Prehospital & Disaster Medicine
Volume 31 – Issue 02 – April 2016
https://journals.cambridge.org/action/displayIssue?jid=PDM&tab=currentissue

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Editorial
Zika Virus Association with Microcephaly: The Power for Population Statistics to Identify Public Health Emergencies
Samuel J. Stratton
DOI: http://dx.doi.org/10.1017/S1049023X16000170
Published online: 04 March 2016
[No abstract]

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Original Research
An Assessment of Collaboration and Disasters: A Hospital Perspective
Sabrina A. Adelainea1 c1, Kimberly Shoafa2 and Caitlin Harveya1
a1 University of California, Los Angeles (UCLA), Fielding School of Public Health, Los Angeles, California USA
a2 University of Utah, Division of Public Health, Salt Lake City, Utah USA
Abstract
Introduction There is no standard guidance for strategies for hospitals to use to coordinate with other agencies during a disaster.
Hypothesis/Problem This study analyzes successful strategies and barriers encountered by hospitals across the nation in coordinating and collaborating with other response agencies.
Methods Quantitative and qualitative data were collected from a web-based study from 577 acute care hospitals sampled from the 2013 American Hospital Association (AHA) database. The results were analyzed using descriptive statistics.
Results The most common barriers to collaboration are related to finances, ability to communicate, and personnel.

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Vaccination Against Seasonal or Pandemic Influenza in Emergency Medical Services
Alexandre Moser, Cédric Mabire, Olivier Hugli, Victor Dorribo, Giorgio Zanetti, Catherine Lazor-Blanchet and Pierre-Nicolas Carron
DOI: http://dx.doi.org/10.1017/S1049023X16000121
Published online: 09 February 2016
Abstract
Introduction Influenza is a major concern for Emergency Medical Services (EMS); EMS workers’ (EMS-Ws) vaccination rates remain low despite promotion. Determinants of vaccination for seasonal influenza (SI) or pandemic influenza (PI) are unknown in this setting.
Hypothesis The influence of the H1N1 pandemic on EMS-W vaccination rates, differences between SI and PI vaccination rates, and the vaccination determinants were investigated.
Methods A survey was conducted in 2011 involving 65 Swiss EMS-Ws. Socio-professional data, self-declared SI/PI vaccination status, and motives for vaccine refusal or acceptation were collected.
Results Response rate was 95%. The EMS-Ws were predominantly male (n=45; 73%), in good health (87%), with a mean age of 36 (SD=7.7) years. Seventy-four percent had more than six years of work experience. Self-declared vaccination rates were 40% for both SI and PI (PI+/SI+), 19% for PI only (PI+/SI-), 1.6% for SI only (PI-/SI+), and 39% were not vaccinated against either (PI-/SI-). Women’s vaccination rates specifically were lower in all categories but the difference was not statistically significant. During the previous three years, 92% of PI+/SI+ EMS-Ws received at least one SI vaccination; it was 8.3% in the case of PI-/SI- (P=.001) and 25% for PI+/SI- (P=.001). During the pandemic, SI vaccination rate increased from 26% during the preceding year to 42% (P=.001). Thirty percent of the PI+/SI+ EMS-Ws declared that they would not get vaccination next year, while this proportion was null for the PI-/SI- and PI+/SI- groups. Altruism and discomfort induced by the surgical mask required were the main motivations to get vaccinated against PI. Factors limiting PI or SI vaccination included the option to wear a mask, avoidance of medication, fear of adverse effects, and concerns about safety and effectiveness.
Conclusion Average vaccination rate in this study’s EMS-Ws was below recommended values, particularly for women. Previous vaccination status was a significant determinant of PI and future vaccinations. The new mask policy seemed to play a dual role, and its net impact is probably limited. This population could be divided in three groups: favorable to all vaccinations; against all, even in a pandemic context; and ambivalent with a “pandemic effect.” These results suggest a consistent vaccination pattern, only altered by exceptional circumstances.

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International Consensus on Key Concepts and Data Definitions for Mass-gathering Health: Process and Progress
Sheila A. Turris, Malinda Steenkamp, Adam Lund, Alison Hutton, Jamie Ranse, Ron Bowles, Katherine Arbuthnott, Olga Anikeeva and Paul Arbon
DOI: http://dx.doi.org/10.1017/S1049023X1600011X
Published online: 04 February 2016
Abstract
Mass gatherings (MGs) occur worldwide on any given day, yet mass-gathering health (MGH) is a relatively new field of scientific inquiry. As the science underpinning the study of MGH continues to develop, there will be increasing opportunities to improve health and safety of those attending events. The emerging body of MG literature demonstrates considerable variation in the collection and reporting of data. This complicates comparison across settings and limits the value and utility of these reported data. Standardization of data points and/or reporting in relation to events would aid in creating a robust evidence base from which governments, researchers, clinicians, and event planners could benefit. Moving towards international consensus on any topic is a complex undertaking. This report describes a collaborative initiative to develop consensus on key concepts and data definitions for a MGH “Minimum Data Set.” This report makes transparent the process undertaken, demonstrates a pragmatic way of managing international collaboration, and proposes a number of steps for progressing international consensus. The process included correspondence through a journal, face-to-face meetings at a conference, then a four-day working meeting; virtual meetings over a two-year period supported by online project management tools; consultation with an international group of MGH researchers via an online Delphi process; and a workshop delivered at the 19thWorld Congress on Disaster and Emergency Medicine held in Cape Town, South Africa in April 2015. This resulted in an agreement by workshop participants that there is a need for international consensus on key concepts and data definitions.

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Special Reports
Research and Evaluations of the Health Aspects of Disasters, Part VI: Interventional Research and the Disaster Logic Model
Marvin L. Birnbaum, Elaine K. Daily, Ann P. O’Rourke and Jennifer Kushner
DOI: http://dx.doi.org/10.1017/S1049023X16000017

Research and Evaluations of the Health Aspects of Disasters, Part VII: The Relief/Recovery Framework
Marvin L. Birnbaum, Elaine K. Daily and Ann P. O’Rourke
DOI: http://dx.doi.org/10.1017/S1049023X16000029