China ; Disaster Planning ; organization & administration ; Emergency Medical Services ; organization & administration ; Humans ; Wounds and Injuries ; prevention & control ; therapy

OBJECTIVES: Bioterrorism (BT) preparedness and response plans are particularly important among healthcare workers who will be among the first involved in the outbreak situations. This study was conducted to evaluate the current status of education for BT preparedness and response in healthcare-related colleges/junior colleges and to develop learning objectives for use in their regular curricula. METHODS: We surveyed all medical colleges/schools, colleges/junior colleges that train nurses, emergency medical technicians or clinical pathologists, and 10% (randomly selected) of them that train general hygienists in Korea. The survey was conducted via mail from March to July of 2007. We surveyed 35 experts to determine if there was a consensus of learning objectives among healthcare workers. RESULTS: Only 31.3% of medical colleges/schools and 13.3% of nursing colleges/junior colleges had education programs that included BT preparedness and responses in their curricula. The most common reason given for the lack of BT educational programs was 'There is not much need for education regarding BT preparedness and response in Korea'. None of the colleges/junior colleges that train clinical pathologists, or general hygienists had an education program for BT response. After evaluating the expert opinions, we developed individual learning objectives designed specifically for educational institutions. CONCLUSIONS: There were only a few colleges/junior colleges that enforce the requirement to provide education for BT preparedness and response in curricula. It is necessary to raise the perception of BT preparedness and response to induce the schools to provide such programs.
*Bioterrorism ; Curriculum ; Disaster Planning/*organization & administration ; Humans ; Korea ; Schools, Health Occupations/*organization & administration

Disaster Planning ; organization & administration ; Emergencies ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; methods

OBJECTIVETo investigate the capacity for risk identification, assessment, and mitigation in public health emergency management in China.

METHODSFour provinces were randomly selected using stratified sampling. All the municipalities under these four provinces were assessed using the 3rd subscale (Risk Identification, Risk Assessment, and Risk Mitigation) of Preparedness and Response Capacity Questionnaire for Public Health Emergencies Used in Provincial or Municipal Governments, which was developed by the Center for Health Statistics and Information, Ministry of Health of the People's Republic of China.

RESULTSSixty of 66 questionnaires (90.91%) were collected. Among 60 investigated municipalities, 35 (58%) identified the potential public health emergencies, 17 (28%) assessed the risks for the identified emergencies, and 5 (8%) conducted risk assessments for the locally accident-prone factories, mines, corporations, and big establishments, 6 (10%) identified the priorities in public health emergency management based on risk assessment, 6 (10%) developed special prevention strategies for main public health emergencies, 3 (5%) assessed the vulnerability of local residents to public health emergencies, and 34 (57%) assessed or were assessing the preparedness and response capacity for public health emergencies in the past 2 years. The mean of standard total score for risk identification, assessment, and mitigation was 24.05 (95% CI: 18.32, 29.77).

CONCLUSIONRisk identification, assessment, and mitigation still require further improvement in China, and both the central and local authorities should implement more effective and efficient measures.

China ; Disaster Planning ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; Risk Assessment

Due to heightened concerns regarding possible bioterrorist attacks, the Korea Center for Disease Control and Prevention introduced syndromic surveillance systems, which have been run by emergency departments in hospitals throughout Korea since 2002. These systems are designed to identify illness clusters before diagnoses are confirmed and reported to public health agencies, to mobilize a rapid response, and thereby to reduce morbidity and mortality. The Korea Center for Disease Control and Prevention performed drop-in syndromic surveillance successfully during the World Cup Football Games in 2002, the Universiad games in 2004, and the Asian Pacific Economic Cooperation meeting in 2005. In addition, sustainable syndromic surveillance system involving the collaborative efforts of 125 sentinel hospitals has been in operation nationwide since 2002. Because active data collection can bias decisions a physician makes, there is a need to generate an automatic and passive data collection system. Therefore, the Korea Center for Disease Control and Prevention plans to establish computerized automatic data collection systems in the near future. These systems will be used not only for the early detection of bioterrorism but also for more effective public health responses to disease.
*Bioterrorism ; Disaster Planning/organization & administration ; Disease Notification/*methods ; Disease Outbreaks/prevention & control ; Emergency Service, Hospital/*organization & administration ; Humans ; Korea ; Public Health Informatics/*organization & administration ; *Sentinel Surveillance ; Syndrome

Bioterrorism events have worldwide impacts, not only in terms of security and public health policy, but also in other related sectors. Many countries, including Korea, have set up new administrative and operational structures and adapted their preparedness and response plans in order to deal with new kinds of threats. Korea has dual surveillance systems for the early detection of bioterrorism. The first is syndromic surveillance that typically monitors non-specific clinical information that may indicate possible bioterrorismassociated diseases before specific diagnoses are made. The other is infectious disease specialist network that diagnoses and responds to specific illnesses caused by intentional release of biologic agents. Infectious disease physicians, clinical microbiologists, and infection control professionals play critical and complementary roles in these networks. Infectious disease specialists should develop practical and realistic response plans for their institutions in partnership with local and state health departments, in preparation for a real or suspected bioterrorism attack.
*Bioterrorism ; Communicable Disease Control/organization & administration ; Disaster Planning/*organization & administration ; Disease Notification/methods ; Disease Outbreaks/prevention & control ; *Health Policy ; Humans ; Korea ; *Sentinel Surveillance ; Specialties, Medical/organization & administration

China ; epidemiology ; Disaster Planning ; organization & administration ; Disease Outbreaks ; prevention & control ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; epidemiology ; prevention & control

OBJECTIVETo establish a comprehensive assessment model on the ability of emergency response within the public health system in flooding-prone areas.

METHODSA hierarchy process theory was used to establish the initial assessing framework. Delphi method was used to screen and choose the ultimate indicators and their weights before an assessment model was set up under the 'synthetic scored method' to assess the ability of the emergency response among twenty county public health units. We then used the 'analysis of variation (ANOVA)' methodology to test the feasibility of distinguishing the ability of emergency response among different county health units and correlation analysis was used to assess the independence of indicators in the assessing model.

RESULTSA comprehensive model was then established including twenty first-class indicators and fifty-six second-class indicators and the degree of ability to emergency response with flooding of public health units was evaluated. There were five public health units having higher, ten having moderate but five with lower levels on emergency response. The assessment model was proved to be a good method in differentiating the ability of public health units, using independent indicators.

CONCLUSIONThe assessment model which we established seemed to be practical and reliable.

Analysis of Variance ; China ; Delphi Technique ; Disaster Planning ; organization & administration ; Emergency Medical Services ; organization & administration ; Feasibility Studies ; Floods ; Geography ; Humans ; Models, Theoretical ; Public Health Administration ; Reproducibility of Results

OBJECTIVETo make the emergency response to the diseases control and prevention with flooding more scientific ally-based and efficient.

METHODSHubei and Jiangxi province were chosen as the study fields and to establish a data management system of emergency response on flooding using remote sensing (RS) and geographical information system (GIS).

RESULTSSpatial and basic data together with data on flooding were linked to the code of location, and established on the platform of GIS. Through this system, information on flooding was able to be more rapidly and visually analysed.

CONCLUSIONUsing this system, the extent of flooding and the possible epidemic of some communicable diseases during flooding could be ascertained and predicted scientifically and the resource and capacity of emergency response to the disease control and prevention in flooding areas could also be evaluated.

China ; Databases, Factual ; Disaster Planning ; organization & administration ; Disasters ; Environmental Monitoring ; Female ; Geographic Information Systems ; organization & administration ; Humans ; Male ; Management Information Systems

OBJECTIVE: To develop a capacity questionnaire in public health emergency for Chinese local governments. METHODS: Literature reviews, conceptual modelling, stake-holder analysis, focus group, interview, and Delphi technique were employed together to develop the questionnaire. Classical test theory and case study were used to assess the reliability and validity. RESULTS: (1) A 2-dimension conceptual model was built. A preparedness and response capacity questionnaire in public health emergency with 10 dimensions and 204 items, was developed. (2) Reliability and validity results. Internal consistency: except for dimension 3 and 8, the Cronbach's alpha coefficient of other dimensions was higher than 0.60. The alpha coefficients of dimension 3 and dimension 8 were 0.59 and 0.39 respectively; Content validity: the questionnaire was recognized by the investigatees; Construct validity: the Spearman correlation coefficients among the 10 dimensions fluctuated around 0.50, ranging from 0.26 to 0.75 (P<0.05); Discrimination validity: comparisons of 10 dimensions among 4 provinces did not show statistical significance using One-way analysis of variance (P>0.05). Criterion-related validity: case study showed significant difference among the 10 dimensions in Beijing between February 2003 (before SARS event) and November 2005 (after SARS event). CONCLUSION The preparedness and response capacity questionnaire in public health emergency is a reliable and valid tool, which can be used in all provinces and municipalities in China.
China ; Community Health Services ; Disaster Planning ; organization & administration ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; education ; Risk Assessment ; Surveys and Questionnaires