhue, Catherine J; Burke, Rita V; Ford, Henri R; Upperman, Jeffrey S

    2012-10-01

    Recent events including the 2001 terrorist attacks on New York; Hurricane Katrina; the 2010 Haitian and Chilean earthquakes; and the 2011 earthquake, tsunami, and nuclear disaster in Japan have reminded disaster planners and responders of the tremendous scale of mass casualty disasters and their resulting human devastation. Although adult disaster medicine is a well-developed field with roots in wartime medicine, we are increasingly recognizing that children may comprise up to 50% of disaster victims, and response mechanisms are often designed without adequate preparation for the number of pediatric victims that can result. In this short educational review, we explore the differences between the pediatric and adult disaster and trauma populations, the requirements for designation of a site as a pediatric trauma center (PTC), and the magnitude of the problem of pediatric disaster patients as described in the literature, specifically as it pertains to the availability and use of designated PTCs as opposed to trauma centers in general. We also review our own experience in planning and simulating pediatric mass casualty events and suggest strategies for preparedness when there is no PTC available. We aim to demonstrate from this brief survey that the availability of a designated PTC in the setting of a mass casualty disaster event is likely to significantly improve the outcome for the pediatric demographic of the affected population. We conclude that the relative scarcity of disaster data specific to children limits epidemiologic study of the pediatric disaster population and offer suggestions for strategies for future study of our hypothesis. Systematic review, level III.

  10. Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia.

    PubMed

    Chim, Harvey; Yew, Woon Si; Song, Colin

    2007-01-01

    Terror attacks in Southeast Asia were almost nonexistent until the 2002 Bali bomb blast, considered the deadliest attack in Indonesian history. Further attacks in 2003 (Jakarta), 2004 (Jakarta), and 2005 (Bali) have turned terrorist attacks into an ever-present reality. The authors reviewed medical charts of victims evacuated to the Singapore General Hospital (SGH) Burns Centre during three suicide attacks involving Bali (2002 and 2005) and the Jakarta Marriott hotel (2003). Problems faced, lessons learnt, and costs incurred are discussed. A burns disaster plan drawing on lessons learnt from these attacks is presented. Thirty-one patients were treated at the SGH Burns Centre in three attacks (2002 Bali attack [n = 15], 2003 Jakarta attack [n = 14], and 2005 Bali attack [n = 2]). For the 2002 Bali attack, median age was 29 years (range 20 to 50 years), median percentage of total burn surface area (TBSA) was 29% (range 5% to 55%), and median abbreviated burn severity index (ABSI) was 6 (range 3 to 10). Eight of 15 patients were admitted to the intensive care unit. For the 2003 Jakarta attack, median age was 35 years (range 24 to 56 years), median percentage of TBSA was 10% (range 2% to 46%), and median ABSI was 4 (range 3 to 9). A large number of patients had other injuries. Problems faced included manpower issues, lack of bed space, shortage of blood products, and lack of cadaver skin. The changing nature of terror attacks mandates continued vigilance and disaster preparedness. The multidimensional burns patient, complicated by other injuries, is likely to become increasingly common. A burns disaster plan with emphasis on effective command, control, and communication as well as organisation of health care personnel following a 'team concept' will do much to ensure that the sudden onset of a crisis situation at an unexpected time does not overwhelm hospital manpower and resources.

  11. Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia

    PubMed Central

    Chim, Harvey; Yew, Woon Si; Song, Colin

    2007-01-01

    Introduction Terror attacks in Southeast Asia were almost nonexistent until the 2002 Bali bomb blast, considered the deadliest attack in Indonesian history. Further attacks in 2003 (Jakarta), 2004 (Jakarta), and 2005 (Bali) have turned terrorist attacks into an ever-present reality. Methods The authors reviewed medical charts of victims evacuated to the Singapore General Hospital (SGH) Burns Centre during three suicide attacks involving Bali (2002 and 2005) and the Jakarta Marriott hotel (2003). Problems faced, lessons learnt, and costs incurred are discussed. A burns disaster plan drawing on lessons learnt from these attacks is presented. Results Thirty-one patients were treated at the SGH Burns Centre in three attacks (2002 Bali attack [n = 15], 2003 Jakarta attack [n = 14], and 2005 Bali attack [n = 2]). For the 2002 Bali attack, median age was 29 years (range 20 to 50 years), median percentage of total burn surface area (TBSA) was 29% (range 5% to 55%), and median abbreviated burn severity index (ABSI) was 6 (range 3 to 10). Eight of 15 patients were admitted to the intensive care unit. For the 2003 Jakarta attack, median age was 35 years (range 24 to 56 years), median percentage of TBSA was 10% (range 2% to 46%), and median ABSI was 4 (range 3 to 9). A large number of patients had other injuries. Problems faced included manpower issues, lack of bed space, shortage of blood products, and lack of cadaver skin. Conclusion The changing nature of terror attacks mandates continued vigilance and disaster preparedness. The multidimensional burns patient, complicated by other injuries, is likely to become increasingly common. A burns disaster plan with emphasis on effective command, control, and communication as well as organisation of health care personnel following a 'team concept' will do much to ensure that the sudden onset of a crisis situation at an unexpected time does not overwhelm hospital manpower and resources. PMID:17274813

  12. Disaster Preparedness and Response: Applied Exposure Science

    EPA Science Inventory

    In 2007, the ISEA, predecessor to ISES, held a special roundtable to discuss lessons learned for exposure science during and following environmental disasters, especially the 9/11 attacks and Hurricane Katrina. Since then, environmental agencies have been involved in responses to...

  13. Disaster Preparedness and Response: Applied Exposure Science

    EPA Science Inventory

    In 2007, the ISEA, predecessor to ISES, held a special roundtable to discuss lessons learned for exposure science during and following environmental disasters, especially the 9/11 attacks and Hurricane Katrina. Since then, environmental agencies have been involved in responses to...

  14. Risk factors for and consequences of persistent lower respiratory symptoms among World Trade Center Health Registrants 10 years after the disaster.

    PubMed

    Friedman, Stephen M; Farfel, Mark R; Maslow, Carey; Jordan, Hannah T; Li, Jiehui; Alper, Howard; Cone, James E; Stellman, Steven D; Brackbill, Robert M

    2016-10-01

    The prevalence of persistent lower respiratory symptoms (LRS) among rescue/recovery workers, local area workers, residents and passers-by in the World Trade Center Health Registry (WTCHR) was analysed to identify associated factors and to measure its effect on quality of life (QoL) 10 years after 9/11/2001. This cross-sectional study included 18 913 adults who completed 3 WTCHR surveys (2003-2004 (Wave 1 (W1)), 2006-2007 (Wave 2 (W2)) and 2011-2012 (Wave 3 (W3)). LRS were defined as self-reported cough, wheeze, dyspnoea or inhaler use in the 30 days before survey. The prevalence of three LRS outcomes: LRS at W1; LRS at W1 and W2; and LRS at W1, W2 and W3 (persistent LRS) was compared with no LRS on WTC exposure and probable mental health conditions determined by standard screening tests. Diminished physical and mental health QoL measures were examined as potential LRS outcomes, using multivariable logistic and Poisson regression. Of the 4 outcomes, persistent LRS was reported by 14.7%. Adjusted ORs for disaster exposure, probable post-traumatic stress disorder (PTSD) at W2, lacking college education and obesity were incrementally higher moving from LRS at W1, LRS at W1 and W2 to persistent LRS. Half of those with persistent LRS were comorbid for probable PTSD, depression or generalised anxiety disorder. Enrollees with persistent LRS were 3 times more likely to report poor physical health and ∼ 50% more likely to report poor mental health than the no LRS group. LRS, accompanied by mental health conditions and decreased QoL, have persisted for at least 10 years after 9/11/2001. Affected adults require continuing surveillance and treatment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. 76 FR 35936 - Alaska Disaster #AK-00020

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ... Doc No: 2011-15127] U.S. SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12632 and 12633] Alaska Disaster AK-00020 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of... to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road...

  16. Recovery of infrastructure networks after localised attacks

    PubMed Central

    Hu, Fuyu; Yeung, Chi Ho; Yang, Saini; Wang, Weiping; Zeng, An

    2016-01-01

    The stability of infrastructure network is always a critical issue studied by researchers in different fields. A lot of works have been devoted to reveal the robustness of the infrastructure networks against random and malicious attacks. However, real attack scenarios such as earthquakes and typhoons are instead localised attacks which are investigated only recently. Unlike previous studies, we examine in this paper the resilience of infrastructure networks by focusing on the recovery process from localised attacks. We introduce various preferential repair strategies and found that they facilitate and improve network recovery compared to that of random repairs, especially when population size is uneven at different locations. Moreover, our strategic repair methods show similar effectiveness as the greedy repair. The validations are conducted on simulated networks, and on real networks with real disasters. Our method is meaningful in practice as it can largely enhance network resilience and contribute to network risk reduction. PMID:27075559

  17. Recovery of infrastructure networks after localised attacks.

    PubMed

    Hu, Fuyu; Yeung, Chi Ho; Yang, Saini; Wang, Weiping; Zeng, An

    2016-04-14

    The stability of infrastructure network is always a critical issue studied by researchers in different fields. A lot of works have been devoted to reveal the robustness of the infrastructure networks against random and malicious attacks. However, real attack scenarios such as earthquakes and typhoons are instead localised attacks which are investigated only recently. Unlike previous studies, we examine in this paper the resilience of infrastructure networks by focusing on the recovery process from localised attacks. We introduce various preferential repair strategies and found that they facilitate and improve network recovery compared to that of random repairs, especially when population size is uneven at different locations. Moreover, our strategic repair methods show similar effectiveness as the greedy repair. The validations are conducted on simulated networks, and on real networks with real disasters. Our method is meaningful in practice as it can largely enhance network resilience and contribute to network risk reduction.

  18. Disaster management following explosion.

    PubMed

    Sharma, B R

    2008-01-01

    Explosions and bombings remain the most common deliberate cause of disasters involving large numbers of casualties, especially as instruments of terrorism. These attacks are virtually always directed against the untrained and unsuspecting civilian population. Unlike the military, civilians are poorly equipped or prepared to handle the severe emotional, logistical, and medical burdens of a sudden large casualty load, and thus are completely vulnerable to terrorist aims. To address the problem to the maximum benefit of mass disaster victims, we must develop collective forethought and a broad-based consensus on triage and these decisions must reach beyond the hospital emergency department. It needs to be realized that physicians should never be placed in a position of individually deciding to deny treatment to patients without the guidance of a policy or protocol. Emergency physicians, however, may easily find themselves in a situation in which the demand for resources clearly exceeds supply and for this reason, emergency care providers, personnel, hospital administrators, religious leaders, and medical ethics committees need to engage in bioethical decision-making.

  19. Disaster Research Team Building: A Case Study of a Web-based Disaster Research Training Program

    PubMed Central

    Beaton, Randal D.; Johnson, L. Clark; Maida, Carl A.; Houston, J. Brian; Pfefferbaum, Betty

    2012-01-01

    This case study describes the process and outcomes of the Northwest Center for Public Health Practice Child and Family Disaster Research Training (UWDRT) Program housed at the University of Washington, which used web-based distance learning technology. The purposes of this program were to provide training and to establish a regional cadre of researchers and clinicians; to increase disaster mental health research capacity and collaboration; and to improve the scientific rigor of research investigations of disaster mental health in children and families. Despite a number of obstacles encountered in development and implementation, outcomes of this program included increased team member awareness and knowledge of child and family disaster mental health issues; improved disaster and public health instruction and training independent of the UWDRT program; informed local and state disaster response preparedness and response; and contributions to the child and family disaster mental health research literature. PMID:23264756

  20. Disaster Research Team Building: A Case Study of a Web-based Disaster Research Training Program.

    PubMed

    Beaton, Randal D; Johnson, L Clark; Maida, Carl A; Houston, J Brian; Pfefferbaum, Betty

    2012-11-19

    This case study describes the process and outcomes of the Northwest Center for Public Health Practice Child and Family Disaster Research Training (UWDRT) Program housed at the University of Washington, which used web-based distance learning technology. The purposes of this program were to provide training and to establish a regional cadre of researchers and clinicians; to increase disaster mental health research capacity and collaboration; and to improve the scientific rigor of research investigations of disaster mental health in children and families. Despite a number of obstacles encountered in development and implementation, outcomes of this program included increased team member awareness and knowledge of child and family disaster mental health issues; improved disaster and public health instruction and training independent of the UWDRT program; informed local and state disaster response preparedness and response; and contributions to the child and family disaster mental health research literature.

  1. Challenges of DNA profiling in mass disaster investigations.

    PubMed

    Alonso, Antonio; Martin, Pablo; Albarrán, Cristina; Garcia, Pilar; Fernandez de Simon, Lourdes; Jesús Iturralde, Maria; Fernández-Rodriguez, Amparo; Atienza, Inmaculada; Capilla, Javier; García-Hirschfeld, Julia; Martinez, Pilar; Vallejo, Gloria; García, Oscar; García, Emilio; Real, Pilar; Alvarez, David; León, Antonio; Sancho, Manuel

    2005-08-01

    In cases of mass disaster, there is often a need for managing, analyzing, and comparing large numbers of biological samples and DNA profiles. This requires the use of laboratory information management systems for large-scale sample logging and tracking, coupled with bioinformatic tools for DNA database searching according to different matching algorithms, and for the evaluation of the significance of each match by likelihood ratio calculations. There are many different interrelated factors and circumstances involved in each specific mass disaster scenario that may challenge the final DNA identification goal, such as: the number of victims, the mechanisms of body destruction, the extent of body fragmentation, the rate of DNA degradation, the body accessibility for sample collection, or the type of DNA reference samples availability. In this paper, we examine the different steps of the DNA identification analysis (DNA sampling, DNA analysis and technology, DNA database searching, and concordance and kinship analysis) reviewing the "lessons learned" and the scientific progress made in some mass disaster cases described in the scientific literature. We will put special emphasis on the valuable scientific feedback that genetic forensic community has received from the collaborative efforts of several public and private USA forensic laboratories in assisting with the more critical areas of the World Trade Center (WTC) mass fatality of September 11, 2001. The main challenges in identifying the victims of the recent South Asian Tsunami disaster, which has produced the steepest death count rise in history, will also be considered. We also present data from two recent mass fatality cases that involved Spanish victims: the Madrid terrorist attack of March 11, 2004, and the Yakolev-42 aircraft accident in Trabzon, Turkey, of May 26, 2003.

  2. Heart Attack Symptoms in Women

    MedlinePlus

    ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure ... a Heart Attack • Treatment of a Heart Attack • Life After a Heart Attack Lifestyle Changes Recovery FAQs • Heart ...

  3. Differences in mental health outcomes by acculturation status following a major urban disaster.

    PubMed

    Adams, Richard E; Boscarino, Joseph A

    2013-01-01

    A number of studies have assessed the association between acculturation and psychological outcomes following a traumatic event. Some suggest that low acculturation is associated with poorer health outcomes, while others show no differences or that low acculturation is associated with better outcomes. One year after the terrorist attacks on the World Trade Center, we surveyed a multi-ethnic population of New York City adults (N= 2,368). We assessed posttraumatic stress disorder (PTSD), major depression, panic attack, anxiety symptoms, and general physical and mental health status. We classified study respondents into "low," "moderate," or "high" acculturation, based on survey responses. Bivariate results indicated that low acculturation individuals were more likely to experience negative life events, have low social support, and less likely to have pre-disaster mental health disorders. Those in the low acculturation group were also more likely to experience post-disaster perievent panic attacks, have higher anxiety, and have poorer mental health status. However, using logistic regression to control for confounding, and adjusting for multiple comparisons, we found that none of these outcomes were associated with acculturation status. Thus, our study suggests that acculturation was not associated with mental health outcomes following a major traumatic event.

  4. Examining disaster planning models for large scale burn incidents--a theoretical plane crash into a high rise building.

    PubMed

    Weissman, Oren; Israeli, Hadar; Rosengard, Heather; Shenhar, Gili; Farber, Nimrod; Winkler, Eyal; Stahl, Shy; Haik, Josef

    2013-12-01

    The escalation of global terrorist attacks has resulted in a rise of traumatic injuries. Planning for mass casualty incidents (MCIs) is critical to decrease the morbidity and mortality that ensues after large-scale terrorist attacks. This study provides criteria for the management of burn victims following large-scale disasters. Mass casualty outcomes from three disasters involving commercial aircraft crashes were analyzed. The three events included the El-Al cargo Aircraft crash near the Amsterdam Schiphol Airport in 1992, the World Trade Center attacks in New York and the attack against the Pentagon in Washington, DC on 9/11/01. Using the data obtained from these events, the severity of injuries in patients were determined. The result is a general template that may be customized with locally or regionally specific data, in order to evaluate the preparedness of a specific burn alignment for such a scenario. Recommendations based on the analysis of previous MCI's were put forth. Based on the needs recognized during these past events, suggestions were made to enhance the preparedness of burn units, hospitals and national agencies as well as municipal authorities. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  5. Disaster response. Natural disaster: Katrina.

    PubMed

    McSwain, Norman E

    2010-07-01

    The aftermath and response to a disaster can be divided into four phases. The importance of each depends on the length of time without resupply and the resources that are required. This in turn depends on the time span of the disaster; the area involved; the number of the population affected; the resupply available; the extent of the devastation; and the size of the evacuation. The above phases are discussed using hurricane Katrina as an example. The phases are as follows: immediate response, evacuation, backfill and resupply, and restoration. The restoration phase is usually the longest and requires the most resources. This article addresses the situation of Katrina, the mistakes that were made, the lessons that were learned, and the solutions that are needed. Appropriate training and practice are required for all participants using realistic scenarios.

  6. Interdisciplinary Environmental-health Science Throughout Disaster Lifecycles

    NASA Astrophysics Data System (ADS)

    Plumlee, G. S.; Morman, S. A.; Hoefen, T. M.

    2014-12-01

    Potential human health effects from exposures to hazardous disaster materials and environmental contamination are common concerns following disasters. Using several examples from US Geological Survey environmental disaster responses (e.g., 2001 World Trade Center, mine tailings spills, 2005 Hurricane Katrina, 2007-2013 wildfires, 2011 Gulf oil spill, 2012 Hurricane Sandy, 2013 Colorado floods) and disaster scenarios (2011 ARkStorm, 2013 SAFRR tsunami) this presentation will illustrate the role for collaborative earth, environmental, and health science throughout disaster lifecycles. Pre-disaster environmental baseline measurements are needed to help understand environmental influences on pre-disaster health baselines, and to constrain the magnitude of a disaster's impacts. During and following disasters, there is a need for interdisciplinary rapid-response and longer-term assessments that: sample and characterize the physical, chemical, and microbial makeup of complex materials generated by the disasters; fingerprint material sources; monitor, map, and model dispersal and evolution of disaster materials in the environment; help understand how the materials are modified by environmental processes; and, identify key characteristics and processes that influence the exposures and toxicity of disaster materials to humans and the living environment. This information helps emergency responders, public health experts, and cleanup managers: 1) identify short- and long-term exposures to disaster materials that may affect health; 2) prioritize areas for cleanup; and 3) develop appropriate disposal solutions or restoration uses for disaster materials. By integrating lessons learned from past disasters with geospatial information on vulnerable sources of natural or anthropogenic contaminants, the environmental health implications of looming disasters or disaster scenarios can be better anticipated, which helps enhance preparedness and resilience. Understanding economic costs of

  7. Emergency Wound Care After a Natural Disaster

    MedlinePlus

    ... Centers Extreme Heat PSAs Related Links MMWR Bibliography Floods Flood Readiness Personal Hygiene After a Disaster Reentering Your Flooded Home Cleanup of Flood Water After a Flood Worker Safety Educational Materials ...

  8. 78 FR 47814 - Pennsylvania Disaster # PA-00059

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-06

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Pennsylvania Disaster PA-00059 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY.... Small Business Administration, Processing And Disbursement Center, 14925 Kingsport Road, Fort Worth, TX...

  9. Burn-injured patients in a disaster: September 11th revisited.

    PubMed

    Yurt, Roger W; Bessey, Palmer Q; Alden, Nicole E; Meisels, Daniel; Delaney, John J; Rabbitts, Angela; Greene, William T

    2006-01-01

    We sought to review the steps taken by the New York Presbyterian Healthcare System to address disaster preparedness in the wake of the terrorist attacks of September 11, 2001. We reviewed the institutional records of emergency preparedness efforts, including improvements in infrastructure, employee education and training, and participation in intramural and extramural disaster response initiatives. We used a state discharge database to review burn injury triage within New York State (1995-2004). Since September 11, 2001, significant resources have been devoted to emergency preparedness: expansion of emergency services training, education, response, equipment, and communications; participation in regional disaster response exercises; revision of hospital preparedness plans; and development of municipal and regional responses to a burn mass casualty incident. A review of state and city burn triage patterns during the period of 1995 to 2004 revealed a decline in the number of burn cases treated in New York State-based hospitals by an average of 81 +/- 24 (mean +/- SEM) fewer cases/year (P = .01), occurring primarily in hospitals outside of New York City. Additionally, there was a steady increase in the proportion of New York City burn patients treated at burn center hospitals by 1.8 +/- 0.1 % per year (P < .0001). In response to the events of September 11, 2001, this health care system and this hospital has taken many steps to enhance its disaster response capabilities.

  10. Transfusion service disaster planning.

    PubMed

    Bundy, K L; Foss, M L; Stubbs, J R

    2008-01-01

    The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is "in charge," planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.

  11. 13 CFR 123.603 - What is the interest rate on an economic injury disaster loan under this subpart?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false What is the interest rate on an economic injury disaster loan under this subpart? 123.603 Section 123.603 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION DISASTER LOAN PROGRAM Economic Injury Disaster Loans as a Result of the September 11, 2001 Terrorist Attacks §...

  12. 13 CFR 123.603 - What is the interest rate on an economic injury disaster loan under this subpart?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false What is the interest rate on an economic injury disaster loan under this subpart? 123.603 Section 123.603 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION DISASTER LOAN PROGRAM Economic Injury Disaster Loans as a Result of the September 11, 2001 Terrorist Attacks §...

  13. 13 CFR 123.603 - What is the interest rate on an economic injury disaster loan under this subpart?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false What is the interest rate on an economic injury disaster loan under this subpart? 123.603 Section 123.603 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION DISASTER LOAN PROGRAM Economic Injury Disaster Loans as a Result of the September 11, 2001 Terrorist Attacks §...

  14. 13 CFR 123.603 - What is the interest rate on an economic injury disaster loan under this subpart?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false What is the interest rate on an economic injury disaster loan under this subpart? 123.603 Section 123.603 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION DISASTER LOAN PROGRAM Economic Injury Disaster Loans as a Result of the September 11, 2001 Terrorist Attacks §...

  15. 13 CFR 123.603 - What is the interest rate on an economic injury disaster loan under this subpart?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What is the interest rate on an economic injury disaster loan under this subpart? 123.603 Section 123.603 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION DISASTER LOAN PROGRAM Economic Injury Disaster Loans as a Result of the September 11, 2001 Terrorist Attacks §...

  16. Comparative Assessment of U.S. Marine Corps Disaster Recovery Plans for Information Systems

    DTIC Science & Technology

    1992-09-01

    Marine Corps were obtained from two Regional Automated Services Centers at Marine Corps Bases C’mp Pendleton, California, and Camp Lejeune, North...Regional Automated Services Center disaster recovery plan. 4 I’ * INDUSTRY PLANS FOR DISASTER RECOVERY PLANNING A. OVERVIEW Review of industry plans...DISASTER PLANNING A. DISCUSSION The disaster recovery plans that were reviewed were obtained from the Regional Automated Services Centers at Marine

  17. Prioritization of disasters and their management in Rwanda.

    PubMed

    Rugigana, E; Nyirazinyoye, L; Umubyeyi, A; Nsengiyumva, J B; Kanyandekwe, C; Ntahobakulira, I

    2013-06-01

    Rwanda has been experiencing quite a significant number of disastrous events of both natural and man-made origin in the last 2 decades. Many cases of disasters are particularly linked to the geographic, historical and socio-cultural aspects of the country. The overall objective of the present article is to perform a situation analysis of disasters in Rwanda and to highlight the institutional and legal framework of disaster management. An assessment questionnaire focused on the current capacity, institutional frameworks and on-going initiatives for disaster management at country level and operational level was administered. The assessment was descriptive and used mainly qualitative methods. These included review of records (country policies and policy briefs, programme documents), interviews with key informants from line ministries, and interviews with key informants from stakeholder agencies. The Rwandan hazard profile, its vulnerability and capacity assessment shows top seven disasters which are related to epidemics, hails storms/floods; roads accidents; environmental degradation and earthquakes/volcanic eruption. Currently, the Institutional framework for disaster management and response is coordinated by Ministry of Disaster Management and Refugee Affairs through the Rwanda National Disasters Operation Center. Although disaster risk reduction has been integrated into sustainable policies and plans, most districts do not have adequate capacity to plan for disasters and the majority of districts disaster committees have not yet been trained. Rwanda has established a legal and institutional framework for disasters management. There is a need to build capacity in disaster management at operational level (District).

  18. Two New York City hospitals' surgical response to the September 11, 2001, terrorist attack in New York City.

    PubMed

    Cushman, James G; Pachter, H Leon; Beaton, Howard L

    2003-01-01

    We describe the surgical response of two affiliated hospitals during the day of, and week following, the September 11th, 2001 terrorist attack at the World Trade Center in New York City. The city of New York has 18 state designated regional trauma centers that receive major trauma victims. The southern half of Manhattan is served by a burn center, two regional trauma centers, and a community hospital that is an affiliate of one of the regional trauma centers. This report accounts for the surgical response by a regional trauma center (Hospital A, located 2.5 miles from the World Trade Center) and its affiliate hospital (Hospital B, located 5 city blocks from the World Trade Center) on September 11th when two commercial jets crashed into the Twin Towers at the World Trade Center mall. Hospital A maintained a concurrent log of patients received during the first 5 hours, the first day, and the first week after the disaster which was kept by the Surgical Triage Officer. The trauma registry completed and verified this data by September 18th. Hospital B collected its data by hand counting and verification by chart review. Both hospitals, A and B, had established disaster plans that were implemented. Nine hundred eleven patients were received by two affiliated hospitals from the World Trade Center attack. Seven hundred seventy six patients (85%) were walking wounded, sustaining mild inhalation and eye irritant injuries. One hundred thirty five (15%) were admitted with 18 (13%) of these undergoing surgery. Twenty two of the 23 transfers were from the community hospital to specialized orthopedic or burn centers. Of the 109 patients admitted to Hospital A, 30 were to the surgical service. The mean ISS score of these patients was 12. There were 4 deaths (within minutes of arrival at the hospital) and 6 delayed deaths (day 1-14). Excluding walking wounded and DOAs, the critical mortality rate was 37.5% overall. The September 11th, 2001, terrorist attack in New York City

  19. Terrorist attacks in the largest metropolitan city of Pakistan: Profile of soft tissue and skeletal injuries from a single trauma center

    PubMed Central

    Khan, Muhammad Shahid; Waheed, Shahan; Ali, Arif; Mumtaz, Narjis; Feroze, Asher; Noordin, Shahryar

    2015-01-01

    BACKGROUND: Pakistan has been hugely struck with massive bomb explosions (car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and soft tissue injuries and to review the outcome of the victims who presented to our hospital. METHODS: This is a retrospective chart review from January 2008 to December 2012. The medical record numbers of patients were obtained from the hospital Health Information and Management Sciences (HIMS) as per the ICD-9 coding. RESULTS: During the study period, more than 100 suicide and implanted bomb blast attacks took place in the public proceedings, government offices, residential areas and other places of the city. Altogether 262 patients were enrolled in the study. The mean age of the patients was 31±14 years. The shrapnel inflicted wounds were present on to the upper limb in 24 patients and the lower limb in 50. CONCLUSION: Long bone fractures were the most common skeletal injuries. The fractures were complicated by penetrating fragments and nails which result in post operative infections and prolonged hospital stay. PMID:26401184

  20. Factor structure of posttraumatic stress among Western New York undergraduates following the September 11th terrorist attack on the World Trade Center.

    PubMed

    Baschnagel, Joseph S; O'Connor, Roisin M; Colder, Craig R; Hawk, Larry W

    2005-12-01

    The structure of posttraumatic stress is of both theoretical and clinical interest. In the present study, seven models of posttraumatic stress were compared using confirmatory factor analysis. A sample of 528 Western New York undergraduate students was assessed 1 and 3 months after the September 11th, 2001 terrorist attacks. At the Month 1 assessment, the current three-factor Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) model, which consists of Intrusions, Avoidance/Numbing, and Hyperarousal, did not provide a good fit to the data; however, a four-factor model consisting of factors labeled Intrusions, Avoidance, Dysphoria, and Hyperarousal did fit the data well and provided better fit than the three-factor model and other competing models. Importantly, Dysphoria spans symptoms from the traditional DSM Numbing and Hyperarousal clusters. The four-factor model continued to fit the data well at Month 3. These findings parallel the results of earlier studies which suggest that a four-factor model better reflects the nature of posttraumatic stress than do simpler models, including the DSM. The present work is consistent with a dimensional model of stress responses and calls for further longitudinal work in this area.

  1. Risk management and disaster recovery planning for online libraries.

    PubMed

    Uzwyshyn, Ray

    2015-01-01

    This article presents an overview of risk management and disaster recovery planning for online libraries. It is suitable for a broad audience interested in online libraries and research centers in universities and colleges. It outlines risk mitigation strategies, and disaster recover planning for online resource-centered information systems.

  2. The enduring mental health impact of the September 11th terrorist attacks: challenges and lessons learned.

    PubMed

    Ozbay, Fatih; Auf der Heyde, Tanja; Reissman, Dori; Sharma, Vansh

    2013-09-01

    The authors review the existing literature on the mental health impact of the September 11th attacks and the implications for disaster mental health clinicians and policy makers. The authors discuss the demographic characteristics of those affected and the state of mental health needs and existing mental health delivery services; the nature of the disaster and primary impacts on lives, infrastructure, and socioeconomic factors; the acute aftermath in the days and weeks after the attacks; the persistent mental health impact and evolution of services of the postacute aftermath; and the implications for future disaster mental health practitioners and policy makers. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. [Communication networks in great natural disasters].

    PubMed

    Galinski, R

    1990-02-01

    A great natural disaster destroys every energy supplies and the communication network necessary for the organisation of health care (telephone, telex) is entirely or partially not functioning. It becomes impossible to be informed about the hospitals and others sanitary availabilities in the disaster area. Our personal experience, during the El Asnam's and Mexico's earthquakes demonstrates the necessity to maintain a functioning network for sanitary use. The unique possibility is the availability of portable, battery operated radio-transmitters. It is necessary to have these equipment in all hospitals and health centers in the area of a previsible disaster. A good scheduled training is necessary for the medical and paramedical personal of these areas.

  4. Pericarditis - after heart attack

    MedlinePlus

    ... medlineplus.gov/ency/article/000166.htm Pericarditis - after heart attack To use the sharing features on this page, ... occur in the days or weeks following a heart attack . Causes Two types of pericarditis can occur after ...

  5. Heart attack first aid

    MedlinePlus

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  6. Wildfire Disasters and Nursing.

    PubMed

    Hanes, Patricia Frohock

    2016-12-01

    Multiple factors contribute to wildfires in California and other regions: drought, winds, climate change, and spreading urbanization. Little has been done to study the multiple roles of nurses related to wildfire disasters. Major nursing organizations support disaster education for nurses. It is essential for nurses to recognize their roles in each phase of the disaster cycle: mitigation, preparedness, response, and recovery. Skills learned in the US federal all-hazards approach to disasters can then be adapted to more specific disasters, such as wildfires, and issues affecting health care. Nursing has an important role in each phase of the disaster cycle.

  7. DoD Response to Natural Disasters - Why the National Guard is Off Limits

    DTIC Science & Technology

    2008-03-15

    to “natural disasters, epidemics, serious health emergencies, terrorists attacks, or other conditions when the authorities of the state are...epidemic, serious health emergency, terrorist attack, or other conditions when the President determines that the authorities of the 17 state are...enforce the laws of the United States when, as a result of a natural disaster, epidemic, or other serious public health emergency, terrorist

  8. Environmental and medical geochemistry in urban disaster response and preparedness

    USGS Publications Warehouse

    Plumlee, Geoffrey S.; Morman, Suzette A.; Cook, A.

    2012-01-01

    History abounds with accounts of cities that were destroyed or significantly damaged by natural or anthropogenic disasters, such as volcanic eruptions, earthquakes, wildland–urban wildfires, hurricanes, tsunamis, floods, urban firestorms, terrorist attacks, and armed conflicts. Burgeoning megacities place ever more people in the way of harm from future disasters. In addition to the physical damage, casualties, and injuries they cause, sudden urban disasters can also release into the environment large volumes of potentially hazardous materials. Environmental and medical geochemistry investigations help us to (1) understand the sources and environmental behavior of disaster materials, (2) assess potential threats the materials pose to the urban environment and health of urban populations, (3) develop strategies for their cleanup/disposal, and (4) anticipate and mitigate potential environmental and health effects from future urban disasters.

  9. Hurricane! Coping With Disaster

    NASA Astrophysics Data System (ADS)

    Lifland, Jonathan

    A new AGU book, Hurricane! Coping With Disaster, analyzes the progress made in hurricane science and recounts how advances in the field have affected the public's and the scientific community's understanding of these storms. The book explores the evolution of hurricane study, from the catastrophic strike in Galveston, Texas in 1900—still the worst natural disaster in United States history—to today's satellite and aircraft observations that track a storm's progress and monitor its strength. In this issue, Eos talks with Robert Simpson, the books' senior editor.Simpson has studied severe storms for more than 60 years, including conducting one of the first research flights through a hurricane in 1945. He was the founding director of the (U.S.) National Hurricane Research Project and has served as director of the National Hurricane Center. In collaboration with Herbert Saffir, Simpson helped design and implement the Saffir/Simpson damage potential scale that is widely used to identify potential damage from hurricanes.

  10. Disaster management teams.

    PubMed

    Briggs, Susan M

    2005-12-01

    All disasters, regardless of cause, have similar medical and public health consequences. A consistent approach to disasters, based on an understanding of their common features and the response expertise they require, is becoming the accepted practice throughout the world. This strategy is called the mass casualty incident response. The complexity of today's disasters, particularly the threat of terrorism and weapons of mass destruction, has increased the need for multidisciplinary medical specialists as critical assets in disaster response. A review of the current literature emphasizes the expanding role of disaster management teams as an integral part of the mass casualty incident response. The incident command system has become the accepted standard for all disaster response. Functional requirements, not titles, determine the organizational hierarchy of the Incident Command System structure. All disaster management teams must adhere to this structure to integrate successfully into the rescue effort. Increasingly, medical specialists are determining how best to incorporate their medical expertise into disaster management teams that meet the functional requirements of the incident command system. Disaster management teams are critical to the mass casualty incident response given the complexity of today's disaster threats. Current disaster planning and response emphasizes the need for an all-hazards approach. Flexibility and mobility are the key assets required of all disaster management teams. Medical providers must respond to both these challenges if they are to be successful disaster team members.

  11. Introduction and Overview: Counseling Psychologists' Roles, Training, and Research Contributions to Large-Scale Disasters

    ERIC Educational Resources Information Center

    Jacobs, Sue C.; Leach, Mark M.; Gerstein, Lawrence H.

    2011-01-01

    Counseling psychologists have responded to many disasters, including the Haiti earthquake, the 2001 terrorist attacks in the United States, and Hurricane Katrina. However, as a profession, their responses have been localized and nonsystematic. In this first of four articles in this contribution, "Counseling Psychology and Large-Scale Disasters,…

  12. Introduction and Overview: Counseling Psychologists' Roles, Training, and Research Contributions to Large-Scale Disasters

    ERIC Educational Resources Information Center

    Jacobs, Sue C.; Leach, Mark M.; Gerstein, Lawrence H.

    2011-01-01

    Counseling psychologists have responded to many disasters, including the Haiti earthquake, the 2001 terrorist attacks in the United States, and Hurricane Katrina. However, as a profession, their responses have been localized and nonsystematic. In this first of four articles in this contribution, "Counseling Psychology and Large-Scale Disasters,…

  13. Design and evaluation of a disaster preparedness logistics tool.

    PubMed

    Neches, Robert; Ryutov, Tatyana; Kichkaylo, Tatiana; Burke, Rita V; Claudius, Ilene A; Upperman, Jeffrey S

    2009-01-01

    The purpose of this article is to describe the development and testing of the Pediatric Emergency Decision Support System (PEDSS), a dynamic tool for pediatric victim disaster planning. This is a descriptive article outlining an innovative automated approach to pediatric decision support and disaster planning. Disaster Resource Centers and umbrella hospitals in Los Angeles County. The authors use a model set of hypothetical patients for our pediatric disaster planning approach. The authors developed the PEDSS software to accomplish two goals: (a) core that supports user interaction and data management requirements (e.g., accessing demographic information about a healthcare facility's catchment area) and (b) set of modules each addressing a critical disaster preparation issue. The authors believe the PEDSS tool will help hospital disaster response personnel produce and maintain disaster response plans that apply best practice pediatric recommendations to their particular local conditions and requirements.

  14. Healing loss, ambiguity, and trauma: a community-based intervention with families of union workers missing after the 9/11 attack in New York City.

    PubMed

    Boss, Pauline; Beaulieu, Lorraine; Wieling, Elizabeth; Turner, William; LaCruz, Shulaika

    2003-10-01

    A team of therapists from Minnesota and New York worked with labor union families of workers gone missing on September 11, 2001, after the attack on the World Trade Center, where they were employed. The clinical team shares what they did, what was learned, the questions raised, and preliminary evaluations about the multiple family meetings that were the major intervention. Because of the vast diversity, training of therapists and interventions for families aimed for cultural competence. The community-based approach, preferred by union families, plus family therapy using the lens of ambiguous loss are proposed as necessary additions to disaster work.

  15. Developing Disaster Contingency Plans: Management Considerations.

    ERIC Educational Resources Information Center

    Abowd, Anthony; Catrambone, Joseph A.

    1979-01-01

    Methods for examining the risk of long-term interruptions of data processing in large computer centers are discussed. Procedures are outlined for responding to such a disaster, with the University of Illinois Administrative Computer Center and its security system cited as an example. (SF)

  16. Disaster Preparation and Recovery

    MedlinePlus

    ... be a natural disaster, like a hurricane, tornado, flood or earthquake. It might also be man-made, ... the insurance you need, including special types, like flood insurance. No matter what kind of disaster you ...

  17. Coping with Disasters

    MedlinePlus

    ... feel dazed or numb after going through a disaster. You may also feel sad, helpless, or anxious. ... places or people that remind you of the disaster. You might have trouble sleeping, eating, or paying ...

  18. Disaster Recovery Guide

    MedlinePlus

    ... Cross Store Home Get Help Prepare for Emergencies Disaster Recovery Guide When the immediate emergency is over, ... local Red Cross chapter . Staying Safe After a Disaster Learn the steps to take during and after ...

  19. Australasian disasters of national significance: an epidemiological analysis, 1900-2012.

    PubMed

    Bradt, David A; Bartley, Bruce; Hibble, Belinda A; Varshney, Kavita

    2015-04-01

    A regional epidemiological analysis of Australasian disasters in the 20th century to present was undertaken to examine trends in disaster epidemiology; to characterise the impacts on civil society through disaster policy, practice and legislation; and to consider future potential limitations in national disaster resilience. A surveillance definition of disaster was developed conforming to the Centre for Research on the Epidemiology of Disasters (CRED) criteria (≥10 deaths, ≥100 affected, or declaration of state emergency or appeal for international assistance). The authors then applied economic and legislative inclusion criteria to identify additional disasters of national significance. The surveillance definition yielded 165 disasters in the period, from which 65 emerged as disasters of national significance. There were 38 natural disasters, 22 technological disasters, three offshore terrorist attacks and two domestic mass shootings. Geographic analysis revealed that states with major population centres experienced the vast majority of disasters of national significance. Timeline analysis revealed an increasing incidence of disasters since the 1980s, which peaked in the period 2005-2009. Recent seasonal bushfires and floods have incurred the highest death toll and economic losses in Australasian history. Reactive hazard-specific legislation emerged after all terrorist acts and after most disasters of national significance. Timeline analysis reveals an increasing incidence in natural disasters over the past 15 years, with the most lethal and costly disasters occurring in the past 3 years. Vulnerability to disaster in Australasia appears to be increasing. Reactive legislation is a recurrent feature of Australasian disaster response that suggests legislative shortsightedness and a need for comprehensive all-hazards model legislation in the future. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  20. Seven Deadliest Network Attacks

    SciTech Connect

    Prowell, Stacy J; Borkin, Michael; Kraus, Robert

    2010-05-01

    Do you need to keep up with the latest hacks, attacks, and exploits effecting networks? Then you need "Seven Deadliest Network Attacks". This book pinpoints the most dangerous hacks and exploits specific to networks, laying out the anatomy of these attacks including how to make your system more secure. You will discover the best ways to defend against these vicious hacks with step-by-step instruction and learn techniques to make your computer and network impenetrable. Attacks detailed in this book include: Denial of Service; War Dialing; Penetration 'Testing'; Protocol Tunneling; Spanning Tree Attacks; Man-in-the-Middle; and, Password Replay. Knowledge is power, find out about the most dominant attacks currently waging war on computers and networks globally. Discover the best ways to defend against these vicious attacks; step-by-step instruction shows you how. Institute countermeasures, don't be caught defenseless again, learn techniques to make your computer and network impenetrable.

  1. Assisting older victims of disasters: roles and responsibilities for social workers.

    PubMed

    Torgusen, Barbra L; Kosberg, Jordan I

    2006-01-01

    The tumultuous catastrophic tragedies of the Oklahoma bombing in 1995 and September 11, 2001 attacks on the World Trade Center and Pentagon have caused urgency for the profession of social work to be ready to respond to unexpected crises whether directed to an individual, group, or nation. While there has always been the possibility of tragedies in the U.S. caused by nature (so-called "acts of God") or the spontaneous or planned acts of criminals or the deranged, the increased awareness of catastrophes includes, as never before, disasters that are perpetrated by terrorist acts from within or outside of the U.S. The creation of the Department of Homeland Security, in 2003, underscores the need for awareness and for preparation on the part of the nation. Based upon its skills and values, social workers have significant roles to play in the face of potential and actual disasters; yet, gerontological social workers have additional responsibilities for addressing the needs of older persons. It is the purpose of this article to provide an overview of issues to be considered by social workers, in general, and gerontological social workers, in particular, with regard to preparation for possible disasters and the consequences from such catastrophes that affect older persons.

  2. Mental health needs in New York state following the September 11th attacks.

    PubMed

    Herman, Daniel; Felton, Chip; Susser, Ezra

    2002-09-01

    In October 2001, the New York State Office of Mental Health and the Department of Epidemiology of the Mailman School of Public Health of Columbia University conducted a rapid assessment of the nature and magnitude of mental health needs in the state resulting from the September 11th terrorist attacks on the World Trade Center. This effort was carried out during a period of great turmoil and uncertainty as New Yorkers responded to the shocking events of this unprecedented disaster. Using the limited data available at the time, we estimated that over 520,000 persons in New York City and the surrounding counties would experience posttraumatic stress disorder resulting from exposure to the attacks, and that more than 129,000 would seek treatment for this disorder during 2002. This assessment is part of an ongoing collaborative process between public and academic partners; the effort is designed to strengthen the capacity of the mental health system to respond to current and future terrorism. Estimates from this initial assessment will be refined over time as further data concerning the impact of the September 11th attacks become available.

  3. Disaster preparedness pays off.

    PubMed

    Reed, M K

    1998-06-01

    Last spring, the Red River Valley of North Dakota and Minnesota was devastated by an unprecedented flood. Flooding caused foundations to collapse and houses to float away or become severely damaged by the raging, sewage-filled water. The river displaced people from their homes, and caused significant disruption of services including water, power, and medical care for 18 days. Find out how a medical contingency plan enabled staff members at the only trauma center and the largest clinic in the region to evacuate safely and effectively nearly 1,000 patients and senior residents in 36 hours, while setting up critical services across the region to care for the 50,000 displaced residents of the flood disaster.

  4. Ten-year cancer incidence in rescue/recovery workers and civilians exposed to the September 11, 2001 terrorist attacks on the World Trade Center.

    PubMed

    Li, Jiehui; Brackbill, Robert M; Liao, Tim S; Qiao, Baozhen; Cone, James E; Farfel, Mark R; Hadler, James L; Kahn, Amy R; Konty, Kevin J; Stayner, Leslie T; Stellman, Steven D

    2016-09-01

    Cancer incidence in exposed rescue/recovery workers (RRWs) and civilians (non-RRWs) was previously reported through 2008. We studied occurrence of first primary cancer among World Trade Center Health Registry enrollees through 2011 using adjusted standardized incidence ratios (SIRs), and the WTC-exposure-cancer association, using Cox proportional hazards models. All-cancer SIR was 1.11 (95% confidence interval (CI) 1.03-1.20) in RRWs, and 1.08 (95% CI 1.02-1.15) in non-RRWs. Prostate cancer and skin melanoma were significantly elevated in both populations. Thyroid cancer was significantly elevated only in RRWs while breast cancer and non-Hodgkin's lymphoma were significantly elevated only in non-RRWs. There was a significant exposure dose-response for bladder cancer among RRWs, and for skin melanoma among non-RRWs. We observed excesses of total and specific cancers in both populations, although the strength of the evidence for causal relationships to WTC exposures is somewhat limited. Continued monitoring of this population is indicated. Am. J. Ind. Med. 59:709-721, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. Disaster planning: the past, present, and future concepts and principles of managing a surge of burn injured patients for those involved in hospital facility planning and preparedness.

    PubMed

    Kearns, Randy D; Holmes, James H; Alson, Roy L; Cairns, Bruce A

    2014-01-01

    The 9/11 attacks reframed the narrative regarding disaster medicine. Bypass strategies have been replaced with absorption strategies and are more specifically described as "surge capacity." In the succeeding years, a consensus has coalesced around stratifying the surge capacity into three distinct tiers: conventional, contingency, and crisis surge capacities. For the purpose of this work, these three distinct tiers were adapted specifically to burn surge for disaster planning activities at hospitals where burn centers are not located. A review was conducted involving published plans, other related academic works, and findings from actual disasters as well as modeling. The aim was to create burn-specific definitions for surge capacity for hospitals where a burn center is not located. The three-tier consensus description of surge capacity is delineated in their respective stratifications by what will hereinafter be referred to as the three "S's"; staff, space, and supplies (also referred to as supplies, pharmaceuticals, and equipment). This effort also included the creation of a checklist for nonburn center hospitals to assist in their development of a burn surge plan. Patients with serious burn injuries should always be moved to and managed at burn centers, but during a medical disaster with significant numbers of burn injured patients, there may be impediments to meeting this goal. It may be necessary for burn injured patients to remain for hours in an outlying hospital until being moved to a burn center. This work was aimed at aiding local and regional hospitals in developing an extemporizing measure until their burn injured patients can be moved to and managed at a burn center(s).

  6. Federal disaster assistance programs

    Treesearch

    William J. Patterson

    1995-01-01

    The Robert T. Stafford Disaster Relief and Emergency Assistance Act—Public Law 93-288, as amended—is designed to provide support and assistance to citizens, state, and local government from catastrophic disasters and emergencies. The law provides support in three distinct phases, including preparedness in avoiding or minimizing the effect of a disaster, response...

  7. Serving through Disaster

    ERIC Educational Resources Information Center

    Kuzyk, Raya

    2007-01-01

    Disaster planning focuses on future function and recovery, on helping libraries expeditiously return to their original states of operation. It all but ignores the concept of continuous function throughout a disaster. This is not true in the private and government sectors, however, which have managed to cover a wider load of disaster response…

  8. Serving through Disaster

    ERIC Educational Resources Information Center

    Kuzyk, Raya

    2007-01-01

    Disaster planning focuses on future function and recovery, on helping libraries expeditiously return to their original states of operation. It all but ignores the concept of continuous function throughout a disaster. This is not true in the private and government sectors, however, which have managed to cover a wider load of disaster response…

  9. Disaster: Planning, Preparation, Prevention.

    ERIC Educational Resources Information Center

    Rutherford, Christine

    1990-01-01

    Discusses causes of library disasters and provides several examples of disasters. Emphasis is on the importance of awareness, insurance protection, a written disaster plan, cooperation with the fire marshall and insurance agent in planning, and staff training. Several elements of the written plan are listed. (22 references) (MES)

  10. Disaster Planning in Libraries

    ERIC Educational Resources Information Center

    Wong, Yi Ling; Green, Ravonne

    2006-01-01

    Disaster preparedness is an important issue in library management today. This article presents a general overview of the theoretical aspects of disaster planning in libraries. The stages of disaster planning are a circular process of planning, prevention, response, recovery, preparedness, and training.

  11. Disaster Planning in Libraries

    ERIC Educational Resources Information Center

    Wong, Yi Ling; Green, Ravonne

    2006-01-01

    Disaster preparedness is an important issue in library management today. This article presents a general overview of the theoretical aspects of disaster planning in libraries. The stages of disaster planning are a circular process of planning, prevention, response, recovery, preparedness, and training.

  12. A qualitative examination of health and health care utilization after the September 11th terror attacks among World Trade Center Health Registry enrollees.

    PubMed

    Welch, Alice E; Caramanica, Kimberly; Debchoudhury, Indira; Pulizzi, Allison; Farfel, Mark R; Stellman, Steven D; Cone, James E

    2012-08-31

    Many individuals who have 9/11-related physical and mental health symptoms do not use or are unaware of 9/11-related health care services despite extensive education and outreach efforts by the World Trade Center (WTC) Health Registry (the Registry) and various other organizations. This study sought to evaluate Registry enrollees' perceptions of the relationship between physical and mental health outcomes and 9/11, as well as utilization of and barriers to 9/11-related health care services. Six focus groups were conducted in January 2010 with diverse subgroups of enrollees, who were likely eligible for 9/11-related treatment services. The 48 participants were of differing race/ethnicities, ages, and boroughs of residence. Qualitative analysis of focus group transcripts was conducted using open coding and the identification of recurring themes. Participants described a variety of physical and mental symptoms and conditions, yet their knowledge and utilization of 9/11 health care services were low. Participants highlighted numerous barriers to accessing 9/11 services, including programmatic barriers (lack of program visibility and accessibility), personal barriers such as stigmatization and unfamiliarity with 9/11-related health problems and services, and a lack of referrals from their primary care providers. Moreover, many participants were reluctant to connect their symptoms to the events of 9/11 due to lack of knowledge, the amount of time that had elapsed since 9/11, and the attribution of current health symptoms to the aging process. Knowledge of the barriers to 9/11-related health care has led to improvements in the Registry's ability to refer eligible enrollees to appropriate treatment programs. These findings highlight areas for consideration in the implementation of the new federal WTC Health Program, now funded under the James Zadroga 9/11 Health and Compensation Act (PL 111-347), which includes provisions for outreach and education.

  13. Conducting research in the aftermath of disasters: ethical considerations.

    PubMed

    O'Mathúna, Dónal P

    2010-05-01

    Disaster research focuses on the impact disasters have on people and social structures. Planning for and responding to disasters require evidence to guide decision-makers. The need for such evidence provides an ethical mandate for the conduct of sound disaster research. Disaster research ethics draws attention to ethical issues common to all research involving human subjects. However, disaster research involves a number of distinctive factors, including the degree of devastation affecting participants and the urgency often involved in initiating research projects. Such factors generate ethical issues not usually encountered with other types of research, and create tensions that must be taken into account in designing and conducting disaster research so that it attains the highest ethical standards. An overview of general research ethics issues is presented here in the context of disaster research. As with all research involving humans, protection of participants and minimizing harm is the highest ethical priority. Other ethical issues include formal ethical approval, informed consent, balancing burdens and benefits, participant recruitment, coercion, the role of compensation, and conflicts of interest. Using examples from specific studies, some of the distinctive features of disaster research ethics are discussed. These include cross-cultural collaboration and communication, vulnerability of participants arising from the degree of devastation, avoiding exploitation of disaster victims, and protecting researchers. The article concludes with some of the major challenges facing disaster research ethics and how they might be addressed. © 2010 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  14. Subgroups of New York City children at high risk of PTSD after the September 11 attacks: a signal detection analysis.

    PubMed

    Rosen, Craig S; Cohen, Michael

    2010-01-01

    Case finding is an important challenge in mental health programs responding to large-scale disasters. Most people who experience psychological symptoms after such events return to normal functioning within a few months. Yet a significant minority continues to experience enduring symptoms. This study demonstrated the use of signal detection analyses of community survey data to identify subgroups of children who were at highest risk of posttraumatic stress disorder (PTSD) after the September 11 attacks. This study reanalyzed results of a needs assessment survey conducted six months after the World Trade Center attacks on September 11, 2001, with a representative sample of 7,832 New York City public school students in grades 4 to 12. Receiver operating characteristic (ROC) analyses conducted on half the sample resulted in a decision tree for classifying children into groups at varying levels of risk of PTSD. These decision rules were subsequently retested on the second half of the sample. We could reliably classify children into groups with varying probabilities of screening positive on a PTSD screen. Nearly two-thirds of children in grades 4 to 12 who screened positive for probable PTSD were concentrated among 4th graders (35%) and among children who had a friend or family member directly exposed to the attacks (28%). Signal detection analysis of community needs assessment surveys can identify community subgroups most likely to screen positive for mental health problems after a disaster or terrorist attack. This information can help target screening and outreach efforts to community segments that have the highest need for services.

  15. Burn disasters in shooting range areas.

    PubMed

    Uygur, Fatih; Oksüz, Sinan; Yüksel, Fuat

    2008-08-06

    Shooting range injuries are generally caused by ballistic accidents, and so far no burn disaster has been reported. In this article we reported a disaster caused by a gunpowder explosion in an indoor shooting range area in Istanbul, Turkey. Fourteen injured people were evacuated from the scene. Our burn center accepted 7 of them. Of the 7 injured people, 2 who were accepted by our burn center, and 3 people who were admitted by another center died. It is clearly identified how this mechanism of injury differs from that of usual burn injuries, due to both the high temperature generated, and the combination of hot and toxic gases produced by the explosion. We described the features of burn injury, and possible reasons of burn disasters.

  16. Natural Disaster Induced Losses at Household Level: A Study on the Disaster Affected Migrants

    NASA Astrophysics Data System (ADS)

    Ishtiaque, A.; Nazem, N. I.; Jerin, T.

    2015-12-01

    Given its geographical location Bangladesh frequently confronts natural disasters. Disaster induced losses often obligate socio-economic dislocation from rural areas to large urban centers. After incurring what type/amount of losses people migrate is still unknown. In this paper we focus on migrants who migrated due to natural disasters. Thus, the objectives of this paper are, first, ascertaining the proportion of disaster migrants in Dhaka city; second, determining types of natural disasters which compel rural out-migration; third, assessing the resource and economic losses stem from these disasters at household level. Using the slum database (N = 4966), we select eight slums randomly with a purpose to include migrants from maximum districts available. In order to identify the proportion of disaster affected migrants a census is conducted in 407 households of those 8 slums and the result demonstrates that 18.43% of the migrants are disaster affected, which was only 5% in 1993. Out of all hydro-meteorological disasters, river bank erosion (RBE), followed by flood, drives most people out of their abode. However, unlike RBE migrants, migrants affected by flood usually return to their origin after certain period. In-depth interviews on the disaster migrants reveal that RBE claims total loss of homestead land & agricultural land while flood causes 20% and 23% loss respectively. Agricultural income decreases 96% because of RBE whereas flood victims encounter 98% decrease. People also incur 79% & 69% loss in livestock owing to RBE and flood severally. These disasters cause more than eighty percent reduction in total monthly income. Albeit RBE appears more vigorous but total economic loss is greater in flood- on average each household experiences a loss of BDT 350,555 due to flood and BDT 300,000 on account of RBE. Receiving no substantial support from community or government the affected people are compelled to migrate.

  17. Real-time Forensic Disaster Analysis

    NASA Astrophysics Data System (ADS)

    Wenzel, F.; Daniell, J.; Khazai, B.; Mühr, B.; Kunz-Plapp, T.; Markus, M.; Vervaeck, A.

    2012-04-01

    The Center for Disaster Management and Risk Reduction Technology (CEDIM, www.cedim.de) - an interdisciplinary research center founded by the German Research Centre for Geoscience (GFZ) and Karlsruhe Institute of Technology (KIT) - has embarked on a new style of disaster research known as Forensic Disaster Analysis. The notion has been coined by the Integrated Research on Disaster Risk initiative (IRDR, www.irdrinternational.org) launched by ICSU in 2010. It has been defined as an approach to studying natural disasters that aims at uncovering the root causes of disasters through in-depth investigations that go beyond the reconnaissance reports and case studies typically conducted after disasters. In adopting this comprehensive understanding of disasters CEDIM adds a real-time component to the assessment and evaluation process. By comprehensive we mean that most if not all relevant aspects of disasters are considered and jointly analysed. This includes the impact (human, economy, and infrastructure), comparisons with recent historic events, social vulnerability, reconstruction and long-term impacts on livelihood issues. The forensic disaster analysis research mode is thus best characterized as "event-based research" through systematic investigation of critical issues arising after a disaster across various inter-related areas. The forensic approach requires (a) availability of global data bases regarding previous earthquake losses, socio-economic parameters, building stock information, etc.; (b) leveraging platforms such as the EERI clearing house, relief-web, and the many sources of local and international sources where information is organized; and (c) rapid access to critical information (e.g., crowd sourcing techniques) to improve our understanding of the complex dynamics of disasters. The main scientific questions being addressed are: What are critical factors that control loss of life, of infrastructure, and for economy? What are the critical interactions

  18. The Central American Network for Disaster and Health Information

    PubMed Central

    Arnesen, Stacey J.; Cid, Victor H.; Scott, John C.; Perez, Ricardo; Zervaas, Dave

    2007-01-01

    Purpose: This paper describes an international outreach program to support rebuilding Central America's health information infrastructure after several natural disasters in the region, including Hurricane Mitch in 1998 and two major earthquakes in 2001. Setting, Participants, and Description: The National Library of Medicine joined forces with the Pan American Health Organization/World Health Organization, the United Nations International Strategy for Disaster Reduction, and the Regional Center of Disaster Information for Latin America and the Caribbean (CRID) to strengthen libraries and information centers in Central America and improve the availability of and access to health and disaster information in the region by developing the Central American Network for Disaster and Health Information (CANDHI). Through CRID, the program created ten disaster health information centers in medical libraries and disaster-related organizations in six countries. Results/Outcome: This project served as a catalyst for the modernization of several medical libraries in Central America. The resulting CANDHI provides much needed electronic access to public health “gray literature” on disasters, as well as access to numerous health information resources. CANDHI members assist their institutions and countries in a variety of disaster preparedness activities through collecting and disseminating information. PMID:17641767

  19. Return of ambiguity attacks

    NASA Astrophysics Data System (ADS)

    Craver, Scott A.

    2002-04-01

    The ambiguity attack, or invertibility attack, was described several years ago as a potential threat to digital watermarking systems. By manipulating the invertibility of watermark embedding, one could negate or subvert the meaning of a copyright mark. These attacks were easily prevented, however, with the appropriate application of one-way functions and cryptographic hashes in watermarking protocols. New research in watermarking, however, has caused the ambiguity attack to resurface as a threat, and this time it will not be as easy averted. Recent work in public-key watermarking create scenarios in which one-way functions may be ineffective against this threat. Furthermore, there are also positive uses for ambiguity attacks, as components in watermarking protocols. This paper provides an overview of the past and possible future of these unusual attacks.

  20. Getting HBCUs in the Disaster-Response Loop

    ERIC Educational Resources Information Center

    Colston, Ladd G.

    2005-01-01

    Natural and man-made disasters represent an ominous threat to the research, instructional and public service missions of colleges and universities. From the bombings in Oklahoma City to the terrorist attacks of Sept. 11 to last year's Hurricane Frances, the potential damage to campus buildings, human life and irreplaceable archival resources is a…

  1. Getting HBCUs in the Disaster-Response Loop

    ERIC Educational Resources Information Center

    Colston, Ladd G.

    2005-01-01

    Natural and man-made disasters represent an ominous threat to the research, instructional and public service missions of colleges and universities. From the bombings in Oklahoma City to the terrorist attacks of Sept. 11 to last year's Hurricane Frances, the potential damage to campus buildings, human life and irreplaceable archival resources is a…

  2. Practitioner Perspectives on a Disaster Management Architecture

    NASA Astrophysics Data System (ADS)

    Moe, K.; Evans, J. D.

    2012-12-01

    The Committee on Earth Observing Satellites (CEOS) Working Group on Information Systems and Services (WGISS) is constructing a high-level reference model for the use of satellites, sensors, models, and associated data products from many different global data and service providers in disaster response and risk assessment. To help streamline broad, effective access to satellite information, the reference model provides structured, shared, holistic views of distributed systems and services - in effect, a common vocabulary describing the system-of-systems building blocks and how they are composed for disaster management. These views are being inferred from real-world experience, by documenting and analyzing how practitioners have gone about using or providing satellite data to manage real disaster events or to assess or mitigate hazard risks. Crucial findings and insights come from case studies of three kinds of experience: - Disaster response and recovery (such as the 2008 Sichuan/Wenchuan earthquake in China; and the 2011 Tohoku earthquake and tsunami in Japan); - Technology pilot projects (such as NASA's Flood Sensor Web pilot in Namibia, or the interagency Virtual Mission Operation Center); - Information brokers (such as the International Charter: Space and Major Disasters, or the U.K.-based Disaster Management Constellation). Each of these experiences sheds light on the scope and stakeholders of disaster management; the information requirements for various disaster types and phases; and the services needed for effective access to information by a variety of users. They also highlight needs and gaps in the supply of satellite information for disaster management. One need stands out: rapid and effective access to complex data from multiple sources, across inter-organizational boundaries. This is the near-real-time challenge writ large: gaining access to satellite data resources from multiple organizationally distant and geographically disperse sources, to meet an

  3. Attack-Related Life Disruption and Child Psychopathology in New York City Public Schoolchildren 6-Months Post-9/11

    ERIC Educational Resources Information Center

    Comer, Jonathan S.; Fan, Bin; Duarte, Cristiane S.; Wu, Ping; Musa, George J.; Mandell, Donald J.; Albano, Anne Marie; Hoven, Christina W.

    2010-01-01

    In the aftermath of disasters, understanding relationships between disaster-related life disruption and children's functioning is key to informing future postdisaster intervention efforts. The present study examined attack-related life disruptions and psychopathology in a representative sample (N = 8,236) of New York City public schoolchildren…

  4. Attack-Related Life Disruption and Child Psychopathology in New York City Public Schoolchildren 6-Months Post-9/11

    ERIC Educational Resources Information Center

    Comer, Jonathan S.; Fan, Bin; Duarte, Cristiane S.; Wu, Ping; Musa, George J.; Mandell, Donald J.; Albano, Anne Marie; Hoven, Christina W.

    2010-01-01

    In the aftermath of disasters, understanding relationships between disaster-related life disruption and children's functioning is key to informing future postdisaster intervention efforts. The present study examined attack-related life disruptions and psychopathology in a representative sample (N = 8,236) of New York City public schoolchildren…

  5. Traumatic tiger attack.

    PubMed

    Chum, Marvin; Ng, Wai Pui

    2011-11-01

    Attacks on humans by large cats are uncommon occurrences and thus the principles of managing such injuries are not well documented. The authors here report the case of an 11-year-old boy who was mauled by a privately owned tiger. The attack resulted in multiple cranial lacerations and fractures, dissection of the internal carotid artery, and persistent neurological deficits. This case outlines the multiple sources of injury and pathology that can result from such an attack. Discussion is focused on the pattern of injury seen in large feline attacks and the treatment approach.

  6. Depression After Heart Attack

    MedlinePlus

    ... ATVB) Circulation → Circ: Arrhythmia and Electrophysiology → Circ: Cardiovascular Genetics → Circ: Cardiovascular ... Patient Page Depression After Heart Attack Why Should I Be Concerned ...

  7. PTSD, depression, prescription drug use, and health care utilization of Chinese workers affected by the WTC attacks.

    PubMed

    de Bocanegra, Heike Thiel; Moskalenko, Sophia; Kramer, Elizabeth J

    2006-07-01

    This study assessed the impact of the World Trade Center (WTC) attacks on emotional problems, prescription drug usage, and utilization of medical and mental health services within the Chinese community in lower Manhattan. We administered a survey to 148 randomly selected Chinese workers affected by the WTC attacks in March 2003. Although nearly half of the respondents had elevated PTSD and/or elevated depression scores, only a few (4.4%) had talked to a counselor. However, nearly all (86%) reported having visited a physician at least once since September 11, 2001. Individuals with elevated PTSD scores were significantly more likely to have gone to a physician after 9/11. They were also more likely to have received prescription drugs and to indicate an interest in counseling after 9/11 than individuals with low PTSD scores. The findings highlight the role of the primary care physician as gatekeeper for mental health symptoms after a disaster. They further suggest that primary care physicians should use screening tools for depression and posttraumatic stress after a major disaster and that they should be sensitive to potential emotional problems that are associated with somatic complaints.

  8. Preparing for Emergencies and Disasters. SPEC Kit 69.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Management Studies.

    Findings from a March 1980 Systems and Procedures Exchange Center (SPEC) survey on preservation indicated that more than one-fourth of the members of the Association of Research Libraries (ARL) had written disaster plans, and many other plans were in preparation. This SPEC kit on preparing for emergencies and disasters comprises excerpts from…

  9. 76 FR 35936 - South Dakota Disaster Number SD-00041

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ...: 2011-15124] U.S. SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12590 and 12591] South Dakota Disaster Number SD-00041 AGENCY: U.S. Small Business Administration. ACTION: Amendment 3. SUMMARY: This is... applications to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road...

  10. 76 FR 35937 - Arkansas Disaster Number AR-00048

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ...: 2011-15135] U.S. SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12560 and 12561] Arkansas Disaster Number AR-00048 AGENCY: U.S. Small Business Administration. ACTION: Amendment 6. SUMMARY: This is an...: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road, Fort...

  11. 76 FR 35935 - South Dakota Disaster Number SD-00041

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ... Doc No: 2011-15140] U.S. SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12590 and 12591] South Dakota Disaster Number SD-00041 AGENCY: U.S. Small Business Administration. ACTION: Amendment 2. SUMMARY... completed loan applications to: U.S. Small Business Administration, Processing and Disbursement Center...

  12. 76 FR 35937 - Kentucky Disaster Number KY-00040

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ... Doc No: 2011-15136] U.S. SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12599 and 12600] Kentucky Disaster Number KY-00040 AGENCY: U.S. Small Business Administration. ACTION: Amendment 3. SUMMARY: This is... applications to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road...

  13. Preparing for Emergencies and Disasters. SPEC Kit 69.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Management Studies.

    Findings from a March 1980 Systems and Procedures Exchange Center (SPEC) survey on preservation indicated that more than one-fourth of the members of the Association of Research Libraries (ARL) had written disaster plans, and many other plans were in preparation. This SPEC kit on preparing for emergencies and disasters comprises excerpts from…

  14. Chemical warfare: disaster preparation in an Israeli hospital.

    PubMed

    Rosenbaum, C

    1993-01-01

    The situation in the Middle East makes it imperative that Israeli hospitals be prepared for disaster, particularly that associated with chemical warfare. To prepare for the impact of chemical warfare, Israeli hospitals have designed mass trauma programs, which include staff training and simulated disaster drill exercises. These have been incorporated in the conventional disaster program since 1989. This article provides a brief overview of the trauma program at Beilinson Medical Center in Petach Tikva, Israel, including definition of four stages of injury, guidelines for intervention, and a discussion of the role of the social worker in the disaster plan.

  15. History of Disaster Medicine.

    PubMed

    Suner, Selim

    2015-10-01

    Erik Noji, mentioned, tongue in cheek, Noah as the first disaster manager during a lecture in 2005. The canonical description of "The Genesis Flood" does describe Noah as a master planner and executer of an evacuation of biblical proportions. After gaining knowledge of a potential catastrophic disaster he planned and executed an evacuation to mitigate the effects of the "Genesis Flood" by building the Ark and organizing a mass exodus. He had to plan for food, water, shelter, medical care, waste disposal and other needs of all the evacuees. Throughout history, management of large disasters was conducted by the military. Indeed, the military still plays a large role in disaster response in many countries, particularly if the response is overseas and prolonged. The histories of emergency preparedness, disaster management and disaster medicine have coevolved and are inextricably intertwined. While disaster management in one form or another existed as long as people started living together in communities, the development of disaster medicine took off with the emergence of modern medicine. Similar to disaster management, disaster medicine also has roots in military organizations.

  16. 75 FR 876 - Notice of Meeting; National Commission on Children and Disasters

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-06

    ... Children and Disasters AGENCY: Administration for Children and Families, Department of Health and Human... resource center on children and disasters; and (3) Plans for future work of the Commission. Written... (202) 401--9306. SUPPLEMENTARY INFORMATION: The National Commission on Children and Disasters is an...

  17. Development of a community pharmacy disaster preparedness manual.

    PubMed

    Noe, Brooke; Smith, April

    2013-01-01

    To share an independent pharmacy's experience creating a practical manual for disaster preparedness that incorporates applicable pharmacy regulations, provides a plan to prepare a community pharmacy for disasters, and addresses the pharmacy's duty to the community during disasters. A literature search was performed to determine if such a manual or a guide had been published previously. The search returned examples of expectations of hospitals during disasters, but few results were specific to community pharmacy. An Internet search for pharmacy contingency planning returned only a few checklists and descriptive reports of pharmacist involvement in past disasters. Public resources available from the Centers for Disease Control and Prevention, Environmental Protection Agency, Drug Enforcement Administration, Department of Public Health, Federal Emergency Management Agency, National Community Pharmacists Association, and American Pharmacists Association were explored. The Iowa State Board of Pharmacy also was contacted. Information was compiled to create a useful guide that addressed disaster planning, risk assessment, and public need during a disaster and that prioritized the needs of the pharmacy and community. Every community pharmacy should have a detailed disaster preparedness manual that is readily accessible and easy to follow. The manual created for Valley Drug focused on continuing pharmacy operations while minimizing disruptions in patient care during a disaster. Our manual included only necessary information required to prepare for, operate during, or recover from a disaster.

  18. 13 CFR 123.604 - How can my business spend my economic injury disaster loan under this subpart?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... September 11, 2001 Terrorist Attacks § 123.604 How can my business spend my economic injury disaster loan... concern until resumption of normal operations and for expenditures necessary to alleviate the...

  19. Hurricane Katrina disaster diplomacy.

    PubMed

    Kelman, Ilan

    2007-09-01

    Hurricane Katrina struck the United States at the end of August 2005. The consequent devastation appeared to be beyond the US government's ability to cope with and aid was offered by several states in varying degrees of conflict with the US. Hurricane Katrina therefore became a potential case study for 'disaster diplomacy', which examines how disaster-related activities do and do not yield diplomatic gains. A review of past disaster diplomacy work is provided. The literature's case studies are then categorised using a new typology: propinquity, aid relationship, level and purpose. Hurricane Katrina and its aftermath are then placed in the context of the US government's foreign policy, the international response to the disaster and the US government's reaction to these responses. The evidence presented is used to discuss the potential implications of Hurricane Katrina disaster diplomacy, indicating that factors other than disaster-related activities generally dominate diplomatic relations and foreign policy.

  20. International disaster research

    NASA Technical Reports Server (NTRS)

    Silverstein, Martin Elliot

    1991-01-01

    No existing telecommunications system can be expected to provide strategy and tactics appropriate to the complex, many faceted problem of disaster. Despite the exciting capabilities of space, communications, remote sensing, and the miracles of modern medicine, complete turnkey transfers to the disaster problem do not make the fit, and cannot be expected to do so. In 1980, a Presidential team assigned the mission of exploring disaster response within the U.S. Federal Government encountered an unanticipated obstacle: disaster was essentially undefined. In the absence of a scientifically based paradigm of disaster, there can be no measure of cost effectiveness, optimum design of manpower structure, or precise application of any technology. These problems spawned a 10-year, multidisciplinary study designed to define the origins, anatomy, and necessary management techniques for catastrophes. The design of the study necessarily reflects interests and expertise in disaster medicine, emergency medicine, telecommunications, computer communications, and forencsic sciences. This study is described.

  1. Trauma system: the backbone of disaster preparedness.

    PubMed

    Cryer, H Gill; Hiatt, Jonathan R

    2009-08-01

    To describe the Los Angeles County trauma system response to disasters. Review of trauma system structure and multicasualty events. The Los Angeles County trauma system is made up of 13 level I and II trauma centers with defined catchment areas that serve 10 million people in 88 cites over 4,000 square miles and receive more than 20,000 trauma activations annually. There is an organized disaster plan, which is orchestrated through the Medical Alert Center that coordinates the distribution of casualties from the scene of a multicasualty event, with the most critically injured patients going to level I centers by air, severe injuries to level I and II centers by ground and air and less severe injuries to local community hospitals by ground. The plan has been used in several multicasualty events over the last 25 years, the most recent of which occurred 6 hours after this paper was presented. The system allows for all critically injured patients to be distributed to several trauma centers, so that all can be cared for in a timely fashion without overwhelming any one trauma center and without critically injured patients being taken to nontrauma centers where they cannot receive optimal care. The answer to disaster preparedness in our country is to develop this kind of trauma system in every state. Doing so will improve access of our population to excellent care on a daily basis and will provide a network of trauma centers that can be mobilized to most effectively care for victims of multicasualty events.

  2. Mental health aspects of disasters.

    PubMed

    Oldham, Robert L

    2013-01-01

    Disaster preparations and responses are incomplete without addressing the mental health aspects of disasters. Unpleasant mental states can be a natural and even adaptive human response following a disaster; however, disasters also can contribute to the development of mental illnesses and substance use disorders or exacerbate existing disorders for disaster survivors, response personnel, and even families and close contacts of survivors and responders. Disaster-related psychopathology can mimic or negatively affect other disaster-related illnesses and can impair health professionals and others who must respond to catastrophic events; however, disasters also can encourage tremendous human coping, perseverance, and resilience and can even enhance personal and collective feelings of purpose, connection, and meaning. Integrating mental health promotion and care into disaster planning and response has the potential to mitigate psychiatric and medical consequences of a disaster and may preserve the mission readiness of disaster response personnel and promote healing among communities traumatized by disaster.

  3. Disaster Olympics: A Model for Resident Education.

    PubMed

    Daniel, P; Gist, R; Grock, A; Kohlhoff, S; Roblin, P; Arquilla, B

    2016-06-01

    The aim of this study was to describe an educational method teaching Disaster Medicine to American Emergency Medicine (EM) physicians and to evaluate knowledge attainment using this method. This was an observational study using a pre-test and a post-test. A full-scale disaster exercise (FSE) was conducted at a large academic center with two hospitals in Brooklyn, New York (USA). Eighty-two EM residents (physicians in training, post medical school) participated in the study. Inclusion criteria for study participation was all EM residents training at the State University of New York (SUNY) Downstate at the time of the study. There were no exclusion criteria. The exercise was a disaster drill designed as "Olympic Games." Participants in the exercise took a pre-test and a post-test. The primary outcome of the study was the mean difference between pre-test and post-test scores of the study participants using independent sample t-tests. Secondary outcomes of the study were percent of critical actions met by the residents and the hospitals as measured by direct observation of trained study personnel during the exercise. Mean resident post-test scores were higher than pre-test scores to a degree that was statistically significant (62% versus 53%; P =.002). The residents' performances ranged from 48% to 63% of objectives met. The hospitals' performances met 50% to 100% of their objectives. The use of an Olympic Games format was an effective model for disaster education for physicians. The model allowed for evaluation of performance and protocols of participants and hospital systems, respectively, and may be used objectively to evaluate for areas of improvement. The Disaster Olympics drill was found to improve emergency preparedness knowledge in the population studied and may constitute a novel and efficacious methodology in disaster training. Daniel P , Gist R , Grock A , Kohlhoff S , Roblin P , Arquilla B . Disaster Olympics: a model for resident education. Prehosp

  4. 78 FR 7848 - Connecticut Disaster Number CT-00028

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Connecticut Disaster Number CT-00028 AGENCY: U.S. Small Business Administration. ACTION: Amendment...: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road,...

  5. Predictors of responses to psychotherapy referral of WTC utility disaster workers.

    PubMed

    Jayasinghe, Nimali; Giosan, Cezar; Difede, Joann; Spielman, Lisa; Robin, Lisa

    2006-04-01

    This study examined male utility disaster workers' responses to referral for trauma-specific psychotherapy. Among 328 workers offered referral for symptoms related to the World Trade Center (WTC) attacks during psychological screening, approximately 48% chose to accept, 28% chose to consider only, and 24% chose to decline. Analyses examined predisposing factors, i.e., age, race/ethnicity, marital status, education, previous mental health treatment, and previous disorder; as well as illness level; i.e., posttraumatic stress disorder (PTSD), depression, and general psychiatric distress; current treatment; and time of referral as predictors of referral response. PTSD (specifically reexperiencing and hyperarousal symptoms), depressive symptoms, and previous mental health treatment were positively associated with workers' accepting referral. Implications and limitations of these findings are discussed.

  6. Posttraumatic stress disorder in disaster relief workers following direct and indirect trauma exposure to Ground Zero.

    PubMed

    Zimering, Rose; Gulliver, Suzy B; Knight, Jeffrey; Munroe, James; Keane, Terence M

    2006-08-01

    The present study compared rates of posttraumatic stress disorder (PTSD) in relief workers at the World Trade Center collapse from two sources: direct exposure to the disaster site and indirect exposure through survivor narratives. Standardized clinical interviews for PTSD were conducted with 109 relief workers 6-8 months after the September 11th terrorist attacks. Rates of acute PTSD from direct and indirect exposure to traumatic stressors were 6.4% and 4.6%, respectively. The findings suggest that indirect exposures can lead to PTSD even when Criterion A1 of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (DSM-IV-TR; American Psychiatric Association, 2000, p. 463), i.e., "experienced by a family member or other close associate" is not met. Further research is necessary to define precisely the parameters of indirect traumatic exposure that may be linked to the development of PTSD.

  7. Report from Ground Zero: How geoscientists aid in the aftermath of environmental disasters

    USGS Publications Warehouse

    Plumlee, Geoffrey S.

    2009-01-01

    People around the world remember when they first learned of the attacks on New York City’s World Trade Center towers on Sept. 11, 2001. For me, the memories are vivid — my feelings of shock, horror and sadness were similarly etched on the faces of all the attendees of a mining and the environment workshop in Buenos Aires, Argentina, where I was speaking. At that time, I had no idea that our small research group at the U.S. Geological Survey in Denver, Colo., would soon be called upon to help public officials understand the potential health and environmental implications of the disaster and the ensuing rescue, recovery and cleanup efforts.

  8. Disaster Management and the Role of Oral Maxillofacial Surgeons

    PubMed Central

    Tiwari, Rahul Vinaychandra; Pandi, Srinivas Chakravarthi; Meka, Sridhar; Lingamaneni, Krishna Prasad

    2015-01-01

    “Disaster” the word itself suggests an event resulting in great loss and misfortune. In this developing world, India is becoming more powerful and is shining across the world. But we are still left to deal with various disasters, so that no harm comes to mankind. India has the occasional national disaster to which we have to promptly respond. Like the rest of the world, India has become a terror prone nation and recent attacks since the last decades affected not only the function but also it made citizens insecure. As we are in a large nation so, no matter how large a disaster it may be; we have to overcome it. The oral and maxillofacial region in a human body is very delicate with complicated anatomy, which decides the life of a human being. The management of disaster is a multitask approach, in which maxillofacial surgeon plays an important role. It is a very difficult task to operate in disaster zone. It is essential for a surgeon to make quick and important decisions under stressful conditions. Usually the surgeries are performed in a well-equipped hospital but, when it comes to disaster zone the surgeon have to treat the patient with a minimal armamentarium available within a fraction of time. The surgical competence in a disaster field is an alarming situation. Disaster management itself is not an alarming situation but the time management is important for better outcomes. A surgeon however should be trained, so that he should not miss injuries for better outcomes along with personal safety. The article discusses about disaster management strategy and guidelines for both oral maxillofacial surgeons and the statuary body to make maxillofacial surgeon as part of disaster management team for better outcomes. PMID:26816920

  9. Can You Recognize a Heart Attack? Quiz

    MedlinePlus

    ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure ... a Heart Attack • Treatment of a Heart Attack • Life After a Heart Attack Lifestyle Changes Recovery FAQs • Heart ...

  10. Three decades of disasters: a review of disaster-specific literature from 1977-2009.

    PubMed

    Smith, Erin; Wasiak, Jason; Sen, Ayan; Archer, Frank; Burkle, Frederick M

    2009-01-01

    The potential for disasters exists in all communities. To mitigate the potential catastrophes that confront humanity in the new millennium, an evidence-based approach to disaster management is required urgently. This study moves toward such an evidence-based approach by identifying peer-reviewed publications following a range of disasters and events over the past three decades. Peer-reviewed, event-specific literature was identified using a comprehensive search of the electronically indexed database, MEDLINE (1956-January 2009). An extended comprehensive search was conducted for one event to compare the event-specific literature indexed in MEDLINE to other electronic databases (EMBASE, CINAHL, AMED, CENTRAL, Psych Info, Maternity and Infant Care, EBM Reviews). Following 25 individual disasters or overwhelming crises, a total of 2,098 peer-reviewed, event-specific publications were published in 789 journals (652 publications following disasters/events caused by natural hazards, 966 following human-made/technological disasters/events, and 480 following conflict/complex humanitarian events).The event with the greatest number of peer-reviewed, event-specific publications was the 11 September 2001 terrorist attacks (686 publications). Prehospital and Disaster Medicine published the greatest number of peer-reviewed, event-specific publications (54), followed by Journal of Traumatic Stress (42), Military Medicine (40), and Psychiatric Services (40). The primary topics of event-specific publications were mental health, medical health, and response. When an extended, comprehensive search was conducted for one event, 75% of all peer-reviewed, event-specific publications were indexed in MEDLINE. A broad range of multi-disciplinary journals publish peer reviewed, event-specific publications. While the majority of peer-reviewed, event-specific literature is indexed in MEDLINE, comprehensive search strategies should include EMBASE to increase yield.

  11. Disaster Preparedness among Health Professionals and Support Staff: What is Effective? An Integrative Literature Review.

    PubMed

    Gowing, Jeremy R; Walker, Kim N; Elmer, Shandell L; Cummings, Elizabeth A

    2017-03-16

    Introduction It is important that health professionals and support staff are prepared for disasters to safeguard themselves and the community during disasters. There has been a significantly heightened focus on disasters since the terrorist attacks of September 11, 2001 in New York (USA); however, despite this, it is evident that health professionals and support staff may not be adequately prepared for disasters. Report An integrative literature review was performed based on a keyword search of the major health databases for primary research evaluating preparedness of health professionals and support staff. The literature was quality appraised using a mixed-methods appraisal tool (MMAT), and a thematic analysis was completed to identify current knowledge and gaps. Discussion The main themes identified were: health professionals and support staff may not be fully prepared for disasters; the most effective content and methods for disaster preparedness is unknown; and the willingness of health professionals and support staff to attend work and perform during disasters needs further evaluation. Gaps were identified to guide further research and the creation of new knowledge to best prepare for disasters. These included the need for: high-quality research to evaluate the best content and methods of disaster preparedness; inclusion of the multi-disciplinary health care team as participants; preparation for internal disasters; the development of validated competencies for preparedness; validated tools for measurement; and the importance of performance in actual disasters to evaluate preparation.

  12. Steps toward a national disaster plan for obstetrics.

    PubMed

    Daniels, Kay; Oakeson, Ann Marie; Hilton, Gillian

    2014-07-01

    Hospitals play a central role in disasters by receiving an influx of casualties and coordinating medical efforts to manage resources. However, plans have not been fully developed in the event the hospital itself is severely damaged, either from natural disasters like earthquakes or tornados or manmade events such as a massive electrical failure or terrorist attacks. Of particular concern is the limited awareness of the obstetric units' specialized needs in the world of disaster planning. Within the same footprint of any obstetric unit, there exists a large variety of patient acuity and needs including laboring women, postoperative patients, and healthy postpartum patients with their newborns. An obstetric-specific triage method is paramount to accurately assess and rapidly triage patients during a disaster. An example is presented here called OB TRAIN (Obstetric Triage by Resource Allocation for Inpatient). To accomplish a comprehensive obstetric disaster plan, there must be 1) national adoption of a common triage and evacuation language including an effective patient tracking system to avoid maternal-neonatal separation; 2) a stratification of maternity hospital levels of care; and 3) a collaborative network of obstetric hospitals, both regionally and nationally. However, obstetric disaster planning goes beyond evacuation and must include plans for shelter-in-place and surge capacity, all uniquely designed for the obstetric patient. Disasters, manmade or natural, are neither predictable nor preventable, but we can and should prepare for them.

  13. Stroke following rottweiler attack.

    PubMed

    Miller, S J; Copass, M; Johansen, K; Winn, H R

    1993-02-01

    A previously healthy 50-year-old man suffered a major right cerebral infarction shortly after receiving head and neck bites in an attack by two rottweilers. Arteriography revealed occlusion of the right middle cerebral artery, an intimal flap and pseudoaneurysm in the high right internal carotid artery just proximal to the skull base, and an obstructed right vertebral artery. The powerful jaw mechanism of rottweilers and other large mastiff-type dogs makes their bites particularly destructive. The predilection of these animals for attacking the head and upper body makes occult crush injury to the extracranial cerebral vessels an important diagnostic consideration following such attacks.

  14. [Atypical panic attacks].

    PubMed

    Boulenger, Jean-Philippe

    2009-04-20

    Panic attacks are acute episodes of severe anxiety characterized by a brutal onset and a progressive ending. When atypical, this symptomatic picture is often the cause of diagnostic errors sometimes costly in terms of clinical work-up and repeated specialized advices. Each of the classical components of panic attacks (psychological, physical, behavioural) being able to give rise to an atypical presentation, these components must be systematically evaluated. The semiological analysis of these attacks, their clinical background and their occurrence in young adults, mostly women, will contribute to the right diagnosis of these emotional reactions so frequent in general practice.

  15. Supply Chain Attack Framework and Attack Patterns

    DTIC Science & Technology

    2013-12-01

    Malware is embedded in a replacement server motherboard (e.g., in the flash memory) in order to alter server functionality from that intended. Attack...Slashdot: Dell Ships Infected Motherboards July 21, 2010(c/o Rick Dove) Threat: An adversary with access to hardware procurement, maintenance, or upgrade...control can embed malware in a critical component server motherboard . Vulnerabilities: The control processes and mechanisms for hardware

  16. Predictors of survival and favorable functional outcomes after an out-of-hospital cardiac arrest in patients systematically brought to a dedicated heart attack center (from the Harefield Cardiac Arrest Study).

    PubMed

    Iqbal, M Bilal; Al-Hussaini, Abtehale; Rosser, Gareth; Salehi, Saleem; Phylactou, Maria; Rajakulasingham, Ramyah; Patel, Jayna; Elliott, Katharine; Mohan, Poornima; Green, Rebecca; Whitbread, Mark; Smith, Robert; Ilsley, Charles

    2015-03-15

    Despite advances in cardiopulmonary resuscitation (CPR), survival remains low after out-of-hospital cardiac arrest (OOHCA). Acute coronary ischemia is the predominating precipitant, and prompt delivery of patients to dedicated facilities may improve outcomes. Since 2011, all patients experiencing OOHCA in London, where a cardiac etiology is suspected, are systematically brought to heart attack centers (HACs). We determined the predictors for survival and favorable functional outcomes in this setting. We analyzed 174 consecutive patients experiencing OOHCA from 2011 to 2013 brought to Harefield Hospital-a designated HAC in London. We analyzed (1) all-cause mortality and (2) functional status using a modified Rankin scale (mRS 0 to 6, where mRS0-3(+) = favorable functional status). The overall survival rates were 66.7% (30 days) and 62.1% (1 year); and 54.5% had mRS0-3(+) at discharge. Patients with mRS0-3(+) had reduced mortality compared to mRS0-3(-): 30 days (1.2% vs 72.2%, p <0.001) and 1 year (5.3% vs 77.2%, p <0.001). Multivariate analyses identified lower patient comorbidity, absence of cardiogenic shock, bystander CPR, ventricular tachycardia/ventricullar fibrillation as initial rhythm, shorter duration of resuscitation, prehospital advanced airway, absence of adrenaline and inotrope use, and intra-aortic balloon pump use as predictors of mRS0-3(+). Consistent predictors of increased mortality were the presence of cardiogenic shock, advanced airway use, increased duration of resuscitation, and absence of therapeutic hypothermia. A streamlined delivery of patients experiencing OOHCA to dedicated facilities is associated with improved functional status and survival. Our study supports the standardization of care for such patients with the widespread adoption of HACs. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Handheld Computer Application for Medical Disaster Management

    PubMed Central

    Grasso, Michael A.

    2006-01-01

    We developed a prototype system that can provide reliable communications in the event of a medical disaster. The system uses redundant wireless protocols on handheld computers to deploy medical personnel, and to facilitate communication between ancillary treatment sites and a command center. PMID:17238551

  18. Agriculture: Natural Events and Disasters

    EPA Pesticide Factsheets

    Natural Events and DiasastersInformation on Natural Events and Disasters. Every year natural disasters, such as hurricanes, floods, fires, earthquakes, and tornadoes, challenge agricultural production.

  19. Signs of a Heart Attack

    MedlinePlus

    ... attack Heart Health and Stroke Signs of a heart attack Related information Make the Call. Don't Miss ... to top More information on Signs of a heart attack Read more from womenshealth.gov Make the Call, ...

  20. When is a natural disaster a development disaster; when is a natural disaster not a disaster?

    NASA Astrophysics Data System (ADS)

    Mutter, J. C.; Archibong, B.; Pi, D.

    2009-12-01

    Extremes of nature like hurricanes, droughts and earthquakes influence human welfare in a variety of ways. While it might seem counterintuitive, evidence from long run macro-economic data suggests that when natural extremes are especially destructive to human societies, and earn the title “natural disaster” they can actually have a beneficial effect on development. The process involved may be akin to the “The gale of creative destruction” first described by the economist Joseph Schumpeter. Applied to disasters the notion is that, in the short term, disasters can stimulate certain industries such as construction with capital flows coming into the disaster region from outside sources such as central government or international aid that can stimulate the economy. Longer term, outdated and inefficient public and private infrastructure destroyed in the disaster can be replaced by up to date, efficient systems that permit the economy to function more effectively, so that post-disaster growth can exceed pre-disaster levels. Disasters are macro-economic shocks, fundamentally similar to the banking shock that lead to the current global recession and, in the same way require external capital stimuli to overcome and that stimulus can result in stronger economies after recovery. These large-scale and long-run trends disguise the fact that disasters have very different development outcomes for different societies. Globally, there is evidence that poorer countries are not systematically stimulated by disaster shocks and may even be driven into poverty traps by certain disasters. Locally, the recovery from Hurricane Katrina in New Orleans has had been very different for different social groups, with both over-recovery and under-recovery occurring simultaneously and in close proximity. We discuss the conditions under which disasters might be a stimulating force and when they might lead to development setbacks.

  1. Confirmatory factor analysis of the PTSD Checklist and the Clinician-Administered PTSD Scale in disaster workers exposed to the World Trade Center Ground Zero.

    PubMed

    Palmieri, Patrick A; Weathers, Frank W; Difede, JoAnn; King, Dainel W

    2007-05-01

    Although posttraumatic stress disorder (PTSD) factor analytic research has yielded little support for the DSM-IV 3-factor model of reexperiencing, avoidance, and hyperarousal symptoms, no clear consensus regarding alternative models has emerged. One possible explanation is differential instrumentation across studies. In the present study, the authors used confirmatory factor analysis to compare a self-report measure, the PTSD Checklist (PCL), and a structured clinical interview, the Clinician-Administered PTSD Scale (CAPS), in 2,960 utility workers exposed to the World Trade Center Ground Zero site. Although two 4-factor models fit adequately for each measure, the latent structure of the PCL was slightly better represented by correlated reexperiencing, avoidance, dysphoria, and hyperarousal factors, whereas that of the CAPS was slightly better represented by correlated reexperiencing, avoidance, emotional numbing, and hyperarousal factors. After accounting for method variance, the model specifying dysphoria as a distinct factor achieved slightly better fit. Patterns of correlations with external variables provided additional support for the dysphoria model. Implications regarding the underlying structure of PTSD are discussed.

  2. Disaster Risk Management - The Kenyan Challenge

    NASA Astrophysics Data System (ADS)

    Nabutola, W.; Scheer, S.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  3. Disaster Risk Management - The Kenyan Challenges

    NASA Astrophysics Data System (ADS)

    Nabutola, W.

    2009-04-01

    Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

  4. New sensitivity analysis attack

    NASA Astrophysics Data System (ADS)

    El Choubassi, Maha; Moulin, Pierre

    2005-03-01

    The sensitivity analysis attacks by Kalker et al. constitute a known family of watermark removal attacks exploiting a vulnerability in some watermarking protocols: the attacker's unlimited access to the watermark detector. In this paper, a new attack on spread spectrum schemes is designed. We first examine one of Kalker's algorithms and prove its convergence using the law of large numbers, which gives more insight into the problem. Next, a new algorithm is presented and compared to existing ones. Various detection algorithms are considered including correlation detectors and normalized correlation detectors, as well as other, more complicated algorithms. Our algorithm is noniterative and requires at most n+1 operations, where n is the dimension of the signal. Moreover, the new approach directly estimates the watermark by exploiting the simple geometry of the detection boundary and the information leaked by the detector.

  5. A fatal leopard attack.

    PubMed

    Hejna, Petr

    2010-05-01

    A rare case of a big cat fatal attack is presented. A male leopard that had escaped from its unlocked cage attacked a 26-year-old male zoo worker. The man sustained penetrating injuries to the neck with consequent external bleeding. The man died while being transported to the hospital as a result of the injuries sustained. The wounds discovered on the victim's body corresponded with the known methods of leopard attacks and with findings on the carcasses of animals killed by leopards in the wild. The conclusion of the medicolegal investigation was that the underlying cause of death was a bite wound to the neck which lacerated the left internal jugular vein, the two main branches of the left external carotid artery, and the cervical spine. The cause of death was massive external bleeding. Special attention is paid to the general pattern of injuries sustained from big cat attacks.

  6. Transient Ischemic Attack

    MedlinePlus

    A transient ischemic attack (TIA) is a stroke lasts only a few minutes. It happens when the blood supply to part of the brain is briefly blocked. Symptoms of a TIA are like other stroke symptoms, but do not ...

  7. Transient Ischemic Attack

    MedlinePlus Videos and Cool Tools

    ... TIA Cardiac Catheter Cholesterol Heart Attack Stent © 2017, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. The content in this library is for educational purposes only, and therefore is ...

  8. Assessing truck driver exposure at the World Trade Center disaster site: personal and area monitoring for particulate matter and volatile organic compounds during October 2001 and April 2002.

    PubMed

    Geyh, Alison S; Chillrud, Steven; Williams, D'Ann L; Herbstman, Julie; Symons, J Morel; Rees, Katherine; Ross, James; Kim, Sung Roul; Lim, Ho-Jin; Turpin, Barbara; Breysse, Patrick

    2005-03-01

    The destruction of the World Trade Center (WTC) in New York City on September 11, 2001, created a 16-acre debris field composed of pulverized and burning material significantly impacting air quality. Site cleanup began almost immediately. Cleanup workers were potentially exposed to airborne contaminants, including particulate matter, volatile organic compounds, and asbestos, at elevated concentrations. This article presents the results of the exposure assessment of one important group of WTC workers, truck drivers, as well as area monitoring that was conducted directly on site during October 2001 and April 2002. In cooperation with a local labor union, 54 drivers (October) and 15 drivers (April) were recruited on site to wear two monitors during their 12-hour work shifts. In addition, drivers were administered a questionnaire asking for information ranging from "first day at the site" to respirator use. Area monitoring was conducted at four perimeter locations during October and three perimeter locations during April. During both months, monitoring was also conducted at one location in the middle of the rubble. Contaminants monitored for included total dust (TD), PM10, PM2.5, and volatile organic compounds. Particle samples were analyzed for mass, as well as elemental and organic carbon content. During October, the median personal exposure to TD was 346 microg/m3. The maximum area concentration, 1742 microg/m3, was found in middle of the debris. The maximum TD concentration found at the perimeter was 392 microg/m3 implying a strong concentration gradient from the middle of debris outward. PM2.5/PM10 ratios ranged from 23% to 100% suggesting significant fire activity during some of the sampled shifts. During April, the median personal exposure to TD was 144 microg/m3, and the highest area concentration, 195 microg/m3, was found at the perimeter. During both months, volatile organic compounds concentrations were low.

  9. Cooperating attackers in neural cryptography.

    PubMed

    Shacham, Lanir N; Klein, Einat; Mislovaty, Rachel; Kanter, Ido; Kinzel, Wolfgang

    2004-06-01

    A successful attack strategy in neural cryptography is presented. The neural cryptosystem, based on synchronization of neural networks by mutual learning, has been recently shown to be secure under different attack strategies. The success of the advanced attacker presented here, called the "majority-flipping attacker," does not decay with the parameters of the model. This attacker's outstanding success is due to its using a group of attackers which cooperate throughout the synchronization process, unlike any other attack strategy known. An analytical description of this attack is also presented, and fits the results of simulations.

  10. Localized attacks on spatially embedded networks with dependencies.

    PubMed

    Berezin, Yehiel; Bashan, Amir; Danziger, Michael M; Li, Daqing; Havlin, Shlomo

    2015-03-11

    Many real world complex systems such as critical infrastructure networks are embedded in space and their components may depend on one another to function. They are also susceptible to geographically localized damage caused by malicious attacks or natural disasters. Here, we study a general model of spatially embedded networks with dependencies under localized attacks. We develop a theoretical and numerical approach to describe and predict the effects of localized attacks on spatially embedded systems with dependencies. Surprisingly, we find that a localized attack can cause substantially more damage than an equivalent random attack. Furthermore, we find that for a broad range of parameters, systems which appear stable are in fact metastable. Though robust to random failures-even of finite fraction-if subjected to a localized attack larger than a critical size which is independent of the system size (i.e., a zero fraction), a cascading failure emerges which leads to complete system collapse. Our results demonstrate the potential high risk of localized attacks on spatially embedded network systems with dependencies and may be useful for designing more resilient systems.

  11. Localized attacks on spatially embedded networks with dependencies

    PubMed Central

    Berezin, Yehiel; Bashan, Amir; Danziger, Michael M.; Li, Daqing; Havlin, Shlomo

    2015-01-01

    Many real world complex systems such as critical infrastructure networks are embedded in space and their components may depend on one another to function. They are also susceptible to geographically localized damage caused by malicious attacks or natural disasters. Here, we study a general model of spatially embedded networks with dependencies under localized attacks. We develop a theoretical and numerical approach to describe and predict the effects of localized attacks on spatially embedded systems with dependencies. Surprisingly, we find that a localized attack can cause substantially more damage than an equivalent random attack. Furthermore, we find that for a broad range of parameters, systems which appear stable are in fact metastable. Though robust to random failures—even of finite fraction—if subjected to a localized attack larger than a critical size which is independent of the system size (i.e., a zero fraction), a cascading failure emerges which leads to complete system collapse. Our results demonstrate the potential high risk of localized attacks on spatially embedded network systems with dependencies and may be useful for designing more resilient systems. PMID:25757572

  12. Preventing sexual attacks in healthcare facilities: risk management considerations.

    PubMed

    Banja, John D

    2014-01-01

    Reports or allegations of sexual attacks in healthcare facilities are extremely upsetting and sometimes not given the attention they deserve. In June 2011, the United States Government Accountability Office (GAO) issued a remarkable report on sexual attacks occurring in Veterans Affairs (VA) health facilities that not only raised awareness of the magnitude of the problem but that detailed numerous system weaknesses in VA facilities that might have enabled such attacks. This article discusses some of the GAO's findings as well as other instances of sexual attacks, such as occurred in the criminal prosecution of Paul Serdula, a former health professional who might have sexually assaulted hundreds of women. Some of Serdula's victims have subsequently sued in civil court, charging Serdula's employers with lack of supervision and raising the possibility of serial sexual attacks such as his evolving into large-scale patient safety disasters. This article will review certain ethical and legal considerations bearing on the liability of healthcare facilities in which sexual attacks are alleged to have occurred. Following a discussion of how two courts have used the legal construct of "foreseeability" in determining a healthcare facility's liability when an employee is charged with sexual assault, the article will conclude with a host of patient safety recommendations aimed at discouraging or deterring the occurrence of sexual attacks. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

  13. Fatal big cat attacks.

    PubMed

    Cohle, S D; Harlan, C W; Harlan, G

    1990-09-01

    Two cases of fatal attacks by large cats are presented. In the first case, a 30-year-old female zoo worker was attacked by a jaguar that had escaped its cage. In the second case, a 2-year-old girl was fatally injured by her father's pet leopard. The pattern of injuries in these cases is nearly identical to those of these cats' prey in the wild.

  14. Large-Scale Disasters

    NASA Astrophysics Data System (ADS)

    Gad-El-Hak, Mohamed

    "Extreme" events - including climatic events, such as hurricanes, tornadoes, and drought - can cause massive disruption to society, including large death tolls and property damage in the billions of dollars. Events in recent years have shown the importance of being prepared and that countries need to work together to help alleviate the resulting pain and suffering. This volume presents a review of the broad research field of large-scale disasters. It establishes a common framework for predicting, controlling and managing both manmade and natural disasters. There is a particular focus on events caused by weather and climate change. Other topics include air pollution, tsunamis, disaster modeling, the use of remote sensing and the logistics of disaster management. It will appeal to scientists, engineers, first responders and health-care professionals, in addition to graduate students and researchers who have an interest in the prediction, prevention or mitigation of large-scale disasters.

  15. Epidemics after natural disasters.

    PubMed

    Watson, John T; Gayer, Michelle; Connolly, Maire A

    2007-01-01

    The relationship between natural disasters and communicable diseases is frequently misconstrued. The risk for outbreaks is often presumed to be very high in the chaos that follows natural disasters, a fear likely derived from a perceived association between dead bodies and epidemics. However, the risk factors for outbreaks after disasters are associated primarily with population displacement. The availability of safe water and sanitation facilities, the degree of crowding, the underlying health status of the population, and the availability of healthcare services all interact within the context of the local disease ecology to influence the risk for communicable diseases and death in the affected population. We outline the risk factors for outbreaks after a disaster, review the communicable diseases likely to be important, and establish priorities to address communicable diseases in disaster settings.

  16. Epidemics after Natural Disasters

    PubMed Central

    Gayer, Michelle; Connolly, Maire A.

    2007-01-01

    The relationship between natural disasters and communicable diseases is frequently misconstrued. The risk for outbreaks is often presumed to be very high in the chaos that follows natural disasters, a fear likely derived from a perceived association between dead bodies and epidemics. However, the risk factors for outbreaks after disasters are associated primarily with population displacement. The availability of safe water and sanitation facilities, the degree of crowding, the underlying health status of the population, and the availability of healthcare services all interact within the context of the local disease ecology to influence the risk for communicable diseases and death in the affected population. We outline the risk factors for outbreaks after a disaster, review the communicable diseases likely to be important, and establish priorities to address communicable diseases in disaster settings. PMID:17370508

  17. PM 2.5 exposure assessment of the population in Lower Manhattan area of New York City after the World Trade Center disaster

    NASA Astrophysics Data System (ADS)

    Ng, S. P.; Dimitroulopoulou, C.; Grossinho, A.; Chen, L. C.; Kendall, M.

    On 11 September 2001, the explosion and the collapse of the World Trade Center (WTC) Twin Towers in New York City (NYC), USA, generated a massive release of dust and inhalable toxic substances to the atmosphere as a result of the pulverization of various building materials, furniture, and computers. Many concerns were raised as Particulate Matter (PM) levels in Lower Manhattan might not meet the current National Ambient Air Quality Standards (NAAQS) (65 μg m -3). The current study aims to provide a first estimate of the scale of population exposures during this episode. Data collected from existing monitoring stations in September showed the occurrence of a series of high peaks of PM 2.5 registered in the Lower Manhattan area after the 11 September. An interpolation technique was used within a Geographical Information Systems (GIS) environment to estimate outdoor PM 2.5 concentrations over NYC. Monthly average of 24 h outdoor PM 2.5 concentration of Lower Manhattan was 20.2 μg m -3 and did not exceed the NAAQS value. PM 2.5 concentrations in indoor micro-environments were simulated by a deterministic micro-environmental model (INTAIR) and linear regression equations. Three typical population groups were identified for the NYC area—home-makers, office/shop-workers, and students/children—and their 12 h nighttime and daytime exposures were estimated from 14 September until the end of September, either as mean exposure (daytime and nighttime) or as exposure weighted by residential population distribution (nighttime only). Average nighttime and daytime exposures of the Lower Manhattan population were calculated to be 37.3 and 23.6 μg m -3, respectively (daily average: 30.45 μg m -3), in which the various group movements and activities, smoking habits of individuals, and special population movements due to access restrictions and risk avoidance behaviors were considered. Within the study period, assuming the real nighttime population distribution followed the

  18. Helping nursing homes prepare for disasters.

    PubMed

    Hyer, Kathryn; Brown, Lisa M; Polivka-West, LuMarie; Berman, Amy

    2010-10-01

    Responding to the deaths and suffering of older adults in long-term care facilities following Hurricanes Katrina, Rita, and Wilma, the John A. Hartford Foundation funded an initiative called Hurricane and Disaster Preparedness for Long-Term Care Facilities. Long-term care providers are now acknowledged as health care providers by most federal and state emergency response centers. This paper describes the planning, research, and dissemination efforts of the Hartford grantees. It also provides insights into successful disaster grant making, noting foundations' unique flexibility, strategic and long-term view, and ability to be a neutral convener of stakeholders that can help grantees work toward achieving major policy change.

  19. Pre-attack stress-load, appraisals, and coping in children’s responses to the 9/11 terrorist attacks

    PubMed Central

    Lengua, Liliana J.; Long, Anna C.; Meltzoff, Andrew N.

    2013-01-01

    Background Appraisal and coping following a disaster are important factors in children’s post-traumatic stress (PTS) symptoms. However, little is known about predictors of disaster coping responses. This study examined stress-load, appraisals and coping styles measured prior to the September 11 terrorist attacks as predictors of 9/11-specific appraisals, coping and PTS. Methods A community sample of children and parents (N = 143) participating in an ongoing study were interviewed by phone approximately 1 month following 9/11. Results Pre-attack stress-load, appraisal and coping styles predicted children’s 9/11-specific appraisals, coping, and PTS. 9/11-specific threat appraisals and avoidant coping predicted higher PTS and mediated the effects of pre-attack stress-load and threat appraisal. Conclusions Pre-disaster stress-load, appraisal and coping styles predict disaster-specific appraisal and coping, which in turn, contribute to PTS. Coping interventions might mitigate PTS symptoms following a disaster. PMID:17176377

  20. DISASTER MEDICAL CARE AND SHELTER-The Federal Program.

    PubMed

    Dearing, W P

    1960-08-01

    The role of the physician in event of natural disaster or overwhelming (perhaps nuclear) attack by an enemy is:To assist the layman in preparing to meet his own health needs in a disaster situation until organized health services can reach him. To prepare and plan for the provision of organized medical care when conditions permit. To extend his own capability to render medical care outside his normal specialty. To assist in the training of allied and professional health workers and laymen for specific mobilization assignments in health services.

  1. DISASTER MEDICAL CARE AND SHELTER—The Federal Program

    PubMed Central

    Dearing, W. Palmer

    1960-01-01

    The role of the physician in event of natural disaster or overwhelming (perhaps nuclear) attack by an enemy is: To assist the layman in preparing to meet his own health needs in a disaster situation until organized health services can reach him. To prepare and plan for the provision of organized medical care when conditions permit. To extend his own capability to render medical care outside his normal specialty. To assist in the training of allied and professional health workers and laymen for specific mobilization assignments in health services. PMID:18732323

  2. Disaster Management through Experiential Learning

    ERIC Educational Resources Information Center

    Rijumol, K. C.; Thangarajathi, S.; Ananthasayanam, R.

    2010-01-01

    Disasters can strike at any time, at any place. The world is becoming increasingly vulnerable to natural disasters. From earthquakes to floods and famines, mankind is even more threatened by the forces of nature. The Theme of the 2006 to 2007 International Day for Disaster Reduction was "Disaster Risk Reduction begins at schools" and…

  3. The EOSDIS Products Usability for Disaster Response

    NASA Technical Reports Server (NTRS)

    Kafle, Durga N.; Wanchoo, Lalit; Won, Young-In; Michael, Karen

    2016-01-01

    The focus of the study is to categorize both NRT and standard data products based on applicability to the SDR-defined disaster types. This will identify which datasets from current NASA satellite missions instruments are best suited for disaster response. The distribution metrics of the products that have been used for studying various selected disasters that have occurred over last 5 years will be analyzed that include volume, number of files, number of users, user domains, user country, etc. This data usage analysis will provide information to the data centers staff that can help them develop the functionality and allocate the resources needed for enhanced access and timely availability of the data products that are critical for the time-sensitive analyses.

  4. What Causes a Heart Attack?

    MedlinePlus

    ... explains how a heart attack occurs and encourages women to seek care right away for heart attack symptoms. For more information, visit www.hearttruth.gov or the Health Topics Heart Attack and Heart Disease in Women articles. What is a heart attack? 05/22/ ...

  5. Collaborative Attack vs. Collaborative Defense

    NASA Astrophysics Data System (ADS)

    Xu, Shouhuai

    We have witnessed many attacks in the cyberspace. However, most attacks are launched by individual attackers even though an attack may involve many compromised computers. In this paper, we envision what we believe to be the next generation cyber attacks — collaborative attacks. Collaborative attacks can be launched by multiple attackers (i.e., human attackers or criminal organizations), each of which may have some specialized expertise. This is possible because cyber attacks can become very sophisticated and specialization of attack expertise naturally becomes relevant. To counter collaborative attacks, we might need collaborative defense because each “chain” in a collaborative attack may be only adequately dealt with by a different defender. In order to understand collaborative attack and collaborative defense, we present a high-level abstracted framework for evaluating the effectiveness of collaborative defense against collaborative attacks. As a first step towards realizing and instantiating the framework, we explore a characterization of collaborative attacks and collaborative defense from the relevant perspectives.

  6. Differences in mental health outcomes among Whites, African Americans, and Hispanics following a community disaster.

    PubMed

    Adams, Richard E; Boscarino, Joseph A

    2005-01-01

    A number of studies have assessed the association between race and ethnicity and psychological health status following exposure to a stressful event. However, some of these studies indicate racial and ethnic minorities have poorer mental health relative to Whites, while others show no differences or that minorities may actually have better psychological health. One year after the terrorist attacks on the World Trade Center, we collected data on a random sample of city residents (N = 2368). The dependent variables were posttraumatic stress disorder (PTSD), PTSD symptom severity, major depression, panic attack, and general physical and mental well-being. We categorized our respondents as Non-Hispanic White, Non-Hispanic African American, Dominican, Puerto Rican, and Other Hispanics. Bivariate results indicated racial/ethnic differences for PTSD symptom severity, depression, general physical and mental health, and panic attack. Using logistic regression and controlling for possible confounding factors, most of these associations were rendered non-significant. That is, we found no post-disaster racial/ethnic differences for PTSD, PTSD symptom severity, or physical health. African Americans and Other Hispanics were less likely to meet criteria for major depression or to be classified as unhealthy on the self-report SF-12 mental health scale compared to Whites. Only for panic attack were African Americans and Puerto Ricans more likely to meet criteria for this outcome. Thus, our study found little support for the hypothesis that Latinos or African Americans consistently suffered from poorer psychological and physical well-being in the aftermath of traumatic events, relative to Whites.

  7. Natural disasters and the lung.

    PubMed

    Robinson, Bruce; Alatas, Mohammad Fahmi; Robertson, Andrew; Steer, Henry

    2011-04-01

    As the world population expands, an increasing number of people are living in areas which may be threatened by natural disasters. Most of these major natural disasters occur in the Asian region. Pulmonary complications are common following natural disasters and can result from direct insults to the lung or may be indirect, secondary to overcrowding and the collapse in infrastructure and health-care systems which often occur in the aftermath of a disaster. Delivery of health care in disaster situations is challenging and anticipation of the types of clinical and public health problems faced in disaster situations is crucial when preparing disaster responses. In this article we review the pulmonary effects of natural disasters in the immediate setting and in the post-disaster aftermath and we discuss how this could inform planning for future disasters.

  8. The Use of DOE Technologies at The World Trade Center Incident: Lessons Learned

    SciTech Connect

    McCabe, B.; Kovach, J.; Carpenter, C.; Blair, D.

    2003-02-25

    In response to the attack of the World Trade Center (WTC) on September 11, 2001, the International Union of Operating Engineers (IUOE) National Hazmat Program (OENHP) assembled and deployed a HAZMAT Emergency Management Team (Team) to the disaster site (Site). The response team consisted of a Certified Industrial Hygienist and a rotating team of industrial hygienists, safety professionals, and certified HAZMAT instructors. Through research funded by the Department of Energy (DOE) Office of Environmental Management (EM) and managed by the National Energy Technology Laboratory (NETL), the IUOE conducted human factors assessments on baseline and innovative technologies during real-world conditions and served as an advocate at the WTC disaster site to identify opportunities for the use and evaluation of DOE technologies. From this work, it is clear that opportunities exist for more DOE technologies to be made readily available for use in future emergencies.

  9. Terrorism, disasters, and security.

    PubMed

    Alexander, David

    2003-01-01

    The purpose of this editorial is to explore the relationship between the new global emphasis on terrorism and the developing academic and practical fields of disaster management. It includes an appraisal of the place of terrorism among the various forms of disaster, a consideration of its relationship to risk assessment and its place in the practical handling of risks and incidents, and some reflections on the role of the private sector in security management. The influence on the current attitude toward managing the terrorism threat by the evolution of the disaster management field is considered and some of the problems with defining scenarios for counter-terrorism planning also are discussed.

  10. Disaster planning for schools.

    PubMed

    2008-10-01

    Community awareness of the school district's disaster plan will optimize a community's capacity to maintain the safety of its school-aged population in the event of a school-based or greater community crisis. This statement is intended to stimulate awareness of the disaster-preparedness process in schools as a part of a global, community-wide preparedness plan. Pediatricians, other health care professionals, first responders, public health officials, the media, school nurses, school staff, and parents all need to be unified in their efforts to support schools in the prevention of, preparedness for, response to, and recovery from a disaster.

  11. The EOSDIS Products Usability for Disaster Response.

    NASA Astrophysics Data System (ADS)

    Kafle, D. N.; Wanchoo, L.; Won, Y. I.; Michael, K.

    2016-12-01

    The Earth Observing System (EOS) Data and Information System (EOSDIS) is a key core capability in NASA's Earth Science Data System Program. The EOSDIS science operations are performed within a distributed system of interconnected nodes: the Science Investigator-led Processing Systems (SIPS), and the distributed, discipline-specific, Earth science Distributed Active Archive Centers (DAACs), which have specific responsibilities for the production, archiving, and distribution of Earth science data products. NASA also established the Land, Atmosphere Near real-time Capability for EOS (LANCE) program through which near real-time (NRT) products are produced and distributed within a latency of no more than 3 hours. These data, including NRT, have been widely used by scientists and researchers for studying Earth system science, climate change, natural variability, and enhanced climate predictions including disaster assessments. The Subcommittee on Disaster Reduction (SDR) has defined 15 major types of disasters such as flood, hurricane, earthquake, volcano, tsunami, etc. The focus of the study is to categorize both NRT and standard data products based on applicability to the SDR-defined disaster types. This will identify which datasets from current NASA satellite missions/instruments are best suited for disaster response. The distribution metrics of the products that have been used for studying various selected disasters that have occurred over last 5 years will be analyzed that include volume, number of files, number of users, user domains, user country, etc. This data usage analysis will provide information to the data centers' staff that can help them develop the functionality and allocate the resources needed for enhanced access and timely availability of the data products that are critical for the time-sensitive analyses.

  12. Social Capital and Disaster Preparedness Among Low Income Mexican Americans in a Disaster Prone Area

    PubMed Central

    Reininger, Belinda M.; Rahbar, Mohammad H.; Lee, MinJae; Chen, Zhongxue; Raja, Sartaj Alam; Pope, Jennifer; Adams, Barbara

    2016-01-01

    Examination of social capital and its relationship to disaster preparedness has grown in prominence partially due to world-wide need to effectively respond to terrorist attacks, viral epidemics, or natural disasters. Recent studies suggested that social capital may be related to a community’s ability to plan for and respond to such disasters. Few studies, however, have examined social capital constructs among low income populations living in disaster prone areas and accounted for the influence of social capital at the individual and community level. We examined social capital as measured by perceived fairness, perceived civic trust, perceived reciprocity and group membership. We undertook a multistage random cluster survey in three coastal counties in Texas (U.S.) noted for their high levels of poverty. Individuals from 3088 households provided data on social capital, socioeconomic and demographic characteristics, and self-reported level of preparedness for a hurricane. We used multivariable logistic regression to test potential associations between social capital measures and disaster preparedness. After adjusting for age, gender, marital status, ethnicity, education, employment, household income, acculturation, self-reported health, special needs persons in household, household size, and distance to the shore we found a higher prevalence of preparedness among individuals who reported the highest perception of fairness [AOR=3.12, 95% CI: (1.86, 5.21)] compared to those individuals who reported lowest perceptions of fairness. We also found a higher prevalence of preparedness [AOR= 2.06; 95% CI: (1.17, 3.62)] among individuals who reported highest perceptions of trust compared to individuals who reported lowest perceptions of trust. Perceived reciprocity and group membership were not associated with preparedness. These results extend previous findings on social capital and disaster preparedness and further characterize social capital’s presence among a low

  13. Social capital and disaster preparedness among low income Mexican Americans in a disaster prone area.

    PubMed

    Reininger, Belinda M; Rahbar, Mohammad H; Lee, Minjae; Chen, Zhongxue; Alam, Sartaj R; Pope, Jennifer; Adams, Barbara

    2013-04-01

    Examination of social capital and its relationship to disaster preparedness has grown in prominence partially due to world-wide need to effectively respond to terrorist attacks, viral epidemics, or natural disasters. Recent studies suggested that social capital may be related to a community's ability to plan for and respond to such disasters. Few studies, however, have examined social capital constructs among low income populations living in disaster prone areas and accounted for the influence of social capital at the individual and community level. We examined social capital as measured by perceived fairness, perceived civic trust, perceived reciprocity and group membership. We undertook a multistage random cluster survey in three coastal counties in Texas (U.S.) noted for their high levels of poverty. Individuals from 3088 households provided data on social capital, socioeconomic and demographic characteristics, and self-reported level of preparedness for a hurricane. We used multivariable logistic regression to test potential associations between social capital measures and disaster preparedness. After adjusting for age, gender, marital status, ethnicity, education, employment, household income, acculturation, self-reported health, special needs persons in household, household size, and distance to the shore we found a higher prevalence of preparedness among individuals who reported the highest perception of fairness [AOR = 3.12, 95% CI: (1.86, 5.21)] compared to those individuals who reported lowest perceptions of fairness. We also found a higher prevalence of preparedness [AOR = 2.06; 95% CI: (1.17, 3.62)] among individuals who reported highest perceptions of trust compared to individuals who reported lowest perceptions of trust. Perceived reciprocity and group membership were not associated with preparedness. These results extend previous findings on social capital and disaster preparedness and further characterize social capital's presence among a low

  14. Implementing a Disaster Preparedness Curriculum for Medical Students.

    PubMed

    Jasper, Edward H; Wanner, Gregory K; Berg, Dale; Berg, Katherine

    2017-08-01

    Training in disaster medicine and preparedness is minimal or absent in the curricula of many medical schools in the United States. Despite a 2003 joint recommendation by the Association of American Medical Colleges and the Centers for Disease Control and Prevention, few medical schools require disaster training for medical students. The challenges of including disaster training in an already rigorous medical school curriculum are significant. We evaluated medical students' experiences with mandatory disaster training during a 2-year period in a medical university setting. Disaster training has been mandatory at Thomas Jefferson University since 2002 and requires all first-year medical students to attend lectures, undergo practical skills simulation training, and participate in the hospital's interdisciplinary disaster exercise. Medical students were encouraged to complete a survey after each component of the required training. Twenty-three survey questions focused on assessing students' experiences and opinions of the training, including evaluation of the disaster exercise. Students provided ratings on a 5-point Likert scale (5 = strongly agree, 1 = strongly disagree). A total of 503 medical students participated in the disaster preparedness curriculum during the course of 2 years. Survey response rates were high for each portion of the training: lectures (91%), skills sessions (84%), and disaster exercise (100%). Students believed that disaster preparedness should remain part of the medical school curriculum (rating 4.58/5). The disaster lectures were considered valuable (rating 4.26/5) and practical skills sessions should continue to be part of the first-year curriculum (4.97/5). Students also believed that participation in the disaster exercise allowed them to better understand the difficulties faced in a real disaster situation (4.2/5). Our mandatory disaster preparedness training course was successfully integrated into the first-year curriculum >10 years ago

  15. An analysis of Disaster Medical Assistance Team (DMAT) deployments in the United States.

    PubMed

    Mace, Sharon E; Jones, Jaszmine T; Bern, Andrew I

    2007-01-01

    To determine the prevalence and types of disasters on which Disaster Medical Assistance Teams (DMAT) teams have been deployed. This descriptive study used the websites of the 42 DMAT teams in the United States with information confirmed by NDMS websites for a historical analysis of DMAT team deployment. All 42 DMAT teams were included in the analysis from 1985 through 2002. One DMAT team did not have a website, so they were contacted by phone. From 1985 through 2002 DMAT teams were deployed for 50 disasters: 41 natural (41/50=82%), and 9 man-made disasters (9/50=18%). Of the 41 natural disasters, there were 17 hurricanes/tropical storms (17/41=41.6%), 10 floods (10/41=24.3%), 7 earthquakes (7/41=17.0%), 4 fires (4/41=9.8%), 2 blizzards/ice storms (2/41=4.9%), and 1 tornado (1/41=2.4%). Of the 9 man-made disasters, there were 3 terrorist attacks (3/9=33.3%), 2 epidemics (2/9=22.2%), 2 plane crashes (2/9=22.2%), 1 fire (1/9=11.1%) and 1 relief mission (1/9=11.1%). Of the 8 disasters outside of the United States, there were 4 earthquakes (4/8=50%), 2 tropical storms (2/8=25%), 1 wildfire (1/8=12.5%) and 1 relief mission (1/8=12.5%). There were also numerous "stand-by" deployments. The majority (over 80%) of DMAT team deployments from 1985 through 2002 were for natural disasters, although there has been an increase in "man-made" disasters in recent years with terrorist attacks being the most frequent man-made disaster. DMAT teams have also been deployed on missions outside the United States, most often responding to earthquakes and secondly for hurricanes/tropical storms. There has been a prevalence of "water-related" natural disasters including hurricanes/tropical storms and floods, which accounted for three fourths of all natural disasters (25/34=73.5%) and about two thirds of all (natural and man-made) disasters (25/43=59.5%) in the United States over an 18 year period. Recent events including hurricane Katrina suggest that our finding of a prevalence of "water

  16. Using Poison Center Data for Postdisaster Surveillance

    PubMed Central

    Wolkin, Amy; Schnall, Amy H.; Law, Royal; Schier, Joshua

    2015-01-01

    The role of public health surveillance in disaster response continues to expand as timely, accurate information is needed to mitigate the impact of disasters. Health surveillance after a disaster involves the rapid assessment of the distribution and determinants of disaster-related deaths, illnesses, and injuries in the affected population. Public health disaster surveillance is one mechanism that can provide information to identify health problems faced by the affected population, establish priorities for decision makers, and target interventions to meet specific needs. Public health surveillance traditionally relies on a wide variety of data sources and methods. Poison center (PC) data can serve as data sources of chemical exposures and poisonings during a disaster. In the US, a system of 57 regional PCs serves the entire population. Poison centers respond to poison-related questions from the public, health care professionals, and public health agencies. The Centers for Disease Control and Prevention (CDC) uses PC data during disasters for surveillance of disaster-related toxic exposures and associated illnesses to enhance situational awareness during disaster response and recovery. Poison center data can also be leveraged during a disaster by local and state public health to supplement existing surveillance systems. Augmenting traditional surveillance data (ie, emergency room visits and death records) with other data sources, such as PCs, allows for better characterization of disaster-related morbidity and mortality. Poison center data can be used during a disaster to detect outbreaks, monitor trends, track particular exposures, and characterize the epidemiology of the event. This timely and accurate information can be used to inform public health decision making during a disaster and mitigate future disaster-related morbidity and mortality. PMID:25205009

  17. Using poison center data for postdisaster surveillance.

    PubMed

    Wolkin, Amy; Schnall, Amy H; Law, Royal; Schier, Joshua

    2014-10-01

    The role of public health surveillance in disaster response continues to expand as timely, accurate information is needed to mitigate the impact of disasters. Health surveillance after a disaster involves the rapid assessment of the distribution and determinants of disaster-related deaths, illnesses, and injuries in the affected population. Public health disaster surveillance is one mechanism that can provide information to identify health problems faced by the affected population, establish priorities for decision makers, and target interventions to meet specific needs. Public health surveillance traditionally relies on a wide variety of data sources and methods. Poison center (PC) data can serve as data sources of chemical exposures and poisonings during a disaster. In the US, a system of 57 regional PCs serves the entire population. Poison centers respond to poison-related questions from the public, health care professionals, and public health agencies. The Centers for Disease Control and Prevention (CDC) uses PC data during disasters for surveillance of disaster-related toxic exposures and associated illnesses to enhance situational awareness during disaster response and recovery. Poison center data can also be leveraged during a disaster by local and state public health to supplement existing surveillance systems. Augmenting traditional surveillance data (ie, emergency room visits and death records) with other data sources, such as PCs, allows for better characterization of disaster-related morbidity and mortality. Poison center data can be used during a disaster to detect outbreaks, monitor trends, track particular exposures, and characterize the epidemiology of the event. This timely and accurate information can be used to inform public health decision making during a disaster and mitigate future disaster-related morbidity and mortality.

  18. Children Who Lost a Parent as a Result of the Terrorist Attacks of September 11, 2001: Registry Construction and Population Description

    ERIC Educational Resources Information Center

    Chemtob, Claude M.; Conroy, David L.; Hochauser, Carl J.; Laraque, Danielle; Banks, Josette; Schmeidler, James; Dela Cruz, Maan; Nelsen, William C.; Landrigan, Philip J.

    2007-01-01

    Children who experience traumatic bereavement in the context of catastrophic disasters are at increased risk for developing post-disaster problems. Despite massive loss of life on September 11th, 2001, no public data were collected on those children who lost a parent in the multiple terrorist attacks. Such a registry would be an important public…

  19. Children Who Lost a Parent as a Result of the Terrorist Attacks of September 11, 2001: Registry Construction and Population Description

    ERIC Educational Resources Information Center

    Chemtob, Claude M.; Conroy, David L.; Hochauser, Carl J.; Laraque, Danielle; Banks, Josette; Schmeidler, James; Dela Cruz, Maan; Nelsen, William C.; Landrigan, Philip J.

    2007-01-01

    Children who experience traumatic bereavement in the context of catastrophic disasters are at increased risk for developing post-disaster problems. Despite massive loss of life on September 11th, 2001, no public data were collected on those children who lost a parent in the multiple terrorist attacks. Such a registry would be an important public…

  20. Integrating the disaster cycle model into traditional disaster diplomacy concepts.

    PubMed

    Callaway, David W; Yim, Eugene S; Stack, Colin; Burkle, Frederick M

    2012-03-01

    Disaster diplomacy is an evolving contemporary model that examines how disaster response strategies can facilitate cooperation between parties in conflict. The concept of disaster diplomacy has emerged during the past decade to address how disaster response can be leveraged to promote peace, facilitate communication, promote human rights, and strengthen intercommunity ties in the increasingly multipolar modern world. Historically, the concept has evolved through two camps, one that focuses on the interactions between national governments in conflict and another that emphasizes the grassroots movements that can promote change. The two divergent approaches can be reconciled and disaster diplomacy further matured by contextualizing the concept within the disaster cycle, a model well established within the disaster risk management community. In particular, access to available health care, especially for the most vulnerable populations, may need to be negotiated. As such, disaster response professionals, including emergency medicine specialists, can play an important role in the development and implementation of disaster diplomacy concepts.

  1. A Peanut Butter Disaster

    ERIC Educational Resources Information Center

    Vento, Carla J.

    1976-01-01

    A discussion of how cross-age tutoring was used with older pupils helping younger ones by making media curriculum materials. How this method was applied to disaster preparedness education is described. (HB)

  2. A Peanut Butter Disaster

    ERIC Educational Resources Information Center

    Vento, Carla J.

    1976-01-01

    A discussion of how cross-age tutoring was used with older pupils helping younger ones by making media curriculum materials. How this method was applied to disaster preparedness education is described. (HB)

  3. Speeding earthquake disaster relief

    USGS Publications Warehouse

    Mortensen, Carl; Donlin, Carolyn; Page, Robert A.; Ward, Peter

    1995-01-01

    In coping with recent multibillion-dollar earthquake disasters, scientists and emergency managers have found new ways to speed and improve relief efforts. This progress is founded on the rapid availability of earthquake information from seismograph networks.

  4. Suicide after natural disasters.

    PubMed

    Krug, E G; Kresnow, M; Peddicord, J P; Dahlberg, L L; Powell, K E; Crosby, A E; Annest, J L

    1998-02-05

    Among the victims of floods, earthquakes, and hurricanes, there is an increased prevalence of post-traumatic stress disorder and depression, which are risk factors for suicidal thinking. We conducted this study to determine whether natural disasters affect suicide rates. From a list of all the events declared by the U.S. government to be federal disasters between 1982 and 1989, we selected the 377 counties that had each been affected by a single natural disaster during that period. We collected data on suicides during the 36 months before and the 48 months after the disaster and aligned the data around the month of the disaster. Pooled rates were calculated according to the type of disaster. Comparisons were made between the suicide rates before and those after disasters in the affected counties and in the entire United States. Suicide rates increased in the four years after floods by 13.8 percent, from 12.1 to 13.8 per 100,000 (P<0.001), in the two years after hurricanes by 31.0 percent, from 12.0 to 15.7 per 100,000 (P<0.001), and in the first year after earthquakes by 62.9 percent, from 19.2 to 31.3 per 100,000 (P<0.001). The four-year increase of 19.7 percent after earthquakes was not statistically significant. Rates computed in a similar manner for the entire United States were stable. The increases in suicide rates were found for both sexes and for all age groups. The suicide rates did not change significantly after tornadoes or severe storms. Our study shows that suicide rates increase after severe earthquakes, floods, and hurricanes and confirms the need for mental health support after severe disasters.

  5. Disasters and public health

    PubMed Central

    Lechat, M. F.

    1979-01-01

    Studies on the health effects of disasters have shown that epidemiological indices can be of value in planning preventive and relief measures and in evaluating their effectiveness. Mortality rates naturally vary considerably, but in earthquakes, for example, the number of deaths per 100 houses destroyed can give an indication of the adequacy of building techniques. Age-specific mortality rates can help to identify particularly vulnerable groups and perhaps indicate what form of education would be valuable. Except in earthquakes, the number of casualties after a disaster is usually low in relation to the number of deaths, and study of the distribution and types of lesions would help in planning the amounts and types of relief supplies and personnel required. Disasters also affect the general level of morbidity in a district because of either interruption of normal health care services or of spraying or other disease control measures. Mental health and nutrition following disasters are particular problems that require further investigation. Study of all these features of disasters has been handicapped by a lack of data, particularly concerning the health situation immediately after the impact. The provision of surveillance teams in disaster-prone areas would appear to be a field in which international cooperation could yield immense benefits. PMID:311707

  6. Fatal crocodile attack.

    PubMed

    Chattopadhyay, Saurabh; Shee, Biplab; Sukul, Biswajit

    2013-11-01

    Attacks on human beings by various animals leading to varied types of injuries and even death in some cases are not uncommon. Crocodile attacks on humans have been reported from a number of countries across the globe. Deaths in such attacks are mostly due to mechanical injuries or drowning. Bites by the crocodiles often cause the limbs to be separated from the body. The present case refers to an incident of a fatal attack by a crocodile on a 35 years old female where only the mutilated head of the female was recovered. Multiple lacerated wounds over the face and scalp along with fracture of the cranial bones was detected on autopsy. Two distinct bite marks in the form of punched in holes were noted over the parietal and frontal bones. Injuries on the head with its traumatic amputation from the body were sufficient to cause death. However, the presence of other fatal injuries on the unrecovered body parts could not be ruled out.

  7. Word Attack Model.

    ERIC Educational Resources Information Center

    Follettie, Joseph F.

    A limited analysis of alternative approaches to phonemic-level word attack instruction is provided in this document. The instruction segment begins with training in letter-sound correspondences for which mastery of certain skills is assumed. Instruction ends with the decoding of novel items having a consonant-vowel-consonant construction. Contents…

  8. Medical student disaster medicine education: the development of an educational resource

    PubMed Central

    Domres, Bernd D.; Stahl, Wolfgang; Bauer, Andreas; Houser, Christine M.; Himmelseher, Sabine

    2010-01-01

    Background Disaster medicine education is an enormous challenge, but indispensable for disaster preparedness. Aims We aimed to develop and implement a disaster medicine curriculum for medical student education that can serve as a peer-reviewed, structured educational guide and resource. Additionally, the process of designing, approving and implementing such a curriculum is presented. Methods The six-step approach to curriculum development for medical education was used as a formal process instrument. Recognized experts from professional and governmental bodies involved in disaster health care provided input using disaster-related physician training programs, scientific evidence if available, proposals for education by international disaster medicine organizations and their expertise as the basis for content development. Results The final course consisted of 14 modules composed of 2-h units. The concepts of disaster medicine, including response, medical assistance, law, command, coordination, communication, and mass casualty management, are introduced. Hospital preparedness plans and experiences from worldwide disaster assistance are reviewed. Life-saving emergency and limited individual treatment under disaster conditions are discussed. Specifics of initial management of explosive, war-related, radiological/nuclear, chemical, and biological incidents emphasizing infectious diseases and terrorist attacks are presented. An evacuation exercise is completed, and a mass casualty triage is simulated in collaboration with local disaster response agencies. Decontamination procedures are demonstrated at a nuclear power plant or the local fire department, and personal decontamination practices are exercised. Mannequin resuscitation is practiced while personal protective equipment is utilized. An interactive review of professional ethics, stress disorders, psychosocial interventions, and quality improvement efforts complete the training. Conclusions The curriculum offers

  9. Periorbital trauma from pit bull terrier attacks.

    PubMed

    Wladis, Edward J; Dewan, Mohit A

    2012-06-01

    To report the nature of periorbital trauma after pit bull attacks. While these attacks have been well-characterized in the popular media, no case series has documented the ophthalmic manifestations of this trauma. We retrospectively reviewed all cases of pit bull terrier attacks that presented to the oculoplastic and orbital surgery service at Albany Medical Center between 2008 and 2011. The age, gender, extent of the injuries, care provided, follow up interval, and complication rate were evaluated for each patient. Seven patients were identified, with a mean age of 17.2 years. Six of the seven patients were in the pediatric age group. All patients suffered eyelid lacerations, and only one patient had additional injuries. Four patients (57.2%) suffered a canalicular laceration. Despite the lack of post-operative oral antibiotic use, no patient developed a wound infection. In the ophthalmic setting, pit bull terrier attacks most frequently involve children and result in eyelid lacerations. Canalicular injuries are common after these attacks.

  10. Nuclear disasters: current plans and future directions for oncologists.

    PubMed

    Goffman, Thomas E

    2008-01-01

    To show that there is a significant role for oncologists in the event of a terrorist nuclear disaster. Professionals need data on current political issues regarding a nuclear attack already put in place by the administration and the military. Review of what actually occurs during a fission bomb's explosion helps to point out what medical care will be most needed. The author contends that those trained in the oncologies could play a major part. Modern-day America. Potential civilian survivors. Large gaps noted in statewide disaster plans in the public domain. Oncologists must get involved now in disaster planning; statewide plans are necessary throughout the nation; the public needs to know the basics of what to do in the advent of a nuclear bomb explosion.

  11. Virtual Disaster Simulation: Lesson Learned from an International Collaboration That Can Be Leveraged for Disaster Education in Iran

    PubMed Central

    Ardalan, Ali; Balikuddembe, Joseph Kimuli; Ingrassia, Pier Luigi; Carenzo, Luca; Della Corte, Francesco; Akbarisari, Ali; Djalali, Ahmadreza

    2015-01-01

    Disaster education needs innovative educational methods to be more effective compared to traditional approaches. This can be done by using virtual simulation method. This article presents an experience about using virtual simulation methods to teach health professional on disaster medicine in Iran. The workshop on the "Application of New Technologies in Disaster Management Simulation" was held in Tehran in January 2015. It was co-organized by the Disaster and Emergency Health Academy of Tehran University of Medical Sciences and Emergency and the Research Center in Disaster Medicine and Computer Science applied to Medicine (CRIMEDIM), Università del Piemonte Orientale. Different simulators were used by the participants, who were from the health system and other relevant fields, both inside and outside Iran. As a result of the workshop, all the concerned stakeholders are called on to support this new initiative of incorporating virtual training and exercise simulation in the field of disaster medicine, so that its professionals are endowed with field-based and practical skills in Iran and elsewhere. Virtual simulation technology is recommended to be used in education of disaster management. This requires capacity building of instructors, and provision of technologies. International collaboration can facilitate this process. Keywords: Virtual simulation, disaster management, education, training, Iran PMID:26236561

  12. Stealth Disasters and Geoethics

    NASA Astrophysics Data System (ADS)

    Kieffer, Susan W.

    2013-04-01

    Natural processes of the earth unleash energy in ways that are sometimes harmful or, at best, inconvenient, for humans: earthquakes, volcanic eruptions, hurricanes, landslides, floods. Ignoring the biological component of the geosphere, we have historically called such events "natural disasters." They are typically characterized by a sudden onset and relatively immediate consequences. There are many historical examples and our human societies have evolved various ways of coping with them logistically, economically, and psychologically. Preparation, co-existence, recovery, and remediation are possible, at least to some extent, even in the largest of events. Geoethical questions exist in each stage, but the limited local extent of these disasters allows the possibility of discussion and resolution. There are other disasters that involve the natural systems that support us. Rather than being driven primarily by natural non-biological processes, these are driven by human behavior. Examples are climate change, desertification, acidification of the oceans, and compaction and erosion of fertile soils. They typically have more gradual onsets than natural disasters and, because of this, I refer to these as "stealth disasters." Although they are unfolding unnoticed or ignored by many, they are having near-term consequences. At a global scale they are new to human experience. Our efforts at preparation, co-existence, recovery, and remediation lag far behind those that we have in place for natural disasters. Furthermore, these four stages in stealth disaster situations involve many ethical questions that typically must be solved in the context of much larger cultural and social differences than encountered in natural disaster settings. Four core ethical principles may provide guidelines—autonomy, non-maleficence, beneficence, and justice (e.g., Jamais Cascio). Geoscientists can contribute to the solutions in many ways. We can work to ensure that as people take responsibility

  13. Disaster Metrics: A Comprehensive Framework for Disaster Evaluation Typologies.

    PubMed

    Wong, Diana F; Spencer, Caroline; Boyd, Lee; Burkle, Frederick Skip; Archer, Frank

    2017-05-08

    Introduction The frequency of disasters is increasing around the world with more people being at risk. There is a moral imperative to improve the way in which disaster evaluations are undertaken and reported with the aim of reducing preventable mortality and morbidity in future events. Disasters are complex events and undertaking disaster evaluations is a specialized area of study at an international level. Hypothesis/Problem While some frameworks have been developed to support consistent disaster research and evaluation, they lack validation, consistent terminology, and standards for reporting across the different phases of a disaster. There is yet to be an agreed, comprehensive framework to structure disaster evaluation typologies. The aim of this paper is to outline an evolving comprehensive framework for disaster evaluation typologies. It is anticipated that this new framework will facilitate an agreement on identifying, structuring, and relating the various evaluations found in the disaster setting with a view to better understand the process, outcomes, and impacts of the effectiveness and efficiency of interventions. Research was undertaken in two phases: (1) a scoping literature review (peer-reviewed and "grey literature") was undertaken to identify current evaluation frameworks and typologies used in the disaster setting; and (2) a structure was developed that included the range of typologies identified in Phase One and suggests possible relationships in the disaster setting. No core, unifying framework to structure disaster evaluation and research was identified in the literature. The authors propose a "Comprehensive Framework for Disaster Evaluation Typologies" that identifies, structures, and suggests relationships for the various typologies detected. The proposed Comprehensive Framework for Disaster Evaluation Typologies outlines the different typologies of disaster evaluations that were identified in this study and brings them together into a single

  14. Disaster nursing: a retrospective review.

    PubMed

    Stangeland, Paula A

    2010-12-01

    A plethora of information exists in the literature regarding emergencies and disasters. Nevertheless, significant gaps in the science related to nurses working during disasters are revealed. Few studies have addressed the perspective of nurses and their intent to respond to future disasters. Because nurses are invaluable to disaster response efforts, more research is essential to validate current findings and elucidate the needs of nurses who respond to disasters and other health emergencies. There is a paucity of research in the literature describing nurses' lived experiences of working during hurricanes. Natural disasters inevitably inflict human suffering, and nurses are expected to respond and provide services during these catastrophic times. Lost within this expectation are the experiences and concerns of the nurses who are called upon and intend to respond to the disaster, and yet are themselves affected by the disaster. Understanding the experiences and needs of nurses who decide to respond to the call of duty and work during disasters remains unclear in the literature. Research in the area of disaster response intentions by nurses becomes the initial step in understanding the phenomenon of working during a disaster and creating innovative approaches that address working during disasters. Disaster policies have been developed and implemented at the international, national, state, local, and hospital level. Nevertheless, disasters continue to adversely impact communities and hospitals at all levels causing injuries, death, and destruction of infrastructure. To reduce the impact of disasters, continued research is needed to inform and strengthen future disaster policies. Knowledge gained from future research has great potential to inform nursing education, research, and practice, as well as health policy related to the care of individuals and responders before, during, and after disasters. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Toward to Disaster Mitigation Science

    NASA Astrophysics Data System (ADS)

    Kaneda, Yoshiyuki; Shiraki, Wataru; Tokozakura, Eiji

    2016-04-01

    Destructive natural disasters such as earthquakes and tsunamis have occurred frequently in the world. For the reduction and mitigation of damages by destructive natural disasters, early detection of natural disasters and speedy and proper evacuations are indispensable. And hardware and software preparations for reduction and mitigation of natural disasters are quite important and significant. Finally, methods on restorations and revivals are necessary after natural disasters. We would like to propose natural disaster mitigation science for early detections, evacuations and restorations against destructive natural disasters. In natural disaster mitigation science, there are lots of research fields such as natural science, engineering, medical treatment, social science and literature/art etc. Especially, natural science, engineering and medical treatment are fundamental research fields for natural disaster mitigation, but social sciences such as sociology, psychology etc. are very important research fields for restorations after natural disasters. We have to progress the natural disaster mitigation science against destructive natural disaster mitigation. in the near future. We will present the details of natural disaster mitigation science.

  16. Who is my leader? A case study from a hospital disaster scenario in a less developed country.

    PubMed

    Filmer, Leighton B; Ranse, Jamie

    2013-11-01

    A paucity of literature exists pertaining to the role of leaders during the health response to disasters. The minimal published literature regarding disaster leadership suggests that health leadership in a disaster should adopt an approach similar to that of professions such as law enforcement, military and freighting. This paper aims to describe observations pertaining to disaster leadership during a mock disaster scenario. This case study is set in Surkhet, Nepal, a small city prone to disasters such as earthquakes and floods. This case presents a mock disaster scenario of an earthquake set at a nongovernment health facility. Observations were made of the performance of responders in establishing triage, treatment and command centers. Institutional leaders among the responders struggled to apply the disaster plans in the face of spontaneous disaster leadership. Both the recognised leadership of an organisation, and those who in a disaster may step up as disaster leaders need to be confident in implementing the disaster contingency plans. Leadership in disasters must have a clear distinction between incident controller and 'clinical leader' roles. This paper provides recommendations that may have applicability to leadership in real world disasters. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Heart Attack Coronary Artery Disease

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Heart Attack Coronary Artery Disease, Angina Basic Facts & Information What ... and oxygen supply; this is what causes a heart attack. If the damaged area is small, however, your ...

  18. Understanding and managing disaster evacuation on a transportation network.

    PubMed

    Lambert, James H; Parlak, Ayse I; Zhou, Qian; Miller, John S; Fontaine, Michael D; Guterbock, Thomas M; Clements, Janet L; Thekdi, Shital A

    2013-01-01

    Uncertain population behaviors in a regional emergency could potentially harm the performance of the region's transportation system and subsequent evacuation effort. The integration of behavioral survey data with travel demand modeling enables an assessment of transportation system performance and the identification of operational and public health countermeasures. This paper analyzes transportation system demand and system performance for emergency management in three disaster scenarios. A two-step methodology first estimates the number of trips evacuating the region, thereby capturing behavioral aspects in a scientifically defensible manner based on survey results, and second, assigns these trips to a regional highway network, using geographic information systems software, thereby making the methodology transferable to other locations. Performance measures are generated for each scenario including maps of volume-to-capacity ratios, geographic contours of evacuation time from the center of the region, and link-specific metrics such as weighted average speed and traffic volume. The methods are demonstrated on a 600 segment transportation network in Washington, DC (USA) and are applied to three scenarios involving attacks from radiological dispersion devices (e.g., dirty bombs). The results suggests that: (1) a single detonation would degrade transportation system performance two to three times more than that which occurs during a typical weekday afternoon peak hour, (2) volume on several critical arterials within the network would exceed capacity in the represented scenarios, and (3) resulting travel times to reach intended destinations imply that un-aided evacuation is impractical. These results assist decisions made by two categories of emergency responders: (1) transportation managers who provide traveler information and who make operational adjustments to improve the network (e.g., signal retiming) and (2) public health officials who maintain shelters, food and

  19. 77 FR 41248 - Disaster Designation Process

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-13

    ... substantially affected by a natural disaster in a designated disaster county. Disaster designations have been... would be considered a disaster area. This rule also revises the definition of ``natural disaster'' to be... conditions from the definition of ``natural disaster'' could lead to potential program abuse and fraud. It...

  20. An Attack Surface Metric

    DTIC Science & Technology

    2005-07-01

    Introduction Measurement of security, both qualitatively and quantitatively, has been a long standing challenge to the research community , and is of...our approach to related work in Section 2. We introduce the entry point and exit point framework in Section 3. We present the definitions of...ignores the specific system configuration that gave rise to the vulnerability, and it does not capture a system’s future attackability. Our approach

  1. Relationship of self-reported asthma severity and urgent health care utilization to psychological sequelae of the September 11, 2001 terrorist attacks on the World Trade Center among New York City area residents.

    PubMed

    Fagan, Joanne; Galea, Sandro; Ahern, Jennifer; Bonner, Sebastian; Vlahov, David

    2003-01-01

    Posttraumatic psychological stress may be associated with increases in somatic illness, including asthma, but the impact of the psychological sequelae of the September 11, 2001 terrorist attacks on physical illness has not been well documented. The authors assessed the relationship between the psychological sequelae of the attacks and asthma symptom severity and the utilization of urgent health care services for asthma since September 11. The authors performed a random digit dial telephone survey of adults in the New York City (NYC) metropolitan area 6 to 9 months after September 11, 2001. Two thousand seven hundred fifty-five demographically representative adults including 364 asthmatics were recruited. The authors assessed self-reported asthma symptom severity, emergency room (ER) visits, and unscheduled physician office visits for asthma since September 11. After adjustment for asthma measures before September 11, demographics, and event exposure in multivariate models posttraumatic stress disorder (PTSD) were a significant predictor of self-reported moderate-to-severe asthma symptoms (OR = 3.4; CI = 1.2-9.4), seeking care for asthma at an ER since September 11 (OR = 6.6; CI = 1.6-28.0), and unscheduled physician visits for asthma since September 11 (OR = 3.6; CI = 1.1-11.5). The number of PTSD symptoms was also significantly related to moderate-to-severe asthma symptoms and unscheduled physician visits since September 11. Neither a panic attack on September 11 nor depression since September 11 was an independent predictor of asthma severity or utilization in multivariate models after September 11. PTSD related to the September 11 terrorist attacks contributed to symptom severity and the utilization of urgent health care services among asthmatics in the NYC metropolitan area.

  2. Compassion Fatigue Following the September 11 Terrorist Attacks: A Study of Secondary Trauma among New York City Social Workers

    PubMed Central

    Boscarino, Joseph A.; Figley, Charles R.; Adams, Richard E.

    2009-01-01

    Experience suggests that individuals working in the caring and psychotherapeutic professions are among those to provide mental health services to disaster victims suffering from psychological trauma following catastrophic events. Yet, few studies have focused on the emotional exhaustion from working with such clients, referred to as compassion fatigue (CF) in this study, and how CF differs from other occupational hazards, such as secondary trauma (ST) and job burnout. In the present study, we used recently validated scales to predict ST and job burnout related to providing services to those affected by the World Trade Center (WTC) attacks. Our study data were based on a random survey of 236 social workers living in New York City (NYC), over 80% of which reported being involved in post-WTC disaster counseling efforts. Our analyses indicated that controlling for demographic factors, years of counseling, and personal trauma history, ST was positively associated with WTC recovery involvement (p < .001) and negatively associated with having a supportive work environment (p < .01). In contrast, job burnout was negatively associated with having a supportive work environment (p < .01), but not associated with WTC involvement or WTC counseling efforts. We discuss these results in light of future conceptual and empirical research needs. PMID:15298076

  3. Building a Dynamic Spectrum Access Smart Radio with Application to Public Safety Disaster Communications

    DTIC Science & Technology

    2009-08-13

    attacks , Hurricane Katrina, the London subway bombings, and the California wildfires, have all highlighted the limitations of current mobile...Recent disasters, including the 9/11 terrorist attacks , Hurricane Katrina, the California wildfires, and the Midwest floods, have highlighted the...protocols such as OLSR to accomplish routing within a single network associated with a single interface, as well as algorithms to route IP-based

  4. Reducing Disaster Exacerbated Non-Communicable Diseases Through Public Health Infrastructure Resilience: Perspectives of Australian Disaster Service Providers.

    PubMed

    Ryan, Benjamin J; Franklin, Richard C; Burkle, Frederick M; Aitken, Peter; Smith, Erin; Watt, Kerrianne; Leggat, Peter

    2016-12-21

    service infrastructure. Specific measures include: increasing the use of telemedicine; preplanning with medical suppliers; effective town planning; health professionals visiting evacuation centers; evacuation centers having power for medical equipment; hubs for treatment and care after a disaster; evacuation of high risk people prior to disaster; mapping people at risk by non-communicable disease; and a mechanism for sharing information between agencies. A common theme from the participants was that having accurate and easily accessible data on people with non-communicable diseases would allow disaster service providers to adequately prepare for and respond to a disaster. Disaster service providers can play a vital role in reducing the risk of disaster exacerbated non-communicable diseases through public health service infrastructure resilience. They are often employed in communities where disasters occur and are therefore best-placed to lead implementation of the mitigation strategies identified in this research. To sustainably implement the mitigation strategies they will need to become integrated into effective performance and monitoring of the disaster response and health sector during non-disaster periods. For this to occur, the strategies should be integrated into business and strategic plans. Achieving this will help implement the Sendia Framework for Disaster Risk Reduction 2015-2030 and, most importantly, help protect the health of people with non-communicable diseases before, during and after a disaster.

  5. Reducing Disaster Exacerbated Non-Communicable Diseases Through Public Health Infrastructure Resilience: Perspectives of Australian Disaster Service Providers

    PubMed Central

    Ryan, Benjamin J.; Franklin, Richard C.; Burkle Jr., Frederick M.; Aitken, Peter; Smith, Erin; Watt, Kerrianne; Leggat, Peter

    2016-01-01

    cycle impacting public health service infrastructure. Specific measures include: increasing the use of telemedicine; preplanning with medical suppliers; effective town planning; health professionals visiting evacuation centers; evacuation centers having power for medical equipment; hubs for treatment and care after a disaster; evacuation of high risk people prior to disaster; mapping people at risk by non-communicable disease; and a mechanism for sharing information between agencies. A common theme from the participants was that having accurate and easily accessible data on people with non-communicable diseases would allow disaster service providers to adequately prepare for and respond to a disaster. Conclusions: Disaster service providers can play a vital role in reducing the risk of disaster exacerbated non-communicable diseases through public health service infrastructure resilience. They are often employed in communities where disasters occur and are therefore best-placed to lead implementation of the mitigation strategies identified in this research. To sustainably implement the mitigation strategies they will need to become integrated into effective performance and monitoring of the disaster response and health sector during non-disaster periods. For this to occur, the strategies should be integrated into business and strategic plans. Achieving this will help implement the Sendia Framework for Disaster Risk Reduction 2015-2030 and, most importantly, help protect the health of people with non-communicable diseases before, during and after a disaster. PMID:28239511

  6. Plants Under Attack

    PubMed Central

    De Vos, Martin; Van Oosten, Vivian R; Jander, Georg; Dicke, Marcel

    2007-01-01

    To defend themselves, plants activate inducible defense mechanisms that are effective against the invader that is encountered. There is partial overlap in the defense signaling pathways that are induced by insect herbivores and microbial pathogens that may result in cross-resistance. We have previously shown that infestation by tissue-chewing Pieris rapae larvae induces resistance in Arabidopsis thaliana against subsequent attack by the microbial pathogens Pseudomonas syringae pv. tomato (Pst), Xanthomonas campestris pv. armoraciae (Xca) and turnip crinkle virus (TCV). Phloem-feeding aphids, such as the generalist Myzus persicae, have a stealthy feeding strategy that is very different from chewing by lepidopteran larvae. Yet, M. persicae feeding results in a large transcriptomic change. Here, we report on the effectiveness of the defense response that is triggered by M. persicae infestation, as well as the sensitivity of M. persicae to microbially-induced resistance. M. persicae reproduction was not affected by prior conspecific feeding, nor was aphid-induced resistance effective against subsequent attack by Pst, Xca or TCV. Moreover, induced systemic resistance (ISR) triggered by beneficial Pseudomonas fluorescens rhizobacteria was not effective against M. persicae. However, systemic acquired resistance (SAR) induced by prior infection with avirulent Pst was associated with reduced aphid reproduction. These data provide insight into the effectiveness of pathogen and insect resistance and highlight the complexity of the defense responses that are triggered during multitrophic plant-attacker interactions. PMID:19704549

  7. When women attack.

    PubMed

    McLaughlin, Bryan; Davis, Catasha; Coppini, David; Kim, Young Mie; Knisely, Sandra; McLeod, Douglas

    2015-01-01

    The common assumption that female candidates on the campaign trail should not go on the attack, because such tactics contradict gender stereotypes, has not received consistent support. We argue that in some circumstances gender stereotypes will favor female politicians going negative. To test this proposition, this study examines how gender cues affect voter reactions to negative ads in the context of a political sex scandal, a context that should prime gender stereotypes that favor females. Using an online experiment involving a national sample of U.S. adults (N = 599), we manipulate the gender and partisan affiliation of a politician who attacks a male opponent caught in a sex scandal involving sexually suggestive texting to a female intern. Results show that in the context of a sex scandal, a female candidate going on the attack is evaluated more positively than a male. Moreover, while female participants viewed the female sponsor more favorably, sponsor gender had no effect on male participants. Partisanship also influenced candidate evaluations: the Democratic female candidate was evaluated more favorably than her Republican female counterpart.

  8. Disaster Rescue and Response Workers

    MedlinePlus

    ... War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment ... Overview Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview ...

  9. Life After a Heart Attack

    MedlinePlus

    ... explains how a heart attack occurs and encourages women to seek care right away for heart attack symptoms. For more information, visit www.hearttruth.gov or the Health Topics Heart Attack and Heart Disease in Women articles. All of Our Stories Are Red: Jennifer's ...

  10. [Terrorists' target World Cup 2006: disaster medicine on the sidelines?! Aspects of hospital disaster planning].

    PubMed

    Weidringer, J W; Ansorg, J; Ulrich, B C; Polonius, M-J; Domres, B D

    2004-09-01

    Focussing on possible mass casualty situations during events such as the soccer world championship in 2006, the Professional Board of Surgeons in Germany and the German Society for Surgery canvassed surgeons-in-chief in the last quarter of 2003 concerning disaster plans for hospitals. The rate of returned questionnaires amounted to 26% covering the following areas of interest: plans-ready to use, known by the employees as well as by the rescue coordination center, performance of exercises, and concepts on decontamination and detoxification. Based on past numbers of casualties during soccer disasters, an excursus into details also includes a description of an approach to reduce the danger of bottleneck effects at doors. A preliminary concept based on the upcoming system for funding hospitals in Germany and including new partnerships is outlined, succeeded by some hopefully helpful hints for a web-based hospital disaster plan.

  11. Determinants of counseling for children in Manhattan after the September 11 attacks.

    PubMed

    Stuber, Jennifer; Fairbrother, Gerry; Galea, Sandro; Pfefferbaum, Betty; Wilson-Genderson, Maureen; Vlahov, David

    2002-07-01

    After the September 11 terrorist attacks, many adults and children received counseling. The authors assessed the prevalence and correlates of counseling for experiences related to the disaster received by children aged four to 18 years living in Manhattan. From a representative sample of 1,008 adult residents of Manhattan who were living below 110th Street five to eight weeks after the attacks, the authors interviewed 112 parents or primary caretakers about their child's level of exposure to the disaster, the extent of loss, receipt of counseling services, and behavioral reaction. Overall, 22 percent of the children had received some form of counseling related to their experiences after the disaster. More than half of the counseling received (58 percent) was delivered in schools. Predictors of counseling in a multivariate model were male sex (odds ratio=5.3), having a parent with current posttraumatic stress disorder related to the attacks (OR=4.3), and having at least one sibling living in the household (OR=3.6). Parents' own level of posttraumatic stress was associated with whether their children received counseling related to the September 11 attacks. This finding has important implications, because parents act as decision makers for their children in seeking health care. After the terrorist attacks, school and health care personnel provided early intervention counseling in Manhattan.

  12. Disaster mental health training programmes in New York City following September 11, 2001.

    PubMed

    Gill, Kimberly B; Gershon, Robyn R

    2010-07-01

    The need for mental health resources to provide care to the community following large-scale disasters is well documented. In the aftermath of the World Trade Center (WTC) disaster on September 11, 2001, many local agencies and organizations responded by providing informal mental health services, including disaster mental health training for practitioners. The quality of these programmes has not been assessed, however. The National Center for Disaster Preparedness at Columbia University's School of Public Health reviewed disaster mental health training programmes administered by community-based organizations, professional associations, hospitals, and government agencies after September 11. Results indicate that the quality and the effectiveness of programmes are difficult to assess. A wide range of curricula and a widespread lack of recordkeeping and credentialing of trainers were noted. Most of the training programmes provided are no longer available. Recommendations for improving the quality of disaster mental health training programmes are provided.

  13. Replacement Attack: A New Zero Text Watermarking Attack

    NASA Astrophysics Data System (ADS)

    Bashardoost, Morteza; Mohd Rahim, Mohd Shafry; Saba, Tanzila; Rehman, Amjad

    2017-03-01

    The main objective of zero watermarking methods that are suggested for the authentication of textual properties is to increase the fragility of produced watermarks against tampering attacks. On the other hand, zero watermarking attacks intend to alter the contents of document without changing the watermark. In this paper, the Replacement attack is proposed, which focuses on maintaining the location of the words in the document. The proposed text watermarking attack is specifically effective on watermarking approaches that exploit words' transition in the document. The evaluation outcomes prove that tested word-based method are unable to detect the existence of replacement attack in the document. Moreover, the comparison results show that the size of Replacement attack is estimated less accurate than other common types of zero text watermarking attacks.

  14. Responses to natural disasters

    NASA Astrophysics Data System (ADS)

    Maggs, William Ward

    Since 1964, natural disasters caused by earthquakes, volcanic eruptions, or extreme weather in the form of floods, droughts, or hurricanes, have been responsible for more than 2,756,000 deaths worldwide in nations other than the United States, the Soviet Union, and the Eastern European Bloc, according to figures tabulated by the Office of Foreign Disaster Assistance (OFDA) of the Agency for International Development (AID). Over 95% of these fatalities occurred in developing or third world countries. Damage resulting from these calamities has been severe but extremely difficult to estimate in monetary terms. In 1986, U.S. government and voluntary agencies spent $303 million on natural disaster assistance around the world, 79% of total world assistance. In 1985 the U.S. total was nearly $900 million, 48% of the $1.84 billion world total.

  15. Learning from history: The Glasgow Airport terrorist attack.

    PubMed

    Crichton, Gillies

    Glasgow Airport was the target of a terrorist attack on 30th June, 2007. Many people within Scotland had come to believe that Scotland was immune from terrorism. This perception was in large part informed by Scotland's experience during the protracted Troubles in Northern Ireland, during which the Provisional Irish Republican Army's mainland bombing campaign focused on targets in England, sparing both Scotland and Wales. While Glasgow Airport did not expect such an attack to take place, meticulous planning, organising and testing of plans had taken place to mitigate the unlikely event of such an attack. The attack stands up as a shining example of robust business continuity management, where the airport reopened for business as usual in less than 24 hours from the time of the attack. Little is known about how the airport handled the situation in conjunction with other responding agencies as people tend to want to focus on high-profile disasters only. Yet countless such incidents are happening worldwide on a daily basis, in which there are excellent learning opportunities, and, taken in the spirit of converting hindsight into foresight, the likelihood of similar incidents could potentially be reduced in the future.

  16. The West Africa Disaster Preparedness Initiative: Strengthening National Capacities for All-Hazards Disaster Preparedness.

    PubMed

    Morton Hamer, Melinda J; Reed, Paul L; Greulich, Jane D; Kelen, Gabor D; Bradstreet, Nicole A; Beadling, Charles W

    2017-08-01

    The Ebola outbreak demonstrated the need for improved disaster response throughout West Africa. The West Africa Disaster Preparedness Initiative was a training and assessment effort led by US Africa Command and partners to strengthen capacities among 12 West African partner nations (PNs). Series of 3-week training sessions with representatives from each PN were held from 13 July through 20 November 2015 at the Kofi Annan International Peacekeeping Training Centre in Accra, Ghana. A team conducted Disaster Management Capabilities Assessments (DMCAs) for each PN, including a review of key data, a survey for leaders, and in-person interviews of key informants. All 12 PNs generated a national Ebola Preparedness and Response Plan and Emergency Operations Center standard operating procedures. DMCA metrics were generated for each PN. Top performers included Ghana, with a plan rated good/excellent, and Benin and Burkina Faso, which both achieved a satisfactory rating for their plans. More than 800 people from 12 nations were trained. PNs have improved disaster management capabilities and awareness of their strengths and weaknesses. The Economic Community of West African States has increased its lead role in this and future planned initiatives. (Disaster Med Public Health Preparedness. 2017;11:431-438).

  17. Disaster Preparedness in YOUR School.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin. Div. of Adult and Continuing Education.

    A look at what to do in time of natural and man-made disasters is presented. Disasters covered include tornados, hurricanes, floods, fires, blizzards, and nuclear disaster. The responsibilities of the Board of Education, school superintendent, school principal, teachers, school nurse, custodian, students, bus drivers, and cafeteria workers are…

  18. Disaster Education in Australian Schools

    ERIC Educational Resources Information Center

    Boon, Helen J.; Pagliano, Paul J.

    2014-01-01

    Australia regularly suffers floods, droughts, bushfires and cyclones, which are predicted to increase and/or intensify in the future due to climate change. While school-aged children are among the most vulnerable to natural disasters, they can be empowered through education to prepare for and respond to disasters. School disaster education is…

  19. Disaster Education in Australian Schools

    ERIC Educational Resources Information Center

    Boon, Helen J.; Pagliano, Paul J.

    2014-01-01

    Australia regularly suffers floods, droughts, bushfires and cyclones, which are predicted to increase and/or intensify in the future due to climate change. While school-aged children are among the most vulnerable to natural disasters, they can be empowered through education to prepare for and respond to disasters. School disaster education is…

  20. Disaster aeromedical evacuation.

    PubMed

    Lezama, Nicholas G; Riddles, Lawrence M; Pollan, William A; Profenna, Leonardo C

    2011-10-01

    Successful disaster aeromedical evacuation depends on applying the principles learned by moving patients since World War II, culminating in today's global patient movement system. This article describes the role of the Department of Defense patient movement system in providing defense support to civil authorities during the 2008 hurricane season and the international disaster response to the 2010 Haiti earthquake. Adapting and applying the principles of active partnerships, establishing patient movement requirements, patient preparation, and in-transit visibility have resulted in the successful aeromedical evacuation of over 1,600 patients since the federal response to Hurricane Katrina.