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- Hugelius, Karin, 1977-
(författare)
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Disaster response for recovery : survivors experiences, and the use of disaster radio to promote health after natural disasters
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Disasters occur all over the world, and affect a rising number of people. The health effects of natural disasters depend on several factors present before, during, and after a disaster event. However, there is only limited knowledge of survivors experiences, needs, and health after natural disasters. Disaster radio means a temporary radio station that broadcasts information, music, and support to the affected population. Disaster radio has the potential to function even in a severely affected area, but its effects need to be further evaluated from a health perspective. The context of this thesis was the Haiyan supertyphoon that hit parts of the Philippines in November 2013.The overall aim was to describe survivors’ and health professionals’ experiences during and in the immediate aftermath of a natural disaster, the health effects from such a disaster, and how disaster radio as a disaster response intervention can be used and evaluated from a health perspective. The thesis includes four studies using qualitative research methods, including content analysis and a phenomenological hermeneutic method, and quantitative methods with statistical analysis.The results show that the Haiyan typhoon affected physical, psychological, and social dimensions of health. Disaster radio was used to broadcast health-related information and psychosocial support, and made a positive contribution to recovery from the perspective of the survivors. Being a health professional deployed during the disaster was an experience of being both a helper and a victim. The use of a self-selected internetbased sample recruited via Facebook for a web-based survey mitigated several practical challenges related to disaster research, but also raised questions about the generalizability of the results.Based on the findings, the importance of an integrated physical, psychological, and social health response to natural disasters is emphazized. Also, the health care system should prepare to use disaster radio as disaster response. In addition, the results suggest that disaster training for health professionals should include personal preparation and coping strategies. Internet-based methods in disaster research need to be further evaluated.
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| 2. |
- Holgersson, Annelie, 1985-
(författare)
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Preparedness for mass-casualty attacks on public transportation
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Public transportation constitutes a vulnerable sector in modern day society with a high probability of generating mass casualties if attacked. By preparing for mass-casualty attacks (MCAs), response can become more effective and public transportation can become a less rewarding target. However, preparedness for attacks, much like response, implies resource constraints, and this dissertation pinpoints some major dilemmas that inhibit achieving preparedness for MCAs on public transportation in Sweden.Aim: The aim of this dissertation was to investigate preparedness for mass-casualty attacks on public transportation. This allowed for identification of major challenges for preparedness and response with a particular focus on the Swedish context.Methods: Study I included 477 MCAs identified through searches of the Global Terrorism Database, journals, newspapers and websites, which were examined with descriptive statistics. Study II thematically analyzed 105 articles attained by systematic searches of the PubMed and Scopus databases. Study III and IV statistically analyzed data from 864 responses to a purposive-designed questionnaire, from operational personnel of the Swedish emergency organizations. Study V entailed validation of a finite element (FE) simulation model of a bombing in a train carriage compared to the bombings in Madrid 2004.Results: International trends of MCAs (≥ 10 fatally injured and/or ≥ 100 non-fatally injured) on public transportation, during the years 1970-2009 (I) showed that the average number of injured increased considerably, despite a quite stable incidence rate since the 1980s. High numbers of injured people were connected to attacks on terminal buildings, multiple targets and complex tactical approaches. Few MCAs occurred in Europe, but the average number of fatalities per incident and injured per incident were the second highest among regions. The literature study (II) of previous on-scene management showed that commonly encountered challenges during unintentional incidents were added to during MCAs, implying specific issues for safety, assessment, triage and treatment, which require collaborative planning and specific training. The study regarding the Swedish emergency organizations’ perceptions of terrorist attacks (III) showed significant differences on perceptions of event likelihood, willingness to respond, estimated management capability and level of confidence in knowledge of tasks to be performed on scene. The police respondents stood out; e.g., fewer police personnel had high estimates of their organizations’ management capability and knowledge of tasks on-scene compared to the other organizations. The study of factors that influence responders’ perceptions of preparedness for terrorism (IV) showed that these were influenced by the responders’ sex, work experience, organizational affiliation, various training arrangements and access to personal protective equipment (PPE). Investing in amenable factors, such as terrorism-related management training and provision of PPE, could improve responders’ perceptions of preparedness for terrorism. A finite-element (FE) model of an explosion in a train carriage (V) was developed and showed that FE modeling techniques could effectively model damage and injuries for explosions with applicability for preparedness and injury mitigation efforts, but, also, there was room for improvement of the model in terms of injuries.Conclusion: Achieving preparedness for MCAs on public transportation is a multiple choice balancing act between ostensible dilemmas regarding investments, disaster plans, training, response strategies, collaboration and inventions.
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| 3. |
- Low, Janina Francisca Aili, 1966-
(författare)
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It’s Not Just a Burn : Physical and Psychological Problems after Burns
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Survival after severe burns has improved in recent decades, but there is limited information on the course of recovery after surviving a burn and on factors that can affect recovery. The aims of this thesis were to investigate the occurrence of physical and psychological problems after burns, and to examine the consequences of psychological problems for the clinical management of burn patients. Three groups of consecutive patients who were treated at the Burn Unit at Uppsala University Hospital between 1980 and 2005 were included in the studies. The Burn Specific Health Scale (BSHS) was used for self-report of burn-specific aspects of health. Personality traits and coping strategies as psychological factors during recovery were examined with the Swedish universities Scales of Personality (SSP) and the Coping with Burns Questionnaire (CBQ). Presence of symptoms of posttraumatic stress were assessed with the Impact of Event Scale-Revised (IES-R), and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to determine the concurrent validity of the IES-R as a measure of Posttraumatic Stress Disorder (PTSD). Furthermore, the effect of pre-injury psychiatric morbidity on perceived health one year after injury was assessed. Both pruritus and nightmares were common problems after burns; 59% of the individuals in the study reported pruritus and 43% reported nightmares. Neuroticism-related personality traits and avoidant coping strategies were associated with an increased risk of having pruritus or nightmares. The presence of nightmares could be used as a screening tool for high scores in the IES-R. The IES-R was in turn shown to be a good, although overly inclusive, test for the diagnosis of PTSD. Pre-injury psychiatric morbidity predicted perceived outcome in six out of nine burn-specific health domains. These studies show that psychological factors and psychiatric morbidity affect outcome after burns.
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