Proposing and developing the definition and conceptual framework for healthcare resilience to cope with disasters

Building healthcare resilience is an important step towards creating more resilient communities to better cope with future disasters. To date, however, there appears to be little literature on how the concept of healthcare resilience should be defined and operationalized with a conceptual framework. This article aims to build a comprehensive healthcare disaster management approach guided by the concept of resilience. Methods: Google and major health electronic databases were searched to retrieve critical relevant publications. A total of 61 related publications were included, to provide a comprehensive overview of theories and definitions relevant to disaster resilience. Results and Discussions: Resilience is an inherent and adaptive capacity to cope with future uncertainty, through multiple strategies with all hazards approaches, in an attempt to achieve a positive outcome with linkage and cooperation. Healthcare resilience can be defined as the capability of healthcare organisations to resist, absorb, and respond to the shock of disasters while maintaining the most essential functions, then recover to their original state or adapt to a new state. It can be assessed by criteria, namely: robustness, redundancy, resourcefulness; and a complex of key dimensions, namely: vulnerability and safety, disaster resources and preparedness, continuity of essential health services, recovery and adaptation. Conclusions: This new concept places healthcare organisations’ disaster capabilities, management tasks, activities and disaster outcomes together into a comprehensive whole view, using an integrated approach and establishing achievable goals.

Progress and challenges of disaster health management in China : a scoping review

Background Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. Objective This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. Design A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. Results The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. Conclusions One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

A case study in flood fatality : Beijing July 2012 flood

Background The aim of this study is to examine the flood fatality with a view to identifying risks which may inform public policy responses to future flood. On July 21st, 2012, Beijing suffered the heaviest rain since 1963. The average rainfall was 215 mm over a 24 hour period in the central city (301mm in Fangshan District). The rain resulted in a flood that caused severe health, social and financial impact. Results This flood caused 79 deaths. Of the 71 deaths for which a specific cause could be identified, 5 were rescue team members, 42 were killed by drowning (11 in the car), and the others by electricity shock, fallen house, falling items and lightning. The total financial cost was estimated to be US$ 1.7 billion. The causations of the deaths inform the risks associated with the flood. Discussion This flood had a catastrophic impact on Beijing, mainly due to the intensity of the rain (the rain was the heaviest in the modern Beijing history; possibly due to global warming and urban heat island effect), the vulnerability of the infrastructure (poor standards of drainage, disorganized water management systems and decreased permeability of the earth as a result of the city’s rapid development), and the capacity of the response system (mainly dependent on the awareness of the citizens, warning systems and the capacity of the emergency rescue). Implication Many risk management measures have been implemented as a result of this flood, including water level warning marks, flood safety education and warnings sent to mobile phones, a project to move about 74,500 farmers away from the flood-prone areas within 5 years. However, further measures targeted at the fundamental issues identified by this analysis are necessary, especially those targeting at health issues. These may include better planning, improved drainage systems and ecological development to increase permeability etc..

How does Nepal Television (NTV) frame natural disasters? A qualitative content analysis of news scripts using news frames and PPRR cycle

Introduction- This study investigates the prevailing status of Nepalese media portrayal of natural disasters. It is contributing to the development of a disaster management model to improve the effectiveness and efficiency of news production throughout the continuum of prevention, preparedness, response and recovery (PPRR) phases of disaster management. Theoretical framework- Studies of media content often rely on framing as the theoretical underpinning of the study, as it describes how the press crafts the message. However there are additional theoretical perspectives that underline an understanding of the role of the media. This article outlines a conceptual understanding of the role of the media in modern society, the way that this conceptual understanding is used in the crafting of media messages and how those theoretical considerations are applied to the concepts that underpin effective disaster management. (R.M. Entman, 2003; Liu, 2007; Meng & Berger, 2008). Methodology- A qualitative descriptive design is used to analyse the disaster news of Nepal Television (NTV). However, this paper presents the preliminary findings of Nepal Television (a government owned Television station) using qualitative content analysis of 105 natural disaster related news scripts (June 2012-March 2013) based on the framing theory and PPRR cycle. Results- The preliminary results indicate that the media focus while framing natural disasters is dominated by human interest frame followed by responsibility frame. News about response phase was found to be most prominent in terms of PPRR cycle. Limited disaster reporting by NTV has impacted the national disaster management programs and strategies. The findings describe natural disasters are being reported within the limited understanding of the important principles of disaster management and PPRR cycle. Conclusion- This paper describes the current status of the coverage of natural disasters by Nepal Television to identify the frames used in the news content. It contributes to determining the characteristics of effective media reporting of natural disasters in the government owned media outlets, and also leads to including communities and agencies involved in disasters. It suggests the frames which are best suited for news making and how media responds to the different phases of the disaster cycle.

Emotion recognition of static and dynamic faces in autism spectrum disorder

There is substantial evidence for facial emotion recognition (FER) deficits in autism spectrum disorder (ASD). The extent of this impairment, however, remains unclear, and there is some suggestion that clinical groups might benefit from the use of dynamic rather than static images. High-functioning individuals with ASD (n = 36) and typically developing controls (n = 36) completed a computerised FER task involving static and dynamic expressions of the six basic emotions. The ASD group showed poorer overall performance in identifying anger and disgust and were disadvantaged by dynamic (relative to static) stimuli when presented with sad expressions. Among both groups, however, dynamic stimuli appeared to improve recognition of anger. This research provides further evidence of specific impairment in the recognition of negative emotions in ASD, but argues against any broad advantages associated with the use of dynamic displays.

Exploitation of the menshutkin reaction for the controlled assembly of halogen bonded architectures incorporating 1,2-diiodotetrafluorobenzene and 1,3,5-Triiodotrifluorobenzene

1,4-Diazabicyclo[2.2.2]octane (DABCO) forms well-defined co-crystals with 1,2-diiodotetrafluorobenzene (1,2-DITFB), [(1,2-DITFB)2DABCO], and 1,3,5-triiodotrifluorobenzene, [(1,3,5-TITFB)2DABCO]. Both systems exhibited lower-than-expected supramolecular connectivity, which inspired a search for polymorphs in alternative crystallization solvents. In dichloromethane solution, the Menshutkin reaction was found to occur, generating chloride anions and quaternary ammonium cations through the reaction between the solvent and DABCO. The controlled in situ production of chloride ions facilitated the crystallization of new halogen bonded networks, DABCO–CH2Cl[(1,2-DITFB)Cl] (zigzag X-bonded chains) and (DABCO–CH2Cl)3[(1,3,5-TITFB)2Cl3]·CHCl3 (2D pseudo-trigonal X-bonded nets displaying Borremean entanglement), propagating with charge-assisted C–I···Cl– halogen bonds. The method was found to be versatile, and substitution of DABCO with triethylamine (TEA) gave (TEA-CH2Cl)3[(1,2-DITFB)Cl3]·4(H2O) (mixed halogen bond hydrogen bond network with 2D supramolecular connectivity) and TEA-CH2Cl[(1,3,5-TITFB)Cl] (tightly packed planar trigonal nets). The co-crystals were typically produced in high yield and purity with relatively predictable supramolecular topology, particularly with respect to the connectivity of the iodobenzene molecules. The potential to use this synthetic methodology for crystal engineering of halogen bonded architectures is demonstrated and discussed.

Troubling silences and taboo texts : constructing safer and more positive school climates for same-sex attracted high school students in Australia

This chapter offers three insights into the relationship between curriculum decision making, positive school climate, and academic achievement for same-sex attracted (SSA) students, highlighting the need for students to be offered more than heteronormative narratives and silence on issues of sexuality in the official school curriculum. The authors firstly provide a review of research and report on findings of a doctoral study (Mikulsky, 2007) explaining the impact of SSA students’ perceptions of school climate on their motivation and academic self-concept. Situating the work in the context of the Australian Curriculum for English and associated classroom texts, the dominant discourse of ‘straight, white female’ heroines as exemplified in the globally popular young adult novel The hunger games and other texts popular with Australian students are critiqued, with an argument made for expanding notions of what it means to ‘attend to’ gender and sexuality through textual choice and critical pedagogy. The authors show how texts that feature LGBTQ characters and storylines continue to be marginalized and constructed as taboo and demonstrate how curricular choices can and do impact academic outcomes for marginalized students. Issues of gender and sexuality are framed as a cross-curriculum imperative, with recommendations made for the explicit inclusion of materials exploring gender and sexuality in the official curriculum of all key learning areas.

Prevalence of malnutrition, obesity and nutritional risk of Australian paediatric inpatients: A national one-day snapshot

Aim Low prevalence rates of malnutrition at 2.5% to 4% have previously been reported in two tertiary paediatric Australian hospitals. The current study is the first to measure the prevalence of malnutrition, obesity and nutritional risk of paediatric inpatients in multiple hospitals throughout Australia. Methods Malnutrition, obesity and nutritional risk prevalence were investigated in 832 and 570 paediatric inpatients, respectively, in eight tertiary paediatric hospitals and eight regional hospitals across Australia on a single day. Malnutrition and obesity prevalence was determined using z-scores and body mass index (BMI) percentiles. High nutritional risk was determined as a Paediatric Yorkhill Malnutrition Score of 2 or more. Results The prevalence rates of malnourished, wasted, stunted, overweight and obese paediatric patients were 15%, 13.8%, 11.9%, 8.8% and 9.9%, respectively. Patients who identified as Aboriginal and Torres Strait Islander were more likely to have lower height-for-age z-scores (P < 0.01); however, BMI and weight-for-age z-scores were not significantly different. Children who were younger, from regional hospitals or with a primary diagnosis of cardiac disease or cystic fibrosis had significantly lower anthropometric z-scores (P = 0.05). Forty-four per cent of patients were identified as at high nutritional risk and requiring further nutritional assessment. Conclusions The prevalence of malnutrition and nutritional risk of Australian paediatric inpatients on a given day was much higher when compared with the healthy population. In contrast, the proportion of overweight and obese patients was less.

A simple nutrition screening tool for paediatric inpatients

Background: Pediatric nutrition risk screening tools are not routinely implemented throughout many hospitals, despite prevalence studies demonstrating malnutrition is common in hospitalized children. Existing tools lack the simplicity of those used to assess nutrition risk in the adult population. This study reports the accuracy of a new, quick, and simple pediatric nutrition screening tool (PNST) designed to be used for pediatric inpatients. Materials and Methods: The pediatric Subjective Global Nutrition Assessment (SGNA) and anthropometric measures were used to develop and assess the validity of 4 simple nutrition screening questions comprising the PNST. Participants were pediatric inpatients in 2 tertiary pediatric hospitals and 1 regional hospital. Results: Two affirmative answers to the PNST questions were found to maximize the specificity and sensitivity to the pediatric SGNA and body mass index (BMI) z scores for malnutrition in 295 patients. The PNST identified 37.6% of patients as being at nutrition risk, whereas the pediatric SGNA identified 34.2%. The sensitivity and specificity of the PNST compared with the pediatric SGNA were 77.8% and 82.1%, respectively. The sensitivity of the PNST at detecting patients with a BMI z score of less than -2 was 89.3%, and the specificity was 66.2%. Both the PNST and pediatric SGNA were relatively poor at detecting patients who were stunted or overweight, with the sensitivity and specificity being less than 69%. Conclusion: The PNST provides a sensitive, valid, and simpler alternative to existing pediatric nutrition screening tools such as Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), Screening Tool Risk on Nutritional status and Growth (STRONGkids), and Paediatric Yorkhill Malnutrition Score (PYMS) to ensure the early detection of hospitalized children at nutrition risk.

Symptom correlates of static and dynamic facial affect processing in schizophrenia : evidence of a double dissociation?

Schizophrenia patients have been shown to be compromised in their ability to recognize facial emotion. This deficit has been shown to be related to negative symptoms severity. However, to date, most studies have used static rather than dynamic depictions of faces. Nineteen patients with schizophrenia were compared with seventeen controls on 2 tasks; the first involving the discrimination of facial identity, emotion, and butterfly wings; the second testing emotion recognition using both static and dynamic stimuli. In the first task, the patients performed more poorly than controls for emotion discrimination only, confirming a specific deficit in facial emotion recognition. In the second task, patients performed more poorly in both static and dynamic facial emotion processing. An interesting pattern of associations suggestive of a possible double dissociation emerged in relation to correlations with symptom ratings: high negative symptom ratings were associated with poorer recognition of static displays of emotion, whereas high positive symptom ratings were associated with poorer recognition of dynamic displays of emotion. However, while the strength of associations between negative symptom ratings and accuracy during static and dynamic facial emotion processing was significantly different, those between positive symptom ratings and task performance were not. The results confirm a facial emotion-processing deficit in schizophrenia using more ecologically valid dynamic expressions of emotion. The pattern of findings may reflect differential patterns of cortical dysfunction associated with negative and positive symptoms of schizophrenia in the context of differential neural mechanisms for the processing of static and dynamic displays of facial emotion.

Mirror neuron activation is associated with facial emotion processing

Theoretical accounts suggest that mirror neurons play a crucial role in social cognition. The current study used transcranial-magnetic stimulation (TMS) to investigate the association between mirror neuron activation and facialemotion processing, a fundamental aspect of social cognition, among healthy adults (n = 20). Facial emotion processing of static (but not dynamic) images correlated significantly with an enhanced motor response, proposed to reflect mirror neuron activation. These correlations did not appear to reflect general facial processing or pattern recognition, and provide support to current theoretical accounts linking the mirror neuron system to aspects of social cognition. We discuss the mechanism by which mirror neurons might facilitate facial emotion recognition.