A photograph of All Right? with their Supreme Award, at the 2014 Canterbury Health System Quality Improvement and Innovation Awards evening. From left is (unknown), Neil Brosnahan (CPH Information Team Manager), Rose Henderson (Director of Allied Health with the Specialist Mental Health Service of CDHB), Dr Lucy D'Aeth (Public Health Specialist for CDHB and All Right? Steering Group member), Sue Turner (All Right? Campaign Manager) and Dr Don Mackie (Chief Medical Officer, Ministry of Health).
A photograph of All Right? with their Supreme Award, at the 2014 Canterbury Health System Quality Improvement and Innovation Awards evening. From left is Gillian Bohm (Principal Advisor Quality Improvement, Health Quality and Safety Commission), David Meates (Chief Executive of the Canterbury and West Coast District Health Boards), Neil Brosnahan (CPH Information Team Manager), Rose Henderson (Director of Allied Health with the Specialist Mental Health Service of CDHB), Dr Lucy D'Aeth (Public Health Specialist for CDHB and All Right? Steering Group member), Sue Turner (All Right? Campaign Manager) and Dr Don Mackie (Chief Medical Officer, Ministry of Health).
A video of a presentation by Dr Erin Smith during the Community Resilience Stream of the 2016 People in Disasters Conference. The presentation is titled, "A Qualitative Study of Paramedic Duty to Treat During Disaster Response".The abstract for this presentation reads as follows: Disasters place unprecedented demands on emergency medical services and test paramedic personal commitment to the health care profession. Despite this challenge, legal guidelines, professional codes of ethics and ambulance service management guidelines are largely silent on the issue of professional obligations during disasters. They provide little to no guidance on what is expected of paramedics or how they ought to approach their duty to treat in the face of risk. This research explores how paramedics view their duty to treat during disasters. Reasons that may limit or override such a duty are examined. Understanding these issues is important in enabling paramedics to make informed and defensible decisions during disasters. The authors employed qualitative methods to gather Australian paramedic perspectives. Participants' views were analysed and organised according to three emerging themes: the scope of individual paramedic obligations, the role and obligations of ambulance services, and the broader ethical context. Our findings suggest that paramedic decisions around duty to treat will largely depend on their individual perception of risk and competing obligations. A reciprocal obligation is expected of paramedic employers. Ambulance services need to provide their employees with the best current information about risks in order to assist paramedics in making defensible decisions in difficult circumstances. Education plays a key role in providing paramedics with an understanding and appreciation of fundamental professional obligations by focusing attention on both the medical and ethical challenges involved with disaster response. Finally, codes of ethics might be useful, but ultimately paramedic decisions around professional obligations will largely depend on their individual risk assessment, perception of risk, and personal value systems.
A video of a presentation by Professor David Johnston during the fourth plenary of the 2016 People in Disasters Conference. Johnston is a Senior Scientist at GNS Science and Director of the Joint Centre for Disaster Research in the School of Psychology at Massey University. The presentation is titled, "Understanding Immediate Human Behaviour to the 2010-2011 Canterbury Earthquake Sequence, Implications for injury prevention and risk communication".The abstract for the presentation reads as follows: The 2010 and 2011 Canterbury earthquake sequences have given us a unique opportunity to better understand human behaviour during and immediately after an earthquake. On 4 September 2010, a magnitude 7.1 earthquake occurred near Darfield in the Canterbury region of New Zealand. There were no deaths, but several thousand people sustained injuries and sought medical assistance. Less than 6 months later, a magnitude 6.2 earthquake occurred under Christchurch City at 12:51 p.m. on 22 February 2011. A total of 182 people were killed in the first 24 hours and over 7,000 people injured overall. To reduce earthquake casualties in future events, it is important to understand how people behaved during and immediately after the shaking, and how their behaviour exposed them to risk of death or injury. Most previous studies have relied on an analysis of medical records and/or reflective interviews and questionnaire studies. In Canterbury we were able to combine a range of methods to explore earthquake shaking behaviours and the causes of injuries. In New Zealand, the Accident Compensation Corporation (a national health payment scheme run by the government) allowed researchers to access injury data from over 9,500 people from the Darfield (4 September 2010) and Christchurch (22 February 2011 ) earthquakes. The total injury burden was analysed for demography, context of injury, causes of injury, and injury type. From the injury data inferences into human behaviour were derived. We were able to classify the injury context as direct (immediate shaking of the primary earthquake or aftershocks causing unavoidable injuries), and secondary (cause of injury after shaking ceased). A second study examined people's immediate responses to earthquakes in Christchurch New Zealand and compared responses to the 2011 earthquake in Hitachi, Japan. A further study has developed a systematic process and coding scheme to analyse earthquake video footage of human behaviour during strong earthquake shaking. From these studies a number of recommendations for injury prevention and risk communication can be made. In general, improved building codes, strengthening buildings, and securing fittings will reduce future earthquake deaths and injuries. However, the high rate of injuries incurred from undertaking an inappropriate action (e.g. moving around) during or immediately after an earthquake suggests that further education is needed to promote appropriate actions during and after earthquakes. In New Zealand - as in US and worldwide - public education efforts such as the 'Shakeout' exercise are trying to address the behavioural aspects of injury prevention.
The Evaluating Maternity Units (EMU) study is a mixed method project involving a prospective cohort study, surveys (two postnatal questionnaires) and focus groups. It is an Australasian project funded by the Australian Health and Medical Research Council. Its primary aim was to compare the birth outcomes of two groups of well women – one group who planned to give birth at a primary maternity unit, and a second group who planned to give birth at a tertiary hospital. The secondary aim was to learn about women’s views and experiences regarding their birthplace decision-making, transfer, maternity care and experiences, and any other issues they raised. The New Zealand arm of the study was carried out in Christchurch, and was seriously affected by the earthquakes, halting recruitment at 702 participants. Comprehensive details were collected from both midwives and women regarding antenatal and early labour changes of birthplace plans and perinatal transfers from the primary units to the tertiary hospital. Women were asked about how they felt about plan changes and transfers in the first survey, and they were discussed in some focus groups. The transfer findings are still being analysed and will be presented. This study is set within the local maternity context, is recent, relevant and robust. It provides midwives with contemporary information about transfers from New Zealand primary maternity units and women’s views and experiences. It may help inform the conversations midwives have with each other, and with women and their families/whānau, regarding the choices of birthplace for well childbearing women.
Background: Up to 6 years after the 2011 Christchurch earthquakes, approximately one-third of parents in the Christchurch region reported difficulties managing the continuously high levels of distress their children were experiencing. In response, an app named Kākano was co-designed with parents to help them better support their children’s mental health. Objective: The objective of this study was to evaluate the acceptability, feasibility, and effectiveness of Kākano, a mobile parenting app to increase parental confidence in supporting children struggling with their mental health. Methods: A cluster-randomized delayed access controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for 4 weeks and encouraged to use it weekly. Web-based pre- and postintervention measurements were undertaken. Results: A total of 231 participants enrolled in the Kākano trial, with 205 (88.7%) participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 (20%) provided full outcome data, of which 19 (18.2%) were for delayed access and 21 (20.8%) were for the immediate Kākano intervention. Among those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief parenting assessment (F1,39=7, P=.012) but not in the Short Warwick-Edinburgh Mental Well-being Scale (F1,39=2.9, P=.099), parenting self-efficacy (F1,39=0.1, P=.805), family cohesion (F1,39=0.4, P=.538), or parenting sense of confidence (F1,40=0.6, P=.457). Waitlisted participants who completed the app after the waitlist period showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and the Short Warwick-Edinburgh Mental Well-being Scale. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing. Conclusions: Kākano is an app co-designed with parents to help manage their children’s mental health. There was a high rate of attrition, as is often seen in digital health interventions. However, for those who did complete the intervention, there was some indication of improved parental well-being and self-assessed parenting. Preliminary indications from this trial show that Kākano has promising acceptability, feasibility, and effectiveness, but further investigation is warranted. Trial Registration: Australia New Zealand Clinical Trials Registry ACTRN12619001040156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377824&isReview=true
A video of the keynote presentation by Sir John Holmes, during the first plenary of the 2016 People in Disasters Conference. Holmes is the former United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, the current Director of Ditchley Foundation, and the chair of the Board of the International Rescue Committee in the UK. The presentation is titled, "The Politics of Humanity: Reflections on international aid in disasters".The abstract for this presentation reads as follows: As United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinate from 2007-2010, Sir John Holmes was heavily involved in the coordination of air provision to countries struck by natural and man-made disasters, raising the necessary funds, and the elaboration of humanitarian policy. The international humanitarian system is fragmented and struggling to cope with rising demands from both conflicts such as that in Syria, and the growing effects of climate change. Sir John will talk about what humanitarian aid can and cannot achieve, the frustrations of getting aid through when access may be difficult or denied, and the need to ensure that assistance encompasses protection of civilians and efforts to get them back on their feet, as well as the delivery of essential short term items such as food, water, medical care and shelter. He will discuss the challenges involved in trying to make the different agencies - UN United Nations, non-government organisations and the International Red Cross/Crescent movement - work together effectively. He will reveal some of the problems in dealing with donor and recipient governments who often have their own political and security agendas, and may be little interested in the necessary neutrality and independence of humanitarian aid. He will illustrate these points by practical examples of political and other dilemmas from aid provision in natural disasters such as Cyclone Nargis in Myanmar in 2009, and the Haiti earthquake of 2010, and in conflict situations such as Darfur, Afghanistan and Sri Lanka in the past, and Syria today. He will also draw conclusions and make recommendations about how humanitarian aid might work better, and why politicians and others need to understand more clearly the impartial space required by humanitarian agencies to operate properly.