Numerous practice reports recommend roles pharmacists may adopt during disasters. This study examines the peer-reviewed literature for factors that explain the roles pharmacists assume in disasters and the differences in roles and disasters when stratified by time.

Quantitative content analysis was used to gather data consisting of words and phrases from peer-reviewed pharmacy literature regarding pharmacists’ roles in disasters. Negative binomial regression and Kruskal-Wallis nonparametric models were applied to the data.

Pharmacists’ roles in disasters have not changed significantly since the 1960s. Pharmaceutical supply remains their preferred role, while patient management and response integration roles decrease in context of common, geographically widespread disasters. Policy coordination roles, however, significantly increase in nuclear terrorism planning.

Pharmacists’ adoption of nonpharmaceutical supply roles may represent a problem of accepting a paradigm shift in nontraditional roles. Possible shortages of personnel in future disasters may change the pharmacists’ approach to disaster management. (Disaster Med Public Health Preparedness. 2013;7:563–572)

Strong earthquakes have been reported to increase the incidence of diseases. One reason for these increases may be the stress from the poor living environment for evacuees in disaster shelters. To reduce stress, makeshift cardboard beds were introduced in shelters in the Ishinomaki region, one of the areas heavily damaged by the Great East Japan Earthquake, 4 months after the earthquake. The study was performed to determine whether use of the beds offered a reduction in the disease burden.

Blood pressure and blood D-dimer values, often used as diagnostic tests for venous thrombosis, were checked. The timed Up & Go (TUG) test, which assesses functional mobility; a questionnaire survey about symptoms (cough, insomnia, and lumbago); and an SF-8 health survey, a health-related quality of life survey, were also administered before and 1 month after introducing the beds.

Blood pressure measurements, TUG test results, and questionnaire survey scores improved significantly 1 month after the introduction of the beds. Also, evacuees with higher blood D-dimer values tended to show improvement, suggesting that the beds may have had a good effect on persons with underlying venous thrombotic disorders.

Makeshift beds of cardboard could be very useful in disaster shelters. (Disaster Med Public Health Preparedness. 2013;7:573–577)

To address limitations in measuring the preparedness capacities of health departments, we developed and tested the Local Health Department Preparedness Capacities Assessment Survey (PCAS).

Preexisting instruments and a modified 4-cycle Delphi panel process were used to select instrument items. Pilot test data were analyzed using exploratory factor analysis. Kappa statistics were calculated to examine rater agreement within items. The final instrument was fielded with 85 North Carolina health departments and a national matched comparison group of 248 health departments.

Factor analysis identified 8 initial domains: communications, surveillance and investigation, plans and protocols, workforce and volunteers, legal infrastructure, incident command, exercises and events, and corrective action. Kappa statistics and z scores indicated substantial to moderate agreement among respondents in 7 domains. Cronbach α coefficients ranged from 0.605 for legal infrastructure to 0.929 for corrective action. Mean scores and standard deviations were also calculated for each domain and ranged from 0.41 to 0.72, indicating sufficient variation in the sample to detect changes over time.

The PCAS is a useful tool to determine how well health departments are performing on preparedness measures and identify opportunities for future preparedness improvements. Future survey implementation will incorporate recent Centers for Disease Control and Prevention's Public Health Preparedness Capabilities: National Standards for State and Local Planning. (Disaster Med Public Health Preparedness. 2013;7:578–584)

Dual-Polarization Radar and Twitter were analyzed to determine the impact on injuries sustained by the Hattiesburg EF-4 tornado.

Tracking data provided from the Dual-Pol radar systems in National Weather Service Jackson were reviewed. Twitter data from four local Twitter handles were obtained. The change in tweets and followers for the day of the storm were compared to historical averages. A Student t-test was utilized in determining statistical significance (p<0.05). Medical records from two local emergency departments were reviewed for patients treated up to 24 hours after the tornado. An Injury Severity Score (ISS) was calculated for trauma records related to the tornado.

Radar detection of the tornado gave approximately 30 minutes of advanced warning time. Statistical significance in follower growth was seen in all four Twitter handles. Out of 50 patients, the average ISS was 3.9 with a range of 1 to 29. There were zero fatalities.

An ISS average of 3.9 was significantly less than two previous tornadoes of similar strength that occurred prior to increased usage of Dual-pol radar and Twitter as a means for communicating severe weather information. Early detection from Dual-pol radar improved warning time. Tweets informed citizens to seek appropriate shelter. (Disaster Med Public Health Preparedness. 2013;7:585-592)

During 2009-2011, Pike County, Kentucky, experienced a series of severe weather events that resulted in property damage, insufficient potable water, and need for temporary shelters. A Community Assessment for Public Health Emergency Response (CASPER) survey was implemented for future planning. CASPER assesses household health status, preparedness level, and anticipated demand for shelters.

We used a 2-stage cluster sampling design to randomly select 210 representative households for in-person interviews. We estimated the proportion of households with children aged 2 years or younger; adults aged 65 years or older; and residents with chronic health conditions, visual impairments, physical limitations, and supplemental oxygen requirements.

Of all households surveyed, 8% included children aged 2 years or younger, and 27% included adults aged 65 years or older. The most common chronic health conditions were heart disease (51%), diabetes (28%), lung disease (23%), and asthma (21%). Visual impairments were reported in 29% of households, physical limitations in 24%, and supplemental oxygen use in 12%.

Pike County residents should be encouraged to maintain an adequate supply of medications and copies of their prescriptions. Emergency response plans should include transportation for persons with physical limitations; and shelter plans should include sufficient medically trained staff and adequate supplies of infant formula, pharmaceuticals, and supplemental oxygen. (Disaster Med Public Health Preparedness. 2013;7:597-602)