A Systematic Review of the Amount of Water per Person per Day Needed to Prevent Morbidity and Mortality in (Post-)Disaster Settings

BackgroundIn order to improve the effectiveness and efficiency of humanitarian efforts, minimum standards for humanitarian assistance and key indicators, showing whether a standard has been attained, have been developed. However, many of these standards and indicators are based on a consensus on best practices and experiences in humanitarian response, because relevant evidence on the impact of humanitarian interventions is often lacking.ObjectivesOne important example of a standard in humanitarian aid in a disaster setting is “water quantity.” The accompanying indicator states how many litres of water are needed per person per day in a disaster setting. It was our objective to determine the evidence base behind this indicator, in order to improve health outcomes such as morbidity (e.g., diarrhoea) and mortality.MethodsA systematic review was performed searching The Cochrane Library, Medline and Embase. We included studies performed during disasters and in refugee camps that reported a specific water amount and health-related outcomes related to water shortages, including diarrhoea, cholera, and mortality. We used GRADE to determine the quality of evidence.ResultsOut of 3,630 articles, 111 references relevant to our question were selected. Based on our selection criteria, we finally retained 6 observational studies, including 1 study that was performed during the disaster and 5 studies in a post-disaster phase. From two studies there is conclusive evidence on the relationship between the amount of water received and diarrhoea or mortality rates in refugee camps. However, overall, these studies do not contain enough data with relevance to a specific amount of water, and the level of evidence is very low.ConclusionsMore primary research on water amounts in a disaster setting is necessary, so that the humanitarian sector can further professionalise its water-related standards, indicators and interventions.     

Tweeting Supertyphoon Haiyan: Evolving Functions of Twitter during and after a Disaster Event

When disaster events capture global attention users of Twitter form transient interest communities that disseminate information and other messages online. This paper examines content related to Typhoon Haiyan (locally known as Yolanda) as it hit the Philippines and triggered international humanitarian response and media attention. It reveals how Twitter conversations about disasters evolve over time, showing an issue attention cycle on a social media platform. The paper examines different functions of Twitter and the information hubs that drive and sustain conversation about the event. Content analysis shows that the majority of tweets contain information about the typhoon or its damage, and disaster relief activities. There are differences in types of content between the most retweeted messages and posts that are original tweets. Original tweets are more likely to come from ordinary users, who are more likely to tweet emotions, messages of support, and political content compared with official sources and key information hubs that include news organizations, aid organization, and celebrities. Original tweets reveal use of the site beyond information to relief coordination and response.     

灾难及突发事件住院信息管理系统研究现状及趋势

信息工作是决策的依据和先导,如何准确、及时、高效地收集、整理、分析灾难及突发事件信息、伤病员基本信息、救治信息等,已成为医院管理信息学的研究热点问题,也是医院在灾难和突发事件大量伤员信息管理中面临的难点问题。本文就灾难及突发事件住院信息管理系统研究现状及趋势进行综述。     

灾难及突发事件住院信息管理系统研究现状及趋势

信息工作是决策的依据和先导,如何准确、及时、高效地收集、整理、分析灾难及突发事件信息、伤病员基本信息、救治信息等,已成为医院管理信息学的研究热点问题,也是医院在灾难和突发事件大量伤员信息管理中面临的难点问题。本文就灾难及突发事件住院信息管理系统研究现状及趋势进行综述。     

Web Information and Social Impacts of Disasters in China

Understanding disasters' social impacts is a key issue for efficient disaster management. This article proposes a framework to assess disasters' social impacts based on network information resources. The proposed approach is validated using statistical analysis. Key factors that change social impacts are also identified for useful decision-making.     

SIMS REIN: a multi-source information system for end-stage renal disease

In France, the prevalence of End-Stage Renal Disease (ESRD) is not precisely known. The sources of information are scattered and not coordinated. Consequently, care is ill adapted to meet the demand. The Multi-Source Information System is the basis of the Renal Epidemiology and Information Network (REIN). It is dedicated to improve and organise our medical and epidemiological knowledge of ESRD and to aid public health decision-making in this area. The proposed approach is based on the datawarehouses. This model allows a unified vision of scattered data into distinct databases, for a better management, be it particular (patient follow-up) or global (regional follow-up), with a finality of aid in decision-making. Several categories of problems were considered: the global conception of the information system, the organisation of the datawarehouse, which offers different viewpoints of the data, the integration of heterogeneous data coming from different sources, data exchange and definition of a specific ontology.     

Weather patterns, food security and humanitarian response in sub-Saharan Africa

Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hence the economic and social well being of rural communities. The rainfall pattern in sub-Saharan Africa is influenced by large-scale intra-seasonal and inter-annual climate variability including occasional El Ni?o events in the tropical Pacific resulting in frequent extreme weather event such as droughts and floods that reduce agricultural outputs resulting in severe food shortages. Households and communities facing acute food shortages are forced to adopt coping strategies to meet the immediate food requirements of their families. These extreme responses may have adverse long-term, impacts on households' ability to have sustainable access to food as well as the environment. The HIV/AIDS crisis has also had adverse impacts on food production activities on the continent. In the absence of safety nets and appropriate financial support mechanisms, humanitarian aid is required to enable households effectively cope with emergencies and manage their limited resources more efficiently. Timely and appropriate humanitarian aid will provide households with opportunities to engage in productive and sustainable livelihood strategies. Investments in poverty reduction efforts would have better impact if complemented with timely and predictable response mechanisms that would ensure the protection of livelihoods during crisis periods whether weather or conflict-related. With an improved understanding of climate variability including El Ni?o, the implications of weather patterns for the food security and vulnerability of rural communities have become more predictable and can be monitored effectively. The purpose of this paper is to investigate how current advances in the understanding of climate variability, weather patterns and food security could contribute to improved humanitarian decision-making. The paper will propose new approaches for triggering humanitarian responses to weather-induced food crises.     

基于马尔科夫链的医疗决策

在临床实践中,医生和患者均面临决策,由于医生和患者个体知识经验的局限性,仅依赖个人经验的决策判断难以全面评估治疗方案的好坏,而通过马尔科夫链模型可以帮助医生和患者对复杂疾病建立抽象模型,便于对疾病的各治疗效果进行决策分析。马尔科夫链模型是处理离散事件的随机过程,通过当前设定的信息,预测将来的情况。本文总结了马尔科夫链在医疗决策中的应用的基本原理,梳理了在医疗决策领域常用的马尔科夫链模型的分类,针对医疗决策的特点探讨不同类型马尔科夫链的矩阵法、队列法以及蒙特卡洛模拟分析方法的适用范围和优缺点。针对疾病进展的三状态模型以及是否使用某药物的实际决策案例,分析比较队列法与蒙特卡洛模拟法的具体应用,总结归纳队列法与蒙特卡洛模拟法的优缺点。     

Characteristics of participatory monitoring projects and their relationship to decision-making in biological resource management: a review

The main objective of participatory monitoring is to enable the local population, though lacking formal training, to participate in the systematic collection of information. Participatory monitoring has been increasingly adopted in recent decades as a way of devolving the power to make decisions about natural resource management from the government to more local institutions. However, participatory monitoring efforts are not always successful at translating the information obtained into management or conservation actions. Based on a review of the current literature, we selected 111 cases that applied participatory monitoring of biological resources, to determine the factors that influence the translation of information into decision-making for management. For this, we categorize the cases into two approaches based on their differences regarding conceptual lines: collaborative-learning and evidence-based, and then assessed which one is more successful in the use of information. According to the cases reviewed, information derived from the collaborative-learning approach was more often used in management decision-making. The use of information is also influenced by the degree of local decision-making power, meaning that in those cases where there are initiatives of decentralization for decision-making besides participatory monitoring, it is more possible that the information derived from monitoring is used to strengthen the local initiatives of management and conservation.     

American Association of Clinical Endocrinologists and American College of Endocrinology Consensus Conference on Obesity: Building an Evidence Base for Comprehensive Action

Objective/MethodsThe American Association of Clinical Endocrinologists/American College of Endocrinology “Consensus conference on obesity: building an evidence base for comprehensive action” convened March 23-25, 2014, in Washington, D.C. The premise of the conference was that by bringing together stakeholders in U.S. obesity care, representing the biomedical and public health models, new information would emerge to formulate actionable recommendations.ResultsKey conference findings include 5 affirmed and 8 emergent concepts. These concepts include the need for a medically meaningful and actionable diagnosis of obesity, research that evaluates and refines a complications- centric clinical approach to obesity, the need for a better understanding of reimbursement mechanisms and the value associated with obesity prevention and management, increased nutrition and obesity education, and enhanced public awareness and health literacy.ConclusionNext steps include deriving a more robust medical definition of obesity, translation of the affirmed and emergent concepts into actionable recommendations in the interests of patients with obesity, and developing logistics for effective implementation. (Endocr Pract. 2014; 20:956-976)     

A management-oriented framework for selecting metrics used to assess habitat- and path-specific quality in spatially structured populations

Mobile species with complex spatial dynamics can be difficult to manage because their population distributions vary across space and time, and because the consequences of managing particular habitats are uncertain when evaluated at the level of the entire population. Metrics to assess the importance of habitats and pathways connecting habitats in a network are necessary to guide a variety of management decisions. Given the many metrics developed for spatially structured models, it can be challenging to select the most appropriate one for a particular decision. To guide the management of spatially structured populations, we define three classes of metrics describing habitat and pathway quality based on their data requirements (graph-based, occupancy-based, and demographic-based metrics) and synopsize the ecological literature relating to these classes. Applying the first steps of a formal decision-making approach (problem framing, objectives, and management actions), we assess the utility of metrics for particular types of management decisions. Our framework can help managers with problem framing, choosing metrics of habitat and pathway quality, and to elucidate the data needs for a particular metric. Our goal is to help managers to narrow the range of suitable metrics for a management project, and aid in decision-making to make the best use of limited resources.     

Factors Associated with Nursing Activities in Humanitarian Aid and Disaster Relief

Background

Although nurses play an important role in humanitarian aid and disaster relief (HA/DR), little is known about the nursing activities that are performed in HA/DR. We aimed to clarify the nursing activities performed by Japanese nurses in HA/DR and to examine the factors associated with the frequency of nursing activities.

Methods

A self-administered questionnaire survey was completed by 147 nurses with HA/DR experience. The survey extracted information on demographic characteristics, past experience (e.g., disaster medical training experience, HA/DR experience), circumstances surrounding their dispatched to HA/DR (e.g., team size, disaster type, post-disaster phase, mission term), and the frequency of nursing activities performed under HA/DR. The frequency of nursing activities was rated on a 5-point Likert scale. Evaluation of nursing activities was conducted based on the “nursing activity score”, which represents the frequency of each nursing activity. Factors related to the nursing activity score were evaluated by multiple logistic regression analysis.

Results

Nurses were involved in 27 nursing activities in HA/DR, 10 of which were performed frequently. On analysis, factors significantly associated with nursing activity score were nursing license as a registered nurse (OR 7.79, 95% CI 2.95–20.57), two or more experiences with disaster medical training (OR 2.90 95%, CI 1.12–7.49) and a post-disaster phase of three weeks or longer (OR 8.77, 95% CI 2.59–29.67).

Conclusions

These results will contribute to the design of evidence-based disaster medical training that improves the quality of nursing activities.     

蝗虫的发生与防控

蝗虫暴发引起的灾害是全球重要的生物灾害,可影响到全世界十分之一的人口。自2019年,东部非洲、西亚、南亚多个国家遭遇严重的沙漠蝗虫灾害,这场蝗灾不但对该区域的粮食安全构成严重威胁,而且还有可能引发严重的人道主义危机。为了制定合理的防治方案,实施有效防控,避免大规模蝗灾的发生,需要掌握蝗虫的生物学、生态学、暴发和为害规律、防治策略和技术特点及其进展等。本文介绍了世界各地包括沙漠蝗、飞蝗、澳大利亚疫蝗在内的11种可以引起灾害的重要种类的主要分布、为害和特性,并对国内外蝗虫防治策略、技术进展进行了重点综述。最后,针对目前蝗虫防治存在的问题提出了相应建议。     

Information Dissemination Analysis of Different Media towards the Application for Disaster Pre-Warning

Knowing the information dissemination mechanisms of different media and having an efficient information dissemination plan for disaster pre-warning plays a very important role in reducing losses and ensuring the safety of human beings. In this paper we established models of information dissemination for six typical information media, including short message service (SMS), microblogs, news portals, cell phones, television, and oral communication. Then, the information dissemination capability of each medium concerning individuals of different ages, genders, and residential areas was simulated, and the dissemination characteristics were studied. Finally, radar graphs were used to illustrate comprehensive assessments of the six media; these graphs show directly the information dissemination characteristics of all media. The models and the results are essential for improving the efficiency of information dissemination for the purpose of disaster pre-warning and for formulating emergency plans which help to reduce the possibility of injuries, deaths and other losses in a disaster.     

Phenology research for natural resource management in the United States

Natural resource professionals in the United States recognize that climate-induced changes in phenology can substantially affect resource management. This is reflected in national climate change response plans recently released by major resource agencies. However, managers on-the-ground are often unclear about how to use phenological information to inform their management practices. Until recently, this was at least partially due to the lack of broad-based, standardized phenology data collection across taxa and geographic regions. Such efforts are now underway, albeit in very early stages. Nonetheless, a major hurdle still exists: phenology-linked climate change research has focused more on describing broad ecological changes rather than making direct connections to local to regional management concerns. To help researchers better design relevant research for use in conservation and management decision-making processes, we describe phenology-related research topics that facilitate “actionable” science. Examples include research on evolution and phenotypic plasticity related to vulnerability, the demographic consequences of trophic mismatch, the role of invasive species, and building robust ecological forecast models. Such efforts will increase phenology literacy among on-the-ground resource managers and provide information relevant for short- and long-term decision-making, particularly as related to climate response planning and implementing climate-informed monitoring in the context of adaptive management. In sum, we argue that phenological information is a crucial component of the resource management toolbox that facilitates identification and evaluation of strategies that will reduce the vulnerability of natural systems to climate change. Management-savvy researchers can play an important role in reaching this goal.     

Effectiveness of Mechanisms and Models of Coordination between Organizations,Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review

Background

Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes.

Methods

We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach.

Results

Of 14,309 identified citations from databases and organizations'' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality.

Conclusion

This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field.     

The Value of In Vitro Diagnostic Testing in Medical Practice: A Status Report

BackgroundIn vitro diagnostic (IVD) investigations are indispensable for routine patient management. Appropriate testing allows early-stage interventions, reducing late-stage healthcare expenditure (HCE).AimTo investigate HCE on IVDs in two developed markets and to assess the perceived value of IVDs on clinical decision-making. Physician-perceived HCE on IVD was evaluated, as well as desired features of new diagnostic markers.MethodsPast and current HCE on IVD was calculated for the US and Germany. A total of 79 US/German oncologists and cardiologists were interviewed to assess the number of cases where: physicians ask for IVDs; IVDs are used for initial diagnosis, treatment monitoring, or post-treatment; and decision-making is based on an IVD test result. A sample of 201 US and German oncologists and cardiologists was questioned regarding the proportion of HCE they believed to be attributable to IVD testing. After disclosing the actual IVD HCE, the physician’s perception of the appropriateness of the amount was captured. Finally, the association between physician-rated impact of IVD on decision-making and perceived contribution of IVD expenditure on overall HCE was assessed.ResultsIVD costs account for 2.3% and 1.4% of total HCE in the US and Germany. Most physicians (81%) believed that the actual HCE on IVDs was >5%; 19% rated the spending correctly (0–4%, p<0.001). When informed of the actual amount, 64% of physicians rated this as appropriate (p<0.0001); 66% of decision-making was based on IVD. Significantly, more physicians asked for either additional clinical or combined clinical/health economic data than for the product (test/platform) alone (p<0.0001).ConclusionsOur results indicate a poor awareness of actual HCE on IVD, but a high attributable value of diagnostic procedures for patient management. New markers should deliver actionable and medically relevant information, to guide decision-making and foster improved patient outcomes.     

全国园林绿化数字化管理体系及平台建设研究

近年来，随着新一代信息技术的兴起和推广应用，城市园林绿化数字化建设目前在国内已普遍开展。针对部、省、市三级园林绿化管理体系的内容和特点，研究以信息技术为载体的不同层级园林绿化管理体系的构建及实现方法。通过建立全国园林绿化数字化管理平台，串联城市园林绿化建设、管理和养护等各项工作，以引导各级管理部门利用园林绿化大数据进行监督管理、辅助决策和服务公众，提升城市园林绿化科学化、动态化、精细化管理水平。     

Elaboración y validación de un nuevo cuestionario de hábitos alimentarios para pacientes con sobrepeso y obesidad

IntroductionWhen designing a comprehensive and personalized treatment for weight control, the information provided by obese patients on their dietary habits must be gathered correctly. Our objective was to develop and validate a new questionnaire on dietary habits for overweight and obese patients that could be used clinically.Material and methodsThe new questionnaire was developed and validated through a three-step process. Firstly, an existing questionnaire was reviewed. Secondly, a new questionnaire was developed, which included new items. Thirdly, scales to aid interpretation of the results in clinical practice were developed. Construct validity was assessed using factor analysis. The internal consistency reliability was analyzed.ResultsThe validity and reliability of the new questionnaire was confirmed. The values of the patients' responses to the new questionnaire were related to variables such as age, sex, body mass index, and whether or not the patients were under treatment for hypertension, diabetes mellitus or dyslipidemia.ConclusionThe validity and reliability of this questionnaire and the scales that aid their interpretation make it a useful tool for initial assessment and monitoring of changes in eating habits in response to treatment both individually and collectively in the Spanish population.