Digital Commons Network^™

The Shortfalls Of Vulnerability Indexes For Public Health Decision-Making In The Face Of Emergent Crises: The Case Of Covid-19 Vaccine Uptake In Virginia, Lydia Cleveland Sa, Erika Frydenlund

VMASC Publications

Equitable and effective vaccine uptake is a key issue in addressing COVID-19. To achieve this, we must comprehensively characterize the context-specific socio-behavioral and structural determinants of vaccine uptake. However, to quickly focus public health interventions, state agencies and planners often rely on already existing indexes of "vulnerability." Many such "vulnerability indexes" exist and become benchmarks for targeting interventions in wide ranging scenarios, but they vary considerably in the factors and themes that they cover. Some are even uncritical of the use of the word "vulnerable," which should take on different meanings in different contexts. The objective of this study is …

Emergency Department Frequent Utilization For Non-Emergent Presentments: Results From A Regional Urban Trauma Center Study, Joshua G. Behr, Rafael Diaz

VMASC Publications

Objectives
First, to test a model of the drivers of frequent emergency department utilization conceptualized as falling within predisposing, enabling, and need dimensions. Second, to extend the model to include social networks and service quality as predictors of frequent utilization. Third, to illustrate the variation in thresholds that define frequent utilization in terms of the number of emergency department encounters by the predictors within the model.

Data Source
Primary data collection over an eight week period within a level-1 trauma urban hospital's emergency department.

Study Design
Representative randomized sample of 1,443 adult patients triaged ESI levels 4'5. Physicians …

Building Resiliency In Response To Sea Level Rise And Recurrent Flooding: Comprehensive Planning In Hampton Roads, Joshua G. Behr, Rafael Diaz, Molly Mitchell

VMASC Publications

[Introduction]

Over the past few decades, the Hampton Roads region, with its extensive coastline, has been experiencing more frequent flooding from surges and precipitation caused by tropical storms, nor’easters and heavy thunderstorms (Figure 1). Recurrent flooding is “flooding that occurs repeatedly in the same area over time due to precipitation events, high tides or storm surge.”¹ The recurrence of tidal/surge flooding in Hampton Roads has increased from 1.7 days of “nuisance” flooding per year in 1960 to 7.3 days per year in 2014.² Although there is no definitive region-wide data to document the increases in precipitation-induced flooding, there …

Theoretically-Driven Infrastructure For Supporting Health Care Teams Training At A Military Treatment Facility, T. Robert Turner Jr., V. Andrea Parodi

VMASC Publications

Designated a Department of Defense Team Resource Center (TRC) in 2008, Naval Medical Center Portsmouth (NMCP) currently hosts three tri-service health care teams training courses annually. Each consists of didactic learning coupled with simulation-based training exercises to provide an interactive educational experience for health care professionals. Simulated cases are developed to reinforce specific teamwork skills and behaviors, and to incorporate a variety of technologies including standardized patients, manikins, and virtual reality. The course is also the foundation of a research program designed to explore applications of modeling and simulation for enhanced team training in health care. The TRC has adopted …

Selection Of Source And Use Of Traffic Information In Emergency Situations, R. Michael Robinson, Asad Khattak

VMASC Publications

The access and the use of advanced traveler information systems (ATISs) by drivers during normal commuting have been extensively assessed and analyzed. Emergency managers and transportation officials have extended the results of studies of ATIS use under routine conditions to emergency scenarios under the assumption that drivers' responses to information under emergency conditions mimic those seen under normal driving conditions. A recent survey of potential hurricane evacuees suggests the need to revisit this assumption. Results indicate that although commercial radio reports and variable message signs continue to be the sources of traffic information cited the most frequently, other information sources …

Route Change Decision Making By Hurricane Evacuees Facing Congestion, R. Michael Robinson, Asad Khattak

VMASC Publications

Successful evacuations of metropolitan areas require overcoming unexpected congestion that reduces traffic flows. Congestion may result from accidents, incidents, or other events that reduce road capacity. Traffic professionals and emergency managers may promote deviations from planned routes to bypass an area of congestion and speed mass exit. However, some route changes may actually reduce traffic flow rates, and in these cases decision makers may want to discourage use of alternate routes. By using results of a behavioral survey of potential hurricane evacuees, this study identifies variables associated with the decision to alter routes and also identifies frequently used information sources. …