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Disasters and emergencies involving radiation can produce numerous social and behavioral impacts, including shadow evacuations, seeking of medical attention by large numbers of people fearful of potential contamination, and stigmatizing of individuals, products and communities perceived to be associated with the incident. Indeed, these, and related impacts, can constitute some of the most important and challenging public health effects of a radiological-nuclear incident. At the present time, it is unclear whether or how such issues are being addressed in preparedness training exercises.
Methods:
With support from the Radiation Studies Branch, Centers for Disease Control and Prevention (CDC), a study (2006–2008) was performed by researchers at the University of Alabama at Birmingham. The aim was to determine how social and behavioral issues are addressed in radiological-nuclear exercises. Radiological-nuclear exercise reports, guidance materials, and related items were gathered, and a systematic review and analysis of the documents was conducted.
Results:
Initial findings from the study suggest that only about half of radiological-nuclear exercises deal with key social and behavioral issues. Where such issues are included, they tend to receive relatively litde attention, components are typically small in scope, and the most difficult challenges often are “assumed away.”
Conclusions:
Even though social-behavioral issues are central in radiological-nuclear incidents, opportunities to practice coping with them in training exercises are quite limited. If preparedness training is to be realistic and useful, this problem urgently needs to be addressed. The present study provides a series of recommendations toward this end.
The emergency department is the frontline of care in any hospital. Quality of work is affected by the skills and knowledge of the medical staff and the stress in their daily grind. The emergency department cannot perform its primary function if its personnel continue to feel the burden of their jobs.
Methods:
This is a descriptive study of the emergency department staff at the University of the Philippines-Philippine General Hospital. A self-administered questionnaire with socio-demographic and occupational variables using the 22-item Maslach Burnout Inventory (MBI) Scale assessing emotional exhaustion, depersonalization, and professional accomplishment was used.
Results were analyzed according to the major subscales of the MBI Scale. The percentage having severe, moderate, and low burnout levels were determined and analyzed based on demographic data (e.g., gender, age, marital status, years of experience, and qualification).
Results:
Eighty-seven qualified emergency personnel were surveyed. Of them, 41 were nurses, 13 were emergency medicine residents, 11 worked for Medical Social Service (MSS), 11 were emergency medical services (EMS) personnel/paramedics, and 11 were emergency department records personnel. Only 64 respondents were able to return the questionnaires (73.5%). Most of the male respondents had low burnout in emotional exhaustion and loss of empathy. They also scored low burnout at the professional level, which indicates that males were more satisfied with their professional achievements. The majority of the respondents 21—40 years of age had low and moderate burnout in the three subscales. Those in the 41–60 year and >61 year age groups experienced low burnout on all subscales. The unmarried showed moderate burnout in emotional exhaustion, but the majority of married respondents had low burnout in loss of empathy and professional fulfillment. Working in the emergency department for six months or six months-one year showed that the majority experienced moderate burnout, but revealed low burnout in professional fulfillment.
Conclusions:
The emergency medicine residents reported to have severe burnout in emotional exhaustion, but scored moderate burnout in loss of empathy and professional fulfillment. The EMS personnel had the lowest burnout level of all three subscales
When Cyclone Nargis hit the Ayeyanwadi delta of Myanmar on 03 May 2008 at a speed of 190 km/h, nearly 140,000 people lost their lives and approximately two million were left homeless. As an additional challenge, the military regime of Myanmar denied any relief organizations or workers outside SouuSeast Asia access to the disaster site.
Methods:
During a one-week mission to the former capital of Yangon beginning one month after the disaster, relief provided to the affected population was studied. The working methods and effectiveness of a small non-governmental organization (NGO) already established in Myanmar were evaluated.
Results:
The long visa queues of relief workers gave organizations already working in Myanmar a great advantage. New strategies involved the rapid employment of personnel from Southeast Asia for fieldwork Improved administrative procedures made the field teams work more effectively. The NGO studied 30 rapidly engaged, new, local, health workers, sufficient for five medical teams to work in the field.
Conclusions:
In spite of denied access to the disaster field, United Nations organizations and NGOs were able to initiate an effective administration and support to the many teams including >80 medical teams sent to the disaster site. The restricted movement gave more time and resources to relief planning, which is of importance for future incidents. Smaller NGOs were able to benefit from the improved administrative procedures introduced in the process.