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COVER -- TITLE PAGE -- COPYRIGHT -- CONTENTS -- LIST OF FIGURES, TABLES, AND BOXES -- FOREWORD -- ABOUT THE AUTHORS -- AUTHORS' REFLECTIONS AND ACKNOWLEDGMENTS -- PUBLISHER'S NOTE -- 1 TYPES OF DISASTERS AND THEIR CONSEQUENCES -- 2 ROLE AND RESPONSIBILITY OF PUBLIC HEALTH -- 3 STRUCTURE AND ORGANIZATION OF HEALTH MANAGEMENT IN DISASTER RESPONSE -- 4 ESSENTIALS OF DISASTER PLANNING -- 5 DISASTER SURVEILLANCE AND INFORMATION SYSTEMS -- 6 RISK AND RAPID HEALTH ASSESSMENTS -- 7 DISASTER COMMUNICATIONS -- 8 BEHAVIORAL HEALTH STRATEGIES -- 9 ENVIRONMENTAL HEALTH ISSUES -- 10 OCCUPATIONAL HEALTH IN DISASTERS -- 11 PEOPLE WITH DISABILITIES AND OTHERS WITH ACCESS AND FUNCTIONAL NEEDS -- 12 PUBLIC HEALTH RESPONSE TO EMERGING INFECTIONS AND BIOEVENTS -- 13 PUBLIC HEALTH CONSIDERATIONS IN RESPONSE, RECOVERY, AND RECONSTRUCTION -- 14 EVALUATION METHODS FOR ASSESSING PUBLIC HEALTH AND MEDICAL RESPONSE TO DISASTERS -- 15 ETHICAL CONSIDERATIONS IN PUBLIC HEALTH EMERGENCIES -- BASICS -- APPENDIX A: COMMON TERMS USED IN DISASTER PREPAREDNESS AND RESPONSE -- APPENDIX B: COMMON ACRONYMS USED IN DISASTER PREPAREDNESS, RESPONSE, AND RECOVERY -- APPENDIX C: THE LANGUAGE OF DISASTERS, EMERGENCIES, HAZARDS, AND INCIDENTS -- APPENDIX D: COMPARISON OF THE LAST FIVE GLOBAL PANDEMICS AND SEASONAL INFLUENZA -- STANDARDS, CAPABILITIES, AND RESPONSIBILITIES -- APPENDIX E: PUBLIC HEALTH PREPAREDNESS AND RESPONSE CORE COMPETENCY MODEL -- APPENDIX F: PUBLIC HEALTH PREPAREDNESS CAPABILITIES: NATIONAL STANDARDS FOR STATE AND LOCAL PLANNING -- APPENDIX G: 10 ESSENTIAL PUBLIC HEALTH SERVICES -- APPENDIX H: EMERGENCY SUPPORT FUNCTION #8: PUBLIC HEALTH AND MEDICAL SERVICES -- APPENDIX I: CORE CAPABILITIES -- MANAGEMENT STANDARDS -- APPENDIX J: REQUIRED ELEMENTS OF RISK ASSESSMENT -- MORBIDITY -- APPENDIX K: COMMON FOOD BORNE DISEASES.

OBJECTIVES: In this study, we collected and analyzed the first data available on the extent of the adoption of safer needle devices (engineered sharps injury protections [ESIPs]) by U.S. hospitals and on the degree to which selected factors influence the use of this technology. METHODS: We gathered data via a telephone survey of a random sample of 494 U.S. hospitals from November 1999 through February 2000. RESULTS: Although 83% of the sample reported some ESIP adoption, adoption was inconsistent across types of devices. All of the appropriate units in 52% of the facilities had adopted needleless intravenous delivery systems, but the hospitals used other types of ESIPs less often. A respondent's perception that the cost of ESIPs would not be a problem for the hospital was the best predictor of adoption of ESIPs in the facility, explaining 8% of the variance. Other predictors of adoption included the size of the hospital and the presence or absence of state legislative activity on the needlestick issue. CONCLUSIONS: Smaller hospitals may require special encouragement and assistance from outside sources to adopt expensive risk-reduction innovations such as ESIPs. Although use of ESIPs is the mandated and preferred way to protect workers from needlesticks, complete adoption of this technology will depend on the support of the social systems in which it is used and the people who use it.

Understanding attitudes, concerns and reactions of individuals and families is critical to emergency planning efforts on all levels. In order to have effective implementation of a disaster plan, people need to be confident in (a) the reliability of information from official sources, (b) the capacity of government to perform effectively in a crisis and (c) the capability of response systems, particularly the health systems and first responders. Absence of confidence in response systems or leadership may undermine the best of crisis plans, leading to unnecessary panic and potential excess loss of life. In August 2003, The National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health, in collaboration with The Children's Health Fund, commissioned the Marist Institute for Public Opinion to conduct a survey of adults nearly two years after the multiple terrorist attacks on New York, Washington, D.C. and Pennsylvania. The survey included both a national and a New York City representative sample of households contacted by telephone. Questions covered a wide range of issues including people's concern about potential new additional acts of terrorism in the U.S., the government's ability to protect citizens, and the health system's capacity to respond. Throughout, specific questions were asked of a subset of parents of children from four to eighteen years of age. To the extent possible, specific questions were replicated from four previous surveys commissioned by The Children's Health Fund since September 11, 2001 to identify trends in public attitudes and perceptions.