How to Reduce the Impact of "Low-Risk Patients" Following a Bioterrorist Incident: Lessons from SARS, Anthrax, and Pneumonic Plague
In: Biosecurity and bioterrorism: biodefense strategy, practice and science, Band 8, Heft 1, S. 37-43
ISSN: 1557-850X
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In: Biosecurity and bioterrorism: biodefense strategy, practice and science, Band 8, Heft 1, S. 37-43
ISSN: 1557-850X
In: Eldridge-Thomas , B & Rubin , G J 2013 , ' Idiopathic environmental intolerance attributed to electromagnetic fields : a content analysis of British newspaper reports ' PloS one , vol 8 , no. 6 , e65713 , pp. N/A . DOI:10.1371/journal.pone.0065713
Idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) is a controversial condition in which people describe symptoms following exposure to electromagnetic fields from everyday electrical devices. However, double-blind experiments have found no convincing evidence that electromagnetic fields cause these symptoms. In this study, we assessed whether recent newspaper reporting in the UK reflected this scientific evidence. We searched a database of newspaper articles to identify all those that contained IEI-EMF related keywords and selected a random sample of 60 for content analysis. For our primary outcomes, we assessed how many articles mainly or wholly presented an electromagnetic cause for IEI-EMF and how many discussed unproven treatments for the condition such as strategies intended to reduce exposure to electromagnetic fields or the use of complementary and alternative therapies. We also assessed whether the type of information source used by a newspaper article (e.g. scientist, person with IEI-EMF, politician) or the type of newspaper (broadsheet, tabloid, local or regional) was associated with either outcome. Of the 60 articles, 43 (71.7%) presented a mainly electromagnetic cause, compared to 13 (21.7%) which presented mainly non-electromagnetic causes and 4 (6.7%) which did not discuss a cause. 29 (48.3%) did not mention any potential treatment, while 24 (40.0%) mentioned eletromagnetic field related strategies and 12 (20.0%) mentioned complementary or alternative therapies. Articles which quoted someone with IEI-EMF were significantly more likely to report an electromagnetic cause and to present unproven treatments. Those which used a scientist as a source were more likely to present a non-electromagnetic cause for the condition. The widespread poor reporting we identified is disappointing and has the potential for to encourage more people to misattribute their symptoms to electromagnetic fields. Scientists should remain engaged with the media to counteract this effect.
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In: Health security, Band 19, Heft 4, S. 353-363
ISSN: 2326-5108
In: Biosecurity and bioterrorism: biodefense strategy, practice and science, Band 11, Heft 1, S. 49-58
ISSN: 1557-850X
In: Biosecurity and bioterrorism: biodefense strategy, practice and science, Band 10, Heft 4, S. 383-395
ISSN: 1557-850X
In: Journal of contingencies and crisis management, Band 29, Heft 1, S. 54-76
ISSN: 1468-5973
AbstractThe UK's Initial Operational Response (IOR) decontamination protocol requires that chemically contaminated casualties remove contaminated clothing (disrobe) and then apply water or absorbent materials to skin. The health‐protective efficacy of the protocol is predicated on casualties quickly accepting both the need to act and the fact that this protocol is an effective action. The aim of this study was to test whether adherence is affected by the presentation of information by first responders about the severity and likelihood of contamination (Threat) and the health‐protective efficacy of IOR procedures (efficacy). A double‐blind randomized controlled experiment (N = 132) with a 3x2 independent measures design (registration number: ISRCTN17886859) was used to assess the effects of threat and efficacy on behavioural expectations during a simulated chemical incident, presented as an immersive video. Results indicated that addressing the threat of contamination made participants more likely to expect themselves to disrobe were the situation real. Emphasizing the efficacy of protective action made participants more likely to expect themselves to apply absorbent materials to skin and had an indirect positive effect on disrobing expectations, mediated by efficacy perceptions. We recommend that first responders explicitly address the threat of contamination and efficacy of decontamination when communicating with chemically contaminated casualties.
Assessing mental health needs following a disaster is important, particularly within high‐risk groups such as first responders or individuals who found themselves directly caught up in the incident. Particularly following events involving widespread destruction, ingenuity and hard work are required to successfully study these issues. When considering responses among the general population following less devastating events such as a conventional terrorist attack, or following an event involving a chemical, biological, radiological or nuclear agent, other variables may become more relevant for determining the population's overall psychosocial well‐being. Trust, perceived risk, sense of safety, willingness to take prophylaxis and unnecessary attendance at medical facilities will all be important in determining the overall psychological, medical, economic and political impact of such attacks. Assessing these variables can help government agencies and non‐governmental organizations to adjust their communication and outreach efforts. As there is often a need to provide these data quickly, telephone surveys using short time‐windows for data collection or which use quota samples are often required. It is unclear whether slower, more conventional and more expensive survey methods with better response rates would produce results different enough to these quicker and cheaper methods to have a major impact on any resulting policy decisions. This empirical question would benefit from further study. Copyright © 2008 John Wiley & Sons, Ltd.
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In: Health security, Band 13, Heft 1, S. 45-53
ISSN: 2326-5108
In: International Journal of Emergency Services, Band 2, Heft 1, S. 29-48
In: Disaster prevention and management: an international journal, Band 22, Heft 2, S. 132-147
ISSN: 1758-6100
PurposeReports from small‐scale incidents in which decontamination was conducted suggest that a successful communication strategy is vital in order to increase public compliance with, and reduce public anxiety about, decontamination. However, it has not been possible to examine public behaviour during large scale incidents involving decontamination. The aim of the research reported here was to examine the relationship between people's positive perceptions of responding agencies' communication strategies and relevant outcome variables, such as level of compliance and level of reassurance, in several field exercises involving mass decontamination.Design/methodology/approachData were collected using feedback questionnaires completed by simulated casualties, which contained items relating to casualties' perceptions of the success of responding agencies' communication strategies, their confidence in emergency responders, and their compliance with the decontamination process. Path analysis was used to examine the relationships between variables.FindingsResults show a significant relationship between responding agencies' communication strategies, level of public reassurance, and level of public compliance. The relationship between responders' communication strategies and the outcome variables was partially mediated by public confidence in responders.Practical implicationsEmergency responders should focus on communication with members of the public as a key element of the decontamination process, as failure to do so could result in high levels of anxiety and low levels of compliance among those who are affected.Originality/valueThis research highlights the importance of effective responder communication strategies. Further, findings indicate the value of examining feedback from field exercises in order to facilitate a greater understanding of public experiences of the decontamination process.
In: Biosecurity and bioterrorism: biodefense strategy, practice and science, Band 10, Heft 3, S. 280-289
ISSN: 1557-850X
OBJECTIVES: Malicious incidents involving chemical agents sometimes trigger high public concern. We aimed to (1) identify levels of emotion, perceived risk and behaviour change with regard to visiting Salisbury, 1 month after three people were poisoned with a nerve agent; and (2) test whether factors including receipt of information, beliefs about personal exposure and trust in government were associated with these outcomes. DESIGN: A cross-sectional telephone survey of a random sample of Salisbury residents. SETTING: Conducted between 5 and 13 April 2018. PARTICIPANTS: 500 residents aged 18 or over. OUTCOME MEASURES: Self-reported anxiety, anger, uncertainty, perceived risk to self and avoidance of Salisbury. RESULTS: Any degree of anxiety, anger and uncertainty was reported by 40.6%, 29.8% and 30.6% of participants, respectively. For the majority, the level of emotion reported was mild. Only 7.0% met the criteria for high anxiety and 5.2% reported feeling any risk to their health, whereas 18.6% reported avoiding Salisbury. Factors associated with avoidance of Salisbury included being female, unable to rule out exposure for oneself or of loved ones, believing the incident was targeted against the general public, and lower trust in the government and responding agencies. Hearing a lot or a little about the recovery support (eg, financial packages), as opposed to nothing at all, and being satisfied with this information were associated with reduced avoidance. CONCLUSIONS: Although the March 2018 Salisbury incident had a relatively modest impact on emotion and risk perception in the community, the number who reported avoiding the city was notable. In this, and in future incidents, assuring people that contamination resulted from a targeted, rather than indiscriminate, incident; demonstrating that contamination is contained within specific areas; improving communication about any financial support; and promoting trust in responding agencies should help provide additional reassurance to the community.
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In: Han , Y K J , Michie , S , Potts , H W W & Rubin , G J 2016 , ' Predictors of influenza vaccine uptake during the 2009/10 influenza A H1N1v ('swine flu') pandemic : Results from five national surveys in the United Kingdom ' , Preventive Medicine , vol. 84 , pp. 57-61 . https://doi.org/10.1016/j.ypmed.2015.12.018
Objectives: To investigate reasons underlying the low uptake of the influenza A H1N1v vaccination in the UK during the 2009/10 pandemic. Methods: We analysed data from five national telephone surveys conducted in the UK during the latter stages of the pandemic to identify predictors of uptake amongst members of the public offered the vaccine by their primary care physician (n=1320). In addition to demographic variables, participants reported: reasons for declining the vaccination, levels of worry about the risk of catching swine flu, whether too much fuss was being made about the pandemic, whether they or a close friend or relative had had swine flu, how effective they felt the vaccine was, whether they had previously had a seasonal flu vaccination, how well prepared they felt the government was for a pandemic and how satisfied they were with information available about the pandemic. Most participants (n=734, 55.6%) reported being vaccinated against swine flu, compared to 396 who had not been vaccinated and were unlikely to be vaccinated in the future. Results: The main reasons given for declining vaccination were concerns over the vaccine's safety, and being generally healthy. Controlling for demographic variables, risk factors for not being vaccinated were: being female, not having a long-standing infirmity or illness, not having been vaccinated against seasonal flu in previous years, feeling that too much fuss had been made about the pandemic and believing that the vaccine was ineffective. Conclusions: Interventions that target these factors may be effective in improving uptake in a future pandemic.
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PURPOSE: To describe and discuss a systematic method for producing a very rapid response (3 days) to a UK government policy question in the context of reducing SARS-CoV-2 transmission. METHODS: A group of behavioural and social scientists advising the UK government on COVID-19 contributed to the analysis and writing of advice through the Government Office for Science. The question was as follows: What are the options for increasing adherence to social distancing (staying at home except for essential journeys and work) and shielding vulnerable people (keeping them at home and away from others)? This was prior to social distancing legislation being implemented. The first two authors produced a draft, based on analysis of the current government guidance and the application of the Behaviour Change Wheel (BCW) framework to identify and evaluate the options. RESULTS: For promoting social distancing, 10 options were identified for improving adherence. They covered improvements in ways of achieving the BCW intervention types of education, persuasion, incentivization, and coercion. For promoting shielding of vulnerable people, four options were identified covering the BCW intervention types of incentivization, coercion, and enablement. CONCLUSIONS: Responding to policymakers very rapidly as has been necessary during the COVID-19 pandemic can be facilitated by using a framework to structure the thinking and reporting of multidisciplinary academics and policymakers.
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PURPOSE: To describe and discuss a systematic method for producing a very rapid response (3 days) to a UK government policy question in the context of reducing SARS‐CoV‐2 transmission. METHODS: A group of behavioural and social scientists advising the UK government on COVID‐19 contributed to the analysis and writing of advice through the Government Office for Science. The question was as follows: What are the options for increasing adherence to social distancing (staying at home except for essential journeys and work) and shielding vulnerable people (keeping them at home and away from others)? This was prior to social distancing legislation being implemented. The first two authors produced a draft, based on analysis of the current government guidance and the application of the Behaviour Change Wheel (BCW) framework to identify and evaluate the options. RESULTS: For promoting social distancing, 10 options were identified for improving adherence. They covered improvements in ways of achieving the BCW intervention types of education, persuasion, incentivization, and coercion. For promoting shielding of vulnerable people, four options were identified covering the BCW intervention types of incentivization, coercion, and enablement. CONCLUSIONS: Responding to policymakers very rapidly as has been necessary during the COVID‐19 pandemic can be facilitated by using a framework to structure the thinking and reporting of multidisciplinary academics and policymakers.
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