Hospital disaster staffing: If you call, will they come?

Objective: To assess hospital employees’ attitudes and needs regarding work commitments during disasters.Methods: A 12-item survey was distributed to employees at nine hospitals in five states. Questions addressed willingness to work during a disaster or its aftermath, support services that could encourage employees to remain for extended hours, and conflicting emergency response obligations (e.g., being a volunteer firefighter) that might prevent employees from working at the hospital. Anonymity was assured, and approval was obtained from each hospital’s institutional review board.Results: Of the 2,004 surveys distributed, 1,711 (85 percent) were returned. Eighty-seven percent of respondents were willing to work after a fire/rescue/collapse mass casualty incident. Respondents were otherwise less willing to work in response to a man-made disaster (biological event: 58 percent; chemical event: 58 percent; radiation event: 57 percent) than a natural disaster (snowstorm: 83 percent; flood: 81 percent; hurricane: 78 percent; earthquake: 79 percent; tornado: 77 percent; ice storm: 75 percent; flu epidemic: 72 percent) (p 0.001 for all comparisons by χ2 testing). While 44 percent of respondents would come to work in response to any of the 11 disaster types listed, 19 percent were only willing to cover four or fewer types. Long-distance phone service (694, 41 percent), email access (584, 34 percent), pet care (568, 33 percent), and child care (506, 30 percent) were the most common support needs, and 365 respondents (21 percent) reported a conflicting emergency response obligation.Conclusions: The majority of hospital workers surveyed were willing to report to work in response to some types of disasters but not others, and some indicated they might not be available at all due to conflicting emergency response obligations.

Novel Analysis and Visualization of Chemical Events for Public Health Surveillance

ObjectivePacific Northwest National Laboratory hosted an intern-basedweb application development contest in the summer of 2016 centeredaround developing novel chemical surveillance applications to aid inhealth situational awareness. Making up the three teams were threegraduate students (n=9) from various US schools majoring in non-public health domains, such as computer sicence and user design. Theinterns suc- cessfully developed three applications that demonstrateda value-add to chemical surveillance—ChemAnalyzer (textanalytics), RetroSpect (retrospective analysis of chemical events),and ToxicBusters (geo-based trend analytics). These applicationswill be the basis for the first chemical surveillance application to beincorporated into the DTRA Biosurveillance Ecosystem (BSVE).IntroductionPacific Northwest National Laboratory (PNNL), on behalf theDefense Threat Reduction Agency (DTRA; project number CB10190),hosts an annual intern- based web app development contest. Previouscompetitions have focused on mobile biosurveillance applications.The 2016 competition pivoted away from biosurveillance to focus onaddressing challenges within the field of chemical surveillance andincreasing public health chemical situational awareness. The result ofthe app will be integrated within the DTRA BSVE.MethodsPNNL hosted nine graduate interns for a 10-week period inthe summer of 2016 as participants in a summer web applicationdevelopment contest. Students were drawn from such fields assoftware engineering and user experience and design and placedinto three teams of three students. The challenge presented to theinterns was to design and develop a fully-functional web applicationthat would address a critical need within the chemical surveillancecommunity. The interns developed their own ideas (vetted by PNNLand DTRA), discovered and inte- grated their own data sources,and produced their own visualizations and an- alytics, independentof any assistence outside of that provided in an advisory capacity.The competition end with a judging event with a panel of subjectmatter experts and cash awards were distributed to the teams.ResultsEach team produced a unique application. Although there wasmild overlap between some of the ideas, the applications weredeveloped independently and each reflected the unique contributionsof the teams. ChemAnalyzer is a text-analytics platform designedto facilitate more data- driven decision, given a corpus of text dataabout a chemical event. Their plat- form provided the ability toautomatically identify and highlight key words in documents relatedto chemical events. The keywords are drawn from an on- tologyinstalled with the system, as well as any user-identified keywords.The ChemAnalyzer team finished in third place. The RetroSpect teamdeveloped a visual analytic tool for performing retrospec- tive analysisand monitoring of chemical events. Their app provided the ability tosearch and analyze past events, as well as visualization of state andcounty information for the recorded chemical events. The RetroSpectteam finished in second place. The Toxicbusters team—the winnersof the competition—created a geo-based situational awareness toolfor tracking chemical events. Their app featured an updateable mapoverlay, search functionality for finding specific or related events,incident and city/state/national-level statistics and trends, as wellas news and social media integration based on keywords related tochemical surveillance.ConclusionsEach of the apps developed by the teams provides value to ananalyst tasked with monitoring chemical events. The apps integratedunique data sources to provides a full picture of a chemical event, andits effects upon the surrounding population. This integrated analyticsprovides a valuable benefit over existing workflows, where analystsmust monitor news, social, and other information sources manuallyfor real-time information. The apps developed by these interns aredesigned to enable identification and analysis of the incident asquickly as possible, allowing for more timely assessments of theincident and its impacts. The web app development contest provideda unique opportunity for students to learn about the emergingneeds in chemical surveillance as it relates to health sit- uationalawareness. Students were drawn from a variety of fields and weretasked with developing novel web apps addressing some of the mostpressing challenges in the field of chemical surveillance. The ideasgenerated by the students will help form the basis for future chemicalsurveillance application development to be integrated with the DTRABSVE.

Cracked Open and Knit Together by Oxygen

The happy insight that biology and geology meet through chemistry has been seen throughout this book when life and rocks interact. A chemical called water transformed this planet’s rocks and opened them to give life its elemental building blocks. The energy in the Earth became the energy in simple cells through chemical wheels. Sunlight split the water with the help of dissolved rocks, and the oxygen from that reaction brought yet more elements out of the rocks and into life. That insight addresses a long-standing mystery here. Long ago, the biggest biologi­cal change in the history of the planet created plant and animal life. What caused the seas to teem with weird new life? I think the periodic table connects that biological event to a previous global geological change. If so, then once again, chemical reactions opened up geology to provide new possibilities for biological complexity. Chemistry shaped the flow of geology and biology at once. The evidence for this connection is like something that happened with the ekko sculpture in northwest Scotland from Chapter 2 (Figure 2.1). After the sculpture had been built, an archaeologist dropped by and found incisions in ekko’s rocks. The archaeologist read the shape and depth of the incisions and concluded that the stones were older than everyone thought, and must have been used for a structure now lost. Like in ekko, there are “incisions” on the Earth made by massive geological processes. Geologists have read these and have concluded that a worldwide event altered the planet’s surface. This geological event was also a chemical event. Soon after, a profusion of fossils filled the rocks. This biological event was also a chemical event. The common denominator of chemistry connects the geology to the biology. The geological event provided chemicals that life used in new ways: especially oxygen, phosphorous, and calcium, resulting in new energy, shells, and signals for life. This hypothesis is that chemical availability drove the evolution of life, and that the periodic table shaped the timing of life’s greatest expansion.