Suchergebnisse

Abstract
Emergency planners and first responders often access web-based information resources during disasters; however, these tools require an active Internet connection, which may be unavailable during a disaster. The National Library of Medicine (NLM) provides several free non-web-based disaster response tools. This study assessed intention to use web-based and non-web-based informational and response tools during disasters among emergency responders and librarians. Educational workshops were held in four Missouri cities in spring, 2016. The NLM tools were presented and attendees practiced using the tools during disaster scenarios. Pre- and post-intervention data about NLM tool awareness and intention to use these tools versus other web-based resources was collected. McNemar tests assessed a pre/post change in intention to use each resource. Four workshops were held, with a total of 74 attendees. Intention to use the NLM tools was low prior to the workshops (range: 20.3–39.2%), but increased significantly immediately afterwards (p < .001 for all pre/post comparisons). The workshops resulted in increased NLM tool awareness and increased intention to use the tools during future disasters. This provides evidence of attendees' perceptions of the usefulness of the non-web-based NLM tools in place of other web-based tools in situations without Internet access.

In the early 1990s, St. Louis County had multiple foodservice worker-related hepatitis A outbreaks uncontrolled by standard outbreak interventions. Restaurant interest groups and the general public applied political pressure to local public health officials for more stringent interventions, including a mandatory vaccination policy. Local health departments can enact mandatory vaccination policies, but this has rarely been done. The study objectives were to describe the approach used to pass a mandatory vaccination policy at the local jurisdiction level and illustrate the outcome from this ordinance 15 years later. A case study design was used. In-depth, semi-structured interviews using guided questions were conducted in spring, 2015, with six key informants who had direct knowledge of the mandatory vaccination policy process. Meeting minutes and/or reports were also analyzed. A Poisson distribution analysis was used to calculate the rate of outbreaks before and after mandatory vaccination policy implementation. The policy appears to have reduced the number of hepatitis A outbreaks, lowering the morbidity and economic burden in St. Louis County. The lessons learned by local public health officials in passing a mandatory hepatitis A vaccination policy are important and relevant in today's environment. The experience and lessons learned may assist other local health departments when faced with the potential need for mandatory policies for any vaccine preventable disease.