MEDICAL & PUBLIC HEALTH PREPAREDNESS FOR DISASTER & EMERGENCIES AND ACTION COLLABORATIVE ON DISASTER RESEARCH RESPONSE

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• 批准号: 10269862
• 负责人: ROBERT DAY
• 金额: $ 1万
• 依托单位: NATIONAL ACADEMY OF SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-26 至 2021-09-25
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10269862
• 关键词: Academia; Academy; Acute; Address; Area; Awareness; Behavioral; Bioethics; Bioinformatics; Biological; Biomedical Engineering; Biomedical Research; Biotechnology; Categories; Charge; Clinical; Clinical assessments; Collaborations; Collection; Communication; Communities; Complex; Dangerousness; Data; Data Collection; Data Science; Data Set; Department of Defense; Development; Disasters; Discipline of Nursing; Disease Outbreaks; Educational workshop; Emergency Situation; Emergency response; Emerging Communicable Diseases; Engineering; Ensure; Environmental Health; Epidemiology; Ethical Issues; Ethics; Evaluation; Event; Exercise; Failure; Federal Government; Food; Fostering; Foundations; Funding; Future; Generations; Geoscience; Government; Government Agencies; Grant; Guidelines; Health; Health Sciences; Health system; Healthcare; Human; Human Subject Research; Individual; Industry; Infrastructure; Institutional Policy; Institutional Review Boards; Intelligence; International; Internet; Lead; Link; Logistics; Maintenance; Medial; Medical; Medical emergency; Medicine; Mental Health; Molecular Biology; National Institute of Allergy and Infectious Disease; National Institute of Environmental Health Sciences; Natural Disasters; Nuclear; Outcome; Paper; Phase; Play; Policies; Population; Populations at Risk; Positioning Attribute; Prevention; Primary Health Care; Principal Investigator; Private Sector; Privatization; Procedures; Process; Professional Organizations; Public Health; Public Policy; Publishing; Radiology Specialty; Readiness; Recovery; Reporting; Research; Research Personnel; Resources; Risk; Risk Reduction; Role; Safety; Science; Secure; Security; Services; Shelter facility; Strategic Planning; Structure; System; Technology; Terrorism; Time; Toxicology; Training and Education; Transportation; United States Dept. of Health and Human Services; United States National Academy of Sciences; United States National Institutes of Health; Veterans; Volunteer Organization; Water; Work; authority; base; chemical threat; clinical practice; computerized tools; cost; design; evidence base; first responder; global health; hazard; health disparity; human subject; improved; information organization; interest; man; mass casualty; medical countermeasure; meetings; member; novel therapeutics; open data; operation; prevent; programs; psychologic; psychosocial; public health emergency; public health research; research and development; resilience; response; social; symposium; virtual

Forum for Medical & Public Health Preparedness for Disaster & Emergencies and Action Collaborative. Policy Context There are many governmental agencies and private organizations charged with ensuring the Nation’s capacity to prevent and respond to the health effects that arise from disasters, both man-made and natural. While each of these stakeholders is critical in guaranteeing adequate prevention and response, their efforts must be coordinated to ensure optimal outcomes. However, the challenge arises from the diverse set of responsibilities of the primary stakeholders, the Department of Health and Human Service (HHS) and the Department of Homeland Security (DHS), and coordinating the efforts among the many other governmental agencies (federal, state, and local), industry, professional societies, foundations, academia, and other interested parties. Unfortunately, venues that bring all of these stakeholders together are limited. The NAS Forum for Medical and Public Health Preparedness began to address these issues in 2008. Aligning the responsibilities and focus of each stakeholder will greatly assist in ensuring adequate protection and response. Each stakeholder offers unique assets that must be linked in to an overall strategy. It is here where the appropriate federal agencies, including the HHS, DHS, Department of Defense, Department of Transportation, and Veterans Affairs, play a vital role in developing a National strategy and logistical support and coordinating with the private sector. The Forum for Medical and Public Health Preparedness for Disasters and Emergencies (the Forum) provides a venue where the major stakeholders may sit down together and discuss the primary issues, afford organizations the opportunity to make assessments, discuss policies, and review outcomes. These areas will focus not only on the immediate responses to disasters and public health emergencies, but also the intermediate and long term needs that arise (e.g. providing adequate shelter, food and water safety, primary care, mental health) during the recovery phase and efforts to enhance preparedness, cooperation and information sharing. The activities of the federal government, volunteer organizations, the private sector, and others in the medical preparedness, resilience, and health sciences are of increasing complexity, both in terms of technology and policy. Currently, it is difficult for the nation's medical emergency response and public and mental health systems to meet the physical and psychological needs that result from all types of disasters including terrorism and natural disasters. Unfortunately, gaps continue to exist in the following areas: (1 Global Health Security, (2) Communication and Coordination, (3) Personal and Community Resilience, and (4) Critical Infrastructure Protection. Addressing the physical, psychological, and social needs that result from various acts of terrorist events or natural disasters will therefore require universal preparedness by all systems responsible for the public's health. Preparedness, response, and recovery are required for all hazards and should include all segments of the population during each phase of the event. The research and development needs of these initiatives are immense and thus require the federal government to seek and coordinate assessment from both national and international clinical practice, as well as biomedical research communities. Such coordination will require the best advice available as federal agencies seek guidance in developing its strategic plans for advancing the practice of medical preparedness. These initiatives include scientific, technical, and workforce issues in the medical and public health arenas (infrastructure, clinical, environmental, and public health, research needs, including the development of new drugs and biologics and the collection and funding of critical data collection in a timely manner); effective training, education, and communication exercises; and evaluation of preparedness. The multiple and complex ethical issues surrounding these developing fields must also be considered. Technical Context The forum will promote open discussion of existing systems and lessons learned from previous disasters and public health emergencies and identify areas for improvement. These discussions exist across four broad categories: (1) Communication and Cooperation; (2) Personal and Community Resilience; (3) Preparedness and Infrastructure Needs; (4) Medical and Public Health Preparedness and Response; Within these areas, topics that might be on the meeting agendas of the forum include: Global Health Security Topics within this theme focus on the ongoing efforts to accelerate progress toward a world safe and secure from emerging infectious diseases and other threats. Discussions concentrate on strengthening the U.S. health care and public health systems capacity to detect, prevent, plan for, respond to, and recover from naturally occurring outbreaks and intentional or accidental releases of dangerous substances. Communication and Cooperation: Topics within this theme focus on ensuring timely communications and effective coordination within all levels of government and between government, the private sector, and the public during large-scale disasters and incidents. Discussions concentrate on ways to improve situational awareness, threat intelligence sharing, risk communication, and collaboration among multi-sector disaster response networks including public, academic, private, governmental, and non-governmental entities, (e.g., improving coordination among disaster response networks from public, academic, private, and governmental entities and stakeholder data collection, harmonization, and management during and post disasters including acute surveillance and longitudinal exposure, health effects, clinical assessment, and evaluative data sets and information; organization and sharing of open data sets and development of computational tools to analyze the datasets (data science for discovery). Personal and Community Resilience: According to the Implementation Plan for the National Health Security Strategy (2015-2018) (http://www.phe.gov/Preparedness/planning/authority/nhss/Documents/nhss-ip.pdf), National health security is achieved when the Nation and its people are prepared for, protected from, respond effectively to, and are able to recover from incidents with potentially negative health consequences. Topics within this theme focus on issues related to the sustained ability of an individual and a community to utilize available resources to respond to, withstand, and recover from adverse situations following a catastrophic event. Discussions concentrate on ways to enhance resilience for individuals and communities through disaster risk reduction, inclusion of health in post-disaster recovery planning efforts, working with non-traditional sectors, and exploring special considerations needed to strengthen a community after a mass casualty incident. Critical Infrastructure Protection Topics within this theme focus on the ongoing efforts to secure the assets, systems, and networks, whether physical or virtual, vital to the security, public health, and safety of the nation. Discussions center on the health care and public health sector and interdependent sector vulnerabilities, consequences of cascading and prolonged failures of infrastructure, threats from chemical, biological, radiological, nuclear, and high yield explosives, and the increasing threat and consequences of cyber-attack, (e.g., investigating steps for building the next decade of disaster preparedness and simultaneously improving the public health infrastructure and addressing how existing public health systems and infrastructure can be strengthened while simultaneously moving forward to meet disaster response needs of the future). Disaster Research Response Action Collaborative The Forum will convene an Action Collaborative on Disaster Science, based on the receipt of additional supporting funds from NIH and other sponsors to: 1) foster improved processes and platforms for developing and implementing needed time-critical data collection and research in response to disasters (“Science Preparedness”); 2) identify evidence-based mechanisms and opportunities for conducting and sharing information gathered from public health research during disasters; 3) engage cross-sector stakeholders in development, refinement, and promotion of disaster research opportunities and best practices; 4) provide a venue to support the development and maintenance of a rapid response mechanism for the National Academies to continue to meet sponsor needs for convening, idea generation and information sharing during the initial stages of a public health emergency. Activities of the Action Collaborative may include1) outlining and defining processes for conducting research (particularly research involving human subjects and at-risk populations) quickly following a disaster to avoid missing critical data; 2) ensuring community engagement and IRB/ethical considerations in disaster research. 3) defining processes for expanding and enhancing a coordinated network of disaster researchers; 3) assembling data collection, research, and best practice resources (or any other substantive products for the first year); 4) exploring appropriate venues to support the development and maintenance of a rapid response mechanisms for the National Academies and other platforms or forums to continue to meet sponsor needs for convening, generating ideas, and sharing information during the initial, as well as later stages of a public health emergency. Since 2008, the forum has held numerous meetings and workshops and published a number of documents regarding the issues listed above. Task Description: The National Academies of Science, Engineering and Medicine (NAS)) established a Forum on Medical Preparedness for Disasters and Emergencies (the “Forum”) in 2008. Forums are designed to provide its members with a venue for exchanging information and presenting individual views, and allow a structured opportunity for dialogue and discussion while scrutinizing critical and possibly contentious scientific and policy issues. Representatives from government, industry, academia, and other interested parties are expected to serve on the Forum, which will convene two to three times a year to confer on subject areas of mutual interest and concern. At its meetings, the Forum identifies and discusses emerging scientific research and policy required to improve the Nation's medical preparedness and resilience to acts of terrorism and/or natural disasters, as well as issues in the coordination of federal, state, local, public, and private medical preparedness and resilience activities. The Forum sponsors workshops as an additional mechanism for informing forum meetings and discussions. The Forum may also commission individually-authored papers. Forum discussions or workshops or other formats of meetings, may lead to proposals for specific studies by units of The National Academies resulting in institutional reports. Such studies, if undertaken, will be conducted independently and at arm’s length from the Forum and in accordance with all institutional policies and procedures governing such study activities. All activities of the Forum will be conducted in accordance with institutional guidelines described in "Roundtables: Policy and Procedures." In addition, with funding from NIH and possibly other sponsors, will support a Disaster Research Action Collaborative as an additional activity of the Forum. For the past several years, NIH and others have sponsored a Standing Committee on Medial and Public Health Research during Large-Scale Emergency Events. After discussion with the sponsors and NASEM, it was decided to move from the Standing Committee to an Action Collaborative under the Forum. The Action Collaborative will work on outlining and defining processes and procedures for conducting research following disasters as described above. Expertise The Forum’s membership includes over 30 individuals, chosen for their professional and policymaking perspectives, as well as their scientific or public policy credentials. Expertise includes government technical program management; medical operations in support of homeland security; biotechnology/bioengineering; strategic planning; threat assessment; toxicology; environmental health and geosciences; bioinformatics; national public health and emergency management and response; epidemiology; molecular biology; state/local public health; health care; risk communication; first responders; bioethics; nursing; pharmacotherapeutics, medical countermeasure planning and response, workforce education and training, health disparities and community engagement, data science and bioethics. Representatives of federal research and regulatory agencies are appointed by virtue of the positions they hold. Additional experts are invited to participate in particular discussions on an ad hoc basis. Each sponsor sends a primary representative and is welcome to also send “alternate” members. Currently Ms. Stacey J. Arnesen, NLM (Florence Chang, alternate) Barbara Mulach, NIAID, and Dr. Aubrey Miller, NIEHS, serve as NIH representatives to the forum. The Action Collaborative will include members, chosen for their professional expertise in developing, conducting, and promoting disaster-related research as well as their general scientific and/or disaster medicine/public health/emergency management credentials. Expertise may include grant management (e.g., as a Principal Investigator), emergency management, homeland security, environmental health and geosciences, toxicology, behavioral/psychosocial/mental health, data science/ bioinformatics, health care, public health, public policy, risk communications, health disparities and community engagement, and human subjects research/bioethics. Work plan The type of work that a forum, such as the Forum on Medical and Public Health Preparedness for Disasters and Emergencies, with mixed Federal, academic, not-for-profit, and industry for-profit participation can engage in include: meetings and workshops on topics of interest to Forum members; symposia held for the purpose of informing Forum members more widely about medical and public health preparedness, response, and resilience consistent with Forum interests and discussions. The Forum can also serve as a locus for informing each of its members of the views and plans of other members about approaches to problems and work on holding public events. Specific activities will be organized according to the following tasks: 1. Forum Meetings. Forum Meetings will be held two or three times a year. They will be open or closed as needed and attended by NAS staff and Forum members. 2. Workshops or Other Activities Sponsored by the Forum. The Forum will consider the use of several mechanisms to convene experts on topics in which it needs to be informed. Examples of activities include workshops and active collaborations. The Projected Costs shown at the end of the proposal includes funding for these activities. 3. Individually authored summary documents or proceedings of the Forum's workshops and symposia may be published by NAP or posted on the internet.

医疗与公共卫生论坛准备灾难与紧急情况与行动合作。 政策上下文 有许多政府机构和私人组织负责确保该国预防和应对人造和自然灾害产生的健康影响的能力。尽管这些利益相关者中的每一个对于保证充分的预防和反应至关重要，但必须协调他们的努力以确保最佳结果。但是，挑战源于主要利益相关者，卫生与公共服务部（HHS）和国土安全部（DHS）的潜水员责任，并协调许多其他政府机构（联邦，州和地方），工业，行业，专业社会，基金会，学术界，学术界和其他有趣的政党之间的努力。不幸的是，将所有这些利益相关者融合在一起的场所都是有限的。 NAS医疗和公共卫生准备论坛于2008年开始解决这些问题。 使每个利益相关者的责任和重点保持一致，将极大地帮助确保充分的保护和回应。每个利益相关者提供的独特资产必须与整体策略联系起来。在这里，适当的联邦机构，包括HHS，国土安全部，国防部，交通运输部和退伍军人事务，在制定国家战略和后勤支持以及与私营部门的协调方面发挥了至关重要的作用。医疗和公共卫生的准备论坛为灾难和紧急情况（论坛）提供了一个场所，主要利益相关者可以一起坐下来讨论主要问题，使组织有机会进行评估，讨论政策和审查结果。这些领域不仅将着重于对灾害和公共卫生紧急情况的直接反应，还将重点放在恢复阶段中出现的中间和长期需求（例如提供适当的庇护所，食品和水安全，初级护理，心理健康），并努力增强准备，合作，合作，合作和信息共享。 在技​​术和政策方面，联邦政府，志愿组织，私营部门以及其他医学科学的活动都具有更高的复杂性。目前，美国的医疗应急响应以及公共和心理卫生系统很难满足各种灾难（包括恐怖主义和自然灾害）所产生的身体和心理需求。不幸的是，在以下领域中继续存在差距：（1全球卫生安全，（2）沟通和协调，（3）个人和社区韧性，以及（4）关键的基础设施保护。 因此，解决恐怖主义事件或自然灾害各种行为所产生的身体，心理和社会需求将需要所有负责公众健康的系统的普遍准备。所有危害都需要准备，响应和恢复，并应在活动的每个阶段包括所有人口的部分。这些举措的研发需求是巨大的，因此要求联邦政府从国家和国际临床实践以及生物医学研究社区寻求和协调评估。这种协调将需要提供最佳建议，因为联邦机构寻求指导，以制定其制定医疗准备实践的战略计划。这些举措包括医学和公共卫生领域（基础设施，临床，环境和公共卫生，研究需求，包括新药和生物制剂的开发以及及时收集和资金收集的研究需求）中的科学，技术和劳动力问题；有效的培训，教育和沟通练习；和评估准备。还必须考虑围绕这些发展领域的多重且复杂的道德问题。 技术环境 该论坛将促进对现有系统的公开讨论以及从以前的灾难和公共卫生紧急情况中汲取的经验教训，并确定改进的领域。这些讨论存在于四个广泛类别：（1）沟通与合作； （2）个人和社区弹性； （3）准备和基础设施需求； （4）医疗和公共卫生的准备和反应；在这些领域中，论坛会议议程中可能存在的主题包括： 全球卫生安全 该主题中的主题集中于正在进行的努力，以加速进步，使世界安全，安全地免受新兴的传染病和其他威胁。讨论集中于加强美国卫生保健和公共卫生系统的能力，以检测，预防，计划，应对，反应和恢复自然发生的爆发以及故意或意外的危险物质。 沟通与合作： 该主题中的主题着重于确保及时的沟通和有效 政府各个层面以及政府，私营部门和 大规模灾难和事件中的公众。讨论集中于 提高情境意识，威胁情报共享，风险交流和 多部门灾难响应网络之间的协作，包括公众，学术， 私人，政府和非政府实体（例如，改善 来自公共，学术，私人和政府实体的灾难响应网络以及 利益相关者的数据收集，协调和管理灾难期间 包括急性监视和纵向暴露，健康效应，临床评估， 并评估数据集和信息；组织和共享开放数据集和开发计算工具来分析数据集（发现数据科学）。 个人和社区的韧性： 根据《国家卫生安全策略的实施计划》（2015-2018）（http://www.phe.gov/preparedness/pleparedness/planning/authority/authority/authority/nhss/documents/nhss-ip.pdf，2018），当国家及其人民能够从中得到有效的侵害，并有效地恢复了健康，从而实现了国家卫生保障，并有效地恢复了国家卫生保障。 该主题中的主题集中于与个人和社区使用可用资源响应，承受和从广告中恢复的持续能力有关的问题 发生灾难性事件后的情况。讨论集中于增强方法 通过减少灾难风险，纳入健康对个人和社区的韧性 在灾后恢复计划工作中，与非传统部门合作以及 探索大规模伤亡后加强社区所需的特殊考虑因素 事件。 关键的基础设施保护 该主题中的主题着重于确保资产，系统和 网络，无论是物理还是虚拟，对安全，公共卫生和安全至关重要 国家。讨论中心关于医疗保健和公共卫生部门以及相互依存 部门脆弱性，级联的后果和基础设施的长期失败， 化学，生物学，放射学，核和高产量炸药的威胁，以及 增加网络攻击的威胁和后果，例如，调查建立该步骤 下一个十年的灾难准备，只是改善了公共卫生 基础架构以及解决现有的公共卫生系统和基础设施如何 加强同时向前迈进，以满足 未来）。 灾难研究反应行动合作 该论坛将基于收到NIH和其他赞助商的额外支持资金的灾难科学合作，以：1）促进改进的流程和平台，用于开发和实施所需的时间关键时间数据收集和研究，以应对灾难（“科学准备”）； 2）确定在灾难期间从公共卫生研究中收集的基于证据的机制和机会； 3）让跨部门利益相关者参与发展，改进和促进灾难研究机会和最佳实践； 4）提供一个场所，以支持和维护快速响应机制，以使国家学院在公共卫生紧急情况的最初阶段继续满足赞助商的召集，想法产生和信息共享的需求。 行动协作的活动可能包括1）在灾难发生灾难后迅速概述和定义进行研究的过程（部分研究涉及人类受试者和处于危险的研究），以避免丢失关键数据； 2）确保灾难研究中的社区参与和IRB/道德考虑。 3）定义扩大和增强协调的灾难研究人员网络的过程； 3）组装数据收集，研究和最佳实践资源（或第一年的任何其他实质性产品）； 4）探索适当的场所，以支持国家学院和其他平台或论坛的快速响应机制的开发和维护，以继续满足赞助商的召集，产生想法和共享信息的需求，并在最初以及公共卫生紧急情况的后期阶段。 自2008年以来，该论坛举办了许多会议和研讨会，并发布了有关上述问题的许多文件。 任务说明： 美国国家科学，工程和医学学院（NAS）在2008年建立了一个关于灾难和紧急情况的医疗准备的论坛。政府，工业，学术界和其他有趣的政党的代表预计将在论坛上任职，该论坛将每年方便两到三次，以讨论相互兴趣和关注的主题领域。 在会议上，该论坛确定并讨论了改善国家的医疗准备和韧性恐怖主义和/或自然灾害行为所需的新兴科学研究和政策，以及联邦，州，地方，公共，公共，私人医疗准备和弹性活动的问题。论坛赞助讲习班是为论坛会议和讨论提供信息的附加机制。该论坛还可以委托单独撰写的论文。 论坛讨论，讲习班或其他会议格式可能会导致国家科学院单位的特定研究提出建议，从而导致机构报告。如果进行此类研究，将根据论坛独立进行，并按照所有有关此类研究活动的机构政策和程序进行。 论坛的所有活动将根据“圆桌会议：政策和程序”中描述的机构准则进行。 此外，在NIH和其他可能的赞助商的资助下，将支持灾难研究行动合作，作为论坛的额外活动。在过去的几年中，NIH和其他人在大规模的紧急事件中赞助了一个媒体和公共卫生研究常务委员会。在与赞助商和NASEM讨论之后，决定从常务委员会转变为论坛下的行动合作。 该行动协作将致力于概述和定义流程和程序，以进行灾难，如上所述。 专业知识 该论坛的会员资格包括30多个人，以专业和政策的观点以及其科学或公共政策证书选择。专业知识包括政府技术计划管理；支持国土安全部的医疗行动；生物技术/生物工程；战略规划；威胁评估；毒理学;环境健康与地球科学；生物信息学；国家公共卫生，应急管理和反应；流行病学；分子生物学；州/地方公共卫生；卫生保健;风险交流；第一响应者；生物伦理学；护士；药物治疗，医学对策计划和响应，劳动力教育和培训，健康分布以及社区参与，数据科学和生物伦理学。联邦研究和监管机构的代表是由他们担任的职位任命的。邀请其他专家在临时讨​​论中参加。 每个赞助商都会发送主要表示，欢迎您发送“替代”成员。目前，NLM的Stacey J. Arnesen女士（佛罗伦萨·张，替代性）芭芭拉·穆拉奇（Barbara Mulach），尼亚德（Niaid）和奥布里·米勒（Aubrey Miller）博士Niehs，是NIH代表论坛的NIH。 该行动合作将包括成员，以其在开发，进行和促进与灾难有关的研究以及一般科学和/或灾难医学/公共卫生/紧急管理资格方面的专业专业知识中被选为成员。专业知识可能包括赠款管理（例如，作为主要研究人员），紧急管理，国土安全，环境健康和地球科学，毒理学，行为/心理社会/心理健康，数据科学/生物信息学，保健，公共卫生，公共卫生，公共政策，风险通信，健康分配，健康分布以及社区参与以及人类受试者研究/BioBioEthics。 工作计划 论坛的工作类型，例如关于灾难和紧急情况的医疗和公共卫生准备论坛，联邦，学术，非营利性和行业营利性参与的混合活动可以包括：论坛成员感兴趣的主题的会议和讲习班；为了向论坛成员提供有关医疗和公共卫生的准备，应对和韧性，与论坛的兴趣和讨论相一致的座谈会。该论坛还可以作为一个目的地，以告知其每个成员的观点和计划，以了解问题的方法并致力于举行公共活动。 具体活动将根据以下任务组织： 1。论坛会议。论坛会议将每年举行两次或三次。他们将根据需要开放或关闭，并由NAS员工和论坛成员参加。 2。论坛赞助的研讨会或其他活动。该论坛将考虑将几种机制用于方便专家，需要了解其知识。活动的示例包括研讨会和主动合作。提案结束时显示的预计费用包括为这些活动提供资金。 3。可以通过小睡或在互联网上发布论坛研讨会和研讨会的单独撰写的摘要文档或论文集。