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BT 15.000 718.042 Td /F2 21.0 Tf  [(Surveillance and Epidemiology in Natural Disasters: A Novel )] TJ ET
BT 15.000 693.094 Td /F2 21.0 Tf  [(Framework and Assessment of Reliability)] TJ ET
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BT 15.000 675.088 Td /F3 9.8 Tf  [(February 10, 2014)] TJ ET
BT 93.263 675.088 Td /F3 9.8 Tf  [(�)] TJ ET
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BT 98.138 675.088 Td /F3 9.8 Tf  [(Research Article)] TJ ET
BT 26.250 663.247 Td /F1 9.8 Tf  [(Yasmin Khan)] TJ ET
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BT 84.233 663.247 Td /F1 9.8 Tf  [(, )] TJ ET
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BT 89.654 663.247 Td /F1 9.8 Tf  [(Brian Schwartz)] TJ ET
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BT 155.213 663.247 Td /F1 9.8 Tf  [(, )] TJ ET
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BT 160.634 663.247 Td /F1 9.8 Tf  [(Ian Johnson)] TJ ET
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BT 26.250 651.342 Td /F1 9.8 Tf  [(Khan Y, Schwartz B, Johnson I. Surveillance and Epidemiology in Natural Disasters: A Novel Framework and Assessment of )] TJ ET
BT 26.250 639.438 Td /F1 9.8 Tf  [(Reliability. PLOS Currents Disasters. 2014 Feb 10 . Edition 1. doi: 10.1371/currents.dis.6773eb9d5e64b733ab490f78de346003.)] TJ ET
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BT 26.250 610.335 Td /F4 12.0 Tf  [(Abstract)] TJ ET
BT 26.250 590.381 Td /F1 9.8 Tf  [(Objective: To create a framework and methodology for organizing relevant disaster epidemiology literature. The target audience )] TJ ET
BT 26.250 578.476 Td /F1 9.8 Tf  [(for the framework is local public health practitioners conducting emergency surveillance in the setting of preparedness or )] TJ ET
BT 26.250 566.571 Td /F1 9.8 Tf  [(response to natural disasters.)] TJ ET
BT 26.250 554.667 Td /F1 9.8 Tf  [(Methods: The approach to developing the framework involved utilizing the public health and emergency management literature. )] TJ ET
BT 26.250 542.762 Td /F1 9.8 Tf  [(It was created along four axes. The first was the type of natural disaster; second was according to phase of disaster cycle; third )] TJ ET
BT 26.250 530.857 Td /F1 9.8 Tf  [(was the impact of the disaster \(health, infrastructure, economic\); and fourth was related to the main outcome of the study \(ie. )] TJ ET
BT 26.250 518.952 Td /F1 9.8 Tf  [(injuries or infectious diseases\). A literature review was conducted and subsequently the current literature was utilized to perform )] TJ ET
BT 26.250 507.048 Td /F1 9.8 Tf  [(a reliability test of the established framework, using two independent reviewers.)] TJ ET
BT 26.250 495.143 Td /F1 9.8 Tf  [(Results: Using existing disaster classification systems and risk analysis tools, a framework was developed along the four axes. )] TJ ET
BT 26.250 483.238 Td /F1 9.8 Tf  [(The final literature search resulted in 85 articles on surveillance in natural disaster settings. The majority of studies are on the )] TJ ET
BT 26.250 471.333 Td /F1 9.8 Tf  [(subject of hurricanes with a catastrophic impact rating. The phase of testing reliability of the framework resulted in percent )] TJ ET
BT 26.250 459.429 Td /F1 9.8 Tf  [(agreement of 74%.)] TJ ET
BT 26.250 447.524 Td /F1 9.8 Tf  [(Conclusions: A reliable framework was developed that enables local public health practitioners to easily access appropriate and )] TJ ET
BT 26.250 435.619 Td /F1 9.8 Tf  [(previously utilized surveillance methods for a natural disaster emergency. This framework contributes to an evidence-informed )] TJ ET
BT 26.250 423.714 Td /F1 9.8 Tf  [(approach to surveillance in natural disasters with public health impacts.)] TJ ET
BT 26.250 387.112 Td /F4 12.0 Tf  [(Funding Statement)] TJ ET
BT 26.250 367.158 Td /F1 9.8 Tf  [(This work was solely supported by the authors� workplace, Public Health Ontario \(PHO\). The opinions, results and conclusions )] TJ ET
BT 26.250 355.253 Td /F1 9.8 Tf  [(reported in this paper are those of the authors. No endorsement by Public Health Ontario/The Ontario Agency for Health )] TJ ET
BT 26.250 343.348 Td /F1 9.8 Tf  [(Protection and Promotion is intended or should be inferred.)] TJ ET
BT 26.250 314.246 Td /F4 12.0 Tf  [(Introduction)] TJ ET
BT 26.250 294.291 Td /F1 9.8 Tf  [(With climate change and the potential for an increasing frequency of natural disasters around the world, it is expected that there )] TJ ET
BT 26.250 282.387 Td /F1 9.8 Tf  [(will be increasing impact on the health of populations.)] TJ ET
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BT 261.929 286.275 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 264.339 283.894 Td /F4 8.7 Tf  [(2)] TJ ET
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BT 269.157 282.387 Td /F1 9.8 Tf  [( In Canada, potential hazards range from meteorological events such )] TJ ET
BT 26.250 270.482 Td /F1 9.8 Tf  [(as hurricanes and storms to geophysical disasters like earthquakes.)] TJ ET
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BT 318.867 271.989 Td /F4 8.7 Tf  [(3)] TJ ET
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BT 323.686 274.370 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 326.095 271.989 Td /F4 8.7 Tf  [(4)] TJ ET
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BT 330.914 270.482 Td /F1 9.8 Tf  [( A disaster is defined as: �a sudden accident or a natural )] TJ ET
BT 26.250 258.577 Td /F1 9.8 Tf  [(catastrophe that causes great damage or loss of life�.)] TJ ET
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BT 256.028 260.084 Td /F4 8.7 Tf  [(5)] TJ ET
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BT 260.847 258.577 Td /F1 9.8 Tf  [( It is crucial that public health organizations prepare for the health )] TJ ET
BT 26.250 246.672 Td /F1 9.8 Tf  [(consequences of potential natural disasters; furthermore, surveillance is an important component of all emergency plans. )] TJ ET
BT 26.250 234.768 Td /F1 9.8 Tf  [(Surveillance is defined as the systematic ongoing collection, collation, and analysis of data and the timely dissemination of )] TJ ET
BT 26.250 222.863 Td /F1 9.8 Tf  [(information to those who need to know so that action can be taken.)] TJ ET
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BT 315.123 224.370 Td /F4 8.7 Tf  [(6)] TJ ET
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BT 319.942 222.863 Td /F1 9.8 Tf  [( Surveillance in the setting of natural disasters can help to )] TJ ET
BT 26.250 210.958 Td /F1 9.8 Tf  [(identify the resulting health-related needs which in turn, will lead to the more rational and effective deployment of resources to )] TJ ET
BT 26.250 199.053 Td /F1 9.8 Tf  [(affected populations.)] TJ ET
BT 26.250 179.649 Td /F1 9.8 Tf  [(One challenge is predicting in advance the type and extent of surveillance required to respond to the disaster. Changes to a )] TJ ET
BT 26.250 167.744 Td /F1 9.8 Tf  [(jurisdiction�s surveillance system in the midst of an emergency can lead to potential biases and misinformation. In addition, )] TJ ET
BT 26.250 155.839 Td /F1 9.8 Tf  [(inadequate surveillance due to lack of planning could inaccurately estimate the need for resources to address the issues, )] TJ ET
BT 26.250 143.934 Td /F1 9.8 Tf  [(potentially resulting in preventable morbidity and mortality.)] TJ ET
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BT 277.137 145.442 Td /F4 8.7 Tf  [(7)] TJ ET
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BT 281.956 143.934 Td /F1 9.8 Tf  [( Thus, matching the type and size of the surveillance response to )] TJ ET
BT 26.250 132.030 Td /F1 9.8 Tf  [(the type and size of the disaster is critical to effective response delivery.)] TJ ET
BT 26.250 112.625 Td /F1 9.8 Tf  [(Frameworks have been increasingly used in the health emergency management field as tools to guide practice. Some )] TJ ET
BT 26.250 100.720 Td /F1 9.8 Tf  [(frameworks pertain to medical and clinically-oriented aspects of health emergency response after the initial disaster impact such )] TJ ET
BT 26.250 88.815 Td /F1 9.8 Tf  [(as mass casualty management and triage.)] TJ ET
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BT 209.413 90.323 Td /F4 8.7 Tf  [(8)] TJ ET
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BT 214.232 92.704 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 216.642 90.323 Td /F4 8.7 Tf  [(9)] TJ ET
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BT 221.460 92.704 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 223.870 90.323 Td /F4 8.7 Tf  [(10)] TJ ET
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BT 233.507 88.815 Td /F1 9.8 Tf  [( Public health consequences of disasters such as communicable diseases and )] TJ ET
BT 26.250 76.911 Td /F1 9.8 Tf  [(food and water insecurity generally occur after the initial disaster impact; tools have been developed to assess the public health )] TJ ET
BT 26.250 65.006 Td /F1 9.8 Tf  [(impact of large-scale disasters.)] TJ ET
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BT 160.625 66.513 Td /F4 8.7 Tf  [(11)] TJ ET
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BT 170.262 68.894 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 172.671 66.513 Td /F4 8.7 Tf  [(12)] TJ ET
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BT 182.309 65.006 Td /F1 9.8 Tf  [( Some tools are focused on settings of complex humanitarian emergencies where there is a )] TJ ET
BT 26.250 53.101 Td /F1 9.8 Tf  [(breakdown of authority as a result of conflict. This makes these frameworks less generalizable to settings that are not in conflict )] TJ ET
BT 26.250 41.196 Td /F1 9.8 Tf  [(and have intact authority structures, but yet may still be at risk for significant impact from natural disasters.)] TJ ET
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BT 500.459 41.196 Td /F1 9.8 Tf  [( The World )] TJ ET
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BT 15.000 718.042 Td /F2 21.0 Tf  [(Surveillance and Epidemiology in Natural Disasters: A Novel )] TJ ET
BT 15.000 693.094 Td /F2 21.0 Tf  [(Framework and Assessment of Reliability)] TJ ET
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BT 15.000 675.088 Td /F3 9.8 Tf  [(February 10, 2014)] TJ ET
BT 93.263 675.088 Td /F3 9.8 Tf  [(�)] TJ ET
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BT 98.138 675.088 Td /F3 9.8 Tf  [(Research Article)] TJ ET
BT 26.250 663.247 Td /F1 9.8 Tf  [(Yasmin Khan)] TJ ET
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BT 84.233 663.247 Td /F1 9.8 Tf  [(, )] TJ ET
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BT 89.654 663.247 Td /F1 9.8 Tf  [(Brian Schwartz)] TJ ET
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BT 155.213 663.247 Td /F1 9.8 Tf  [(, )] TJ ET
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BT 160.634 663.247 Td /F1 9.8 Tf  [(Ian Johnson)] TJ ET
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BT 26.250 651.342 Td /F1 9.8 Tf  [(Khan Y, Schwartz B, Johnson I. Surveillance and Epidemiology in Natural Disasters: A Novel Framework and Assessment of )] TJ ET
BT 26.250 639.438 Td /F1 9.8 Tf  [(Reliability. PLOS Currents Disasters. 2014 Feb 10 . Edition 1. doi: 10.1371/currents.dis.6773eb9d5e64b733ab490f78de346003.)] TJ ET
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BT 26.250 610.335 Td /F4 12.0 Tf  [(Abstract)] TJ ET
BT 26.250 590.381 Td /F1 9.8 Tf  [(Objective: To create a framework and methodology for organizing relevant disaster epidemiology literature. The target audience )] TJ ET
BT 26.250 578.476 Td /F1 9.8 Tf  [(for the framework is local public health practitioners conducting emergency surveillance in the setting of preparedness or )] TJ ET
BT 26.250 566.571 Td /F1 9.8 Tf  [(response to natural disasters.)] TJ ET
BT 26.250 554.667 Td /F1 9.8 Tf  [(Methods: The approach to developing the framework involved utilizing the public health and emergency management literature. )] TJ ET
BT 26.250 542.762 Td /F1 9.8 Tf  [(It was created along four axes. The first was the type of natural disaster; second was according to phase of disaster cycle; third )] TJ ET
BT 26.250 530.857 Td /F1 9.8 Tf  [(was the impact of the disaster \(health, infrastructure, economic\); and fourth was related to the main outcome of the study \(ie. )] TJ ET
BT 26.250 518.952 Td /F1 9.8 Tf  [(injuries or infectious diseases\). A literature review was conducted and subsequently the current literature was utilized to perform )] TJ ET
BT 26.250 507.048 Td /F1 9.8 Tf  [(a reliability test of the established framework, using two independent reviewers.)] TJ ET
BT 26.250 495.143 Td /F1 9.8 Tf  [(Results: Using existing disaster classification systems and risk analysis tools, a framework was developed along the four axes. )] TJ ET
BT 26.250 483.238 Td /F1 9.8 Tf  [(The final literature search resulted in 85 articles on surveillance in natural disaster settings. The majority of studies are on the )] TJ ET
BT 26.250 471.333 Td /F1 9.8 Tf  [(subject of hurricanes with a catastrophic impact rating. The phase of testing reliability of the framework resulted in percent )] TJ ET
BT 26.250 459.429 Td /F1 9.8 Tf  [(agreement of 74%.)] TJ ET
BT 26.250 447.524 Td /F1 9.8 Tf  [(Conclusions: A reliable framework was developed that enables local public health practitioners to easily access appropriate and )] TJ ET
BT 26.250 435.619 Td /F1 9.8 Tf  [(previously utilized surveillance methods for a natural disaster emergency. This framework contributes to an evidence-informed )] TJ ET
BT 26.250 423.714 Td /F1 9.8 Tf  [(approach to surveillance in natural disasters with public health impacts.)] TJ ET
BT 26.250 387.112 Td /F4 12.0 Tf  [(Funding Statement)] TJ ET
BT 26.250 367.158 Td /F1 9.8 Tf  [(This work was solely supported by the authors� workplace, Public Health Ontario \(PHO\). The opinions, results and conclusions )] TJ ET
BT 26.250 355.253 Td /F1 9.8 Tf  [(reported in this paper are those of the authors. No endorsement by Public Health Ontario/The Ontario Agency for Health )] TJ ET
BT 26.250 343.348 Td /F1 9.8 Tf  [(Protection and Promotion is intended or should be inferred.)] TJ ET
BT 26.250 314.246 Td /F4 12.0 Tf  [(Introduction)] TJ ET
BT 26.250 294.291 Td /F1 9.8 Tf  [(With climate change and the potential for an increasing frequency of natural disasters around the world, it is expected that there )] TJ ET
BT 26.250 282.387 Td /F1 9.8 Tf  [(will be increasing impact on the health of populations.)] TJ ET
0.267 0.267 0.267 rg
BT 257.111 283.894 Td /F4 8.7 Tf  [(1)] TJ ET
0.271 0.267 0.267 rg
BT 261.929 286.275 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 264.339 283.894 Td /F4 8.7 Tf  [(2)] TJ ET
0.271 0.267 0.267 rg
BT 269.157 282.387 Td /F1 9.8 Tf  [( In Canada, potential hazards range from meteorological events such )] TJ ET
BT 26.250 270.482 Td /F1 9.8 Tf  [(as hurricanes and storms to geophysical disasters like earthquakes.)] TJ ET
0.267 0.267 0.267 rg
BT 318.867 271.989 Td /F4 8.7 Tf  [(3)] TJ ET
0.271 0.267 0.267 rg
BT 323.686 274.370 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 326.095 271.989 Td /F4 8.7 Tf  [(4)] TJ ET
0.271 0.267 0.267 rg
BT 330.914 270.482 Td /F1 9.8 Tf  [( A disaster is defined as: �a sudden accident or a natural )] TJ ET
BT 26.250 258.577 Td /F1 9.8 Tf  [(catastrophe that causes great damage or loss of life�.)] TJ ET
0.267 0.267 0.267 rg
BT 256.028 260.084 Td /F4 8.7 Tf  [(5)] TJ ET
0.271 0.267 0.267 rg
BT 260.847 258.577 Td /F1 9.8 Tf  [( It is crucial that public health organizations prepare for the health )] TJ ET
BT 26.250 246.672 Td /F1 9.8 Tf  [(consequences of potential natural disasters; furthermore, surveillance is an important component of all emergency plans. )] TJ ET
BT 26.250 234.768 Td /F1 9.8 Tf  [(Surveillance is defined as the systematic ongoing collection, collation, and analysis of data and the timely dissemination of )] TJ ET
BT 26.250 222.863 Td /F1 9.8 Tf  [(information to those who need to know so that action can be taken.)] TJ ET
0.267 0.267 0.267 rg
BT 315.123 224.370 Td /F4 8.7 Tf  [(6)] TJ ET
0.271 0.267 0.267 rg
BT 319.942 222.863 Td /F1 9.8 Tf  [( Surveillance in the setting of natural disasters can help to )] TJ ET
BT 26.250 210.958 Td /F1 9.8 Tf  [(identify the resulting health-related needs which in turn, will lead to the more rational and effective deployment of resources to )] TJ ET
BT 26.250 199.053 Td /F1 9.8 Tf  [(affected populations.)] TJ ET
BT 26.250 179.649 Td /F1 9.8 Tf  [(One challenge is predicting in advance the type and extent of surveillance required to respond to the disaster. Changes to a )] TJ ET
BT 26.250 167.744 Td /F1 9.8 Tf  [(jurisdiction�s surveillance system in the midst of an emergency can lead to potential biases and misinformation. In addition, )] TJ ET
BT 26.250 155.839 Td /F1 9.8 Tf  [(inadequate surveillance due to lack of planning could inaccurately estimate the need for resources to address the issues, )] TJ ET
BT 26.250 143.934 Td /F1 9.8 Tf  [(potentially resulting in preventable morbidity and mortality.)] TJ ET
0.267 0.267 0.267 rg
BT 277.137 145.442 Td /F4 8.7 Tf  [(7)] TJ ET
0.271 0.267 0.267 rg
BT 281.956 143.934 Td /F1 9.8 Tf  [( Thus, matching the type and size of the surveillance response to )] TJ ET
BT 26.250 132.030 Td /F1 9.8 Tf  [(the type and size of the disaster is critical to effective response delivery.)] TJ ET
BT 26.250 112.625 Td /F1 9.8 Tf  [(Frameworks have been increasingly used in the health emergency management field as tools to guide practice. Some )] TJ ET
BT 26.250 100.720 Td /F1 9.8 Tf  [(frameworks pertain to medical and clinically-oriented aspects of health emergency response after the initial disaster impact such )] TJ ET
BT 26.250 88.815 Td /F1 9.8 Tf  [(as mass casualty management and triage.)] TJ ET
0.267 0.267 0.267 rg
BT 209.413 90.323 Td /F4 8.7 Tf  [(8)] TJ ET
0.271 0.267 0.267 rg
BT 214.232 92.704 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 216.642 90.323 Td /F4 8.7 Tf  [(9)] TJ ET
0.271 0.267 0.267 rg
BT 221.460 92.704 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 223.870 90.323 Td /F4 8.7 Tf  [(10)] TJ ET
0.271 0.267 0.267 rg
BT 233.507 88.815 Td /F1 9.8 Tf  [( Public health consequences of disasters such as communicable diseases and )] TJ ET
BT 26.250 76.911 Td /F1 9.8 Tf  [(food and water insecurity generally occur after the initial disaster impact; tools have been developed to assess the public health )] TJ ET
BT 26.250 65.006 Td /F1 9.8 Tf  [(impact of large-scale disasters.)] TJ ET
0.267 0.267 0.267 rg
BT 160.625 66.513 Td /F4 8.7 Tf  [(11)] TJ ET
0.271 0.267 0.267 rg
BT 170.262 68.894 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 172.671 66.513 Td /F4 8.7 Tf  [(12)] TJ ET
0.271 0.267 0.267 rg
BT 182.309 65.006 Td /F1 9.8 Tf  [( Some tools are focused on settings of complex humanitarian emergencies where there is a )] TJ ET
BT 26.250 53.101 Td /F1 9.8 Tf  [(breakdown of authority as a result of conflict. This makes these frameworks less generalizable to settings that are not in conflict )] TJ ET
BT 26.250 41.196 Td /F1 9.8 Tf  [(and have intact authority structures, but yet may still be at risk for significant impact from natural disasters.)] TJ ET
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BT 483.593 42.704 Td /F4 8.7 Tf  [(7)] TJ ET
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BT 488.412 45.085 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 490.821 42.704 Td /F4 8.7 Tf  [(13)] TJ ET
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BT 500.459 41.196 Td /F1 9.8 Tf  [( The World )] TJ ET
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BT 15.000 718.042 Td /F2 21.0 Tf  [(Surveillance and Epidemiology in Natural Disasters: A Novel )] TJ ET
BT 15.000 693.094 Td /F2 21.0 Tf  [(Framework and Assessment of Reliability)] TJ ET
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BT 15.000 675.088 Td /F3 9.8 Tf  [(February 10, 2014)] TJ ET
BT 93.263 675.088 Td /F3 9.8 Tf  [(�)] TJ ET
0.267 0.267 0.267 rg
BT 98.138 675.088 Td /F3 9.8 Tf  [(Research Article)] TJ ET
BT 26.250 663.247 Td /F1 9.8 Tf  [(Yasmin Khan)] TJ ET
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BT 84.233 663.247 Td /F1 9.8 Tf  [(, )] TJ ET
0.267 0.267 0.267 rg
BT 89.654 663.247 Td /F1 9.8 Tf  [(Brian Schwartz)] TJ ET
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BT 155.213 663.247 Td /F1 9.8 Tf  [(, )] TJ ET
0.267 0.267 0.267 rg
BT 160.634 663.247 Td /F1 9.8 Tf  [(Ian Johnson)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 651.342 Td /F1 9.8 Tf  [(Khan Y, Schwartz B, Johnson I. Surveillance and Epidemiology in Natural Disasters: A Novel Framework and Assessment of )] TJ ET
BT 26.250 639.438 Td /F1 9.8 Tf  [(Reliability. PLOS Currents Disasters. 2014 Feb 10 . Edition 1. doi: 10.1371/currents.dis.6773eb9d5e64b733ab490f78de346003.)] TJ ET
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BT 26.250 610.335 Td /F4 12.0 Tf  [(Abstract)] TJ ET
BT 26.250 590.381 Td /F1 9.8 Tf  [(Objective: To create a framework and methodology for organizing relevant disaster epidemiology literature. The target audience )] TJ ET
BT 26.250 578.476 Td /F1 9.8 Tf  [(for the framework is local public health practitioners conducting emergency surveillance in the setting of preparedness or )] TJ ET
BT 26.250 566.571 Td /F1 9.8 Tf  [(response to natural disasters.)] TJ ET
BT 26.250 554.667 Td /F1 9.8 Tf  [(Methods: The approach to developing the framework involved utilizing the public health and emergency management literature. )] TJ ET
BT 26.250 542.762 Td /F1 9.8 Tf  [(It was created along four axes. The first was the type of natural disaster; second was according to phase of disaster cycle; third )] TJ ET
BT 26.250 530.857 Td /F1 9.8 Tf  [(was the impact of the disaster \(health, infrastructure, economic\); and fourth was related to the main outcome of the study \(ie. )] TJ ET
BT 26.250 518.952 Td /F1 9.8 Tf  [(injuries or infectious diseases\). A literature review was conducted and subsequently the current literature was utilized to perform )] TJ ET
BT 26.250 507.048 Td /F1 9.8 Tf  [(a reliability test of the established framework, using two independent reviewers.)] TJ ET
BT 26.250 495.143 Td /F1 9.8 Tf  [(Results: Using existing disaster classification systems and risk analysis tools, a framework was developed along the four axes. )] TJ ET
BT 26.250 483.238 Td /F1 9.8 Tf  [(The final literature search resulted in 85 articles on surveillance in natural disaster settings. The majority of studies are on the )] TJ ET
BT 26.250 471.333 Td /F1 9.8 Tf  [(subject of hurricanes with a catastrophic impact rating. The phase of testing reliability of the framework resulted in percent )] TJ ET
BT 26.250 459.429 Td /F1 9.8 Tf  [(agreement of 74%.)] TJ ET
BT 26.250 447.524 Td /F1 9.8 Tf  [(Conclusions: A reliable framework was developed that enables local public health practitioners to easily access appropriate and )] TJ ET
BT 26.250 435.619 Td /F1 9.8 Tf  [(previously utilized surveillance methods for a natural disaster emergency. This framework contributes to an evidence-informed )] TJ ET
BT 26.250 423.714 Td /F1 9.8 Tf  [(approach to surveillance in natural disasters with public health impacts.)] TJ ET
BT 26.250 387.112 Td /F4 12.0 Tf  [(Funding Statement)] TJ ET
BT 26.250 367.158 Td /F1 9.8 Tf  [(This work was solely supported by the authors� workplace, Public Health Ontario \(PHO\). The opinions, results and conclusions )] TJ ET
BT 26.250 355.253 Td /F1 9.8 Tf  [(reported in this paper are those of the authors. No endorsement by Public Health Ontario/The Ontario Agency for Health )] TJ ET
BT 26.250 343.348 Td /F1 9.8 Tf  [(Protection and Promotion is intended or should be inferred.)] TJ ET
BT 26.250 314.246 Td /F4 12.0 Tf  [(Introduction)] TJ ET
BT 26.250 294.291 Td /F1 9.8 Tf  [(With climate change and the potential for an increasing frequency of natural disasters around the world, it is expected that there )] TJ ET
BT 26.250 282.387 Td /F1 9.8 Tf  [(will be increasing impact on the health of populations.)] TJ ET
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BT 257.111 283.894 Td /F4 8.7 Tf  [(1)] TJ ET
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BT 261.929 286.275 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 264.339 283.894 Td /F4 8.7 Tf  [(2)] TJ ET
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BT 269.157 282.387 Td /F1 9.8 Tf  [( In Canada, potential hazards range from meteorological events such )] TJ ET
BT 26.250 270.482 Td /F1 9.8 Tf  [(as hurricanes and storms to geophysical disasters like earthquakes.)] TJ ET
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BT 318.867 271.989 Td /F4 8.7 Tf  [(3)] TJ ET
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BT 323.686 274.370 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 326.095 271.989 Td /F4 8.7 Tf  [(4)] TJ ET
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BT 330.914 270.482 Td /F1 9.8 Tf  [( A disaster is defined as: �a sudden accident or a natural )] TJ ET
BT 26.250 258.577 Td /F1 9.8 Tf  [(catastrophe that causes great damage or loss of life�.)] TJ ET
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BT 256.028 260.084 Td /F4 8.7 Tf  [(5)] TJ ET
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BT 260.847 258.577 Td /F1 9.8 Tf  [( It is crucial that public health organizations prepare for the health )] TJ ET
BT 26.250 246.672 Td /F1 9.8 Tf  [(consequences of potential natural disasters; furthermore, surveillance is an important component of all emergency plans. )] TJ ET
BT 26.250 234.768 Td /F1 9.8 Tf  [(Surveillance is defined as the systematic ongoing collection, collation, and analysis of data and the timely dissemination of )] TJ ET
BT 26.250 222.863 Td /F1 9.8 Tf  [(information to those who need to know so that action can be taken.)] TJ ET
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BT 315.123 224.370 Td /F4 8.7 Tf  [(6)] TJ ET
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BT 319.942 222.863 Td /F1 9.8 Tf  [( Surveillance in the setting of natural disasters can help to )] TJ ET
BT 26.250 210.958 Td /F1 9.8 Tf  [(identify the resulting health-related needs which in turn, will lead to the more rational and effective deployment of resources to )] TJ ET
BT 26.250 199.053 Td /F1 9.8 Tf  [(affected populations.)] TJ ET
BT 26.250 179.649 Td /F1 9.8 Tf  [(One challenge is predicting in advance the type and extent of surveillance required to respond to the disaster. Changes to a )] TJ ET
BT 26.250 167.744 Td /F1 9.8 Tf  [(jurisdiction�s surveillance system in the midst of an emergency can lead to potential biases and misinformation. In addition, )] TJ ET
BT 26.250 155.839 Td /F1 9.8 Tf  [(inadequate surveillance due to lack of planning could inaccurately estimate the need for resources to address the issues, )] TJ ET
BT 26.250 143.934 Td /F1 9.8 Tf  [(potentially resulting in preventable morbidity and mortality.)] TJ ET
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BT 277.137 145.442 Td /F4 8.7 Tf  [(7)] TJ ET
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BT 281.956 143.934 Td /F1 9.8 Tf  [( Thus, matching the type and size of the surveillance response to )] TJ ET
BT 26.250 132.030 Td /F1 9.8 Tf  [(the type and size of the disaster is critical to effective response delivery.)] TJ ET
BT 26.250 112.625 Td /F1 9.8 Tf  [(Frameworks have been increasingly used in the health emergency management field as tools to guide practice. Some )] TJ ET
BT 26.250 100.720 Td /F1 9.8 Tf  [(frameworks pertain to medical and clinically-oriented aspects of health emergency response after the initial disaster impact such )] TJ ET
BT 26.250 88.815 Td /F1 9.8 Tf  [(as mass casualty management and triage.)] TJ ET
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BT 209.413 90.323 Td /F4 8.7 Tf  [(8)] TJ ET
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BT 214.232 92.704 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 216.642 90.323 Td /F4 8.7 Tf  [(9)] TJ ET
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BT 221.460 92.704 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 223.870 90.323 Td /F4 8.7 Tf  [(10)] TJ ET
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BT 233.507 88.815 Td /F1 9.8 Tf  [( Public health consequences of disasters such as communicable diseases and )] TJ ET
BT 26.250 76.911 Td /F1 9.8 Tf  [(food and water insecurity generally occur after the initial disaster impact; tools have been developed to assess the public health )] TJ ET
BT 26.250 65.006 Td /F1 9.8 Tf  [(impact of large-scale disasters.)] TJ ET
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BT 160.625 66.513 Td /F4 8.7 Tf  [(11)] TJ ET
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BT 170.262 68.894 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 172.671 66.513 Td /F4 8.7 Tf  [(12)] TJ ET
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BT 182.309 65.006 Td /F1 9.8 Tf  [( Some tools are focused on settings of complex humanitarian emergencies where there is a )] TJ ET
BT 26.250 53.101 Td /F1 9.8 Tf  [(breakdown of authority as a result of conflict. This makes these frameworks less generalizable to settings that are not in conflict )] TJ ET
BT 26.250 41.196 Td /F1 9.8 Tf  [(and have intact authority structures, but yet may still be at risk for significant impact from natural disasters.)] TJ ET
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BT 483.593 42.704 Td /F4 8.7 Tf  [(7)] TJ ET
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BT 490.821 42.704 Td /F4 8.7 Tf  [(13)] TJ ET
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BT 26.250 745.174 Td /F4 8.7 Tf  [(16)] TJ ET
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BT 35.887 743.667 Td /F1 9.8 Tf  [( While guidance particularly at the national level includes population assessment and surveillance, practices often do not )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(conform to standardized reporting and assessment templates such as the Rapid Needs Assessment or the Utstein template for )] TJ ET
BT 26.250 719.857 Td /F1 9.8 Tf  [(health disaster management.)] TJ ET
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BT 151.976 721.364 Td /F4 8.7 Tf  [(12)] TJ ET
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BT 161.614 723.745 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 26.250 700.452 Td /F1 9.8 Tf  [(Despite the lack of conformity to a given reporting or surveillance template, a growing number of studies have been published in )] TJ ET
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BT 223.399 688.548 Td /F1 9.8 Tf  [( We wished to explore how current practices of surveillance in the literature could )] TJ ET
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BT 26.250 629.024 Td /F1 9.8 Tf  [(decision-making. Specific objectives were to a\) characterize relevant parameters of natural disaster events, including health )] TJ ET
BT 26.250 617.119 Td /F1 9.8 Tf  [(outcomes and b\) determine which modes of surveillance are best incorporated and useful within this classification system. )] TJ ET
BT 26.250 605.214 Td /F1 9.8 Tf  [(Ultimately, this tool could become a surveillance resource for practitioners in local public health departments to access in the )] TJ ET
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BT 26.250 556.707 Td /F4 12.0 Tf  [(Methods)] TJ ET
BT 26.250 536.753 Td /F4 9.8 Tf  [(Development of the Framework)] TJ ET
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BT 26.250 474.134 Td /F1 9.8 Tf  [(internationally-recognized disaster category classification system.)] TJ ET
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BT 26.250 536.753 Td /F4 9.8 Tf  [(Development of the Framework)] TJ ET
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BT 435.813 462.229 Td /F1 9.8 Tf  [( Although additional phases of )] TJ ET
BT 26.250 450.324 Td /F1 9.8 Tf  [(non/inter-disaster and pre-disaster management are also described in the cycle, the focus was on the aforementioned phases )] TJ ET
BT 26.250 438.420 Td /F1 9.8 Tf  [(for the current scope of work. In future, however, it is anticipated that emergency preparedness and mitigation practices would )] TJ ET
BT 26.250 426.515 Td /F1 9.8 Tf  [(be informed by surveillance parameters and practices described in this study.)] TJ ET
BT 26.250 407.110 Td /F1 9.8 Tf  [(The extent of damage to health, infrastructure and the economy was classified using impact rating systems that are commonly )] TJ ET
BT 26.250 395.205 Td /F1 9.8 Tf  [(utilized to assess risk associated with potential and real disasters. Within the frameworks examined from published literature, )] TJ ET
BT 26.250 383.301 Td /F1 9.8 Tf  [(similar themes were found pertaining to human impact \(fatalities or injuries\); physical impact or property damage; and )] TJ ET
BT 26.250 371.396 Td /F1 9.8 Tf  [(economic/social impact \(including critical infrastructure and resources\). Categories were developed based on severity of impact )] TJ ET
BT 26.250 359.491 Td /F1 9.8 Tf  [(and combined into an overall impact rating which was scored based on review of previously used frameworks and discussion )] TJ ET
BT 26.250 347.586 Td /F1 9.8 Tf  [(with content experts.)] TJ ET
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BT 125.305 351.475 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 127.714 349.094 Td /F4 8.7 Tf  [(20)] TJ ET
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BT 137.351 351.475 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 161.445 347.586 Td /F1 9.8 Tf  [( This framework can be found in Appendix 1. The fourth and final classification axis was the )] TJ ET
BT 26.250 335.682 Td /F1 9.8 Tf  [(main surveillance area being studied. For this section, a literature review was conducted to assess the most common types of )] TJ ET
BT 26.250 323.777 Td /F1 9.8 Tf  [(surveillance associated with the types and phases of the disaster.)] TJ ET
BT 26.250 304.372 Td /F1 9.8 Tf  [(The literature search utilized two databases \(Medline and EMBASE\) and was limited to original studies on humans from 1980, )] TJ ET
BT 26.250 292.467 Td /F1 9.8 Tf  [(the approximate time the field of disaster epidemiology began to develop, and extending to 2010.)] TJ ET
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BT 26.250 280.563 Td /F1 9.8 Tf  [(relevant to Ontario were included; those not relevant \(for example, volcanoes, avalanches or tsunamis\) were excluded.)] TJ ET
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BT 26.250 268.658 Td /F1 9.8 Tf  [(English language articles were examined by abstract. Reviews were included in the literature search for purposes of checking )] TJ ET
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BT 26.250 232.944 Td /F1 9.8 Tf  [(\(MeSH\); determination of which was assisted by information specialists. The MeSH headings were combined using Boolean )] TJ ET
BT 26.250 221.039 Td /F1 9.8 Tf  [(logic. These search terms are provided in Appendix 2.)] TJ ET
BT 26.250 201.634 Td /F1 9.8 Tf  [(Search results were initially screened by title for relevance to public health surveillance by one reviewer; relevance at this stage )] TJ ET
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BT 26.250 177.825 Td /F1 9.8 Tf  [(over-inclusion at this stage and subsequently, search results were examined by abstract for relevance to the study objective by )] TJ ET
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BT 26.250 122.706 Td /F1 9.8 Tf  [(recent articles found in the literature search were chosen given the observation that the field of disaster epidemiology has )] TJ ET
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BT 26.250 55.682 Td /F4 9.8 Tf  [(Testing the Reliability of the Framework)] TJ ET
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BT 26.250 664.738 Td /F1 9.8 Tf  [(of this study was to develop and test the reliability of a framework of current practices based on characteristics of disasters as )] TJ ET
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BT 26.250 556.707 Td /F4 12.0 Tf  [(Methods)] TJ ET
BT 26.250 536.753 Td /F4 9.8 Tf  [(Development of the Framework)] TJ ET
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BT 26.250 474.134 Td /F1 9.8 Tf  [(internationally-recognized disaster category classification system.)] TJ ET
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BT 435.813 462.229 Td /F1 9.8 Tf  [( Although additional phases of )] TJ ET
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BT 26.250 426.515 Td /F1 9.8 Tf  [(be informed by surveillance parameters and practices described in this study.)] TJ ET
BT 26.250 407.110 Td /F1 9.8 Tf  [(The extent of damage to health, infrastructure and the economy was classified using impact rating systems that are commonly )] TJ ET
BT 26.250 395.205 Td /F1 9.8 Tf  [(utilized to assess risk associated with potential and real disasters. Within the frameworks examined from published literature, )] TJ ET
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BT 26.250 371.396 Td /F1 9.8 Tf  [(economic/social impact \(including critical infrastructure and resources\). Categories were developed based on severity of impact )] TJ ET
BT 26.250 359.491 Td /F1 9.8 Tf  [(and combined into an overall impact rating which was scored based on review of previously used frameworks and discussion )] TJ ET
BT 26.250 347.586 Td /F1 9.8 Tf  [(with content experts.)] TJ ET
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0.267 0.267 0.267 rg
26.625 386.023 189.119 0.750 re f
26.625 373.743 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 376.874 Td /F4 9.8 Tf  [(IMPACT PHASE)] TJ ET
0.965 0.965 0.965 rg
215.744 374.118 364.756 12.280 re f
0.267 0.267 0.267 rg
215.744 386.023 86.563 0.750 re f
302.307 386.023 79.978 0.750 re f
382.286 386.023 77.268 0.750 re f
459.553 386.023 121.322 0.750 re f
580.125 373.743 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 220.244 376.874 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 349.933 188.744 24.184 re f
0.267 0.267 0.267 rg
26.625 373.743 189.119 0.750 re f
26.625 349.558 0.750 24.934 re f
0.271 0.267 0.267 rg
BT 31.500 364.594 Td /F4 9.8 Tf  [(Surveillance Area)] TJ ET
0.965 0.965 0.965 rg
215.744 349.933 86.563 24.184 re f
0.267 0.267 0.267 rg
215.744 373.743 86.563 0.750 re f
0.271 0.267 0.267 rg
BT 220.244 364.594 Td /F4 9.8 Tf  [(1)] TJ ET
BT 220.244 352.689 Td /F4 9.8 Tf  [(Marginal)] TJ ET
0.965 0.965 0.965 rg
302.307 349.933 79.978 24.184 re f
0.267 0.267 0.267 rg
302.307 373.743 79.978 0.750 re f
0.271 0.267 0.267 rg
BT 306.807 364.594 Td /F4 9.8 Tf  [(2)] TJ ET
BT 306.807 352.689 Td /F4 9.8 Tf  [(Serious)] TJ ET
0.965 0.965 0.965 rg
382.286 349.933 77.268 24.184 re f
0.267 0.267 0.267 rg
382.286 373.743 77.268 0.750 re f
0.271 0.267 0.267 rg
BT 386.786 364.594 Td /F4 9.8 Tf  [(3)] TJ ET
BT 386.786 352.689 Td /F4 9.8 Tf  [(Critical)] TJ ET
0.965 0.965 0.965 rg
459.553 349.933 120.947 24.184 re f
0.267 0.267 0.267 rg
459.553 373.743 121.322 0.750 re f
580.125 349.558 0.750 24.934 re f
0.271 0.267 0.267 rg
BT 464.053 364.594 Td /F4 9.8 Tf  [(4)] TJ ET
BT 464.053 352.689 Td /F4 9.8 Tf  [(Catastrophic)] TJ ET
0.267 0.267 0.267 rg
26.625 349.558 189.494 0.750 re f
26.625 333.677 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 339.703 Td /F1 9.8 Tf  [(area x)] TJ ET
0.267 0.267 0.267 rg
215.369 349.558 87.313 0.750 re f
215.369 333.677 0.750 16.631 re f
301.932 349.558 80.728 0.750 re f
301.932 333.677 0.750 16.631 re f
381.911 349.558 78.018 0.750 re f
381.911 333.677 0.750 16.631 re f
459.178 349.558 121.697 0.750 re f
459.178 333.677 0.750 16.631 re f
580.125 333.677 0.750 16.631 re f
26.625 333.677 189.494 0.750 re f
26.625 317.796 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 323.822 Td /F1 9.8 Tf  [(area y)] TJ ET
0.267 0.267 0.267 rg
215.369 333.677 87.313 0.750 re f
215.369 317.796 0.750 16.631 re f
301.932 333.677 80.728 0.750 re f
301.932 317.796 0.750 16.631 re f
381.911 333.677 78.018 0.750 re f
381.911 317.796 0.750 16.631 re f
459.178 333.677 121.697 0.750 re f
459.178 317.796 0.750 16.631 re f
580.125 317.796 0.750 16.631 re f
26.625 317.796 189.494 0.750 re f
26.625 301.915 189.494 0.750 re f
26.625 301.915 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 307.941 Td /F1 9.8 Tf  [(area z)] TJ ET
0.267 0.267 0.267 rg
215.369 317.796 87.313 0.750 re f
215.369 301.915 87.313 0.750 re f
215.369 301.915 0.750 16.631 re f
301.932 317.796 80.728 0.750 re f
301.932 301.915 80.728 0.750 re f
301.932 301.915 0.750 16.631 re f
381.911 317.796 78.018 0.750 re f
381.911 301.915 78.018 0.750 re f
381.911 301.915 0.750 16.631 re f
459.178 317.796 121.697 0.750 re f
459.178 301.915 121.697 0.750 re f
459.178 301.915 0.750 16.631 re f
580.125 301.915 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 26.250 247.016 Td /F1 9.8 Tf  [(After assessing the approximately 25% pilot articles, the finalized subject areas for surveillance were determined. These )] TJ ET
BT 26.250 235.111 Td /F1 9.8 Tf  [(relevant areas are listed in Table 2. Studies were entered into the framework during the reliability phase based on disaster )] TJ ET
BT 26.250 223.206 Td /F1 9.8 Tf  [(characteristics of type and impact factor, and study characteristics of phase of disaster and key area. The finalized template is )] TJ ET
BT 26.250 211.302 Td /F1 9.8 Tf  [(displayed in Table 3.)] TJ ET
Q
q
15.000 180.184 577.500 596.816 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(process was initiated by conducting a review of the literature. Henceforth, the term �reliability� will be used in reference to this )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(phase of the study.)] TJ ET
BT 26.250 736.167 Td /F1 9.8 Tf  [(Using the same literature search described above, the methods for entering studies into the finalized four axis framework were )] TJ ET
BT 26.250 724.262 Td /F1 9.8 Tf  [(as follows. For each natural disaster, the event was classified by disaster type \(e.g. earthquake\). Then, individual articles were )] TJ ET
BT 26.250 712.357 Td /F1 9.8 Tf  [(examined for the phase of disaster to which the study pertained, and for each natural disaster event for which an article had )] TJ ET
BT 26.250 700.452 Td /F1 9.8 Tf  [(been retrieved, the event was categorized by impact. Information on impact parameters for specific historical natural disasters )] TJ ET
BT 26.250 688.548 Td /F1 9.8 Tf  [(was obtained from The International Disaster Database, a publicly accessible database maintained by the Centre for Research )] TJ ET
BT 26.250 676.643 Td /F1 9.8 Tf  [(on the Epidemiology of Disasters.)] TJ ET
0.267 0.267 0.267 rg
BT 171.476 678.150 Td /F4 8.7 Tf  [(24)] TJ ET
0.271 0.267 0.267 rg
BT 181.114 676.643 Td /F1 9.8 Tf  [( If impact data were not found in the database on all parameters, government websites were )] TJ ET
BT 26.250 664.738 Td /F1 9.8 Tf  [(accessed for further information [e.g. Federal Emergency Management Agency, United States of America \(USA\)]. Finally, the )] TJ ET
BT 26.250 652.833 Td /F1 9.8 Tf  [(key area its research pursued was classified as the last axis in the framework.)] TJ ET
BT 26.250 633.429 Td /F1 9.8 Tf  [(Of methodological note, articles that describe surveillance for populations that migrated from their original residence location )] TJ ET
BT 26.250 621.524 Td /F1 9.8 Tf  [(\(e.g. surveillance in evacuation centres\) were classified according to the origin disaster type and impact. Additionally, articles )] TJ ET
BT 26.250 609.619 Td /F1 9.8 Tf  [(were only classified once; thus, the best subject area or exposure was chosen. For example, an article describing injuries and )] TJ ET
BT 26.250 597.714 Td /F1 9.8 Tf  [(illnesses after a disaster would be classified under basic descriptive study, rather than under injuries alone.)] TJ ET
BT 26.250 578.310 Td /F1 9.8 Tf  [(One reviewer \(a\) examined all articles retrieved by literature search and entered the articles into a template. The final template )] TJ ET
BT 26.250 566.405 Td /F1 9.8 Tf  [(of studies and references was organized into a multi-layer Microsoft Excel� Version 97-2003 \(Microsoft�: Redmond, )] TJ ET
BT 26.250 554.500 Td /F1 9.8 Tf  [(Washington\) spreadsheet. Approximately 25% of articles were assessed by a second reviewer \(b\) for both impact score and )] TJ ET
BT 26.250 542.595 Td /F1 9.8 Tf  [(article classification into the template. Percent agreement was determined for this 25% and differences were resolved by )] TJ ET
BT 26.250 530.691 Td /F1 9.8 Tf  [(consensus discussion.)] TJ ET
BT 26.250 494.088 Td /F4 12.0 Tf  [(Results)] TJ ET
BT 26.250 474.134 Td /F4 9.8 Tf  [(Development of the Framework)] TJ ET
BT 26.250 454.729 Td /F1 9.8 Tf  [(Based on a review of the classification systems and existing risk analysis tools, a sample framework was developed based on )] TJ ET
BT 26.250 442.824 Td /F1 9.8 Tf  [(disaster type and impact, as demonstrated in Table 1.)] TJ ET
q
26.250 419.207 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 421.954 Td /F1 9.8 Tf  [(Table 1: Sample Framework)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 301.540 555.000 110.167 re f
0.965 0.965 0.965 rg
27.000 398.677 188.744 12.280 re f
0.267 0.267 0.267 rg
26.625 410.582 189.119 0.750 re f
26.625 398.302 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 401.433 Td /F4 9.8 Tf  [(REHABILITATION PHASE)] TJ ET
0.965 0.965 0.965 rg
215.744 398.677 364.756 12.280 re f
0.267 0.267 0.267 rg
215.744 410.582 86.563 0.750 re f
302.307 410.582 79.978 0.750 re f
382.286 410.582 77.268 0.750 re f
459.553 410.582 121.322 0.750 re f
580.125 398.302 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 220.244 401.433 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 386.398 188.744 12.280 re f
0.267 0.267 0.267 rg
26.625 398.302 189.119 0.750 re f
26.625 386.023 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 389.154 Td /F4 9.8 Tf  [(EMERGENCY PHASE)] TJ ET
0.965 0.965 0.965 rg
215.744 386.398 364.756 12.280 re f
0.267 0.267 0.267 rg
215.744 398.302 86.563 0.750 re f
302.307 398.302 79.978 0.750 re f
382.286 398.302 77.268 0.750 re f
459.553 398.302 121.322 0.750 re f
580.125 386.023 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 220.244 389.154 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 374.118 188.744 12.280 re f
0.267 0.267 0.267 rg
26.625 386.023 189.119 0.750 re f
26.625 373.743 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 376.874 Td /F4 9.8 Tf  [(IMPACT PHASE)] TJ ET
0.965 0.965 0.965 rg
215.744 374.118 364.756 12.280 re f
0.267 0.267 0.267 rg
215.744 386.023 86.563 0.750 re f
302.307 386.023 79.978 0.750 re f
382.286 386.023 77.268 0.750 re f
459.553 386.023 121.322 0.750 re f
580.125 373.743 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 220.244 376.874 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 349.933 188.744 24.184 re f
0.267 0.267 0.267 rg
26.625 373.743 189.119 0.750 re f
26.625 349.558 0.750 24.934 re f
0.271 0.267 0.267 rg
BT 31.500 364.594 Td /F4 9.8 Tf  [(Surveillance Area)] TJ ET
0.965 0.965 0.965 rg
215.744 349.933 86.563 24.184 re f
0.267 0.267 0.267 rg
215.744 373.743 86.563 0.750 re f
0.271 0.267 0.267 rg
BT 220.244 364.594 Td /F4 9.8 Tf  [(1)] TJ ET
BT 220.244 352.689 Td /F4 9.8 Tf  [(Marginal)] TJ ET
0.965 0.965 0.965 rg
302.307 349.933 79.978 24.184 re f
0.267 0.267 0.267 rg
302.307 373.743 79.978 0.750 re f
0.271 0.267 0.267 rg
BT 306.807 364.594 Td /F4 9.8 Tf  [(2)] TJ ET
BT 306.807 352.689 Td /F4 9.8 Tf  [(Serious)] TJ ET
0.965 0.965 0.965 rg
382.286 349.933 77.268 24.184 re f
0.267 0.267 0.267 rg
382.286 373.743 77.268 0.750 re f
0.271 0.267 0.267 rg
BT 386.786 364.594 Td /F4 9.8 Tf  [(3)] TJ ET
BT 386.786 352.689 Td /F4 9.8 Tf  [(Critical)] TJ ET
0.965 0.965 0.965 rg
459.553 349.933 120.947 24.184 re f
0.267 0.267 0.267 rg
459.553 373.743 121.322 0.750 re f
580.125 349.558 0.750 24.934 re f
0.271 0.267 0.267 rg
BT 464.053 364.594 Td /F4 9.8 Tf  [(4)] TJ ET
BT 464.053 352.689 Td /F4 9.8 Tf  [(Catastrophic)] TJ ET
0.267 0.267 0.267 rg
26.625 349.558 189.494 0.750 re f
26.625 333.677 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 339.703 Td /F1 9.8 Tf  [(area x)] TJ ET
0.267 0.267 0.267 rg
215.369 349.558 87.313 0.750 re f
215.369 333.677 0.750 16.631 re f
301.932 349.558 80.728 0.750 re f
301.932 333.677 0.750 16.631 re f
381.911 349.558 78.018 0.750 re f
381.911 333.677 0.750 16.631 re f
459.178 349.558 121.697 0.750 re f
459.178 333.677 0.750 16.631 re f
580.125 333.677 0.750 16.631 re f
26.625 333.677 189.494 0.750 re f
26.625 317.796 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 323.822 Td /F1 9.8 Tf  [(area y)] TJ ET
0.267 0.267 0.267 rg
215.369 333.677 87.313 0.750 re f
215.369 317.796 0.750 16.631 re f
301.932 333.677 80.728 0.750 re f
301.932 317.796 0.750 16.631 re f
381.911 333.677 78.018 0.750 re f
381.911 317.796 0.750 16.631 re f
459.178 333.677 121.697 0.750 re f
459.178 317.796 0.750 16.631 re f
580.125 317.796 0.750 16.631 re f
26.625 317.796 189.494 0.750 re f
26.625 301.915 189.494 0.750 re f
26.625 301.915 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 307.941 Td /F1 9.8 Tf  [(area z)] TJ ET
0.267 0.267 0.267 rg
215.369 317.796 87.313 0.750 re f
215.369 301.915 87.313 0.750 re f
215.369 301.915 0.750 16.631 re f
301.932 317.796 80.728 0.750 re f
301.932 301.915 80.728 0.750 re f
301.932 301.915 0.750 16.631 re f
381.911 317.796 78.018 0.750 re f
381.911 301.915 78.018 0.750 re f
381.911 301.915 0.750 16.631 re f
459.178 317.796 121.697 0.750 re f
459.178 301.915 121.697 0.750 re f
459.178 301.915 0.750 16.631 re f
580.125 301.915 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 26.250 247.016 Td /F1 9.8 Tf  [(After assessing the approximately 25% pilot articles, the finalized subject areas for surveillance were determined. These )] TJ ET
BT 26.250 235.111 Td /F1 9.8 Tf  [(relevant areas are listed in Table 2. Studies were entered into the framework during the reliability phase based on disaster )] TJ ET
BT 26.250 223.206 Td /F1 9.8 Tf  [(characteristics of type and impact factor, and study characteristics of phase of disaster and key area. The finalized template is )] TJ ET
BT 26.250 211.302 Td /F1 9.8 Tf  [(displayed in Table 3.)] TJ ET
Q
q
0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(3)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET

Q
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0.271 0.267 0.267 rg
q
15.000 43.529 577.500 733.471 re W n
q
26.250 763.264 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 766.011 Td /F1 9.8 Tf  [(Table 2: Key Surveillance Areas Identified in the Literature)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 485.887 555.000 269.877 re f
0.965 0.965 0.965 rg
27.000 742.734 222.648 12.280 re f
0.267 0.267 0.267 rg
26.625 754.639 223.023 0.750 re f
26.625 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 745.490 Td /F4 9.8 Tf  [(Theme)] TJ ET
0.965 0.965 0.965 rg
249.648 742.734 330.852 12.280 re f
0.267 0.267 0.267 rg
249.648 754.639 331.227 0.750 re f
580.125 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 254.148 745.490 Td /F4 9.8 Tf  [(Examples)] TJ ET
0.267 0.267 0.267 rg
26.625 742.359 223.398 0.750 re f
26.625 726.478 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 732.504 Td /F1 9.8 Tf  [(Basic descriptive studies)] TJ ET
0.267 0.267 0.267 rg
249.273 742.359 331.602 0.750 re f
249.273 726.478 0.750 16.631 re f
580.125 726.478 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 732.504 Td /F1 9.8 Tf  [(Mortality or morbidity)] TJ ET
0.267 0.267 0.267 rg
26.625 726.478 223.398 0.750 re f
26.625 710.596 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 716.623 Td /F1 9.8 Tf  [(Injuries)] TJ ET
0.267 0.267 0.267 rg
249.273 726.478 331.602 0.750 re f
249.273 710.596 0.750 16.631 re f
580.125 710.596 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 716.623 Td /F1 9.8 Tf  [(Emergency department visits for injuries)] TJ ET
0.267 0.267 0.267 rg
26.625 710.596 223.398 0.750 re f
26.625 694.715 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 700.741 Td /F1 9.8 Tf  [(Environmental exposure)] TJ ET
0.267 0.267 0.267 rg
249.273 710.596 331.602 0.750 re f
249.273 694.715 0.750 16.631 re f
580.125 694.715 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 700.741 Td /F1 9.8 Tf  [(Carbon monoxide poisoning, hyperthermia)] TJ ET
0.267 0.267 0.267 rg
26.625 694.715 223.398 0.750 re f
26.625 678.834 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 684.860 Td /F1 9.8 Tf  [(Infectious disease)] TJ ET
0.267 0.267 0.267 rg
249.273 694.715 331.602 0.750 re f
249.273 678.834 0.750 16.631 re f
580.125 678.834 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 684.860 Td /F1 9.8 Tf  [(Enteric outbreaks, other viral outbreaks)] TJ ET
0.267 0.267 0.267 rg
26.625 678.834 223.398 0.750 re f
26.625 662.953 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 668.979 Td /F1 9.8 Tf  [(Chronic disease)] TJ ET
0.267 0.267 0.267 rg
249.273 678.834 331.602 0.750 re f
249.273 662.953 0.750 16.631 re f
580.125 662.953 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 668.979 Td /F1 9.8 Tf  [(Prescription medication needs)] TJ ET
0.267 0.267 0.267 rg
26.625 662.953 223.398 0.750 re f
26.625 518.024 0.750 145.679 re f
0.271 0.267 0.267 rg
BT 31.875 653.098 Td /F1 9.8 Tf  [(Rapid needs assessment)] TJ ET
0.267 0.267 0.267 rg
249.273 662.953 331.602 0.750 re f
249.273 518.024 0.750 145.679 re f
580.125 518.024 0.750 145.679 re f
0.271 0.267 0.267 rg
BT 254.523 653.098 Td /F1 9.8 Tf  [(Cluster analysis technique)] TJ ET
0.267 0.267 0.267 rg
26.625 518.024 223.398 0.750 re f
26.625 502.143 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 508.169 Td /F1 9.8 Tf  [(Vulnerable populations)] TJ ET
0.267 0.267 0.267 rg
249.273 518.024 331.602 0.750 re f
249.273 502.143 0.750 16.631 re f
580.125 502.143 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 508.169 Td /F1 9.8 Tf  [(Elderly)] TJ ET
0.267 0.267 0.267 rg
26.625 502.143 223.398 0.750 re f
26.625 486.262 223.398 0.750 re f
26.625 486.262 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 492.288 Td /F1 9.8 Tf  [(Other \(including novel methods\))] TJ ET
0.267 0.267 0.267 rg
249.273 502.143 331.602 0.750 re f
249.273 486.262 331.602 0.750 re f
249.273 486.262 0.750 16.631 re f
580.125 486.262 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 492.288 Td /F1 9.8 Tf  [(Use of cellular phones to transmit surveillance information)] TJ ET
q
26.250 427.150 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 429.898 Td /F1 9.8 Tf  [(Table 3: Finalized Classification Framework)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 230.077 555.000 189.574 re f
0.965 0.965 0.965 rg
27.000 406.621 197.834 12.280 re f
0.267 0.267 0.267 rg
26.625 418.525 198.209 0.750 re f
26.625 406.246 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 409.377 Td /F4 9.8 Tf  [(REHABILITATION PHASE)] TJ ET
0.965 0.965 0.965 rg
224.834 406.621 355.666 12.280 re f
0.267 0.267 0.267 rg
224.834 418.525 84.437 0.750 re f
309.271 418.525 77.981 0.750 re f
387.252 418.525 75.271 0.750 re f
462.523 418.525 118.352 0.750 re f
580.125 406.246 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 229.334 409.377 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 394.341 197.834 12.280 re f
0.267 0.267 0.267 rg
26.625 406.246 198.209 0.750 re f
26.625 393.966 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 397.097 Td /F4 9.8 Tf  [(EMERGENCY PHASE)] TJ ET
0.965 0.965 0.965 rg
224.834 394.341 355.666 12.280 re f
0.267 0.267 0.267 rg
224.834 406.246 84.437 0.750 re f
309.271 406.246 77.981 0.750 re f
387.252 406.246 75.271 0.750 re f
462.523 406.246 118.352 0.750 re f
580.125 393.966 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 229.334 397.097 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 382.061 197.834 12.280 re f
0.267 0.267 0.267 rg
26.625 393.966 198.209 0.750 re f
26.625 381.686 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 384.817 Td /F4 9.8 Tf  [(IMPACT PHASE)] TJ ET
0.965 0.965 0.965 rg
224.834 382.061 355.666 12.280 re f
0.267 0.267 0.267 rg
224.834 393.966 84.437 0.750 re f
309.271 393.966 77.981 0.750 re f
387.252 393.966 75.271 0.750 re f
462.523 393.966 118.352 0.750 re f
580.125 381.686 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 229.334 384.817 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 357.877 197.834 24.184 re f
0.267 0.267 0.267 rg
26.625 381.686 198.209 0.750 re f
26.625 357.502 0.750 24.934 re f
0.271 0.267 0.267 rg
BT 31.500 372.537 Td /F4 9.8 Tf  [(Surveillance Area)] TJ ET
0.965 0.965 0.965 rg
224.834 357.877 84.437 24.184 re f
0.267 0.267 0.267 rg
224.834 381.686 84.437 0.750 re f
0.271 0.267 0.267 rg
BT 229.334 372.537 Td /F4 9.8 Tf  [(1)] TJ ET
BT 229.334 360.633 Td /F4 9.8 Tf  [(Marginal)] TJ ET
0.965 0.965 0.965 rg
309.271 357.877 77.981 24.184 re f
0.267 0.267 0.267 rg
309.271 381.686 77.981 0.750 re f
0.271 0.267 0.267 rg
BT 313.771 372.537 Td /F4 9.8 Tf  [(2)] TJ ET
BT 313.771 360.633 Td /F4 9.8 Tf  [(Serious)] TJ ET
0.965 0.965 0.965 rg
387.252 357.877 75.271 24.184 re f
0.267 0.267 0.267 rg
387.252 381.686 75.271 0.750 re f
0.271 0.267 0.267 rg
BT 391.752 372.537 Td /F4 9.8 Tf  [(3)] TJ ET
BT 391.752 360.633 Td /F4 9.8 Tf  [(Critical)] TJ ET
0.965 0.965 0.965 rg
462.523 357.877 117.977 24.184 re f
0.267 0.267 0.267 rg
462.523 381.686 118.352 0.750 re f
580.125 357.502 0.750 24.934 re f
0.271 0.267 0.267 rg
BT 467.023 372.537 Td /F4 9.8 Tf  [(4)] TJ ET
BT 467.023 360.633 Td /F4 9.8 Tf  [(Catastrophic)] TJ ET
0.267 0.267 0.267 rg
26.625 357.502 198.584 0.750 re f
26.625 341.620 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 347.647 Td /F1 9.8 Tf  [(Basic descriptive studies)] TJ ET
0.267 0.267 0.267 rg
224.459 357.502 85.187 0.750 re f
224.459 341.620 0.750 16.631 re f
308.896 357.502 78.731 0.750 re f
308.896 341.620 0.750 16.631 re f
386.877 357.502 76.021 0.750 re f
386.877 341.620 0.750 16.631 re f
462.148 357.502 118.727 0.750 re f
462.148 341.620 0.750 16.631 re f
580.125 341.620 0.750 16.631 re f
26.625 341.620 198.584 0.750 re f
26.625 325.739 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 331.765 Td /F1 9.8 Tf  [(Injuries)] TJ ET
0.267 0.267 0.267 rg
224.459 341.620 85.187 0.750 re f
224.459 325.739 0.750 16.631 re f
308.896 341.620 78.731 0.750 re f
308.896 325.739 0.750 16.631 re f
386.877 341.620 76.021 0.750 re f
386.877 325.739 0.750 16.631 re f
462.148 341.620 118.727 0.750 re f
462.148 325.739 0.750 16.631 re f
580.125 325.739 0.750 16.631 re f
26.625 325.739 198.584 0.750 re f
26.625 309.858 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 315.884 Td /F1 9.8 Tf  [(Environmental exposure)] TJ ET
0.267 0.267 0.267 rg
224.459 325.739 85.187 0.750 re f
224.459 309.858 0.750 16.631 re f
308.896 325.739 78.731 0.750 re f
308.896 309.858 0.750 16.631 re f
386.877 325.739 76.021 0.750 re f
386.877 309.858 0.750 16.631 re f
462.148 325.739 118.727 0.750 re f
462.148 309.858 0.750 16.631 re f
580.125 309.858 0.750 16.631 re f
26.625 309.858 198.584 0.750 re f
26.625 293.977 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 300.003 Td /F1 9.8 Tf  [(Infectious disease)] TJ ET
0.267 0.267 0.267 rg
224.459 309.858 85.187 0.750 re f
224.459 293.977 0.750 16.631 re f
308.896 309.858 78.731 0.750 re f
308.896 293.977 0.750 16.631 re f
386.877 309.858 76.021 0.750 re f
386.877 293.977 0.750 16.631 re f
462.148 309.858 118.727 0.750 re f
462.148 293.977 0.750 16.631 re f
580.125 293.977 0.750 16.631 re f
26.625 293.977 198.584 0.750 re f
26.625 278.095 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 284.122 Td /F1 9.8 Tf  [(Chronic disease)] TJ ET
0.267 0.267 0.267 rg
224.459 293.977 85.187 0.750 re f
224.459 278.095 0.750 16.631 re f
308.896 293.977 78.731 0.750 re f
308.896 278.095 0.750 16.631 re f
386.877 293.977 76.021 0.750 re f
386.877 278.095 0.750 16.631 re f
462.148 293.977 118.727 0.750 re f
462.148 278.095 0.750 16.631 re f
580.125 278.095 0.750 16.631 re f
26.625 278.095 198.584 0.750 re f
26.625 262.214 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 268.240 Td /F1 9.8 Tf  [(Rapid needs assessment)] TJ ET
0.267 0.267 0.267 rg
224.459 278.095 85.187 0.750 re f
224.459 262.214 0.750 16.631 re f
308.896 278.095 78.731 0.750 re f
308.896 262.214 0.750 16.631 re f
386.877 278.095 76.021 0.750 re f
386.877 262.214 0.750 16.631 re f
462.148 278.095 118.727 0.750 re f
462.148 262.214 0.750 16.631 re f
580.125 262.214 0.750 16.631 re f
26.625 262.214 198.584 0.750 re f
26.625 246.333 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 252.359 Td /F1 9.8 Tf  [(Vulnerable populations)] TJ ET
0.267 0.267 0.267 rg
224.459 262.214 85.187 0.750 re f
224.459 246.333 0.750 16.631 re f
308.896 262.214 78.731 0.750 re f
308.896 246.333 0.750 16.631 re f
386.877 262.214 76.021 0.750 re f
386.877 246.333 0.750 16.631 re f
462.148 262.214 118.727 0.750 re f
462.148 246.333 0.750 16.631 re f
580.125 246.333 0.750 16.631 re f
26.625 246.333 198.584 0.750 re f
26.625 230.452 198.584 0.750 re f
26.625 230.452 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 236.478 Td /F1 9.8 Tf  [(Other \(including novel methods\))] TJ ET
0.267 0.267 0.267 rg
224.459 246.333 85.187 0.750 re f
224.459 230.452 85.187 0.750 re f
224.459 230.452 0.750 16.631 re f
308.896 246.333 78.731 0.750 re f
308.896 230.452 78.731 0.750 re f
308.896 230.452 0.750 16.631 re f
386.877 246.333 76.021 0.750 re f
386.877 230.452 76.021 0.750 re f
386.877 230.452 0.750 16.631 re f
462.148 246.333 118.727 0.750 re f
462.148 230.452 118.727 0.750 re f
462.148 230.452 0.750 16.631 re f
580.125 230.452 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 26.250 175.553 Td /F4 9.8 Tf  [(Testing the Reliability of the Framework)] TJ ET
BT 26.250 156.148 Td /F1 9.8 Tf  [(Medline search strategy resulted in 2384 citations with an additional 689 non-duplicate EMBASE citations, for a total of 3073. )] TJ ET
BT 26.250 144.243 Td /F1 9.8 Tf  [(After initial assessment for relevance by title only, 394 citations remained. The independent review by two authors of these 394 )] TJ ET
BT 26.250 132.339 Td /F1 9.8 Tf  [(citations by abstract resulted in good agreement with a kappa statistic of 0.80. Three hundred and fourteen \(314\) articles were )] TJ ET
BT 26.250 120.434 Td /F1 9.8 Tf  [(agreed upon unanimously with the remainder resolved by consensus discussion. It was determined that saturation in content )] TJ ET
BT 26.250 108.529 Td /F1 9.8 Tf  [(was achieved with inclusion of English articles; non-English articles that were reviewed by abstract were not felt to be )] TJ ET
BT 26.250 96.624 Td /F1 9.8 Tf  [(substantially different from the group. Thus, further translation and analysis of non-English articles was not pursued. Final )] TJ ET
BT 26.250 84.720 Td /F1 9.8 Tf  [(agreement between reviewers based on abstract resulted in 85 articles.)] TJ ET
BT 26.250 65.315 Td /F1 9.8 Tf  [(Twenty articles \(23.5% of final total\) were examined in order to assess the applicability of the framework.)] TJ ET
0.267 0.267 0.267 rg
BT 476.544 66.822 Td /F4 8.7 Tf  [(25)] TJ ET
0.271 0.267 0.267 rg
BT 486.181 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 488.591 66.822 Td /F4 8.7 Tf  [(26)] TJ ET
0.271 0.267 0.267 rg
BT 498.228 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 500.637 66.822 Td /F4 8.7 Tf  [(27)] TJ ET
0.271 0.267 0.267 rg
BT 510.275 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 512.684 66.822 Td /F4 8.7 Tf  [(28)] TJ ET
0.271 0.267 0.267 rg
BT 522.321 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 524.731 66.822 Td /F4 8.7 Tf  [(29)] TJ ET
0.271 0.267 0.267 rg
BT 534.368 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 536.777 66.822 Td /F4 8.7 Tf  [(30)] TJ ET
0.271 0.267 0.267 rg
BT 546.415 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 548.824 66.822 Td /F4 8.7 Tf  [(31)] TJ ET
0.271 0.267 0.267 rg
BT 558.461 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 560.871 66.822 Td /F4 8.7 Tf  [(32)] TJ ET
0.271 0.267 0.267 rg
BT 570.508 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 54.917 Td /F4 8.7 Tf  [(33)] TJ ET
0.271 0.267 0.267 rg
BT 35.887 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 38.297 54.917 Td /F4 8.7 Tf  [(34)] TJ ET
0.271 0.267 0.267 rg
BT 47.934 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 50.343 54.917 Td /F4 8.7 Tf  [(35)] TJ ET
0.271 0.267 0.267 rg
BT 59.981 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 62.390 54.917 Td /F4 8.7 Tf  [(36)] TJ ET
0.271 0.267 0.267 rg
BT 72.027 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 74.437 54.917 Td /F4 8.7 Tf  [(37)] TJ ET
0.271 0.267 0.267 rg
BT 84.074 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 86.483 54.917 Td /F4 8.7 Tf  [(38)] TJ ET
0.271 0.267 0.267 rg
BT 96.121 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 98.530 54.917 Td /F4 8.7 Tf  [(39)] TJ ET
0.271 0.267 0.267 rg
BT 108.167 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 110.577 54.917 Td /F4 8.7 Tf  [(40)] TJ ET
0.271 0.267 0.267 rg
BT 120.214 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 122.623 54.917 Td /F4 8.7 Tf  [(41)] TJ ET
0.271 0.267 0.267 rg
BT 132.261 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 134.670 54.917 Td /F4 8.7 Tf  [(42)] TJ ET
0.271 0.267 0.267 rg
BT 144.307 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 146.717 54.917 Td /F4 8.7 Tf  [(43)] TJ ET
0.271 0.267 0.267 rg
BT 156.354 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 158.763 54.917 Td /F4 8.7 Tf  [(44)] TJ ET
0.271 0.267 0.267 rg
BT 168.401 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 170.810 54.917 Td /F4 8.7 Tf  [(45)] TJ ET
0.271 0.267 0.267 rg
BT 180.447 53.410 Td /F1 9.8 Tf  [( The percent agreement between reviewers in utilizing the framework was 74%.)] TJ ET
Q
q
15.000 43.529 577.500 733.471 re W n
q
26.250 763.264 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 766.011 Td /F1 9.8 Tf  [(Table 2: Key Surveillance Areas Identified in the Literature)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 485.887 555.000 269.877 re f
0.965 0.965 0.965 rg
27.000 742.734 222.648 12.280 re f
0.267 0.267 0.267 rg
26.625 754.639 223.023 0.750 re f
26.625 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 745.490 Td /F4 9.8 Tf  [(Theme)] TJ ET
0.965 0.965 0.965 rg
249.648 742.734 330.852 12.280 re f
0.267 0.267 0.267 rg
249.648 754.639 331.227 0.750 re f
580.125 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 254.148 745.490 Td /F4 9.8 Tf  [(Examples)] TJ ET
0.267 0.267 0.267 rg
26.625 742.359 223.398 0.750 re f
26.625 726.478 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 732.504 Td /F1 9.8 Tf  [(Basic descriptive studies)] TJ ET
0.267 0.267 0.267 rg
249.273 742.359 331.602 0.750 re f
249.273 726.478 0.750 16.631 re f
580.125 726.478 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 732.504 Td /F1 9.8 Tf  [(Mortality or morbidity)] TJ ET
0.267 0.267 0.267 rg
26.625 726.478 223.398 0.750 re f
26.625 710.596 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 716.623 Td /F1 9.8 Tf  [(Injuries)] TJ ET
0.267 0.267 0.267 rg
249.273 726.478 331.602 0.750 re f
249.273 710.596 0.750 16.631 re f
580.125 710.596 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 716.623 Td /F1 9.8 Tf  [(Emergency department visits for injuries)] TJ ET
0.267 0.267 0.267 rg
26.625 710.596 223.398 0.750 re f
26.625 694.715 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 700.741 Td /F1 9.8 Tf  [(Environmental exposure)] TJ ET
0.267 0.267 0.267 rg
249.273 710.596 331.602 0.750 re f
249.273 694.715 0.750 16.631 re f
580.125 694.715 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 700.741 Td /F1 9.8 Tf  [(Carbon monoxide poisoning, hyperthermia)] TJ ET
0.267 0.267 0.267 rg
26.625 694.715 223.398 0.750 re f
26.625 678.834 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 684.860 Td /F1 9.8 Tf  [(Infectious disease)] TJ ET
0.267 0.267 0.267 rg
249.273 694.715 331.602 0.750 re f
249.273 678.834 0.750 16.631 re f
580.125 678.834 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 684.860 Td /F1 9.8 Tf  [(Enteric outbreaks, other viral outbreaks)] TJ ET
0.267 0.267 0.267 rg
26.625 678.834 223.398 0.750 re f
26.625 662.953 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 668.979 Td /F1 9.8 Tf  [(Chronic disease)] TJ ET
0.267 0.267 0.267 rg
249.273 678.834 331.602 0.750 re f
249.273 662.953 0.750 16.631 re f
580.125 662.953 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 668.979 Td /F1 9.8 Tf  [(Prescription medication needs)] TJ ET
0.267 0.267 0.267 rg
26.625 662.953 223.398 0.750 re f
26.625 518.024 0.750 145.679 re f
0.271 0.267 0.267 rg
BT 31.875 653.098 Td /F1 9.8 Tf  [(Rapid needs assessment)] TJ ET
0.267 0.267 0.267 rg
249.273 662.953 331.602 0.750 re f
249.273 518.024 0.750 145.679 re f
580.125 518.024 0.750 145.679 re f
0.271 0.267 0.267 rg
BT 254.523 653.098 Td /F1 9.8 Tf  [(Cluster analysis technique)] TJ ET
0.267 0.267 0.267 rg
26.625 518.024 223.398 0.750 re f
26.625 502.143 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 508.169 Td /F1 9.8 Tf  [(Vulnerable populations)] TJ ET
0.267 0.267 0.267 rg
249.273 518.024 331.602 0.750 re f
249.273 502.143 0.750 16.631 re f
580.125 502.143 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 508.169 Td /F1 9.8 Tf  [(Elderly)] TJ ET
0.267 0.267 0.267 rg
26.625 502.143 223.398 0.750 re f
26.625 486.262 223.398 0.750 re f
26.625 486.262 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 492.288 Td /F1 9.8 Tf  [(Other \(including novel methods\))] TJ ET
0.267 0.267 0.267 rg
249.273 502.143 331.602 0.750 re f
249.273 486.262 331.602 0.750 re f
249.273 486.262 0.750 16.631 re f
580.125 486.262 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 492.288 Td /F1 9.8 Tf  [(Use of cellular phones to transmit surveillance information)] TJ ET
q
26.250 427.150 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 429.898 Td /F1 9.8 Tf  [(Table 3: Finalized Classification Framework)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 230.077 555.000 189.574 re f
0.965 0.965 0.965 rg
27.000 406.621 197.834 12.280 re f
0.267 0.267 0.267 rg
26.625 418.525 198.209 0.750 re f
26.625 406.246 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 409.377 Td /F4 9.8 Tf  [(REHABILITATION PHASE)] TJ ET
0.965 0.965 0.965 rg
224.834 406.621 355.666 12.280 re f
0.267 0.267 0.267 rg
224.834 418.525 84.437 0.750 re f
309.271 418.525 77.981 0.750 re f
387.252 418.525 75.271 0.750 re f
462.523 418.525 118.352 0.750 re f
580.125 406.246 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 229.334 409.377 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 394.341 197.834 12.280 re f
0.267 0.267 0.267 rg
26.625 406.246 198.209 0.750 re f
26.625 393.966 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 397.097 Td /F4 9.8 Tf  [(EMERGENCY PHASE)] TJ ET
0.965 0.965 0.965 rg
224.834 394.341 355.666 12.280 re f
0.267 0.267 0.267 rg
224.834 406.246 84.437 0.750 re f
309.271 406.246 77.981 0.750 re f
387.252 406.246 75.271 0.750 re f
462.523 406.246 118.352 0.750 re f
580.125 393.966 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 229.334 397.097 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 382.061 197.834 12.280 re f
0.267 0.267 0.267 rg
26.625 393.966 198.209 0.750 re f
26.625 381.686 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 384.817 Td /F4 9.8 Tf  [(IMPACT PHASE)] TJ ET
0.965 0.965 0.965 rg
224.834 382.061 355.666 12.280 re f
0.267 0.267 0.267 rg
224.834 393.966 84.437 0.750 re f
309.271 393.966 77.981 0.750 re f
387.252 393.966 75.271 0.750 re f
462.523 393.966 118.352 0.750 re f
580.125 381.686 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 229.334 384.817 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 357.877 197.834 24.184 re f
0.267 0.267 0.267 rg
26.625 381.686 198.209 0.750 re f
26.625 357.502 0.750 24.934 re f
0.271 0.267 0.267 rg
BT 31.500 372.537 Td /F4 9.8 Tf  [(Surveillance Area)] TJ ET
0.965 0.965 0.965 rg
224.834 357.877 84.437 24.184 re f
0.267 0.267 0.267 rg
224.834 381.686 84.437 0.750 re f
0.271 0.267 0.267 rg
BT 229.334 372.537 Td /F4 9.8 Tf  [(1)] TJ ET
BT 229.334 360.633 Td /F4 9.8 Tf  [(Marginal)] TJ ET
0.965 0.965 0.965 rg
309.271 357.877 77.981 24.184 re f
0.267 0.267 0.267 rg
309.271 381.686 77.981 0.750 re f
0.271 0.267 0.267 rg
BT 313.771 372.537 Td /F4 9.8 Tf  [(2)] TJ ET
BT 313.771 360.633 Td /F4 9.8 Tf  [(Serious)] TJ ET
0.965 0.965 0.965 rg
387.252 357.877 75.271 24.184 re f
0.267 0.267 0.267 rg
387.252 381.686 75.271 0.750 re f
0.271 0.267 0.267 rg
BT 391.752 372.537 Td /F4 9.8 Tf  [(3)] TJ ET
BT 391.752 360.633 Td /F4 9.8 Tf  [(Critical)] TJ ET
0.965 0.965 0.965 rg
462.523 357.877 117.977 24.184 re f
0.267 0.267 0.267 rg
462.523 381.686 118.352 0.750 re f
580.125 357.502 0.750 24.934 re f
0.271 0.267 0.267 rg
BT 467.023 372.537 Td /F4 9.8 Tf  [(4)] TJ ET
BT 467.023 360.633 Td /F4 9.8 Tf  [(Catastrophic)] TJ ET
0.267 0.267 0.267 rg
26.625 357.502 198.584 0.750 re f
26.625 341.620 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 347.647 Td /F1 9.8 Tf  [(Basic descriptive studies)] TJ ET
0.267 0.267 0.267 rg
224.459 357.502 85.187 0.750 re f
224.459 341.620 0.750 16.631 re f
308.896 357.502 78.731 0.750 re f
308.896 341.620 0.750 16.631 re f
386.877 357.502 76.021 0.750 re f
386.877 341.620 0.750 16.631 re f
462.148 357.502 118.727 0.750 re f
462.148 341.620 0.750 16.631 re f
580.125 341.620 0.750 16.631 re f
26.625 341.620 198.584 0.750 re f
26.625 325.739 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 331.765 Td /F1 9.8 Tf  [(Injuries)] TJ ET
0.267 0.267 0.267 rg
224.459 341.620 85.187 0.750 re f
224.459 325.739 0.750 16.631 re f
308.896 341.620 78.731 0.750 re f
308.896 325.739 0.750 16.631 re f
386.877 341.620 76.021 0.750 re f
386.877 325.739 0.750 16.631 re f
462.148 341.620 118.727 0.750 re f
462.148 325.739 0.750 16.631 re f
580.125 325.739 0.750 16.631 re f
26.625 325.739 198.584 0.750 re f
26.625 309.858 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 315.884 Td /F1 9.8 Tf  [(Environmental exposure)] TJ ET
0.267 0.267 0.267 rg
224.459 325.739 85.187 0.750 re f
224.459 309.858 0.750 16.631 re f
308.896 325.739 78.731 0.750 re f
308.896 309.858 0.750 16.631 re f
386.877 325.739 76.021 0.750 re f
386.877 309.858 0.750 16.631 re f
462.148 325.739 118.727 0.750 re f
462.148 309.858 0.750 16.631 re f
580.125 309.858 0.750 16.631 re f
26.625 309.858 198.584 0.750 re f
26.625 293.977 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 300.003 Td /F1 9.8 Tf  [(Infectious disease)] TJ ET
0.267 0.267 0.267 rg
224.459 309.858 85.187 0.750 re f
224.459 293.977 0.750 16.631 re f
308.896 309.858 78.731 0.750 re f
308.896 293.977 0.750 16.631 re f
386.877 309.858 76.021 0.750 re f
386.877 293.977 0.750 16.631 re f
462.148 309.858 118.727 0.750 re f
462.148 293.977 0.750 16.631 re f
580.125 293.977 0.750 16.631 re f
26.625 293.977 198.584 0.750 re f
26.625 278.095 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 284.122 Td /F1 9.8 Tf  [(Chronic disease)] TJ ET
0.267 0.267 0.267 rg
224.459 293.977 85.187 0.750 re f
224.459 278.095 0.750 16.631 re f
308.896 293.977 78.731 0.750 re f
308.896 278.095 0.750 16.631 re f
386.877 293.977 76.021 0.750 re f
386.877 278.095 0.750 16.631 re f
462.148 293.977 118.727 0.750 re f
462.148 278.095 0.750 16.631 re f
580.125 278.095 0.750 16.631 re f
26.625 278.095 198.584 0.750 re f
26.625 262.214 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 268.240 Td /F1 9.8 Tf  [(Rapid needs assessment)] TJ ET
0.267 0.267 0.267 rg
224.459 278.095 85.187 0.750 re f
224.459 262.214 0.750 16.631 re f
308.896 278.095 78.731 0.750 re f
308.896 262.214 0.750 16.631 re f
386.877 278.095 76.021 0.750 re f
386.877 262.214 0.750 16.631 re f
462.148 278.095 118.727 0.750 re f
462.148 262.214 0.750 16.631 re f
580.125 262.214 0.750 16.631 re f
26.625 262.214 198.584 0.750 re f
26.625 246.333 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 252.359 Td /F1 9.8 Tf  [(Vulnerable populations)] TJ ET
0.267 0.267 0.267 rg
224.459 262.214 85.187 0.750 re f
224.459 246.333 0.750 16.631 re f
308.896 262.214 78.731 0.750 re f
308.896 246.333 0.750 16.631 re f
386.877 262.214 76.021 0.750 re f
386.877 246.333 0.750 16.631 re f
462.148 262.214 118.727 0.750 re f
462.148 246.333 0.750 16.631 re f
580.125 246.333 0.750 16.631 re f
26.625 246.333 198.584 0.750 re f
26.625 230.452 198.584 0.750 re f
26.625 230.452 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 236.478 Td /F1 9.8 Tf  [(Other \(including novel methods\))] TJ ET
0.267 0.267 0.267 rg
224.459 246.333 85.187 0.750 re f
224.459 230.452 85.187 0.750 re f
224.459 230.452 0.750 16.631 re f
308.896 246.333 78.731 0.750 re f
308.896 230.452 78.731 0.750 re f
308.896 230.452 0.750 16.631 re f
386.877 246.333 76.021 0.750 re f
386.877 230.452 76.021 0.750 re f
386.877 230.452 0.750 16.631 re f
462.148 246.333 118.727 0.750 re f
462.148 230.452 118.727 0.750 re f
462.148 230.452 0.750 16.631 re f
580.125 230.452 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 26.250 175.553 Td /F4 9.8 Tf  [(Testing the Reliability of the Framework)] TJ ET
BT 26.250 156.148 Td /F1 9.8 Tf  [(Medline search strategy resulted in 2384 citations with an additional 689 non-duplicate EMBASE citations, for a total of 3073. )] TJ ET
BT 26.250 144.243 Td /F1 9.8 Tf  [(After initial assessment for relevance by title only, 394 citations remained. The independent review by two authors of these 394 )] TJ ET
BT 26.250 132.339 Td /F1 9.8 Tf  [(citations by abstract resulted in good agreement with a kappa statistic of 0.80. Three hundred and fourteen \(314\) articles were )] TJ ET
BT 26.250 120.434 Td /F1 9.8 Tf  [(agreed upon unanimously with the remainder resolved by consensus discussion. It was determined that saturation in content )] TJ ET
BT 26.250 108.529 Td /F1 9.8 Tf  [(was achieved with inclusion of English articles; non-English articles that were reviewed by abstract were not felt to be )] TJ ET
BT 26.250 96.624 Td /F1 9.8 Tf  [(substantially different from the group. Thus, further translation and analysis of non-English articles was not pursued. Final )] TJ ET
BT 26.250 84.720 Td /F1 9.8 Tf  [(agreement between reviewers based on abstract resulted in 85 articles.)] TJ ET
BT 26.250 65.315 Td /F1 9.8 Tf  [(Twenty articles \(23.5% of final total\) were examined in order to assess the applicability of the framework.)] TJ ET
0.267 0.267 0.267 rg
BT 476.544 66.822 Td /F4 8.7 Tf  [(25)] TJ ET
0.271 0.267 0.267 rg
BT 486.181 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 488.591 66.822 Td /F4 8.7 Tf  [(26)] TJ ET
0.271 0.267 0.267 rg
BT 498.228 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 500.637 66.822 Td /F4 8.7 Tf  [(27)] TJ ET
0.271 0.267 0.267 rg
BT 510.275 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 512.684 66.822 Td /F4 8.7 Tf  [(28)] TJ ET
0.271 0.267 0.267 rg
BT 522.321 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 524.731 66.822 Td /F4 8.7 Tf  [(29)] TJ ET
0.271 0.267 0.267 rg
BT 534.368 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 536.777 66.822 Td /F4 8.7 Tf  [(30)] TJ ET
0.271 0.267 0.267 rg
BT 546.415 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 548.824 66.822 Td /F4 8.7 Tf  [(31)] TJ ET
0.271 0.267 0.267 rg
BT 558.461 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 560.871 66.822 Td /F4 8.7 Tf  [(32)] TJ ET
0.271 0.267 0.267 rg
BT 570.508 69.203 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 54.917 Td /F4 8.7 Tf  [(33)] TJ ET
0.271 0.267 0.267 rg
BT 35.887 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 38.297 54.917 Td /F4 8.7 Tf  [(34)] TJ ET
0.271 0.267 0.267 rg
BT 47.934 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 50.343 54.917 Td /F4 8.7 Tf  [(35)] TJ ET
0.271 0.267 0.267 rg
BT 59.981 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 62.390 54.917 Td /F4 8.7 Tf  [(36)] TJ ET
0.271 0.267 0.267 rg
BT 72.027 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 74.437 54.917 Td /F4 8.7 Tf  [(37)] TJ ET
0.271 0.267 0.267 rg
BT 84.074 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 86.483 54.917 Td /F4 8.7 Tf  [(38)] TJ ET
0.271 0.267 0.267 rg
BT 96.121 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 98.530 54.917 Td /F4 8.7 Tf  [(39)] TJ ET
0.271 0.267 0.267 rg
BT 108.167 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 110.577 54.917 Td /F4 8.7 Tf  [(40)] TJ ET
0.271 0.267 0.267 rg
BT 120.214 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 122.623 54.917 Td /F4 8.7 Tf  [(41)] TJ ET
0.271 0.267 0.267 rg
BT 132.261 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 134.670 54.917 Td /F4 8.7 Tf  [(42)] TJ ET
0.271 0.267 0.267 rg
BT 144.307 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 146.717 54.917 Td /F4 8.7 Tf  [(43)] TJ ET
0.271 0.267 0.267 rg
BT 156.354 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 158.763 54.917 Td /F4 8.7 Tf  [(44)] TJ ET
0.271 0.267 0.267 rg
BT 168.401 57.298 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 170.810 54.917 Td /F4 8.7 Tf  [(45)] TJ ET
0.271 0.267 0.267 rg
BT 180.447 53.410 Td /F1 9.8 Tf  [( The percent agreement between reviewers in utilizing the framework was 74%.)] TJ ET
Q
q
15.000 43.529 577.500 733.471 re W n
q
26.250 763.264 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 766.011 Td /F1 9.8 Tf  [(Table 2: Key Surveillance Areas Identified in the Literature)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 485.887 555.000 269.877 re f
0.965 0.965 0.965 rg
27.000 742.734 222.648 12.280 re f
0.267 0.267 0.267 rg
26.625 754.639 223.023 0.750 re f
26.625 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 745.490 Td /F4 9.8 Tf  [(Theme)] TJ ET
0.965 0.965 0.965 rg
249.648 742.734 330.852 12.280 re f
0.267 0.267 0.267 rg
249.648 754.639 331.227 0.750 re f
580.125 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 254.148 745.490 Td /F4 9.8 Tf  [(Examples)] TJ ET
0.267 0.267 0.267 rg
26.625 742.359 223.398 0.750 re f
26.625 726.478 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 732.504 Td /F1 9.8 Tf  [(Basic descriptive studies)] TJ ET
0.267 0.267 0.267 rg
249.273 742.359 331.602 0.750 re f
249.273 726.478 0.750 16.631 re f
580.125 726.478 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 732.504 Td /F1 9.8 Tf  [(Mortality or morbidity)] TJ ET
0.267 0.267 0.267 rg
26.625 726.478 223.398 0.750 re f
26.625 710.596 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 716.623 Td /F1 9.8 Tf  [(Injuries)] TJ ET
0.267 0.267 0.267 rg
249.273 726.478 331.602 0.750 re f
249.273 710.596 0.750 16.631 re f
580.125 710.596 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 716.623 Td /F1 9.8 Tf  [(Emergency department visits for injuries)] TJ ET
0.267 0.267 0.267 rg
26.625 710.596 223.398 0.750 re f
26.625 694.715 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 700.741 Td /F1 9.8 Tf  [(Environmental exposure)] TJ ET
0.267 0.267 0.267 rg
249.273 710.596 331.602 0.750 re f
249.273 694.715 0.750 16.631 re f
580.125 694.715 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 700.741 Td /F1 9.8 Tf  [(Carbon monoxide poisoning, hyperthermia)] TJ ET
0.267 0.267 0.267 rg
26.625 694.715 223.398 0.750 re f
26.625 678.834 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 684.860 Td /F1 9.8 Tf  [(Infectious disease)] TJ ET
0.267 0.267 0.267 rg
249.273 694.715 331.602 0.750 re f
249.273 678.834 0.750 16.631 re f
580.125 678.834 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 684.860 Td /F1 9.8 Tf  [(Enteric outbreaks, other viral outbreaks)] TJ ET
0.267 0.267 0.267 rg
26.625 678.834 223.398 0.750 re f
26.625 662.953 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 668.979 Td /F1 9.8 Tf  [(Chronic disease)] TJ ET
0.267 0.267 0.267 rg
249.273 678.834 331.602 0.750 re f
249.273 662.953 0.750 16.631 re f
580.125 662.953 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 668.979 Td /F1 9.8 Tf  [(Prescription medication needs)] TJ ET
0.267 0.267 0.267 rg
26.625 662.953 223.398 0.750 re f
26.625 518.024 0.750 145.679 re f
0.271 0.267 0.267 rg
BT 31.875 653.098 Td /F1 9.8 Tf  [(Rapid needs assessment)] TJ ET
0.267 0.267 0.267 rg
249.273 662.953 331.602 0.750 re f
249.273 518.024 0.750 145.679 re f
580.125 518.024 0.750 145.679 re f
0.271 0.267 0.267 rg
BT 254.523 653.098 Td /F1 9.8 Tf  [(Cluster analysis technique)] TJ ET
0.267 0.267 0.267 rg
26.625 518.024 223.398 0.750 re f
26.625 502.143 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 508.169 Td /F1 9.8 Tf  [(Vulnerable populations)] TJ ET
0.267 0.267 0.267 rg
249.273 518.024 331.602 0.750 re f
249.273 502.143 0.750 16.631 re f
580.125 502.143 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 508.169 Td /F1 9.8 Tf  [(Elderly)] TJ ET
0.267 0.267 0.267 rg
26.625 502.143 223.398 0.750 re f
26.625 486.262 223.398 0.750 re f
26.625 486.262 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 492.288 Td /F1 9.8 Tf  [(Other \(including novel methods\))] TJ ET
0.267 0.267 0.267 rg
249.273 502.143 331.602 0.750 re f
249.273 486.262 331.602 0.750 re f
249.273 486.262 0.750 16.631 re f
580.125 486.262 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 254.523 492.288 Td /F1 9.8 Tf  [(Use of cellular phones to transmit surveillance information)] TJ ET
q
26.250 427.150 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 429.898 Td /F1 9.8 Tf  [(Table 3: Finalized Classification Framework)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 230.077 555.000 189.574 re f
0.965 0.965 0.965 rg
27.000 406.621 197.834 12.280 re f
0.267 0.267 0.267 rg
26.625 418.525 198.209 0.750 re f
26.625 406.246 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 409.377 Td /F4 9.8 Tf  [(REHABILITATION PHASE)] TJ ET
0.965 0.965 0.965 rg
224.834 406.621 355.666 12.280 re f
0.267 0.267 0.267 rg
224.834 418.525 84.437 0.750 re f
309.271 418.525 77.981 0.750 re f
387.252 418.525 75.271 0.750 re f
462.523 418.525 118.352 0.750 re f
580.125 406.246 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 229.334 409.377 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 394.341 197.834 12.280 re f
0.267 0.267 0.267 rg
26.625 406.246 198.209 0.750 re f
26.625 393.966 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 397.097 Td /F4 9.8 Tf  [(EMERGENCY PHASE)] TJ ET
0.965 0.965 0.965 rg
224.834 394.341 355.666 12.280 re f
0.267 0.267 0.267 rg
224.834 406.246 84.437 0.750 re f
309.271 406.246 77.981 0.750 re f
387.252 406.246 75.271 0.750 re f
462.523 406.246 118.352 0.750 re f
580.125 393.966 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 229.334 397.097 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 382.061 197.834 12.280 re f
0.267 0.267 0.267 rg
26.625 393.966 198.209 0.750 re f
26.625 381.686 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 384.817 Td /F4 9.8 Tf  [(IMPACT PHASE)] TJ ET
0.965 0.965 0.965 rg
224.834 382.061 355.666 12.280 re f
0.267 0.267 0.267 rg
224.834 393.966 84.437 0.750 re f
309.271 393.966 77.981 0.750 re f
387.252 393.966 75.271 0.750 re f
462.523 393.966 118.352 0.750 re f
580.125 381.686 0.750 13.030 re f
0.271 0.267 0.267 rg
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0.267 0.267 0.267 rg
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0.267 0.267 0.267 rg
224.834 381.686 84.437 0.750 re f
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0.267 0.267 0.267 rg
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0.267 0.267 0.267 rg
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0.271 0.267 0.267 rg
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0.267 0.267 0.267 rg
462.523 381.686 118.352 0.750 re f
580.125 357.502 0.750 24.934 re f
0.271 0.267 0.267 rg
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26.625 341.620 0.750 16.631 re f
0.271 0.267 0.267 rg
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224.459 341.620 0.750 16.631 re f
308.896 357.502 78.731 0.750 re f
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462.148 341.620 0.750 16.631 re f
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26.625 341.620 198.584 0.750 re f
26.625 325.739 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 331.765 Td /F1 9.8 Tf  [(Injuries)] TJ ET
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224.459 341.620 85.187 0.750 re f
224.459 325.739 0.750 16.631 re f
308.896 341.620 78.731 0.750 re f
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0.271 0.267 0.267 rg
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224.459 309.858 0.750 16.631 re f
308.896 325.739 78.731 0.750 re f
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462.148 309.858 0.750 16.631 re f
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26.625 293.977 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 300.003 Td /F1 9.8 Tf  [(Infectious disease)] TJ ET
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224.459 309.858 85.187 0.750 re f
224.459 293.977 0.750 16.631 re f
308.896 309.858 78.731 0.750 re f
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26.625 278.095 0.750 16.631 re f
0.271 0.267 0.267 rg
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0.267 0.267 0.267 rg
224.459 293.977 85.187 0.750 re f
224.459 278.095 0.750 16.631 re f
308.896 293.977 78.731 0.750 re f
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462.148 278.095 0.750 16.631 re f
580.125 278.095 0.750 16.631 re f
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0.271 0.267 0.267 rg
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224.459 278.095 85.187 0.750 re f
224.459 262.214 0.750 16.631 re f
308.896 278.095 78.731 0.750 re f
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462.148 262.214 0.750 16.631 re f
580.125 262.214 0.750 16.631 re f
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0.271 0.267 0.267 rg
BT 31.875 252.359 Td /F1 9.8 Tf  [(Vulnerable populations)] TJ ET
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224.459 246.333 0.750 16.631 re f
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0.267 0.267 0.267 rg
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0.271 0.267 0.267 rg
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0.267 0.267 0.267 rg
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0.267 0.267 0.267 rg
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0.271 0.267 0.267 rg
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0.267 0.267 0.267 rg
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0.271 0.267 0.267 rg
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0.267 0.267 0.267 rg
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355.976 414.015 224.899 0.750 re f
355.976 390.503 224.899 0.750 re f
355.976 390.503 0.750 24.262 re f
580.125 390.503 0.750 24.262 re f
0.271 0.267 0.267 rg
BT 361.226 401.800 Td /F1 9.8 Tf  [(\(Yang, Yang, Luo, & Gong, 2009)] TJ ET
0.267 0.267 0.267 rg
BT 502.698 402.249 Td /F4 8.7 Tf  [(54)] TJ ET
0.271 0.267 0.267 rg
BT 512.335 401.800 Td /F1 9.8 Tf  [( \))] TJ ET
BT 26.250 318.406 Td /F4 12.0 Tf  [(Discussion)] TJ ET
BT 26.250 298.452 Td /F1 9.8 Tf  [(Natural disasters with impact on human health and well-being can leave a jurisdiction in a varying state of disarray with )] TJ ET
BT 26.250 286.547 Td /F1 9.8 Tf  [(significant pressure to respond to real, perceived or potential health threats. While it is important to respond quickly, it has also )] TJ ET
BT 26.250 274.643 Td /F1 9.8 Tf  [(been shown that public health emergency response based on an assessment of health needs is more effective.)] TJ ET
0.267 0.267 0.267 rg
BT 505.872 276.150 Td /F4 8.7 Tf  [(18)] TJ ET
0.271 0.267 0.267 rg
BT 515.509 274.643 Td /F1 9.8 Tf  [( Given that )] TJ ET
BT 26.250 262.738 Td /F1 9.8 Tf  [(the field of disaster epidemiology is evolving and may not be familiar to all local public health practitioners, a resource of )] TJ ET
BT 26.250 250.833 Td /F1 9.8 Tf  [(disaster surveillance and epidemiology would be useful. Using the four axes described; namely, type of disaster, phase of )] TJ ET
BT 26.250 238.928 Td /F1 9.8 Tf  [(disaster, impact and major outcomes, this study created a framework where relevant surveillance systems can be classified. )] TJ ET
BT 26.250 227.024 Td /F1 9.8 Tf  [(This study also demonstrated reliable classification of studies within this framework among two authors.)] TJ ET
BT 26.250 207.619 Td /F1 9.8 Tf  [(The potential use of this framework is three-fold. One is that it creates a resource table of surveillance systems that can direct )] TJ ET
BT 26.250 195.714 Td /F1 9.8 Tf  [(people to the existing literature in a rapid and effective manner. This first is practical: if a jurisdiction is planning for or facing a )] TJ ET
BT 26.250 183.809 Td /F1 9.8 Tf  [(major disaster with a potential human health impact and a surveillance system is required, the table directly links the )] TJ ET
BT 26.250 171.905 Td /F1 9.8 Tf  [(responsible persons to the relevant literature. While the database currently represents the literature base reviewed as of 2010, )] TJ ET
BT 26.250 160.000 Td /F1 9.8 Tf  [(and for disasters relevant to the authors� jurisdiction, the development of a live, web-based, open-source database would allow )] TJ ET
BT 26.250 148.095 Td /F1 9.8 Tf  [(an ongoing classification of the up-to-date literature, with contributions from global experts. Different surveillance approaches for )] TJ ET
BT 26.250 136.190 Td /F1 9.8 Tf  [(health outcomes could be quickly reviewed and considered for implementation.)] TJ ET
BT 26.250 116.786 Td /F1 9.8 Tf  [(Secondly, over time, this classification may lead to a better understanding of the best practices in conducting surveillance during )] TJ ET
BT 26.250 104.881 Td /F1 9.8 Tf  [(an emergency response. If a particular method is routinely shown to perform well with respect to important characteristics, it )] TJ ET
BT 26.250 92.976 Td /F1 9.8 Tf  [(might become standard operating practice, and be relevant to the type and scope of a local event for which it has been shown )] TJ ET
BT 26.250 81.071 Td /F1 9.8 Tf  [(to be effective. Finally, the framework may be used to identify gaps where research on the optimal surveillance methodology )] TJ ET
BT 26.250 69.167 Td /F1 9.8 Tf  [(needs to be done.)] TJ ET
BT 26.250 49.762 Td /F1 9.8 Tf  [(The disaster type, phases of the disaster cycle, and severity of a disaster�s impact formed the basis of this framework. In reality, )] TJ ET
BT 26.250 37.857 Td /F1 9.8 Tf  [(each disaster may not fit neatly into every category. For example, during the reliability component of the study it was found that )] TJ ET
Q
q
15.000 23.571 577.500 753.429 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(The remainder \(65\) articles were input into the framework by one reviewer. A flowchart depicting the selection process for )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(articles is provided in Appendix 3. In general, a description of the entirety of studies utilized for the reliability phase reveals that )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(the majority of studies \(58%\) were on the subject of hurricanes, followed by earthquakes \(16%\). The majority of studies by )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(impact fell into the category of either catastrophic or critical \(81%\) and 67% of studies were conducted during the emergency )] TJ ET
BT 26.250 719.857 Td /F1 9.8 Tf  [(phase of the disaster. Thirteen percent of studies were rapid health assessments utilizing the Centers for Disease Control )] TJ ET
BT 26.250 707.952 Td /F1 9.8 Tf  [(\(CDC\)/WHO-endorsed methodology of cluster analysis; 53% of studies were general \(non-cluster analysis\) descriptions of )] TJ ET
BT 26.250 696.048 Td /F1 9.8 Tf  [(health needs and outcomes, including morbidity and mortality. The remaining articles were generally descriptive studies in )] TJ ET
BT 26.250 684.143 Td /F1 9.8 Tf  [(various subject areas. Areas were noted to evolve over time to include relevant novel approaches, such as internet-based )] TJ ET
BT 26.250 672.238 Td /F1 9.8 Tf  [(surveillance and use of cellular phones in surveillance.)] TJ ET
0.267 0.267 0.267 rg
BT 261.430 673.745 Td /F4 8.7 Tf  [(25)] TJ ET
0.271 0.267 0.267 rg
BT 271.067 676.126 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 273.476 673.745 Td /F4 8.7 Tf  [(27)] TJ ET
0.271 0.267 0.267 rg
BT 283.114 672.238 Td /F1 9.8 Tf  [( An example of the final completed framework using earthquakes in )] TJ ET
BT 26.250 660.333 Td /F1 9.8 Tf  [(the emergency phase is demonstrated in Table 4.)] TJ ET
0.267 0.267 0.267 rg
BT 240.311 661.841 Td /F4 8.7 Tf  [(25)] TJ ET
0.271 0.267 0.267 rg
BT 249.949 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 252.358 661.841 Td /F4 8.7 Tf  [(46)] TJ ET
0.271 0.267 0.267 rg
BT 261.995 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 264.405 661.841 Td /F4 8.7 Tf  [(47)] TJ ET
0.271 0.267 0.267 rg
BT 274.042 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 276.451 661.841 Td /F4 8.7 Tf  [(48)] TJ ET
0.271 0.267 0.267 rg
BT 286.089 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 288.498 661.841 Td /F4 8.7 Tf  [(49)] TJ ET
0.271 0.267 0.267 rg
BT 298.135 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 300.545 661.841 Td /F4 8.7 Tf  [(50)] TJ ET
0.271 0.267 0.267 rg
BT 310.182 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 312.591 661.841 Td /F4 8.7 Tf  [(51)] TJ ET
0.271 0.267 0.267 rg
BT 322.229 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 324.638 661.841 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 334.275 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 336.685 661.841 Td /F4 8.7 Tf  [(53)] TJ ET
q
26.250 636.716 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 639.463 Td /F1 9.8 Tf  [(Table 4)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 390.128 555.000 239.088 re f
0.965 0.965 0.965 rg
27.000 616.186 116.578 12.280 re f
0.267 0.267 0.267 rg
26.625 628.091 116.953 0.750 re f
26.625 615.811 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 618.942 Td /F4 9.8 Tf  [(EMERGENCY PHASE)] TJ ET
0.965 0.965 0.965 rg
143.578 616.186 436.922 12.280 re f
0.267 0.267 0.267 rg
143.578 628.091 61.104 0.750 re f
204.683 628.091 56.052 0.750 re f
260.735 628.091 95.616 0.750 re f
356.351 628.091 224.524 0.750 re f
580.125 615.811 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 148.078 618.942 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 592.002 116.578 24.185 re f
0.267 0.267 0.267 rg
26.625 615.811 116.953 0.750 re f
26.625 591.627 0.750 24.935 re f
0.271 0.267 0.267 rg
BT 31.500 606.663 Td /F4 9.8 Tf  [(Surveillance Area)] TJ ET
0.965 0.965 0.965 rg
143.578 592.002 61.104 24.185 re f
0.267 0.267 0.267 rg
143.578 615.811 61.104 0.750 re f
0.271 0.267 0.267 rg
BT 148.078 606.663 Td /F4 9.8 Tf  [(1)] TJ ET
BT 148.078 594.758 Td /F4 9.8 Tf  [(Marginal)] TJ ET
0.965 0.965 0.965 rg
204.683 592.002 56.052 24.185 re f
0.267 0.267 0.267 rg
204.683 615.811 56.052 0.750 re f
0.271 0.267 0.267 rg
BT 209.183 606.663 Td /F4 9.8 Tf  [(2)] TJ ET
BT 209.183 594.758 Td /F4 9.8 Tf  [(Serious)] TJ ET
0.965 0.965 0.965 rg
260.735 592.002 95.616 24.185 re f
0.267 0.267 0.267 rg
260.735 615.811 95.616 0.750 re f
0.271 0.267 0.267 rg
BT 265.235 606.663 Td /F4 9.8 Tf  [(3)] TJ ET
BT 265.235 594.758 Td /F4 9.8 Tf  [(Critical)] TJ ET
0.965 0.965 0.965 rg
356.351 592.002 224.149 24.185 re f
0.267 0.267 0.267 rg
356.351 615.811 224.524 0.750 re f
580.125 591.627 0.750 24.935 re f
0.271 0.267 0.267 rg
BT 360.851 606.663 Td /F4 9.8 Tf  [(4)] TJ ET
BT 360.851 594.758 Td /F4 9.8 Tf  [(Catastrophic)] TJ ET
0.267 0.267 0.267 rg
26.625 591.627 117.328 0.750 re f
26.625 541.049 0.750 51.328 re f
0.271 0.267 0.267 rg
BT 31.875 581.772 Td /F4 9.8 Tf  [(Basic descriptive )] TJ ET
BT 31.875 574.141 Td /F4 9.8 Tf  [(studies)] TJ ET
0.267 0.267 0.267 rg
143.203 591.627 61.854 0.750 re f
143.203 541.049 0.750 51.328 re f
204.308 591.627 56.802 0.750 re f
204.308 541.049 0.750 51.328 re f
260.360 591.627 96.366 0.750 re f
260.360 541.049 0.750 51.328 re f
0.271 0.267 0.267 rg
BT 265.610 581.772 Td /F1 9.8 Tf  [(\(Carr, Leahy, )] TJ ET
BT 265.610 574.141 Td /F1 9.8 Tf  [(London, Sidhu, & )] TJ ET
BT 265.610 564.149 Td /F1 9.8 Tf  [(Vogt, 1996)] TJ ET
0.267 0.267 0.267 rg
BT 312.771 564.598 Td /F4 8.7 Tf  [(47)] TJ ET
0.271 0.267 0.267 rg
BT 322.408 564.149 Td /F1 9.8 Tf  [(\))] TJ ET
0.267 0.267 0.267 rg
355.976 591.627 224.899 0.750 re f
355.976 541.049 0.750 51.328 re f
580.125 541.049 0.750 51.328 re f
0.271 0.267 0.267 rg
BT 361.226 579.411 Td /F1 9.8 Tf  [(\(Akbari, Farshad, & Asadi-Lari, 2004)] TJ ET
0.267 0.267 0.267 rg
BT 518.912 579.860 Td /F4 8.7 Tf  [(46)] TJ ET
0.271 0.267 0.267 rg
BT 528.550 579.411 Td /F1 9.8 Tf  [( ; De )] TJ ET
BT 361.226 568.829 Td /F1 9.8 Tf  [(Bruycker et al., 1985)] TJ ET
0.267 0.267 0.267 rg
BT 450.643 569.278 Td /F4 8.7 Tf  [(50)] TJ ET
0.271 0.267 0.267 rg
BT 460.280 568.829 Td /F1 9.8 Tf  [( ; Helminen, Saarela, & )] TJ ET
BT 361.226 558.247 Td /F1 9.8 Tf  [(Salmela, 2006)] TJ ET
0.267 0.267 0.267 rg
BT 423.548 558.696 Td /F4 8.7 Tf  [(51)] TJ ET
0.271 0.267 0.267 rg
BT 433.185 558.247 Td /F1 9.8 Tf  [( ; Pawar, Shelke, & Kakrani, )] TJ ET
BT 361.226 547.665 Td /F1 9.8 Tf  [(2005)] TJ ET
0.267 0.267 0.267 rg
BT 382.910 548.114 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 392.547 547.665 Td /F1 9.8 Tf  [( \))] TJ ET
0.267 0.267 0.267 rg
26.625 541.049 117.328 0.750 re f
26.625 522.217 0.750 19.582 re f
0.271 0.267 0.267 rg
BT 31.875 531.194 Td /F4 9.8 Tf  [(Injuries)] TJ ET
0.267 0.267 0.267 rg
143.203 541.049 61.854 0.750 re f
143.203 522.217 0.750 19.582 re f
204.308 541.049 56.802 0.750 re f
204.308 522.217 0.750 19.582 re f
260.360 541.049 96.366 0.750 re f
260.360 522.217 0.750 19.582 re f
355.976 541.049 224.899 0.750 re f
355.976 522.217 0.750 19.582 re f
580.125 522.217 0.750 19.582 re f
0.271 0.267 0.267 rg
BT 361.226 528.833 Td /F1 9.8 Tf  [(\(Roces, White, Dayrit, & Durkin, 1992)] TJ ET
0.267 0.267 0.267 rg
BT 523.232 529.282 Td /F4 8.7 Tf  [(53)] TJ ET
0.271 0.267 0.267 rg
BT 532.869 528.833 Td /F1 9.8 Tf  [( \))] TJ ET
0.267 0.267 0.267 rg
26.625 522.217 117.328 0.750 re f
26.625 498.704 0.750 24.262 re f
0.271 0.267 0.267 rg
BT 31.875 512.362 Td /F4 9.8 Tf  [(Environmental )] TJ ET
BT 31.875 504.731 Td /F4 9.8 Tf  [(exposure)] TJ ET
0.267 0.267 0.267 rg
143.203 522.217 61.854 0.750 re f
143.203 498.704 0.750 24.262 re f
204.308 522.217 56.802 0.750 re f
204.308 498.704 0.750 24.262 re f
260.360 522.217 96.366 0.750 re f
260.360 498.704 0.750 24.262 re f
355.976 522.217 224.899 0.750 re f
355.976 498.704 0.750 24.262 re f
580.125 498.704 0.750 24.262 re f
26.625 498.704 117.328 0.750 re f
26.625 482.823 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 488.849 Td /F4 9.8 Tf  [(Infectious disease)] TJ ET
0.267 0.267 0.267 rg
143.203 498.704 61.854 0.750 re f
143.203 482.823 0.750 16.631 re f
204.308 498.704 56.802 0.750 re f
204.308 482.823 0.750 16.631 re f
260.360 498.704 96.366 0.750 re f
260.360 482.823 0.750 16.631 re f
355.976 498.704 224.899 0.750 re f
355.976 482.823 0.750 16.631 re f
580.125 482.823 0.750 16.631 re f
26.625 482.823 117.328 0.750 re f
26.625 466.942 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 472.968 Td /F4 9.8 Tf  [(Chronic disease)] TJ ET
0.267 0.267 0.267 rg
143.203 482.823 61.854 0.750 re f
143.203 466.942 0.750 16.631 re f
204.308 482.823 56.802 0.750 re f
204.308 466.942 0.750 16.631 re f
260.360 482.823 96.366 0.750 re f
260.360 466.942 0.750 16.631 re f
355.976 482.823 224.899 0.750 re f
355.976 466.942 0.750 16.631 re f
580.125 466.942 0.750 16.631 re f
26.625 466.942 117.328 0.750 re f
26.625 437.528 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 31.875 457.087 Td /F4 9.8 Tf  [(Rapid needs )] TJ ET
BT 31.875 449.456 Td /F4 9.8 Tf  [(assessment)] TJ ET
0.267 0.267 0.267 rg
143.203 466.942 61.854 0.750 re f
143.203 437.528 0.750 30.164 re f
204.308 466.942 56.802 0.750 re f
204.308 437.528 0.750 30.164 re f
260.360 466.942 96.366 0.750 re f
260.360 437.528 0.750 30.164 re f
355.976 466.942 224.899 0.750 re f
355.976 437.528 0.750 30.164 re f
580.125 437.528 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 361.226 454.726 Td /F1 9.8 Tf  [(\(Chen, Chen, Malilay, & Twu, 2003)] TJ ET
0.267 0.267 0.267 rg
BT 512.409 455.175 Td /F4 8.7 Tf  [(48)] TJ ET
0.271 0.267 0.267 rg
BT 522.046 454.726 Td /F1 9.8 Tf  [( ; Daley, )] TJ ET
BT 361.226 444.144 Td /F1 9.8 Tf  [(Karpati, & Sheik, 2001)] TJ ET
0.267 0.267 0.267 rg
BT 458.238 444.593 Td /F4 8.7 Tf  [(49)] TJ ET
0.271 0.267 0.267 rg
BT 467.875 444.144 Td /F1 9.8 Tf  [( \))] TJ ET
0.267 0.267 0.267 rg
26.625 437.528 117.328 0.750 re f
26.625 414.015 0.750 24.262 re f
0.271 0.267 0.267 rg
BT 31.875 427.673 Td /F4 9.8 Tf  [(Vulnerable )] TJ ET
BT 31.875 420.042 Td /F4 9.8 Tf  [(populations)] TJ ET
0.267 0.267 0.267 rg
143.203 437.528 61.854 0.750 re f
143.203 414.015 0.750 24.262 re f
204.308 437.528 56.802 0.750 re f
204.308 414.015 0.750 24.262 re f
260.360 437.528 96.366 0.750 re f
260.360 414.015 0.750 24.262 re f
355.976 437.528 224.899 0.750 re f
355.976 414.015 0.750 24.262 re f
580.125 414.015 0.750 24.262 re f
26.625 414.015 117.328 0.750 re f
26.625 390.503 117.328 0.750 re f
26.625 390.503 0.750 24.262 re f
0.271 0.267 0.267 rg
BT 31.875 404.160 Td /F4 9.8 Tf  [(Other \(including novel )] TJ ET
BT 31.875 396.529 Td /F4 9.8 Tf  [(methods\))] TJ ET
0.267 0.267 0.267 rg
143.203 414.015 61.854 0.750 re f
143.203 390.503 61.854 0.750 re f
143.203 390.503 0.750 24.262 re f
204.308 414.015 56.802 0.750 re f
204.308 390.503 56.802 0.750 re f
204.308 390.503 0.750 24.262 re f
260.360 414.015 96.366 0.750 re f
260.360 390.503 96.366 0.750 re f
260.360 390.503 0.750 24.262 re f
355.976 414.015 224.899 0.750 re f
355.976 390.503 224.899 0.750 re f
355.976 390.503 0.750 24.262 re f
580.125 390.503 0.750 24.262 re f
0.271 0.267 0.267 rg
BT 361.226 401.800 Td /F1 9.8 Tf  [(\(Yang, Yang, Luo, & Gong, 2009)] TJ ET
0.267 0.267 0.267 rg
BT 502.698 402.249 Td /F4 8.7 Tf  [(54)] TJ ET
0.271 0.267 0.267 rg
BT 512.335 401.800 Td /F1 9.8 Tf  [( \))] TJ ET
BT 26.250 318.406 Td /F4 12.0 Tf  [(Discussion)] TJ ET
BT 26.250 298.452 Td /F1 9.8 Tf  [(Natural disasters with impact on human health and well-being can leave a jurisdiction in a varying state of disarray with )] TJ ET
BT 26.250 286.547 Td /F1 9.8 Tf  [(significant pressure to respond to real, perceived or potential health threats. While it is important to respond quickly, it has also )] TJ ET
BT 26.250 274.643 Td /F1 9.8 Tf  [(been shown that public health emergency response based on an assessment of health needs is more effective.)] TJ ET
0.267 0.267 0.267 rg
BT 505.872 276.150 Td /F4 8.7 Tf  [(18)] TJ ET
0.271 0.267 0.267 rg
BT 515.509 274.643 Td /F1 9.8 Tf  [( Given that )] TJ ET
BT 26.250 262.738 Td /F1 9.8 Tf  [(the field of disaster epidemiology is evolving and may not be familiar to all local public health practitioners, a resource of )] TJ ET
BT 26.250 250.833 Td /F1 9.8 Tf  [(disaster surveillance and epidemiology would be useful. Using the four axes described; namely, type of disaster, phase of )] TJ ET
BT 26.250 238.928 Td /F1 9.8 Tf  [(disaster, impact and major outcomes, this study created a framework where relevant surveillance systems can be classified. )] TJ ET
BT 26.250 227.024 Td /F1 9.8 Tf  [(This study also demonstrated reliable classification of studies within this framework among two authors.)] TJ ET
BT 26.250 207.619 Td /F1 9.8 Tf  [(The potential use of this framework is three-fold. One is that it creates a resource table of surveillance systems that can direct )] TJ ET
BT 26.250 195.714 Td /F1 9.8 Tf  [(people to the existing literature in a rapid and effective manner. This first is practical: if a jurisdiction is planning for or facing a )] TJ ET
BT 26.250 183.809 Td /F1 9.8 Tf  [(major disaster with a potential human health impact and a surveillance system is required, the table directly links the )] TJ ET
BT 26.250 171.905 Td /F1 9.8 Tf  [(responsible persons to the relevant literature. While the database currently represents the literature base reviewed as of 2010, )] TJ ET
BT 26.250 160.000 Td /F1 9.8 Tf  [(and for disasters relevant to the authors� jurisdiction, the development of a live, web-based, open-source database would allow )] TJ ET
BT 26.250 148.095 Td /F1 9.8 Tf  [(an ongoing classification of the up-to-date literature, with contributions from global experts. Different surveillance approaches for )] TJ ET
BT 26.250 136.190 Td /F1 9.8 Tf  [(health outcomes could be quickly reviewed and considered for implementation.)] TJ ET
BT 26.250 116.786 Td /F1 9.8 Tf  [(Secondly, over time, this classification may lead to a better understanding of the best practices in conducting surveillance during )] TJ ET
BT 26.250 104.881 Td /F1 9.8 Tf  [(an emergency response. If a particular method is routinely shown to perform well with respect to important characteristics, it )] TJ ET
BT 26.250 92.976 Td /F1 9.8 Tf  [(might become standard operating practice, and be relevant to the type and scope of a local event for which it has been shown )] TJ ET
BT 26.250 81.071 Td /F1 9.8 Tf  [(to be effective. Finally, the framework may be used to identify gaps where research on the optimal surveillance methodology )] TJ ET
BT 26.250 69.167 Td /F1 9.8 Tf  [(needs to be done.)] TJ ET
BT 26.250 49.762 Td /F1 9.8 Tf  [(The disaster type, phases of the disaster cycle, and severity of a disaster�s impact formed the basis of this framework. In reality, )] TJ ET
BT 26.250 37.857 Td /F1 9.8 Tf  [(each disaster may not fit neatly into every category. For example, during the reliability component of the study it was found that )] TJ ET
Q
q
15.000 23.571 577.500 753.429 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(The remainder \(65\) articles were input into the framework by one reviewer. A flowchart depicting the selection process for )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(articles is provided in Appendix 3. In general, a description of the entirety of studies utilized for the reliability phase reveals that )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(the majority of studies \(58%\) were on the subject of hurricanes, followed by earthquakes \(16%\). The majority of studies by )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(impact fell into the category of either catastrophic or critical \(81%\) and 67% of studies were conducted during the emergency )] TJ ET
BT 26.250 719.857 Td /F1 9.8 Tf  [(phase of the disaster. Thirteen percent of studies were rapid health assessments utilizing the Centers for Disease Control )] TJ ET
BT 26.250 707.952 Td /F1 9.8 Tf  [(\(CDC\)/WHO-endorsed methodology of cluster analysis; 53% of studies were general \(non-cluster analysis\) descriptions of )] TJ ET
BT 26.250 696.048 Td /F1 9.8 Tf  [(health needs and outcomes, including morbidity and mortality. The remaining articles were generally descriptive studies in )] TJ ET
BT 26.250 684.143 Td /F1 9.8 Tf  [(various subject areas. Areas were noted to evolve over time to include relevant novel approaches, such as internet-based )] TJ ET
BT 26.250 672.238 Td /F1 9.8 Tf  [(surveillance and use of cellular phones in surveillance.)] TJ ET
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BT 261.430 673.745 Td /F4 8.7 Tf  [(25)] TJ ET
0.271 0.267 0.267 rg
BT 271.067 676.126 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 273.476 673.745 Td /F4 8.7 Tf  [(27)] TJ ET
0.271 0.267 0.267 rg
BT 283.114 672.238 Td /F1 9.8 Tf  [( An example of the final completed framework using earthquakes in )] TJ ET
BT 26.250 660.333 Td /F1 9.8 Tf  [(the emergency phase is demonstrated in Table 4.)] TJ ET
0.267 0.267 0.267 rg
BT 240.311 661.841 Td /F4 8.7 Tf  [(25)] TJ ET
0.271 0.267 0.267 rg
BT 249.949 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 252.358 661.841 Td /F4 8.7 Tf  [(46)] TJ ET
0.271 0.267 0.267 rg
BT 261.995 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 264.405 661.841 Td /F4 8.7 Tf  [(47)] TJ ET
0.271 0.267 0.267 rg
BT 274.042 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 276.451 661.841 Td /F4 8.7 Tf  [(48)] TJ ET
0.271 0.267 0.267 rg
BT 286.089 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 288.498 661.841 Td /F4 8.7 Tf  [(49)] TJ ET
0.271 0.267 0.267 rg
BT 298.135 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 300.545 661.841 Td /F4 8.7 Tf  [(50)] TJ ET
0.271 0.267 0.267 rg
BT 310.182 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 312.591 661.841 Td /F4 8.7 Tf  [(51)] TJ ET
0.271 0.267 0.267 rg
BT 322.229 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 324.638 661.841 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 334.275 664.222 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 336.685 661.841 Td /F4 8.7 Tf  [(53)] TJ ET
q
26.250 636.716 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 639.463 Td /F1 9.8 Tf  [(Table 4)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 390.128 555.000 239.088 re f
0.965 0.965 0.965 rg
27.000 616.186 116.578 12.280 re f
0.267 0.267 0.267 rg
26.625 628.091 116.953 0.750 re f
26.625 615.811 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 618.942 Td /F4 9.8 Tf  [(EMERGENCY PHASE)] TJ ET
0.965 0.965 0.965 rg
143.578 616.186 436.922 12.280 re f
0.267 0.267 0.267 rg
143.578 628.091 61.104 0.750 re f
204.683 628.091 56.052 0.750 re f
260.735 628.091 95.616 0.750 re f
356.351 628.091 224.524 0.750 re f
580.125 615.811 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 148.078 618.942 Td /F4 9.8 Tf  [(Impact Severity of Event \(Earthquake\))] TJ ET
0.965 0.965 0.965 rg
27.000 592.002 116.578 24.185 re f
0.267 0.267 0.267 rg
26.625 615.811 116.953 0.750 re f
26.625 591.627 0.750 24.935 re f
0.271 0.267 0.267 rg
BT 31.500 606.663 Td /F4 9.8 Tf  [(Surveillance Area)] TJ ET
0.965 0.965 0.965 rg
143.578 592.002 61.104 24.185 re f
0.267 0.267 0.267 rg
143.578 615.811 61.104 0.750 re f
0.271 0.267 0.267 rg
BT 148.078 606.663 Td /F4 9.8 Tf  [(1)] TJ ET
BT 148.078 594.758 Td /F4 9.8 Tf  [(Marginal)] TJ ET
0.965 0.965 0.965 rg
204.683 592.002 56.052 24.185 re f
0.267 0.267 0.267 rg
204.683 615.811 56.052 0.750 re f
0.271 0.267 0.267 rg
BT 209.183 606.663 Td /F4 9.8 Tf  [(2)] TJ ET
BT 209.183 594.758 Td /F4 9.8 Tf  [(Serious)] TJ ET
0.965 0.965 0.965 rg
260.735 592.002 95.616 24.185 re f
0.267 0.267 0.267 rg
260.735 615.811 95.616 0.750 re f
0.271 0.267 0.267 rg
BT 265.235 606.663 Td /F4 9.8 Tf  [(3)] TJ ET
BT 265.235 594.758 Td /F4 9.8 Tf  [(Critical)] TJ ET
0.965 0.965 0.965 rg
356.351 592.002 224.149 24.185 re f
0.267 0.267 0.267 rg
356.351 615.811 224.524 0.750 re f
580.125 591.627 0.750 24.935 re f
0.271 0.267 0.267 rg
BT 360.851 606.663 Td /F4 9.8 Tf  [(4)] TJ ET
BT 360.851 594.758 Td /F4 9.8 Tf  [(Catastrophic)] TJ ET
0.267 0.267 0.267 rg
26.625 591.627 117.328 0.750 re f
26.625 541.049 0.750 51.328 re f
0.271 0.267 0.267 rg
BT 31.875 581.772 Td /F4 9.8 Tf  [(Basic descriptive )] TJ ET
BT 31.875 574.141 Td /F4 9.8 Tf  [(studies)] TJ ET
0.267 0.267 0.267 rg
143.203 591.627 61.854 0.750 re f
143.203 541.049 0.750 51.328 re f
204.308 591.627 56.802 0.750 re f
204.308 541.049 0.750 51.328 re f
260.360 591.627 96.366 0.750 re f
260.360 541.049 0.750 51.328 re f
0.271 0.267 0.267 rg
BT 265.610 581.772 Td /F1 9.8 Tf  [(\(Carr, Leahy, )] TJ ET
BT 265.610 574.141 Td /F1 9.8 Tf  [(London, Sidhu, & )] TJ ET
BT 265.610 564.149 Td /F1 9.8 Tf  [(Vogt, 1996)] TJ ET
0.267 0.267 0.267 rg
BT 312.771 564.598 Td /F4 8.7 Tf  [(47)] TJ ET
0.271 0.267 0.267 rg
BT 322.408 564.149 Td /F1 9.8 Tf  [(\))] TJ ET
0.267 0.267 0.267 rg
355.976 591.627 224.899 0.750 re f
355.976 541.049 0.750 51.328 re f
580.125 541.049 0.750 51.328 re f
0.271 0.267 0.267 rg
BT 361.226 579.411 Td /F1 9.8 Tf  [(\(Akbari, Farshad, & Asadi-Lari, 2004)] TJ ET
0.267 0.267 0.267 rg
BT 518.912 579.860 Td /F4 8.7 Tf  [(46)] TJ ET
0.271 0.267 0.267 rg
BT 528.550 579.411 Td /F1 9.8 Tf  [( ; De )] TJ ET
BT 361.226 568.829 Td /F1 9.8 Tf  [(Bruycker et al., 1985)] TJ ET
0.267 0.267 0.267 rg
BT 450.643 569.278 Td /F4 8.7 Tf  [(50)] TJ ET
0.271 0.267 0.267 rg
BT 460.280 568.829 Td /F1 9.8 Tf  [( ; Helminen, Saarela, & )] TJ ET
BT 361.226 558.247 Td /F1 9.8 Tf  [(Salmela, 2006)] TJ ET
0.267 0.267 0.267 rg
BT 423.548 558.696 Td /F4 8.7 Tf  [(51)] TJ ET
0.271 0.267 0.267 rg
BT 433.185 558.247 Td /F1 9.8 Tf  [( ; Pawar, Shelke, & Kakrani, )] TJ ET
BT 361.226 547.665 Td /F1 9.8 Tf  [(2005)] TJ ET
0.267 0.267 0.267 rg
BT 382.910 548.114 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 392.547 547.665 Td /F1 9.8 Tf  [( \))] TJ ET
0.267 0.267 0.267 rg
26.625 541.049 117.328 0.750 re f
26.625 522.217 0.750 19.582 re f
0.271 0.267 0.267 rg
BT 31.875 531.194 Td /F4 9.8 Tf  [(Injuries)] TJ ET
0.267 0.267 0.267 rg
143.203 541.049 61.854 0.750 re f
143.203 522.217 0.750 19.582 re f
204.308 541.049 56.802 0.750 re f
204.308 522.217 0.750 19.582 re f
260.360 541.049 96.366 0.750 re f
260.360 522.217 0.750 19.582 re f
355.976 541.049 224.899 0.750 re f
355.976 522.217 0.750 19.582 re f
580.125 522.217 0.750 19.582 re f
0.271 0.267 0.267 rg
BT 361.226 528.833 Td /F1 9.8 Tf  [(\(Roces, White, Dayrit, & Durkin, 1992)] TJ ET
0.267 0.267 0.267 rg
BT 523.232 529.282 Td /F4 8.7 Tf  [(53)] TJ ET
0.271 0.267 0.267 rg
BT 532.869 528.833 Td /F1 9.8 Tf  [( \))] TJ ET
0.267 0.267 0.267 rg
26.625 522.217 117.328 0.750 re f
26.625 498.704 0.750 24.262 re f
0.271 0.267 0.267 rg
BT 31.875 512.362 Td /F4 9.8 Tf  [(Environmental )] TJ ET
BT 31.875 504.731 Td /F4 9.8 Tf  [(exposure)] TJ ET
0.267 0.267 0.267 rg
143.203 522.217 61.854 0.750 re f
143.203 498.704 0.750 24.262 re f
204.308 522.217 56.802 0.750 re f
204.308 498.704 0.750 24.262 re f
260.360 522.217 96.366 0.750 re f
260.360 498.704 0.750 24.262 re f
355.976 522.217 224.899 0.750 re f
355.976 498.704 0.750 24.262 re f
580.125 498.704 0.750 24.262 re f
26.625 498.704 117.328 0.750 re f
26.625 482.823 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 488.849 Td /F4 9.8 Tf  [(Infectious disease)] TJ ET
0.267 0.267 0.267 rg
143.203 498.704 61.854 0.750 re f
143.203 482.823 0.750 16.631 re f
204.308 498.704 56.802 0.750 re f
204.308 482.823 0.750 16.631 re f
260.360 498.704 96.366 0.750 re f
260.360 482.823 0.750 16.631 re f
355.976 498.704 224.899 0.750 re f
355.976 482.823 0.750 16.631 re f
580.125 482.823 0.750 16.631 re f
26.625 482.823 117.328 0.750 re f
26.625 466.942 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 472.968 Td /F4 9.8 Tf  [(Chronic disease)] TJ ET
0.267 0.267 0.267 rg
143.203 482.823 61.854 0.750 re f
143.203 466.942 0.750 16.631 re f
204.308 482.823 56.802 0.750 re f
204.308 466.942 0.750 16.631 re f
260.360 482.823 96.366 0.750 re f
260.360 466.942 0.750 16.631 re f
355.976 482.823 224.899 0.750 re f
355.976 466.942 0.750 16.631 re f
580.125 466.942 0.750 16.631 re f
26.625 466.942 117.328 0.750 re f
26.625 437.528 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 31.875 457.087 Td /F4 9.8 Tf  [(Rapid needs )] TJ ET
BT 31.875 449.456 Td /F4 9.8 Tf  [(assessment)] TJ ET
0.267 0.267 0.267 rg
143.203 466.942 61.854 0.750 re f
143.203 437.528 0.750 30.164 re f
204.308 466.942 56.802 0.750 re f
204.308 437.528 0.750 30.164 re f
260.360 466.942 96.366 0.750 re f
260.360 437.528 0.750 30.164 re f
355.976 466.942 224.899 0.750 re f
355.976 437.528 0.750 30.164 re f
580.125 437.528 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 361.226 454.726 Td /F1 9.8 Tf  [(\(Chen, Chen, Malilay, & Twu, 2003)] TJ ET
0.267 0.267 0.267 rg
BT 512.409 455.175 Td /F4 8.7 Tf  [(48)] TJ ET
0.271 0.267 0.267 rg
BT 522.046 454.726 Td /F1 9.8 Tf  [( ; Daley, )] TJ ET
BT 361.226 444.144 Td /F1 9.8 Tf  [(Karpati, & Sheik, 2001)] TJ ET
0.267 0.267 0.267 rg
BT 458.238 444.593 Td /F4 8.7 Tf  [(49)] TJ ET
0.271 0.267 0.267 rg
BT 467.875 444.144 Td /F1 9.8 Tf  [( \))] TJ ET
0.267 0.267 0.267 rg
26.625 437.528 117.328 0.750 re f
26.625 414.015 0.750 24.262 re f
0.271 0.267 0.267 rg
BT 31.875 427.673 Td /F4 9.8 Tf  [(Vulnerable )] TJ ET
BT 31.875 420.042 Td /F4 9.8 Tf  [(populations)] TJ ET
0.267 0.267 0.267 rg
143.203 437.528 61.854 0.750 re f
143.203 414.015 0.750 24.262 re f
204.308 437.528 56.802 0.750 re f
204.308 414.015 0.750 24.262 re f
260.360 437.528 96.366 0.750 re f
260.360 414.015 0.750 24.262 re f
355.976 437.528 224.899 0.750 re f
355.976 414.015 0.750 24.262 re f
580.125 414.015 0.750 24.262 re f
26.625 414.015 117.328 0.750 re f
26.625 390.503 117.328 0.750 re f
26.625 390.503 0.750 24.262 re f
0.271 0.267 0.267 rg
BT 31.875 404.160 Td /F4 9.8 Tf  [(Other \(including novel )] TJ ET
BT 31.875 396.529 Td /F4 9.8 Tf  [(methods\))] TJ ET
0.267 0.267 0.267 rg
143.203 414.015 61.854 0.750 re f
143.203 390.503 61.854 0.750 re f
143.203 390.503 0.750 24.262 re f
204.308 414.015 56.802 0.750 re f
204.308 390.503 56.802 0.750 re f
204.308 390.503 0.750 24.262 re f
260.360 414.015 96.366 0.750 re f
260.360 390.503 96.366 0.750 re f
260.360 390.503 0.750 24.262 re f
355.976 414.015 224.899 0.750 re f
355.976 390.503 224.899 0.750 re f
355.976 390.503 0.750 24.262 re f
580.125 390.503 0.750 24.262 re f
0.271 0.267 0.267 rg
BT 361.226 401.800 Td /F1 9.8 Tf  [(\(Yang, Yang, Luo, & Gong, 2009)] TJ ET
0.267 0.267 0.267 rg
BT 502.698 402.249 Td /F4 8.7 Tf  [(54)] TJ ET
0.271 0.267 0.267 rg
BT 512.335 401.800 Td /F1 9.8 Tf  [( \))] TJ ET
BT 26.250 318.406 Td /F4 12.0 Tf  [(Discussion)] TJ ET
BT 26.250 298.452 Td /F1 9.8 Tf  [(Natural disasters with impact on human health and well-being can leave a jurisdiction in a varying state of disarray with )] TJ ET
BT 26.250 286.547 Td /F1 9.8 Tf  [(significant pressure to respond to real, perceived or potential health threats. While it is important to respond quickly, it has also )] TJ ET
BT 26.250 274.643 Td /F1 9.8 Tf  [(been shown that public health emergency response based on an assessment of health needs is more effective.)] TJ ET
0.267 0.267 0.267 rg
BT 505.872 276.150 Td /F4 8.7 Tf  [(18)] TJ ET
0.271 0.267 0.267 rg
BT 515.509 274.643 Td /F1 9.8 Tf  [( Given that )] TJ ET
BT 26.250 262.738 Td /F1 9.8 Tf  [(the field of disaster epidemiology is evolving and may not be familiar to all local public health practitioners, a resource of )] TJ ET
BT 26.250 250.833 Td /F1 9.8 Tf  [(disaster surveillance and epidemiology would be useful. Using the four axes described; namely, type of disaster, phase of )] TJ ET
BT 26.250 238.928 Td /F1 9.8 Tf  [(disaster, impact and major outcomes, this study created a framework where relevant surveillance systems can be classified. )] TJ ET
BT 26.250 227.024 Td /F1 9.8 Tf  [(This study also demonstrated reliable classification of studies within this framework among two authors.)] TJ ET
BT 26.250 207.619 Td /F1 9.8 Tf  [(The potential use of this framework is three-fold. One is that it creates a resource table of surveillance systems that can direct )] TJ ET
BT 26.250 195.714 Td /F1 9.8 Tf  [(people to the existing literature in a rapid and effective manner. This first is practical: if a jurisdiction is planning for or facing a )] TJ ET
BT 26.250 183.809 Td /F1 9.8 Tf  [(major disaster with a potential human health impact and a surveillance system is required, the table directly links the )] TJ ET
BT 26.250 171.905 Td /F1 9.8 Tf  [(responsible persons to the relevant literature. While the database currently represents the literature base reviewed as of 2010, )] TJ ET
BT 26.250 160.000 Td /F1 9.8 Tf  [(and for disasters relevant to the authors� jurisdiction, the development of a live, web-based, open-source database would allow )] TJ ET
BT 26.250 148.095 Td /F1 9.8 Tf  [(an ongoing classification of the up-to-date literature, with contributions from global experts. Different surveillance approaches for )] TJ ET
BT 26.250 136.190 Td /F1 9.8 Tf  [(health outcomes could be quickly reviewed and considered for implementation.)] TJ ET
BT 26.250 116.786 Td /F1 9.8 Tf  [(Secondly, over time, this classification may lead to a better understanding of the best practices in conducting surveillance during )] TJ ET
BT 26.250 104.881 Td /F1 9.8 Tf  [(an emergency response. If a particular method is routinely shown to perform well with respect to important characteristics, it )] TJ ET
BT 26.250 92.976 Td /F1 9.8 Tf  [(might become standard operating practice, and be relevant to the type and scope of a local event for which it has been shown )] TJ ET
BT 26.250 81.071 Td /F1 9.8 Tf  [(to be effective. Finally, the framework may be used to identify gaps where research on the optimal surveillance methodology )] TJ ET
BT 26.250 69.167 Td /F1 9.8 Tf  [(needs to be done.)] TJ ET
BT 26.250 49.762 Td /F1 9.8 Tf  [(The disaster type, phases of the disaster cycle, and severity of a disaster�s impact formed the basis of this framework. In reality, )] TJ ET
BT 26.250 37.857 Td /F1 9.8 Tf  [(each disaster may not fit neatly into every category. For example, during the reliability component of the study it was found that )] TJ ET
Q
q
0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(5)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET

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BT 26.250 767.476 Td /F1 9.8 Tf  [(some studies cannot be classified clearly within the �emergency phase� or �rehabilitation/recovery phase� but fall somewhere in )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(a transition zone between. This could generally be seen to occur in an actual event, as a disaster transitions from one phase to )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(another. It was decided which phase was most relevant for purposes of study classification, based on when the data was )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(collected and whether the data would have been available in a particular phase. Additionally, certain areas of study in the )] TJ ET
BT 26.250 719.857 Td /F1 9.8 Tf  [(literature evolved. Creating the category called �novel methods� utilized in surveillance could be a meaningful category for public )] TJ ET
BT 26.250 707.952 Td /F1 9.8 Tf  [(health practitioners. However, it is recognized that what is novel today may not be novel in a few years time. For this framework, )] TJ ET
BT 26.250 696.048 Td /F1 9.8 Tf  [(novel methodologies were defined by a new development in a surveillance system or the application of an existing surveillance )] TJ ET
BT 26.250 684.143 Td /F1 9.8 Tf  [(system in a new way.)] TJ ET
BT 26.250 664.738 Td /F1 9.8 Tf  [(There are several limitations of this review and synthesis. Firstly, the focus was on natural disasters only, rather than assuming )] TJ ET
BT 26.250 652.833 Td /F1 9.8 Tf  [(an �all-hazards� approach. Much of current emergency management practice emphasizes the need for an �all-hazards� )] TJ ET
BT 26.250 640.929 Td /F1 9.8 Tf  [(approach, which the authors support; however, it was chosen to focus on the preliminary development of a framework and )] TJ ET
BT 26.250 629.024 Td /F1 9.8 Tf  [(literature review on natural disasters in order to pilot the strategy and achieve an initially feasible goal. It is hoped that this )] TJ ET
BT 26.250 617.119 Td /F1 9.8 Tf  [(framework could be applied to additional hazards in the future. Secondly, the literature review that was used for validation of the )] TJ ET
BT 26.250 605.214 Td /F1 9.8 Tf  [(database is primarily focused on the published and indexed literature until 2010. It is likely that more information has been )] TJ ET
BT 26.250 593.310 Td /F1 9.8 Tf  [(gathered on surveillance of health needs during and after natural disasters, with not all having been published or may be found )] TJ ET
BT 26.250 581.405 Td /F1 9.8 Tf  [(within the �grey literature�. With focusing on the published literature, a sample of epidemiological research on this topic was )] TJ ET
BT 26.250 569.500 Td /F1 9.8 Tf  [(sought in order to inform public health emergency preparedness in Ontario. Further validation could be done to increase the )] TJ ET
BT 26.250 557.595 Td /F1 9.8 Tf  [(scope of hazards and also number of studies. This would increase the generalizability of this methodology.)] TJ ET
BT 26.250 538.191 Td /F1 9.8 Tf  [(A third limitation is that the majority of published studies described severe or catastrophic disasters, particularly hurricanes, )] TJ ET
BT 26.250 526.286 Td /F1 9.8 Tf  [(were published in the last decade, and were conducted in the USA. While this is not surprising, it means that there was limited )] TJ ET
BT 26.250 514.381 Td /F1 9.8 Tf  [(opportunity to apply the framework to less severe disasters and those in non-USA settings. On the other hand, the framework )] TJ ET
BT 26.250 502.476 Td /F1 9.8 Tf  [(will likely be most useful in large scale disasters. Fourth, the impact rating, while developed from previously published )] TJ ET
BT 26.250 490.572 Td /F1 9.8 Tf  [(classification scales, is subject to bias given the qualitative nature of the assessment components. However we tested the )] TJ ET
BT 26.250 478.667 Td /F1 9.8 Tf  [(reliability of the scales when testing the framework itself and found the percent agreement to be high when performed )] TJ ET
BT 26.250 466.762 Td /F1 9.8 Tf  [(independently by two authors. Finally, the framework is still in development and is based on a limited number of studies. Utility )] TJ ET
BT 26.250 454.857 Td /F1 9.8 Tf  [(and relevance of the developed resource will need to be tested and evaluated for generalizability by the stakeholders for whom )] TJ ET
BT 26.250 442.953 Td /F1 9.8 Tf  [(it was designed: namely, local public health. Furthermore, in order to be relevant to the evolving nature of disaster epidemiology )] TJ ET
BT 26.250 431.048 Td /F1 9.8 Tf  [(as natural disasters continue to occur around the globe, ongoing review of the literature needs to be conducted and the )] TJ ET
BT 26.250 419.143 Td /F1 9.8 Tf  [(database should be updated in a live modality while accessible to local public health. Utilizing the internet to establish an )] TJ ET
BT 26.250 407.238 Td /F1 9.8 Tf  [(internet database would allow this functionality.)] TJ ET
BT 26.250 387.834 Td /F1 9.8 Tf  [(While the authors recognize the limitations of this study, it is viewed as an important building block for enhancing surveillance )] TJ ET
BT 26.250 375.929 Td /F1 9.8 Tf  [(capacity for emergency settings at the local level. Future work could include validating the framework at the local level in either )] TJ ET
BT 26.250 364.024 Td /F1 9.8 Tf  [(real-world natural disaster settings or through simulation methodology employing natural disaster scenarios.)] TJ ET
BT 26.250 327.422 Td /F4 12.0 Tf  [(Conclusions)] TJ ET
BT 26.250 307.467 Td /F1 9.8 Tf  [(A framework was developed that can allow local public health practitioners to access the appropriate and previously utilized )] TJ ET
BT 26.250 295.563 Td /F1 9.8 Tf  [(surveillance methods for a natural disaster in a rapid fashion. The largely descriptive analyses were organized into a database )] TJ ET
BT 26.250 283.658 Td /F1 9.8 Tf  [(by disaster characteristics and type of study in order to classify and create an analytic framework. It is felt that in a rapidly )] TJ ET
BT 26.250 271.753 Td /F1 9.8 Tf  [(evolving disaster, an accessible and structured database of surveillance knowledge can inform best practices to target the )] TJ ET
BT 26.250 259.848 Td /F1 9.8 Tf  [(actual health needs of the affected population. While the focus was on literature conducted at the time of or in the aftermath of a )] TJ ET
BT 26.250 247.944 Td /F1 9.8 Tf  [(disaster, the database is conceptually viewed as a resource to be accessed during emergency preparedness and planning to )] TJ ET
BT 26.250 236.039 Td /F1 9.8 Tf  [(facilitate an evidence-informed epidemiology component to emergency plans. It is important, however, that larger organizations )] TJ ET
BT 26.250 224.134 Td /F1 9.8 Tf  [(such as national, provincial/state and academic institutions continue to support public health capacity in conducting disaster )] TJ ET
BT 26.250 212.229 Td /F1 9.8 Tf  [(research in analytic methodologies. Further research is needed to evaluate the utility of the developed surveillance framework in )] TJ ET
BT 26.250 200.325 Td /F1 9.8 Tf  [(the local public health setting.)] TJ ET
BT 26.250 163.722 Td /F4 12.0 Tf  [(Competing Interest)] TJ ET
BT 26.250 143.768 Td /F1 9.8 Tf  [(The authors report no competing interests exist.)] TJ ET
BT 26.250 107.165 Td /F4 12.0 Tf  [(APPENDIX 1)] TJ ET
BT 26.250 70.013 Td /F4 12.0 Tf  [(Framework to Classify Disasters Based on Overall Impact)] TJ ET
BT 26.250 50.059 Td /F1 9.8 Tf  [(References:)] TJ ET
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BT 78.812 51.566 Td /F4 8.7 Tf  [(19)] TJ ET
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BT 88.450 50.059 Td /F1 9.8 Tf  [(�)] TJ ET
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BT 91.160 51.566 Td /F4 8.7 Tf  [(20)] TJ ET
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BT 100.797 50.059 Td /F1 9.8 Tf  [(�)] TJ ET
0.267 0.267 0.267 rg
BT 103.508 51.566 Td /F4 8.7 Tf  [(21)] TJ ET
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BT 113.145 50.059 Td /F1 9.8 Tf  [(�)] TJ ET
0.267 0.267 0.267 rg
BT 115.856 51.566 Td /F4 8.7 Tf  [(22)] TJ ET
0.271 0.267 0.267 rg
BT 125.493 50.059 Td /F1 9.8 Tf  [(�)] TJ ET
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BT 26.250 767.476 Td /F1 9.8 Tf  [(some studies cannot be classified clearly within the �emergency phase� or �rehabilitation/recovery phase� but fall somewhere in )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(a transition zone between. This could generally be seen to occur in an actual event, as a disaster transitions from one phase to )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(another. It was decided which phase was most relevant for purposes of study classification, based on when the data was )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(collected and whether the data would have been available in a particular phase. Additionally, certain areas of study in the )] TJ ET
BT 26.250 719.857 Td /F1 9.8 Tf  [(literature evolved. Creating the category called �novel methods� utilized in surveillance could be a meaningful category for public )] TJ ET
BT 26.250 707.952 Td /F1 9.8 Tf  [(health practitioners. However, it is recognized that what is novel today may not be novel in a few years time. For this framework, )] TJ ET
BT 26.250 696.048 Td /F1 9.8 Tf  [(novel methodologies were defined by a new development in a surveillance system or the application of an existing surveillance )] TJ ET
BT 26.250 684.143 Td /F1 9.8 Tf  [(system in a new way.)] TJ ET
BT 26.250 664.738 Td /F1 9.8 Tf  [(There are several limitations of this review and synthesis. Firstly, the focus was on natural disasters only, rather than assuming )] TJ ET
BT 26.250 652.833 Td /F1 9.8 Tf  [(an �all-hazards� approach. Much of current emergency management practice emphasizes the need for an �all-hazards� )] TJ ET
BT 26.250 640.929 Td /F1 9.8 Tf  [(approach, which the authors support; however, it was chosen to focus on the preliminary development of a framework and )] TJ ET
BT 26.250 629.024 Td /F1 9.8 Tf  [(literature review on natural disasters in order to pilot the strategy and achieve an initially feasible goal. It is hoped that this )] TJ ET
BT 26.250 617.119 Td /F1 9.8 Tf  [(framework could be applied to additional hazards in the future. Secondly, the literature review that was used for validation of the )] TJ ET
BT 26.250 605.214 Td /F1 9.8 Tf  [(database is primarily focused on the published and indexed literature until 2010. It is likely that more information has been )] TJ ET
BT 26.250 593.310 Td /F1 9.8 Tf  [(gathered on surveillance of health needs during and after natural disasters, with not all having been published or may be found )] TJ ET
BT 26.250 581.405 Td /F1 9.8 Tf  [(within the �grey literature�. With focusing on the published literature, a sample of epidemiological research on this topic was )] TJ ET
BT 26.250 569.500 Td /F1 9.8 Tf  [(sought in order to inform public health emergency preparedness in Ontario. Further validation could be done to increase the )] TJ ET
BT 26.250 557.595 Td /F1 9.8 Tf  [(scope of hazards and also number of studies. This would increase the generalizability of this methodology.)] TJ ET
BT 26.250 538.191 Td /F1 9.8 Tf  [(A third limitation is that the majority of published studies described severe or catastrophic disasters, particularly hurricanes, )] TJ ET
BT 26.250 526.286 Td /F1 9.8 Tf  [(were published in the last decade, and were conducted in the USA. While this is not surprising, it means that there was limited )] TJ ET
BT 26.250 514.381 Td /F1 9.8 Tf  [(opportunity to apply the framework to less severe disasters and those in non-USA settings. On the other hand, the framework )] TJ ET
BT 26.250 502.476 Td /F1 9.8 Tf  [(will likely be most useful in large scale disasters. Fourth, the impact rating, while developed from previously published )] TJ ET
BT 26.250 490.572 Td /F1 9.8 Tf  [(classification scales, is subject to bias given the qualitative nature of the assessment components. However we tested the )] TJ ET
BT 26.250 478.667 Td /F1 9.8 Tf  [(reliability of the scales when testing the framework itself and found the percent agreement to be high when performed )] TJ ET
BT 26.250 466.762 Td /F1 9.8 Tf  [(independently by two authors. Finally, the framework is still in development and is based on a limited number of studies. Utility )] TJ ET
BT 26.250 454.857 Td /F1 9.8 Tf  [(and relevance of the developed resource will need to be tested and evaluated for generalizability by the stakeholders for whom )] TJ ET
BT 26.250 442.953 Td /F1 9.8 Tf  [(it was designed: namely, local public health. Furthermore, in order to be relevant to the evolving nature of disaster epidemiology )] TJ ET
BT 26.250 431.048 Td /F1 9.8 Tf  [(as natural disasters continue to occur around the globe, ongoing review of the literature needs to be conducted and the )] TJ ET
BT 26.250 419.143 Td /F1 9.8 Tf  [(database should be updated in a live modality while accessible to local public health. Utilizing the internet to establish an )] TJ ET
BT 26.250 407.238 Td /F1 9.8 Tf  [(internet database would allow this functionality.)] TJ ET
BT 26.250 387.834 Td /F1 9.8 Tf  [(While the authors recognize the limitations of this study, it is viewed as an important building block for enhancing surveillance )] TJ ET
BT 26.250 375.929 Td /F1 9.8 Tf  [(capacity for emergency settings at the local level. Future work could include validating the framework at the local level in either )] TJ ET
BT 26.250 364.024 Td /F1 9.8 Tf  [(real-world natural disaster settings or through simulation methodology employing natural disaster scenarios.)] TJ ET
BT 26.250 327.422 Td /F4 12.0 Tf  [(Conclusions)] TJ ET
BT 26.250 307.467 Td /F1 9.8 Tf  [(A framework was developed that can allow local public health practitioners to access the appropriate and previously utilized )] TJ ET
BT 26.250 295.563 Td /F1 9.8 Tf  [(surveillance methods for a natural disaster in a rapid fashion. The largely descriptive analyses were organized into a database )] TJ ET
BT 26.250 283.658 Td /F1 9.8 Tf  [(by disaster characteristics and type of study in order to classify and create an analytic framework. It is felt that in a rapidly )] TJ ET
BT 26.250 271.753 Td /F1 9.8 Tf  [(evolving disaster, an accessible and structured database of surveillance knowledge can inform best practices to target the )] TJ ET
BT 26.250 259.848 Td /F1 9.8 Tf  [(actual health needs of the affected population. While the focus was on literature conducted at the time of or in the aftermath of a )] TJ ET
BT 26.250 247.944 Td /F1 9.8 Tf  [(disaster, the database is conceptually viewed as a resource to be accessed during emergency preparedness and planning to )] TJ ET
BT 26.250 236.039 Td /F1 9.8 Tf  [(facilitate an evidence-informed epidemiology component to emergency plans. It is important, however, that larger organizations )] TJ ET
BT 26.250 224.134 Td /F1 9.8 Tf  [(such as national, provincial/state and academic institutions continue to support public health capacity in conducting disaster )] TJ ET
BT 26.250 212.229 Td /F1 9.8 Tf  [(research in analytic methodologies. Further research is needed to evaluate the utility of the developed surveillance framework in )] TJ ET
BT 26.250 200.325 Td /F1 9.8 Tf  [(the local public health setting.)] TJ ET
BT 26.250 163.722 Td /F4 12.0 Tf  [(Competing Interest)] TJ ET
BT 26.250 143.768 Td /F1 9.8 Tf  [(The authors report no competing interests exist.)] TJ ET
BT 26.250 107.165 Td /F4 12.0 Tf  [(APPENDIX 1)] TJ ET
BT 26.250 70.013 Td /F4 12.0 Tf  [(Framework to Classify Disasters Based on Overall Impact)] TJ ET
BT 26.250 50.059 Td /F1 9.8 Tf  [(References:)] TJ ET
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BT 26.250 767.476 Td /F1 9.8 Tf  [(some studies cannot be classified clearly within the �emergency phase� or �rehabilitation/recovery phase� but fall somewhere in )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(a transition zone between. This could generally be seen to occur in an actual event, as a disaster transitions from one phase to )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(another. It was decided which phase was most relevant for purposes of study classification, based on when the data was )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(collected and whether the data would have been available in a particular phase. Additionally, certain areas of study in the )] TJ ET
BT 26.250 719.857 Td /F1 9.8 Tf  [(literature evolved. Creating the category called �novel methods� utilized in surveillance could be a meaningful category for public )] TJ ET
BT 26.250 707.952 Td /F1 9.8 Tf  [(health practitioners. However, it is recognized that what is novel today may not be novel in a few years time. For this framework, )] TJ ET
BT 26.250 696.048 Td /F1 9.8 Tf  [(novel methodologies were defined by a new development in a surveillance system or the application of an existing surveillance )] TJ ET
BT 26.250 684.143 Td /F1 9.8 Tf  [(system in a new way.)] TJ ET
BT 26.250 664.738 Td /F1 9.8 Tf  [(There are several limitations of this review and synthesis. Firstly, the focus was on natural disasters only, rather than assuming )] TJ ET
BT 26.250 652.833 Td /F1 9.8 Tf  [(an �all-hazards� approach. Much of current emergency management practice emphasizes the need for an �all-hazards� )] TJ ET
BT 26.250 640.929 Td /F1 9.8 Tf  [(approach, which the authors support; however, it was chosen to focus on the preliminary development of a framework and )] TJ ET
BT 26.250 629.024 Td /F1 9.8 Tf  [(literature review on natural disasters in order to pilot the strategy and achieve an initially feasible goal. It is hoped that this )] TJ ET
BT 26.250 617.119 Td /F1 9.8 Tf  [(framework could be applied to additional hazards in the future. Secondly, the literature review that was used for validation of the )] TJ ET
BT 26.250 605.214 Td /F1 9.8 Tf  [(database is primarily focused on the published and indexed literature until 2010. It is likely that more information has been )] TJ ET
BT 26.250 593.310 Td /F1 9.8 Tf  [(gathered on surveillance of health needs during and after natural disasters, with not all having been published or may be found )] TJ ET
BT 26.250 581.405 Td /F1 9.8 Tf  [(within the �grey literature�. With focusing on the published literature, a sample of epidemiological research on this topic was )] TJ ET
BT 26.250 569.500 Td /F1 9.8 Tf  [(sought in order to inform public health emergency preparedness in Ontario. Further validation could be done to increase the )] TJ ET
BT 26.250 557.595 Td /F1 9.8 Tf  [(scope of hazards and also number of studies. This would increase the generalizability of this methodology.)] TJ ET
BT 26.250 538.191 Td /F1 9.8 Tf  [(A third limitation is that the majority of published studies described severe or catastrophic disasters, particularly hurricanes, )] TJ ET
BT 26.250 526.286 Td /F1 9.8 Tf  [(were published in the last decade, and were conducted in the USA. While this is not surprising, it means that there was limited )] TJ ET
BT 26.250 514.381 Td /F1 9.8 Tf  [(opportunity to apply the framework to less severe disasters and those in non-USA settings. On the other hand, the framework )] TJ ET
BT 26.250 502.476 Td /F1 9.8 Tf  [(will likely be most useful in large scale disasters. Fourth, the impact rating, while developed from previously published )] TJ ET
BT 26.250 490.572 Td /F1 9.8 Tf  [(classification scales, is subject to bias given the qualitative nature of the assessment components. However we tested the )] TJ ET
BT 26.250 478.667 Td /F1 9.8 Tf  [(reliability of the scales when testing the framework itself and found the percent agreement to be high when performed )] TJ ET
BT 26.250 466.762 Td /F1 9.8 Tf  [(independently by two authors. Finally, the framework is still in development and is based on a limited number of studies. Utility )] TJ ET
BT 26.250 454.857 Td /F1 9.8 Tf  [(and relevance of the developed resource will need to be tested and evaluated for generalizability by the stakeholders for whom )] TJ ET
BT 26.250 442.953 Td /F1 9.8 Tf  [(it was designed: namely, local public health. Furthermore, in order to be relevant to the evolving nature of disaster epidemiology )] TJ ET
BT 26.250 431.048 Td /F1 9.8 Tf  [(as natural disasters continue to occur around the globe, ongoing review of the literature needs to be conducted and the )] TJ ET
BT 26.250 419.143 Td /F1 9.8 Tf  [(database should be updated in a live modality while accessible to local public health. Utilizing the internet to establish an )] TJ ET
BT 26.250 407.238 Td /F1 9.8 Tf  [(internet database would allow this functionality.)] TJ ET
BT 26.250 387.834 Td /F1 9.8 Tf  [(While the authors recognize the limitations of this study, it is viewed as an important building block for enhancing surveillance )] TJ ET
BT 26.250 375.929 Td /F1 9.8 Tf  [(capacity for emergency settings at the local level. Future work could include validating the framework at the local level in either )] TJ ET
BT 26.250 364.024 Td /F1 9.8 Tf  [(real-world natural disaster settings or through simulation methodology employing natural disaster scenarios.)] TJ ET
BT 26.250 327.422 Td /F4 12.0 Tf  [(Conclusions)] TJ ET
BT 26.250 307.467 Td /F1 9.8 Tf  [(A framework was developed that can allow local public health practitioners to access the appropriate and previously utilized )] TJ ET
BT 26.250 295.563 Td /F1 9.8 Tf  [(surveillance methods for a natural disaster in a rapid fashion. The largely descriptive analyses were organized into a database )] TJ ET
BT 26.250 283.658 Td /F1 9.8 Tf  [(by disaster characteristics and type of study in order to classify and create an analytic framework. It is felt that in a rapidly )] TJ ET
BT 26.250 271.753 Td /F1 9.8 Tf  [(evolving disaster, an accessible and structured database of surveillance knowledge can inform best practices to target the )] TJ ET
BT 26.250 259.848 Td /F1 9.8 Tf  [(actual health needs of the affected population. While the focus was on literature conducted at the time of or in the aftermath of a )] TJ ET
BT 26.250 247.944 Td /F1 9.8 Tf  [(disaster, the database is conceptually viewed as a resource to be accessed during emergency preparedness and planning to )] TJ ET
BT 26.250 236.039 Td /F1 9.8 Tf  [(facilitate an evidence-informed epidemiology component to emergency plans. It is important, however, that larger organizations )] TJ ET
BT 26.250 224.134 Td /F1 9.8 Tf  [(such as national, provincial/state and academic institutions continue to support public health capacity in conducting disaster )] TJ ET
BT 26.250 212.229 Td /F1 9.8 Tf  [(research in analytic methodologies. Further research is needed to evaluate the utility of the developed surveillance framework in )] TJ ET
BT 26.250 200.325 Td /F1 9.8 Tf  [(the local public health setting.)] TJ ET
BT 26.250 163.722 Td /F4 12.0 Tf  [(Competing Interest)] TJ ET
BT 26.250 143.768 Td /F1 9.8 Tf  [(The authors report no competing interests exist.)] TJ ET
BT 26.250 107.165 Td /F4 12.0 Tf  [(APPENDIX 1)] TJ ET
BT 26.250 70.013 Td /F4 12.0 Tf  [(Framework to Classify Disasters Based on Overall Impact)] TJ ET
BT 26.250 50.059 Td /F1 9.8 Tf  [(References:)] TJ ET
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580.125 543.971 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 549.997 Td /F1 9.8 Tf  [(High)] TJ ET
0.267 0.267 0.267 rg
26.625 543.971 141.016 0.750 re f
26.625 528.090 141.016 0.750 re f
26.625 528.090 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 534.116 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
166.891 543.971 247.534 0.750 re f
166.891 528.090 247.534 0.750 re f
166.891 528.090 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 534.116 Td /F1 9.8 Tf  [(Widespread damage)] TJ ET
0.267 0.267 0.267 rg
413.675 543.971 167.200 0.750 re f
413.675 528.090 167.200 0.750 re f
413.675 528.090 0.750 16.631 re f
580.125 528.090 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 534.116 Td /F1 9.8 Tf  [(Very high)] TJ ET
q
26.250 468.979 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 471.726 Td /F1 9.8 Tf  [(Critical Infrastructure & Resources and Economic & Social Impact)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 380.572 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 460.354 120.896 0.750 re f
26.625 444.472 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 450.499 Td /F1 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
146.771 460.354 291.531 0.750 re f
146.771 444.472 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 450.499 Td /F1 9.8 Tf  [(Assessment)] TJ ET
0.267 0.267 0.267 rg
437.551 460.354 143.324 0.750 re f
437.551 444.472 0.750 16.631 re f
580.125 444.472 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 450.499 Td /F1 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 444.472 120.896 0.750 re f
26.625 428.591 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 434.617 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
146.771 444.472 291.531 0.750 re f
146.771 428.591 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 434.617 Td /F1 9.8 Tf  [(Temporary interruption/impact)] TJ ET
0.267 0.267 0.267 rg
437.551 444.472 143.324 0.750 re f
437.551 428.591 0.750 16.631 re f
580.125 428.591 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 434.617 Td /F1 9.8 Tf  [(Very low)] TJ ET
0.267 0.267 0.267 rg
26.625 428.591 120.896 0.750 re f
26.625 412.710 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 418.736 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
146.771 428.591 291.531 0.750 re f
146.771 412.710 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 418.736 Td /F1 9.8 Tf  [(Temporary and widespread)] TJ ET
0.267 0.267 0.267 rg
437.551 428.591 143.324 0.750 re f
437.551 412.710 0.750 16.631 re f
580.125 412.710 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 418.736 Td /F1 9.8 Tf  [(Low)] TJ ET
0.267 0.267 0.267 rg
26.625 412.710 120.896 0.750 re f
26.625 396.829 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 402.855 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
146.771 412.710 291.531 0.750 re f
146.771 396.829 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 402.855 Td /F1 9.8 Tf  [(Extended and widespread)] TJ ET
0.267 0.267 0.267 rg
437.551 412.710 143.324 0.750 re f
437.551 396.829 0.750 16.631 re f
580.125 396.829 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 402.855 Td /F1 9.8 Tf  [(High)] TJ ET
0.267 0.267 0.267 rg
26.625 396.829 120.896 0.750 re f
26.625 380.947 120.896 0.750 re f
26.625 380.947 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 386.974 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
146.771 396.829 291.531 0.750 re f
146.771 380.947 291.531 0.750 re f
146.771 380.947 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 386.974 Td /F1 9.8 Tf  [(Permanent impact)] TJ ET
0.267 0.267 0.267 rg
437.551 396.829 143.324 0.750 re f
437.551 380.947 143.324 0.750 re f
437.551 380.947 0.750 16.631 re f
580.125 380.947 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 386.974 Td /F1 9.8 Tf  [(Very high)] TJ ET
q
26.250 321.836 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 324.583 Td /F1 9.8 Tf  [(OVERALL IMPACT RATING)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 233.430 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 313.211 188.488 0.750 re f
26.625 297.330 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 303.356 Td /F4 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
214.363 313.211 133.758 0.750 re f
214.363 297.330 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 303.356 Td /F4 9.8 Tf  [(Score)] TJ ET
0.267 0.267 0.267 rg
347.371 313.211 233.504 0.750 re f
347.371 297.330 0.750 16.631 re f
580.125 297.330 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 303.356 Td /F4 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 297.330 188.488 0.750 re f
26.625 281.449 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 287.475 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
214.363 297.330 133.758 0.750 re f
214.363 281.449 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 287.475 Td /F1 9.8 Tf  [(3-4)] TJ ET
0.267 0.267 0.267 rg
347.371 297.330 233.504 0.750 re f
347.371 281.449 0.750 16.631 re f
580.125 281.449 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 287.475 Td /F1 9.8 Tf  [(Marginal)] TJ ET
0.267 0.267 0.267 rg
26.625 281.449 188.488 0.750 re f
26.625 265.567 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 271.594 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
214.363 281.449 133.758 0.750 re f
214.363 265.567 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 271.594 Td /F1 9.8 Tf  [(5-7)] TJ ET
0.267 0.267 0.267 rg
347.371 281.449 233.504 0.750 re f
347.371 265.567 0.750 16.631 re f
580.125 265.567 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 271.594 Td /F1 9.8 Tf  [(Serious)] TJ ET
0.267 0.267 0.267 rg
26.625 265.567 188.488 0.750 re f
26.625 249.686 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 255.712 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
214.363 265.567 133.758 0.750 re f
214.363 249.686 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 255.712 Td /F1 9.8 Tf  [(8-10)] TJ ET
0.267 0.267 0.267 rg
347.371 265.567 233.504 0.750 re f
347.371 249.686 0.750 16.631 re f
580.125 249.686 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 255.712 Td /F1 9.8 Tf  [(Critical)] TJ ET
0.267 0.267 0.267 rg
26.625 249.686 188.488 0.750 re f
26.625 233.805 188.488 0.750 re f
26.625 233.805 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 239.831 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
214.363 249.686 133.758 0.750 re f
214.363 233.805 133.758 0.750 re f
214.363 233.805 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 239.831 Td /F1 9.8 Tf  [(11-12)] TJ ET
0.267 0.267 0.267 rg
347.371 249.686 233.504 0.750 re f
347.371 233.805 233.504 0.750 re f
347.371 233.805 0.750 16.631 re f
580.125 233.805 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 239.831 Td /F1 9.8 Tf  [(Catastrophic)] TJ ET
BT 26.250 161.708 Td /F4 12.0 Tf  [(APPENDIX 2)] TJ ET
BT 26.250 124.556 Td /F4 12.0 Tf  [(Final Search Terms Utilized for Medline and Embase Database Searching)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 104.602 Td /F1 9.8 Tf  [(Download PDF)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 68.000 Td /F4 12.0 Tf  [(APPENDIX 3)] TJ ET
Q
q
15.000 20.417 577.500 756.583 re W n
q
26.250 763.264 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 766.011 Td /F1 9.8 Tf  [(Human Impact \(Fatalities\))] TJ ET
Q
1.000 1.000 1.000 rg
26.250 674.857 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 754.639 160.659 0.750 re f
26.625 738.757 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 744.784 Td /F1 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
186.534 754.639 204.581 0.750 re f
186.534 738.757 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 744.784 Td /F1 9.8 Tf  [(Assessment)] TJ ET
0.267 0.267 0.267 rg
390.365 754.639 190.510 0.750 re f
390.365 738.757 0.750 16.631 re f
580.125 738.757 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 744.784 Td /F1 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 738.757 160.659 0.750 re f
26.625 722.876 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 728.902 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
186.534 738.757 204.581 0.750 re f
186.534 722.876 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 728.902 Td /F1 9.8 Tf  [(0-4)] TJ ET
0.267 0.267 0.267 rg
390.365 738.757 190.510 0.750 re f
390.365 722.876 0.750 16.631 re f
580.125 722.876 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 728.902 Td /F1 9.8 Tf  [(Very low)] TJ ET
0.267 0.267 0.267 rg
26.625 722.876 160.659 0.750 re f
26.625 706.995 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 713.021 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
186.534 722.876 204.581 0.750 re f
186.534 706.995 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 713.021 Td /F1 9.8 Tf  [(5-10)] TJ ET
0.267 0.267 0.267 rg
390.365 722.876 190.510 0.750 re f
390.365 706.995 0.750 16.631 re f
580.125 706.995 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 713.021 Td /F1 9.8 Tf  [(Low)] TJ ET
0.267 0.267 0.267 rg
26.625 706.995 160.659 0.750 re f
26.625 691.114 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 697.140 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
186.534 706.995 204.581 0.750 re f
186.534 691.114 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 697.140 Td /F1 9.8 Tf  [(11-50)] TJ ET
0.267 0.267 0.267 rg
390.365 706.995 190.510 0.750 re f
390.365 691.114 0.750 16.631 re f
580.125 691.114 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 697.140 Td /F1 9.8 Tf  [(High)] TJ ET
0.267 0.267 0.267 rg
26.625 691.114 160.659 0.750 re f
26.625 675.232 160.659 0.750 re f
26.625 675.232 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 681.259 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
186.534 691.114 204.581 0.750 re f
186.534 675.232 204.581 0.750 re f
186.534 675.232 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 681.259 Td /F1 9.8 Tf  [(>50)] TJ ET
0.267 0.267 0.267 rg
390.365 691.114 190.510 0.750 re f
390.365 675.232 190.510 0.750 re f
390.365 675.232 0.750 16.631 re f
580.125 675.232 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 681.259 Td /F1 9.8 Tf  [(Very high)] TJ ET
q
26.250 616.121 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 618.868 Td /F1 9.8 Tf  [(Physical Impact \(Property Damage\))] TJ ET
Q
1.000 1.000 1.000 rg
26.250 527.715 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 607.496 141.016 0.750 re f
26.625 591.615 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 597.641 Td /F1 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
166.891 607.496 247.534 0.750 re f
166.891 591.615 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 597.641 Td /F1 9.8 Tf  [(Assessment)] TJ ET
0.267 0.267 0.267 rg
413.675 607.496 167.200 0.750 re f
413.675 591.615 0.750 16.631 re f
580.125 591.615 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 597.641 Td /F1 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 591.615 141.016 0.750 re f
26.625 575.734 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 581.760 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
166.891 591.615 247.534 0.750 re f
166.891 575.734 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 581.760 Td /F1 9.8 Tf  [(Minimal damage)] TJ ET
0.267 0.267 0.267 rg
413.675 591.615 167.200 0.750 re f
413.675 575.734 0.750 16.631 re f
580.125 575.734 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 581.760 Td /F1 9.8 Tf  [(Very low)] TJ ET
0.267 0.267 0.267 rg
26.625 575.734 141.016 0.750 re f
26.625 559.852 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 565.879 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
166.891 575.734 247.534 0.750 re f
166.891 559.852 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 565.879 Td /F1 9.8 Tf  [(Localized damage)] TJ ET
0.267 0.267 0.267 rg
413.675 575.734 167.200 0.750 re f
413.675 559.852 0.750 16.631 re f
580.125 559.852 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 565.879 Td /F1 9.8 Tf  [(Low)] TJ ET
0.267 0.267 0.267 rg
26.625 559.852 141.016 0.750 re f
26.625 543.971 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 549.997 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
166.891 559.852 247.534 0.750 re f
166.891 543.971 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 549.997 Td /F1 9.8 Tf  [(Severe damage)] TJ ET
0.267 0.267 0.267 rg
413.675 559.852 167.200 0.750 re f
413.675 543.971 0.750 16.631 re f
580.125 543.971 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 549.997 Td /F1 9.8 Tf  [(High)] TJ ET
0.267 0.267 0.267 rg
26.625 543.971 141.016 0.750 re f
26.625 528.090 141.016 0.750 re f
26.625 528.090 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 534.116 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
166.891 543.971 247.534 0.750 re f
166.891 528.090 247.534 0.750 re f
166.891 528.090 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 534.116 Td /F1 9.8 Tf  [(Widespread damage)] TJ ET
0.267 0.267 0.267 rg
413.675 543.971 167.200 0.750 re f
413.675 528.090 167.200 0.750 re f
413.675 528.090 0.750 16.631 re f
580.125 528.090 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 534.116 Td /F1 9.8 Tf  [(Very high)] TJ ET
q
26.250 468.979 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 471.726 Td /F1 9.8 Tf  [(Critical Infrastructure & Resources and Economic & Social Impact)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 380.572 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 460.354 120.896 0.750 re f
26.625 444.472 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 450.499 Td /F1 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
146.771 460.354 291.531 0.750 re f
146.771 444.472 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 450.499 Td /F1 9.8 Tf  [(Assessment)] TJ ET
0.267 0.267 0.267 rg
437.551 460.354 143.324 0.750 re f
437.551 444.472 0.750 16.631 re f
580.125 444.472 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 450.499 Td /F1 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 444.472 120.896 0.750 re f
26.625 428.591 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 434.617 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
146.771 444.472 291.531 0.750 re f
146.771 428.591 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 434.617 Td /F1 9.8 Tf  [(Temporary interruption/impact)] TJ ET
0.267 0.267 0.267 rg
437.551 444.472 143.324 0.750 re f
437.551 428.591 0.750 16.631 re f
580.125 428.591 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 434.617 Td /F1 9.8 Tf  [(Very low)] TJ ET
0.267 0.267 0.267 rg
26.625 428.591 120.896 0.750 re f
26.625 412.710 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 418.736 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
146.771 428.591 291.531 0.750 re f
146.771 412.710 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 418.736 Td /F1 9.8 Tf  [(Temporary and widespread)] TJ ET
0.267 0.267 0.267 rg
437.551 428.591 143.324 0.750 re f
437.551 412.710 0.750 16.631 re f
580.125 412.710 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 418.736 Td /F1 9.8 Tf  [(Low)] TJ ET
0.267 0.267 0.267 rg
26.625 412.710 120.896 0.750 re f
26.625 396.829 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 402.855 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
146.771 412.710 291.531 0.750 re f
146.771 396.829 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 402.855 Td /F1 9.8 Tf  [(Extended and widespread)] TJ ET
0.267 0.267 0.267 rg
437.551 412.710 143.324 0.750 re f
437.551 396.829 0.750 16.631 re f
580.125 396.829 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 402.855 Td /F1 9.8 Tf  [(High)] TJ ET
0.267 0.267 0.267 rg
26.625 396.829 120.896 0.750 re f
26.625 380.947 120.896 0.750 re f
26.625 380.947 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 386.974 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
146.771 396.829 291.531 0.750 re f
146.771 380.947 291.531 0.750 re f
146.771 380.947 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 386.974 Td /F1 9.8 Tf  [(Permanent impact)] TJ ET
0.267 0.267 0.267 rg
437.551 396.829 143.324 0.750 re f
437.551 380.947 143.324 0.750 re f
437.551 380.947 0.750 16.631 re f
580.125 380.947 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 386.974 Td /F1 9.8 Tf  [(Very high)] TJ ET
q
26.250 321.836 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 324.583 Td /F1 9.8 Tf  [(OVERALL IMPACT RATING)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 233.430 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 313.211 188.488 0.750 re f
26.625 297.330 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 303.356 Td /F4 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
214.363 313.211 133.758 0.750 re f
214.363 297.330 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 303.356 Td /F4 9.8 Tf  [(Score)] TJ ET
0.267 0.267 0.267 rg
347.371 313.211 233.504 0.750 re f
347.371 297.330 0.750 16.631 re f
580.125 297.330 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 303.356 Td /F4 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 297.330 188.488 0.750 re f
26.625 281.449 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 287.475 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
214.363 297.330 133.758 0.750 re f
214.363 281.449 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 287.475 Td /F1 9.8 Tf  [(3-4)] TJ ET
0.267 0.267 0.267 rg
347.371 297.330 233.504 0.750 re f
347.371 281.449 0.750 16.631 re f
580.125 281.449 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 287.475 Td /F1 9.8 Tf  [(Marginal)] TJ ET
0.267 0.267 0.267 rg
26.625 281.449 188.488 0.750 re f
26.625 265.567 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 271.594 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
214.363 281.449 133.758 0.750 re f
214.363 265.567 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 271.594 Td /F1 9.8 Tf  [(5-7)] TJ ET
0.267 0.267 0.267 rg
347.371 281.449 233.504 0.750 re f
347.371 265.567 0.750 16.631 re f
580.125 265.567 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 271.594 Td /F1 9.8 Tf  [(Serious)] TJ ET
0.267 0.267 0.267 rg
26.625 265.567 188.488 0.750 re f
26.625 249.686 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 255.712 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
214.363 265.567 133.758 0.750 re f
214.363 249.686 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 255.712 Td /F1 9.8 Tf  [(8-10)] TJ ET
0.267 0.267 0.267 rg
347.371 265.567 233.504 0.750 re f
347.371 249.686 0.750 16.631 re f
580.125 249.686 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 255.712 Td /F1 9.8 Tf  [(Critical)] TJ ET
0.267 0.267 0.267 rg
26.625 249.686 188.488 0.750 re f
26.625 233.805 188.488 0.750 re f
26.625 233.805 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 239.831 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
214.363 249.686 133.758 0.750 re f
214.363 233.805 133.758 0.750 re f
214.363 233.805 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 239.831 Td /F1 9.8 Tf  [(11-12)] TJ ET
0.267 0.267 0.267 rg
347.371 249.686 233.504 0.750 re f
347.371 233.805 233.504 0.750 re f
347.371 233.805 0.750 16.631 re f
580.125 233.805 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 239.831 Td /F1 9.8 Tf  [(Catastrophic)] TJ ET
BT 26.250 161.708 Td /F4 12.0 Tf  [(APPENDIX 2)] TJ ET
BT 26.250 124.556 Td /F4 12.0 Tf  [(Final Search Terms Utilized for Medline and Embase Database Searching)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 104.602 Td /F1 9.8 Tf  [(Download PDF)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 68.000 Td /F4 12.0 Tf  [(APPENDIX 3)] TJ ET
Q
q
15.000 20.417 577.500 756.583 re W n
q
26.250 763.264 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 766.011 Td /F1 9.8 Tf  [(Human Impact \(Fatalities\))] TJ ET
Q
1.000 1.000 1.000 rg
26.250 674.857 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 754.639 160.659 0.750 re f
26.625 738.757 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 744.784 Td /F1 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
186.534 754.639 204.581 0.750 re f
186.534 738.757 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 744.784 Td /F1 9.8 Tf  [(Assessment)] TJ ET
0.267 0.267 0.267 rg
390.365 754.639 190.510 0.750 re f
390.365 738.757 0.750 16.631 re f
580.125 738.757 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 744.784 Td /F1 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 738.757 160.659 0.750 re f
26.625 722.876 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 728.902 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
186.534 738.757 204.581 0.750 re f
186.534 722.876 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 728.902 Td /F1 9.8 Tf  [(0-4)] TJ ET
0.267 0.267 0.267 rg
390.365 738.757 190.510 0.750 re f
390.365 722.876 0.750 16.631 re f
580.125 722.876 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 728.902 Td /F1 9.8 Tf  [(Very low)] TJ ET
0.267 0.267 0.267 rg
26.625 722.876 160.659 0.750 re f
26.625 706.995 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 713.021 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
186.534 722.876 204.581 0.750 re f
186.534 706.995 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 713.021 Td /F1 9.8 Tf  [(5-10)] TJ ET
0.267 0.267 0.267 rg
390.365 722.876 190.510 0.750 re f
390.365 706.995 0.750 16.631 re f
580.125 706.995 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 713.021 Td /F1 9.8 Tf  [(Low)] TJ ET
0.267 0.267 0.267 rg
26.625 706.995 160.659 0.750 re f
26.625 691.114 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 697.140 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
186.534 706.995 204.581 0.750 re f
186.534 691.114 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 697.140 Td /F1 9.8 Tf  [(11-50)] TJ ET
0.267 0.267 0.267 rg
390.365 706.995 190.510 0.750 re f
390.365 691.114 0.750 16.631 re f
580.125 691.114 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 697.140 Td /F1 9.8 Tf  [(High)] TJ ET
0.267 0.267 0.267 rg
26.625 691.114 160.659 0.750 re f
26.625 675.232 160.659 0.750 re f
26.625 675.232 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 681.259 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
186.534 691.114 204.581 0.750 re f
186.534 675.232 204.581 0.750 re f
186.534 675.232 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 191.784 681.259 Td /F1 9.8 Tf  [(>50)] TJ ET
0.267 0.267 0.267 rg
390.365 691.114 190.510 0.750 re f
390.365 675.232 190.510 0.750 re f
390.365 675.232 0.750 16.631 re f
580.125 675.232 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 395.615 681.259 Td /F1 9.8 Tf  [(Very high)] TJ ET
q
26.250 616.121 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 618.868 Td /F1 9.8 Tf  [(Physical Impact \(Property Damage\))] TJ ET
Q
1.000 1.000 1.000 rg
26.250 527.715 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 607.496 141.016 0.750 re f
26.625 591.615 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 597.641 Td /F1 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
166.891 607.496 247.534 0.750 re f
166.891 591.615 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 597.641 Td /F1 9.8 Tf  [(Assessment)] TJ ET
0.267 0.267 0.267 rg
413.675 607.496 167.200 0.750 re f
413.675 591.615 0.750 16.631 re f
580.125 591.615 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 597.641 Td /F1 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 591.615 141.016 0.750 re f
26.625 575.734 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 581.760 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
166.891 591.615 247.534 0.750 re f
166.891 575.734 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 581.760 Td /F1 9.8 Tf  [(Minimal damage)] TJ ET
0.267 0.267 0.267 rg
413.675 591.615 167.200 0.750 re f
413.675 575.734 0.750 16.631 re f
580.125 575.734 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 581.760 Td /F1 9.8 Tf  [(Very low)] TJ ET
0.267 0.267 0.267 rg
26.625 575.734 141.016 0.750 re f
26.625 559.852 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 565.879 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
166.891 575.734 247.534 0.750 re f
166.891 559.852 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 565.879 Td /F1 9.8 Tf  [(Localized damage)] TJ ET
0.267 0.267 0.267 rg
413.675 575.734 167.200 0.750 re f
413.675 559.852 0.750 16.631 re f
580.125 559.852 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 565.879 Td /F1 9.8 Tf  [(Low)] TJ ET
0.267 0.267 0.267 rg
26.625 559.852 141.016 0.750 re f
26.625 543.971 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 549.997 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
166.891 559.852 247.534 0.750 re f
166.891 543.971 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 549.997 Td /F1 9.8 Tf  [(Severe damage)] TJ ET
0.267 0.267 0.267 rg
413.675 559.852 167.200 0.750 re f
413.675 543.971 0.750 16.631 re f
580.125 543.971 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 549.997 Td /F1 9.8 Tf  [(High)] TJ ET
0.267 0.267 0.267 rg
26.625 543.971 141.016 0.750 re f
26.625 528.090 141.016 0.750 re f
26.625 528.090 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 534.116 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
166.891 543.971 247.534 0.750 re f
166.891 528.090 247.534 0.750 re f
166.891 528.090 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 172.141 534.116 Td /F1 9.8 Tf  [(Widespread damage)] TJ ET
0.267 0.267 0.267 rg
413.675 543.971 167.200 0.750 re f
413.675 528.090 167.200 0.750 re f
413.675 528.090 0.750 16.631 re f
580.125 528.090 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 418.925 534.116 Td /F1 9.8 Tf  [(Very high)] TJ ET
q
26.250 468.979 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 471.726 Td /F1 9.8 Tf  [(Critical Infrastructure & Resources and Economic & Social Impact)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 380.572 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 460.354 120.896 0.750 re f
26.625 444.472 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 450.499 Td /F1 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
146.771 460.354 291.531 0.750 re f
146.771 444.472 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 450.499 Td /F1 9.8 Tf  [(Assessment)] TJ ET
0.267 0.267 0.267 rg
437.551 460.354 143.324 0.750 re f
437.551 444.472 0.750 16.631 re f
580.125 444.472 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 450.499 Td /F1 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 444.472 120.896 0.750 re f
26.625 428.591 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 434.617 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
146.771 444.472 291.531 0.750 re f
146.771 428.591 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 434.617 Td /F1 9.8 Tf  [(Temporary interruption/impact)] TJ ET
0.267 0.267 0.267 rg
437.551 444.472 143.324 0.750 re f
437.551 428.591 0.750 16.631 re f
580.125 428.591 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 434.617 Td /F1 9.8 Tf  [(Very low)] TJ ET
0.267 0.267 0.267 rg
26.625 428.591 120.896 0.750 re f
26.625 412.710 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 418.736 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
146.771 428.591 291.531 0.750 re f
146.771 412.710 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 418.736 Td /F1 9.8 Tf  [(Temporary and widespread)] TJ ET
0.267 0.267 0.267 rg
437.551 428.591 143.324 0.750 re f
437.551 412.710 0.750 16.631 re f
580.125 412.710 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 418.736 Td /F1 9.8 Tf  [(Low)] TJ ET
0.267 0.267 0.267 rg
26.625 412.710 120.896 0.750 re f
26.625 396.829 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 402.855 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
146.771 412.710 291.531 0.750 re f
146.771 396.829 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 402.855 Td /F1 9.8 Tf  [(Extended and widespread)] TJ ET
0.267 0.267 0.267 rg
437.551 412.710 143.324 0.750 re f
437.551 396.829 0.750 16.631 re f
580.125 396.829 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 402.855 Td /F1 9.8 Tf  [(High)] TJ ET
0.267 0.267 0.267 rg
26.625 396.829 120.896 0.750 re f
26.625 380.947 120.896 0.750 re f
26.625 380.947 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 386.974 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
146.771 396.829 291.531 0.750 re f
146.771 380.947 291.531 0.750 re f
146.771 380.947 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 152.021 386.974 Td /F1 9.8 Tf  [(Permanent impact)] TJ ET
0.267 0.267 0.267 rg
437.551 396.829 143.324 0.750 re f
437.551 380.947 143.324 0.750 re f
437.551 380.947 0.750 16.631 re f
580.125 380.947 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 442.801 386.974 Td /F1 9.8 Tf  [(Very high)] TJ ET
q
26.250 321.836 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 324.583 Td /F1 9.8 Tf  [(OVERALL IMPACT RATING)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 233.430 555.000 80.906 re f
0.267 0.267 0.267 rg
26.625 313.211 188.488 0.750 re f
26.625 297.330 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 303.356 Td /F4 9.8 Tf  [(Category)] TJ ET
0.267 0.267 0.267 rg
214.363 313.211 133.758 0.750 re f
214.363 297.330 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 303.356 Td /F4 9.8 Tf  [(Score)] TJ ET
0.267 0.267 0.267 rg
347.371 313.211 233.504 0.750 re f
347.371 297.330 0.750 16.631 re f
580.125 297.330 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 303.356 Td /F4 9.8 Tf  [(Description)] TJ ET
0.267 0.267 0.267 rg
26.625 297.330 188.488 0.750 re f
26.625 281.449 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 287.475 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
214.363 297.330 133.758 0.750 re f
214.363 281.449 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 287.475 Td /F1 9.8 Tf  [(3-4)] TJ ET
0.267 0.267 0.267 rg
347.371 297.330 233.504 0.750 re f
347.371 281.449 0.750 16.631 re f
580.125 281.449 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 287.475 Td /F1 9.8 Tf  [(Marginal)] TJ ET
0.267 0.267 0.267 rg
26.625 281.449 188.488 0.750 re f
26.625 265.567 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 271.594 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
214.363 281.449 133.758 0.750 re f
214.363 265.567 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 271.594 Td /F1 9.8 Tf  [(5-7)] TJ ET
0.267 0.267 0.267 rg
347.371 281.449 233.504 0.750 re f
347.371 265.567 0.750 16.631 re f
580.125 265.567 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 271.594 Td /F1 9.8 Tf  [(Serious)] TJ ET
0.267 0.267 0.267 rg
26.625 265.567 188.488 0.750 re f
26.625 249.686 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 255.712 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
214.363 265.567 133.758 0.750 re f
214.363 249.686 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 255.712 Td /F1 9.8 Tf  [(8-10)] TJ ET
0.267 0.267 0.267 rg
347.371 265.567 233.504 0.750 re f
347.371 249.686 0.750 16.631 re f
580.125 249.686 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 255.712 Td /F1 9.8 Tf  [(Critical)] TJ ET
0.267 0.267 0.267 rg
26.625 249.686 188.488 0.750 re f
26.625 233.805 188.488 0.750 re f
26.625 233.805 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 239.831 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
214.363 249.686 133.758 0.750 re f
214.363 233.805 133.758 0.750 re f
214.363 233.805 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 219.613 239.831 Td /F1 9.8 Tf  [(11-12)] TJ ET
0.267 0.267 0.267 rg
347.371 249.686 233.504 0.750 re f
347.371 233.805 233.504 0.750 re f
347.371 233.805 0.750 16.631 re f
580.125 233.805 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 352.621 239.831 Td /F1 9.8 Tf  [(Catastrophic)] TJ ET
BT 26.250 161.708 Td /F4 12.0 Tf  [(APPENDIX 2)] TJ ET
BT 26.250 124.556 Td /F4 12.0 Tf  [(Final Search Terms Utilized for Medline and Embase Database Searching)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 104.602 Td /F1 9.8 Tf  [(Download PDF)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 68.000 Td /F4 12.0 Tf  [(APPENDIX 3)] TJ ET
Q
q
0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(7)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET

Q
endstream
endobj
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/H /I
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>>
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513 0 obj
<< /Type /Action
/S /URI
/URI (https://currents.plos.org/disasters/files/2013/10/Appendix-2.pdf)
>>
endobj
514 0 obj
<< /Type /Annot
/Subtype /Link
/A 515 0 R
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/H /I
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515 0 obj
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BT 26.250 693.722 Td /F4 12.0 Tf  [(References)] TJ ET
BT 26.250 666.267 Td /F1 9.8 Tf  [(1.)] TJ ET
BT 38.132 666.267 Td /F1 9.8 Tf  [(Haines A, Kovats RS, Campbell-Lendrum D, Corvalan C. Climate change and human health: impacts, vulnerability, and )] TJ ET
BT 26.250 654.363 Td /F1 9.8 Tf  [(mitigation. Lancet. 2006 Jun 24;367\(9528\):2101-9. PubMed PMID:16798393.)] TJ ET
BT 26.250 634.958 Td /F1 9.8 Tf  [(2.)] TJ ET
BT 38.132 634.958 Td /F1 9.8 Tf  [(Environment Canada. Climate Change: Canada's Action on Climate Change 2009. )] TJ ET
BT 26.250 623.053 Td /F1 9.8 Tf  [(https://www.ec.gc.ca/Publications/E5E4BB6D-1824-4B00-9512-933F961FD7DD/Climate_Change.pdf. Accessed November )] TJ ET
BT 26.250 611.148 Td /F1 9.8 Tf  [(2010.)] TJ ET
BT 26.250 591.744 Td /F1 9.8 Tf  [(3.)] TJ ET
BT 38.132 591.744 Td /F1 9.8 Tf  [(Below R, Wirtz A, Guha-Sapir D. Working Paper: Disaster Category Classification and Peril Terminology for Operational )] TJ ET
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BT 38.132 560.434 Td /F1 9.8 Tf  [(Emergency Management Ontario. Province of Ontario: Emergency Response Plan. Toronto: Emergency Management )] TJ ET
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BT 38.132 529.125 Td /F1 9.8 Tf  [(Oxford Dictionaries. New York: Oxford University Press; 2011: )] TJ ET
BT 26.250 517.220 Td /F1 9.8 Tf  [(https://oxforddictionaries.com/view/entry/m_en_gb0229250#m_en_gb0229250. Accessed January 11, 2011.)] TJ ET
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BT 38.132 497.815 Td /F1 9.8 Tf  [(Last JM, ed. A Dictionary of Epidemiology. Fourth ed. Oxford: Oxford University Press; 2001.)] TJ ET
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BT 38.132 478.410 Td /F1 9.8 Tf  [(WHO \(2012\) Outbreak surveillance and response in humanitarian emergencies: WHO guidelines for EWARN )] TJ ET
BT 26.250 466.506 Td /F1 9.8 Tf  [(implementation. World Health Organization: Geneva.)] TJ ET
BT 26.250 447.101 Td /F1 9.8 Tf  [(8.)] TJ ET
BT 38.132 447.101 Td /F1 9.8 Tf  [(Culley, JM, Effken, JA \(2010\) �Development and Validation of a Mass Casualty Conceptual Model. Journal of Nursing )] TJ ET
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BT 38.132 415.791 Td /F1 9.8 Tf  [(De Boer, J \(1999\) Order in chaos: modelling medical management in disasters. Eur J Emerg Med, 6: 141-148.)] TJ ET
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BT 43.553 396.387 Td /F1 9.8 Tf  [(Debacker M, et al \(2012\) Utstein-Style Template for Uniform Data Reporting of Acute Medical Response in Disasters. PLOS )] TJ ET
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BT 43.553 365.077 Td /F1 9.8 Tf  [(Lillibridge, SR, Noji, EK, Burkle, FM \(1993\) Disaster assessment: The emergency health evaluation of a population affected )] TJ ET
BT 26.250 353.172 Td /F1 9.8 Tf  [(by a disaster. Ann Emerg Med,22:1715-20.)] TJ ET
BT 26.250 333.768 Td /F1 9.8 Tf  [(12.)] TJ ET
BT 43.553 333.768 Td /F1 9.8 Tf  [(Sundnes, KO \(1999\) Health disaster management: guidelines for evaluation and research in the Utstein style: executive )] TJ ET
BT 26.250 321.863 Td /F1 9.8 Tf  [(summary. Task Force on Quality Control of Disaster Management. Prehosp Disaster Med, 14:43-52.)] TJ ET
BT 26.250 302.458 Td /F1 9.8 Tf  [(13.)] TJ ET
BT 43.553 302.458 Td /F1 9.8 Tf  [(Bayram, JD, Kysia, R, Kirsch, TD \(2012\) Disaster Metrics: A Proposed Quantitative Assessment Tool in Complex )] TJ ET
BT 26.250 290.553 Td /F1 9.8 Tf  [(Humanitarian Emergencies � The Public Health Impact Severity Scale \(PHISS\). PLOS Currents Disasters. 2012 Aug 21. Edition )] TJ ET
BT 26.250 278.649 Td /F1 9.8 Tf  [(1. doi: 10.1371/4f7b4bab0d1a3.)] TJ ET
BT 26.250 259.244 Td /F1 9.8 Tf  [(14.)] TJ ET
BT 43.553 259.244 Td /F1 9.8 Tf  [(WHO \(2012\) Strengthening health-system emergency preparedness: Toolkit for Assessing Health System Capacity for )] TJ ET
BT 26.250 247.339 Td /F1 9.8 Tf  [(Crisis Management. WHO Regional Office for Europe.)] TJ ET
BT 26.250 227.934 Td /F1 9.8 Tf  [(15.)] TJ ET
BT 43.553 227.934 Td /F1 9.8 Tf  [(WHO \(2009\) Inter-Agency Steering Committee Global Health Cluster. Health Cluster Guide: A practical guide for country-)] TJ ET
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BT 43.553 196.625 Td /F1 9.8 Tf  [(John Hopkins and Red Cross \(2008\) Public Health Guide in Emergencies 2nd Edition.)] TJ ET
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BT 43.553 177.220 Td /F1 9.8 Tf  [(Challen, K, Lee, A, Booth, A, Gardois, P, Woods, H, Goodacre, S \(2012\) Where is the evidence for emergency planning: a )] TJ ET
BT 26.250 165.315 Td /F1 9.8 Tf  [(scoping review. BMC Public Health, 12: 542-50.)] TJ ET
BT 26.250 145.911 Td /F1 9.8 Tf  [(18.)] TJ ET
BT 43.553 145.911 Td /F1 9.8 Tf  [(Noji EK. The Public Health Consequences of Disasters. New York: Oxford University Press; 1997.)] TJ ET
BT 26.250 126.506 Td /F1 9.8 Tf  [(19.)] TJ ET
BT 43.553 126.506 Td /F1 9.8 Tf  [(Centre for Excellence in Emergency Preparedness. Risk Assessment Tool for Medical Facilities: Centre for Excellence in )] TJ ET
BT 26.250 114.601 Td /F1 9.8 Tf  [(Emergency Preparedness; 2009.)] TJ ET
BT 26.250 95.196 Td /F1 9.8 Tf  [(20.)] TJ ET
BT 43.553 95.196 Td /F1 9.8 Tf  [(Sider D, Henry B. \(2007\) Public Health Risk Assessment: Centre for Excellence in Emergency Preparedness.)] TJ ET
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BT 43.553 75.792 Td /F1 9.8 Tf  [(Nirupama N. Disaster Risk Management. In: Bobrowski P, ed. Encyclopedia of Natural Hazards. New York: Springer; 2010.)] TJ ET
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BT 43.553 56.387 Td /F1 9.8 Tf  [(Provincial Emergency Program. British Columbia Hazard, Risk and Vulnerability Analysis Toolkit: British Columbia Ministry )] TJ ET
BT 26.250 44.482 Td /F1 9.8 Tf  [(of Public Safety and Solicitor General Provincial Emergency Program; 2010:62.)] TJ ET
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BT 26.250 666.267 Td /F1 9.8 Tf  [(1.)] TJ ET
BT 38.132 666.267 Td /F1 9.8 Tf  [(Haines A, Kovats RS, Campbell-Lendrum D, Corvalan C. Climate change and human health: impacts, vulnerability, and )] TJ ET
BT 26.250 654.363 Td /F1 9.8 Tf  [(mitigation. Lancet. 2006 Jun 24;367\(9528\):2101-9. PubMed PMID:16798393.)] TJ ET
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BT 38.132 634.958 Td /F1 9.8 Tf  [(Environment Canada. Climate Change: Canada's Action on Climate Change 2009. )] TJ ET
BT 26.250 623.053 Td /F1 9.8 Tf  [(https://www.ec.gc.ca/Publications/E5E4BB6D-1824-4B00-9512-933F961FD7DD/Climate_Change.pdf. Accessed November )] TJ ET
BT 26.250 611.148 Td /F1 9.8 Tf  [(2010.)] TJ ET
BT 26.250 591.744 Td /F1 9.8 Tf  [(3.)] TJ ET
BT 38.132 591.744 Td /F1 9.8 Tf  [(Below R, Wirtz A, Guha-Sapir D. Working Paper: Disaster Category Classification and Peril Terminology for Operational )] TJ ET
BT 26.250 579.839 Td /F1 9.8 Tf  [(Purposes. Universite catholique de Louvain: WHO Collaborating Centre for Research on the Epidemiology of Disasters; 2009.)] TJ ET
BT 26.250 560.434 Td /F1 9.8 Tf  [(4.)] TJ ET
BT 38.132 560.434 Td /F1 9.8 Tf  [(Emergency Management Ontario. Province of Ontario: Emergency Response Plan. Toronto: Emergency Management )] TJ ET
BT 26.250 548.529 Td /F1 9.8 Tf  [(Ontario; 2008.)] TJ ET
BT 26.250 529.125 Td /F1 9.8 Tf  [(5.)] TJ ET
BT 38.132 529.125 Td /F1 9.8 Tf  [(Oxford Dictionaries. New York: Oxford University Press; 2011: )] TJ ET
BT 26.250 517.220 Td /F1 9.8 Tf  [(https://oxforddictionaries.com/view/entry/m_en_gb0229250#m_en_gb0229250. Accessed January 11, 2011.)] TJ ET
BT 26.250 497.815 Td /F1 9.8 Tf  [(6.)] TJ ET
BT 38.132 497.815 Td /F1 9.8 Tf  [(Last JM, ed. A Dictionary of Epidemiology. Fourth ed. Oxford: Oxford University Press; 2001.)] TJ ET
BT 26.250 478.410 Td /F1 9.8 Tf  [(7.)] TJ ET
BT 38.132 478.410 Td /F1 9.8 Tf  [(WHO \(2012\) Outbreak surveillance and response in humanitarian emergencies: WHO guidelines for EWARN )] TJ ET
BT 26.250 466.506 Td /F1 9.8 Tf  [(implementation. World Health Organization: Geneva.)] TJ ET
BT 26.250 447.101 Td /F1 9.8 Tf  [(8.)] TJ ET
BT 38.132 447.101 Td /F1 9.8 Tf  [(Culley, JM, Effken, JA \(2010\) �Development and Validation of a Mass Casualty Conceptual Model. Journal of Nursing )] TJ ET
BT 26.250 435.196 Td /F1 9.8 Tf  [(Scholarship, 42\(1\):66�75.)] TJ ET
BT 26.250 415.791 Td /F1 9.8 Tf  [(9.)] TJ ET
BT 38.132 415.791 Td /F1 9.8 Tf  [(De Boer, J \(1999\) Order in chaos: modelling medical management in disasters. Eur J Emerg Med, 6: 141-148.)] TJ ET
BT 26.250 396.387 Td /F1 9.8 Tf  [(10.)] TJ ET
BT 43.553 396.387 Td /F1 9.8 Tf  [(Debacker M, et al \(2012\) Utstein-Style Template for Uniform Data Reporting of Acute Medical Response in Disasters. PLOS )] TJ ET
BT 26.250 384.482 Td /F1 9.8 Tf  [(Currents Disasters. 2012 Mar 23. Edition 1. doi: 10.1371/4f6cf3e8df15a.)] TJ ET
BT 26.250 365.077 Td /F1 9.8 Tf  [(11.)] TJ ET
BT 43.553 365.077 Td /F1 9.8 Tf  [(Lillibridge, SR, Noji, EK, Burkle, FM \(1993\) Disaster assessment: The emergency health evaluation of a population affected )] TJ ET
BT 26.250 353.172 Td /F1 9.8 Tf  [(by a disaster. Ann Emerg Med,22:1715-20.)] TJ ET
BT 26.250 333.768 Td /F1 9.8 Tf  [(12.)] TJ ET
BT 43.553 333.768 Td /F1 9.8 Tf  [(Sundnes, KO \(1999\) Health disaster management: guidelines for evaluation and research in the Utstein style: executive )] TJ ET
BT 26.250 321.863 Td /F1 9.8 Tf  [(summary. Task Force on Quality Control of Disaster Management. Prehosp Disaster Med, 14:43-52.)] TJ ET
BT 26.250 302.458 Td /F1 9.8 Tf  [(13.)] TJ ET
BT 43.553 302.458 Td /F1 9.8 Tf  [(Bayram, JD, Kysia, R, Kirsch, TD \(2012\) Disaster Metrics: A Proposed Quantitative Assessment Tool in Complex )] TJ ET
BT 26.250 290.553 Td /F1 9.8 Tf  [(Humanitarian Emergencies � The Public Health Impact Severity Scale \(PHISS\). PLOS Currents Disasters. 2012 Aug 21. Edition )] TJ ET
BT 26.250 278.649 Td /F1 9.8 Tf  [(1. doi: 10.1371/4f7b4bab0d1a3.)] TJ ET
BT 26.250 259.244 Td /F1 9.8 Tf  [(14.)] TJ ET
BT 43.553 259.244 Td /F1 9.8 Tf  [(WHO \(2012\) Strengthening health-system emergency preparedness: Toolkit for Assessing Health System Capacity for )] TJ ET
BT 26.250 247.339 Td /F1 9.8 Tf  [(Crisis Management. WHO Regional Office for Europe.)] TJ ET
BT 26.250 227.934 Td /F1 9.8 Tf  [(15.)] TJ ET
BT 43.553 227.934 Td /F1 9.8 Tf  [(WHO \(2009\) Inter-Agency Steering Committee Global Health Cluster. Health Cluster Guide: A practical guide for country-)] TJ ET
BT 26.250 216.030 Td /F1 9.8 Tf  [(level implementation of the Health Cluster. World Health Organization: Geneva.)] TJ ET
BT 26.250 196.625 Td /F1 9.8 Tf  [(16.)] TJ ET
BT 43.553 196.625 Td /F1 9.8 Tf  [(John Hopkins and Red Cross \(2008\) Public Health Guide in Emergencies 2nd Edition.)] TJ ET
BT 26.250 177.220 Td /F1 9.8 Tf  [(17.)] TJ ET
BT 43.553 177.220 Td /F1 9.8 Tf  [(Challen, K, Lee, A, Booth, A, Gardois, P, Woods, H, Goodacre, S \(2012\) Where is the evidence for emergency planning: a )] TJ ET
BT 26.250 165.315 Td /F1 9.8 Tf  [(scoping review. BMC Public Health, 12: 542-50.)] TJ ET
BT 26.250 145.911 Td /F1 9.8 Tf  [(18.)] TJ ET
BT 43.553 145.911 Td /F1 9.8 Tf  [(Noji EK. The Public Health Consequences of Disasters. New York: Oxford University Press; 1997.)] TJ ET
BT 26.250 126.506 Td /F1 9.8 Tf  [(19.)] TJ ET
BT 43.553 126.506 Td /F1 9.8 Tf  [(Centre for Excellence in Emergency Preparedness. Risk Assessment Tool for Medical Facilities: Centre for Excellence in )] TJ ET
BT 26.250 114.601 Td /F1 9.8 Tf  [(Emergency Preparedness; 2009.)] TJ ET
BT 26.250 95.196 Td /F1 9.8 Tf  [(20.)] TJ ET
BT 43.553 95.196 Td /F1 9.8 Tf  [(Sider D, Henry B. \(2007\) Public Health Risk Assessment: Centre for Excellence in Emergency Preparedness.)] TJ ET
BT 26.250 75.792 Td /F1 9.8 Tf  [(21.)] TJ ET
BT 43.553 75.792 Td /F1 9.8 Tf  [(Nirupama N. Disaster Risk Management. In: Bobrowski P, ed. Encyclopedia of Natural Hazards. New York: Springer; 2010.)] TJ ET
BT 26.250 56.387 Td /F1 9.8 Tf  [(22.)] TJ ET
BT 43.553 56.387 Td /F1 9.8 Tf  [(Provincial Emergency Program. British Columbia Hazard, Risk and Vulnerability Analysis Toolkit: British Columbia Ministry )] TJ ET
BT 26.250 44.482 Td /F1 9.8 Tf  [(of Public Safety and Solicitor General Provincial Emergency Program; 2010:62.)] TJ ET
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BT 26.250 750.278 Td /F4 12.0 Tf  [(�)] TJ ET
BT 29.586 750.278 Td /F4 12.0 Tf  [(Flowchart Depicting Selection of Articles for Developing and Testing Framework)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 730.324 Td /F1 9.8 Tf  [(Download PDF)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 693.722 Td /F4 12.0 Tf  [(References)] TJ ET
BT 26.250 666.267 Td /F1 9.8 Tf  [(1.)] TJ ET
BT 38.132 666.267 Td /F1 9.8 Tf  [(Haines A, Kovats RS, Campbell-Lendrum D, Corvalan C. Climate change and human health: impacts, vulnerability, and )] TJ ET
BT 26.250 654.363 Td /F1 9.8 Tf  [(mitigation. Lancet. 2006 Jun 24;367\(9528\):2101-9. PubMed PMID:16798393.)] TJ ET
BT 26.250 634.958 Td /F1 9.8 Tf  [(2.)] TJ ET
BT 38.132 634.958 Td /F1 9.8 Tf  [(Environment Canada. Climate Change: Canada's Action on Climate Change 2009. )] TJ ET
BT 26.250 623.053 Td /F1 9.8 Tf  [(https://www.ec.gc.ca/Publications/E5E4BB6D-1824-4B00-9512-933F961FD7DD/Climate_Change.pdf. Accessed November )] TJ ET
BT 26.250 611.148 Td /F1 9.8 Tf  [(2010.)] TJ ET
BT 26.250 591.744 Td /F1 9.8 Tf  [(3.)] TJ ET
BT 38.132 591.744 Td /F1 9.8 Tf  [(Below R, Wirtz A, Guha-Sapir D. Working Paper: Disaster Category Classification and Peril Terminology for Operational )] TJ ET
BT 26.250 579.839 Td /F1 9.8 Tf  [(Purposes. Universite catholique de Louvain: WHO Collaborating Centre for Research on the Epidemiology of Disasters; 2009.)] TJ ET
BT 26.250 560.434 Td /F1 9.8 Tf  [(4.)] TJ ET
BT 38.132 560.434 Td /F1 9.8 Tf  [(Emergency Management Ontario. Province of Ontario: Emergency Response Plan. Toronto: Emergency Management )] TJ ET
BT 26.250 548.529 Td /F1 9.8 Tf  [(Ontario; 2008.)] TJ ET
BT 26.250 529.125 Td /F1 9.8 Tf  [(5.)] TJ ET
BT 38.132 529.125 Td /F1 9.8 Tf  [(Oxford Dictionaries. New York: Oxford University Press; 2011: )] TJ ET
BT 26.250 517.220 Td /F1 9.8 Tf  [(https://oxforddictionaries.com/view/entry/m_en_gb0229250#m_en_gb0229250. Accessed January 11, 2011.)] TJ ET
BT 26.250 497.815 Td /F1 9.8 Tf  [(6.)] TJ ET
BT 38.132 497.815 Td /F1 9.8 Tf  [(Last JM, ed. A Dictionary of Epidemiology. Fourth ed. Oxford: Oxford University Press; 2001.)] TJ ET
BT 26.250 478.410 Td /F1 9.8 Tf  [(7.)] TJ ET
BT 38.132 478.410 Td /F1 9.8 Tf  [(WHO \(2012\) Outbreak surveillance and response in humanitarian emergencies: WHO guidelines for EWARN )] TJ ET
BT 26.250 466.506 Td /F1 9.8 Tf  [(implementation. World Health Organization: Geneva.)] TJ ET
BT 26.250 447.101 Td /F1 9.8 Tf  [(8.)] TJ ET
BT 38.132 447.101 Td /F1 9.8 Tf  [(Culley, JM, Effken, JA \(2010\) �Development and Validation of a Mass Casualty Conceptual Model. Journal of Nursing )] TJ ET
BT 26.250 435.196 Td /F1 9.8 Tf  [(Scholarship, 42\(1\):66�75.)] TJ ET
BT 26.250 415.791 Td /F1 9.8 Tf  [(9.)] TJ ET
BT 38.132 415.791 Td /F1 9.8 Tf  [(De Boer, J \(1999\) Order in chaos: modelling medical management in disasters. Eur J Emerg Med, 6: 141-148.)] TJ ET
BT 26.250 396.387 Td /F1 9.8 Tf  [(10.)] TJ ET
BT 43.553 396.387 Td /F1 9.8 Tf  [(Debacker M, et al \(2012\) Utstein-Style Template for Uniform Data Reporting of Acute Medical Response in Disasters. PLOS )] TJ ET
BT 26.250 384.482 Td /F1 9.8 Tf  [(Currents Disasters. 2012 Mar 23. Edition 1. doi: 10.1371/4f6cf3e8df15a.)] TJ ET
BT 26.250 365.077 Td /F1 9.8 Tf  [(11.)] TJ ET
BT 43.553 365.077 Td /F1 9.8 Tf  [(Lillibridge, SR, Noji, EK, Burkle, FM \(1993\) Disaster assessment: The emergency health evaluation of a population affected )] TJ ET
BT 26.250 353.172 Td /F1 9.8 Tf  [(by a disaster. Ann Emerg Med,22:1715-20.)] TJ ET
BT 26.250 333.768 Td /F1 9.8 Tf  [(12.)] TJ ET
BT 43.553 333.768 Td /F1 9.8 Tf  [(Sundnes, KO \(1999\) Health disaster management: guidelines for evaluation and research in the Utstein style: executive )] TJ ET
BT 26.250 321.863 Td /F1 9.8 Tf  [(summary. Task Force on Quality Control of Disaster Management. Prehosp Disaster Med, 14:43-52.)] TJ ET
BT 26.250 302.458 Td /F1 9.8 Tf  [(13.)] TJ ET
BT 43.553 302.458 Td /F1 9.8 Tf  [(Bayram, JD, Kysia, R, Kirsch, TD \(2012\) Disaster Metrics: A Proposed Quantitative Assessment Tool in Complex )] TJ ET
BT 26.250 290.553 Td /F1 9.8 Tf  [(Humanitarian Emergencies � The Public Health Impact Severity Scale \(PHISS\). PLOS Currents Disasters. 2012 Aug 21. Edition )] TJ ET
BT 26.250 278.649 Td /F1 9.8 Tf  [(1. doi: 10.1371/4f7b4bab0d1a3.)] TJ ET
BT 26.250 259.244 Td /F1 9.8 Tf  [(14.)] TJ ET
BT 43.553 259.244 Td /F1 9.8 Tf  [(WHO \(2012\) Strengthening health-system emergency preparedness: Toolkit for Assessing Health System Capacity for )] TJ ET
BT 26.250 247.339 Td /F1 9.8 Tf  [(Crisis Management. WHO Regional Office for Europe.)] TJ ET
BT 26.250 227.934 Td /F1 9.8 Tf  [(15.)] TJ ET
BT 43.553 227.934 Td /F1 9.8 Tf  [(WHO \(2009\) Inter-Agency Steering Committee Global Health Cluster. Health Cluster Guide: A practical guide for country-)] TJ ET
BT 26.250 216.030 Td /F1 9.8 Tf  [(level implementation of the Health Cluster. World Health Organization: Geneva.)] TJ ET
BT 26.250 196.625 Td /F1 9.8 Tf  [(16.)] TJ ET
BT 43.553 196.625 Td /F1 9.8 Tf  [(John Hopkins and Red Cross \(2008\) Public Health Guide in Emergencies 2nd Edition.)] TJ ET
BT 26.250 177.220 Td /F1 9.8 Tf  [(17.)] TJ ET
BT 43.553 177.220 Td /F1 9.8 Tf  [(Challen, K, Lee, A, Booth, A, Gardois, P, Woods, H, Goodacre, S \(2012\) Where is the evidence for emergency planning: a )] TJ ET
BT 26.250 165.315 Td /F1 9.8 Tf  [(scoping review. BMC Public Health, 12: 542-50.)] TJ ET
BT 26.250 145.911 Td /F1 9.8 Tf  [(18.)] TJ ET
BT 43.553 145.911 Td /F1 9.8 Tf  [(Noji EK. The Public Health Consequences of Disasters. New York: Oxford University Press; 1997.)] TJ ET
BT 26.250 126.506 Td /F1 9.8 Tf  [(19.)] TJ ET
BT 43.553 126.506 Td /F1 9.8 Tf  [(Centre for Excellence in Emergency Preparedness. Risk Assessment Tool for Medical Facilities: Centre for Excellence in )] TJ ET
BT 26.250 114.601 Td /F1 9.8 Tf  [(Emergency Preparedness; 2009.)] TJ ET
BT 26.250 95.196 Td /F1 9.8 Tf  [(20.)] TJ ET
BT 43.553 95.196 Td /F1 9.8 Tf  [(Sider D, Henry B. \(2007\) Public Health Risk Assessment: Centre for Excellence in Emergency Preparedness.)] TJ ET
BT 26.250 75.792 Td /F1 9.8 Tf  [(21.)] TJ ET
BT 43.553 75.792 Td /F1 9.8 Tf  [(Nirupama N. Disaster Risk Management. In: Bobrowski P, ed. Encyclopedia of Natural Hazards. New York: Springer; 2010.)] TJ ET
BT 26.250 56.387 Td /F1 9.8 Tf  [(22.)] TJ ET
BT 43.553 56.387 Td /F1 9.8 Tf  [(Provincial Emergency Program. British Columbia Hazard, Risk and Vulnerability Analysis Toolkit: British Columbia Ministry )] TJ ET
BT 26.250 44.482 Td /F1 9.8 Tf  [(of Public Safety and Solicitor General Provincial Emergency Program; 2010:62.)] TJ ET
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BT 26.250 716.762 Td /F1 9.8 Tf  [(https://www.emdat.be/. Accessed April, 2010.)] TJ ET
BT 26.250 697.357 Td /F1 9.8 Tf  [(25.)] TJ ET
BT 43.553 697.357 Td /F1 9.8 Tf  [(Yang C, Yang J, Luo X, Gong P. Use of mobile phones in an emergency reporting system for infectious disease )] TJ ET
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BT 43.553 666.048 Td /F1 9.8 Tf  [(Knowlton K, Rotkin-Ellman M, King G, et al. The 2006 California heat wave: impacts on hospitalizations and emergency )] TJ ET
BT 26.250 654.143 Td /F1 9.8 Tf  [(department visits. Environ Health Perspect. 2009;117\(1\):61-67.)] TJ ET
BT 26.250 634.738 Td /F1 9.8 Tf  [(27.)] TJ ET
BT 43.553 634.738 Td /F1 9.8 Tf  [(Cookson ST, Soetebier K, Murray EL, et al. Internet-based morbidity and mortality surveillance among Hurricane Katrina )] TJ ET
BT 26.250 622.833 Td /F1 9.8 Tf  [(evacuees in Georgia. Prev Chronic Dis. 2008;5\(4\):A133.)] TJ ET
BT 26.250 603.429 Td /F1 9.8 Tf  [(28.)] TJ ET
BT 43.553 603.429 Td /F1 9.8 Tf  [(Dyer CB, Regev M, Burnett J, Festa N, Cloyd B. SWiFT: a rapid triage tool for vulnerable older adults in disaster situations. )] TJ ET
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BT 26.250 572.119 Td /F1 9.8 Tf  [(29.)] TJ ET
BT 43.553 572.119 Td /F1 9.8 Tf  [(Ghosh TS, Patnaik JL, Vogt RL. Rapid needs assessment among Hurricane Katrina evacuees in metro-Denver. J Health )] TJ ET
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BT 43.553 540.810 Td /F1 9.8 Tf  [(Holt JB, Mokdad AH, Ford ES, Simoes EJ, Mensah GA, Bartoli WP. Use of BRFSS data and GIS technology for rapid public )] TJ ET
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BT 26.250 509.500 Td /F1 9.8 Tf  [(31.)] TJ ET
BT 43.553 509.500 Td /F1 9.8 Tf  [(Jhung MA, Shehab N, Rohr-Allegrini C, et al. Chronic disease and disasters medication demands of Hurricane Katrina )] TJ ET
BT 26.250 497.595 Td /F1 9.8 Tf  [(evacuees. Am J Prev Med. 2007;33\(3\):207-210.)] TJ ET
BT 26.250 478.191 Td /F1 9.8 Tf  [(32.)] TJ ET
BT 43.553 478.191 Td /F1 9.8 Tf  [(Pierce JR, Jr., Pittard AE, West TA, Richardson JM. Medical response to hurricanes Katrina and Rita: local public health )] TJ ET
BT 26.250 466.286 Td /F1 9.8 Tf  [(preparedness in action. J Public Health Manag Pract. 2007;13\(5\):441-446.)] TJ ET
BT 26.250 446.881 Td /F1 9.8 Tf  [(33.)] TJ ET
BT 43.553 446.881 Td /F1 9.8 Tf  [(Ridenour ML, Cummings KJ, Sinclair JR, Bixler D. Displacement of the underserved: medical needs of Hurricane Katrina )] TJ ET
BT 26.250 434.976 Td /F1 9.8 Tf  [(evacuees in West Virginia. J Health Care Poor Underserved. 2007;18\(2\):369-381.)] TJ ET
BT 26.250 415.572 Td /F1 9.8 Tf  [(34.)] TJ ET
BT 43.553 415.572 Td /F1 9.8 Tf  [(Sharma AJ, Weiss EC, Young SL, et al. Chronic disease and related conditions at emergency treatment facilities in the New )] TJ ET
BT 26.250 403.667 Td /F1 9.8 Tf  [(Orleans area after Hurricane Katrina. Disaster Med Public Health Prep. 2008;2\(1\):27-32.)] TJ ET
BT 26.250 384.262 Td /F1 9.8 Tf  [(35.)] TJ ET
BT 43.553 384.262 Td /F1 9.8 Tf  [(Stephens KU, Sr., Grew D, Chin K, et al. Excess mortality in the aftermath of Hurricane Katrina: a preliminary report. )] TJ ET
BT 26.250 372.357 Td /F1 9.8 Tf  [(Disaster Med Public Health Prep. 2007;1\(1\):15-20.)] TJ ET
BT 26.250 352.953 Td /F1 9.8 Tf  [(36.)] TJ ET
BT 43.553 352.953 Td /F1 9.8 Tf  [(Stone G, Lekht A, Burris N, Williams C. Data collection and communications in the public health response to a disaster: )] TJ ET
BT 26.250 341.048 Td /F1 9.8 Tf  [(rapid population estimate surveys and the Daily Dashboard in post-Katrina New Orleans. J Public Health Manag Pract. )] TJ ET
BT 26.250 329.143 Td /F1 9.8 Tf  [(2007;13\(5\):453-460.)] TJ ET
BT 26.250 309.738 Td /F1 9.8 Tf  [(37.)] TJ ET
BT 43.553 309.738 Td /F1 9.8 Tf  [(Taylor MM, Stokes WS, Bajuscak R, et al. Mobilizing mobile medical units for hurricane relief: the United States Public )] TJ ET
BT 26.250 297.834 Td /F1 9.8 Tf  [(Health Service and Broward County Health Department response to hurricane Wilma, Broward County, Florida. J Public Health )] TJ ET
BT 26.250 285.929 Td /F1 9.8 Tf  [(Manag Pract. 2007;15\(5\):447-452.)] TJ ET
BT 26.250 266.524 Td /F1 9.8 Tf  [(38.)] TJ ET
BT 43.553 266.524 Td /F1 9.8 Tf  [(Cretikos MA, Merritt TD, Main K, et al. Mitigating the health impacts of a natural disaster-the June 2007 long-weekend storm )] TJ ET
BT 26.250 254.619 Td /F1 9.8 Tf  [(in the Hunter region of New South Wales. Med J Aust. 2007;187\(11-12\):670-673.)] TJ ET
BT 26.250 235.215 Td /F1 9.8 Tf  [(39.)] TJ ET
BT 43.553 235.215 Td /F1 9.8 Tf  [(Cretikos M, Eastwood K, Dalton C, et al. Household disaster preparedness and information sources: Rapid cluster survey )] TJ ET
BT 26.250 223.310 Td /F1 9.8 Tf  [(after a storm in New South Wales, Australia. BMC Public Health. 2008;8\(195\).)] TJ ET
BT 26.250 203.905 Td /F1 9.8 Tf  [(40.)] TJ ET
BT 43.553 203.905 Td /F1 9.8 Tf  [(Hope K, Merritt T, Eastwood K, et al. The public health value of emergency department syndromic surveillance following a )] TJ ET
BT 26.250 192.000 Td /F1 9.8 Tf  [(natural disaster. Commun Dis Intell. 2008;32\(1\):92-94.)] TJ ET
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BT 26.250 141.286 Td /F1 9.8 Tf  [(42.)] TJ ET
BT 43.553 141.286 Td /F1 9.8 Tf  [(Englande AJ, Jr. Katrina and the Thai Tsunami - water quality and public health aspects mitigation and research needs. Int )] TJ ET
BT 26.250 129.381 Td /F1 9.8 Tf  [(J Environ Res Public Health. 2008;5\(5\):384-393.)] TJ ET
BT 26.250 109.977 Td /F1 9.8 Tf  [(43.)] TJ ET
BT 43.553 109.977 Td /F1 9.8 Tf  [(Ablah E, Tinius AM, Konda K, Synovitz C, Subbarao I. Regional Health System Response to the 2007 Greensburg, Kansas, )] TJ ET
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BT 43.553 78.667 Td /F1 9.8 Tf  [(CDC. Carbon monoxide exposures after hurricane Ike - Texas, September 2008. MMWR Morb Mortal Wkly Rep. )] TJ ET
BT 26.250 66.762 Td /F1 9.8 Tf  [(2009;58\(31\):845-849.)] TJ ET
BT 26.250 47.358 Td /F1 9.8 Tf  [(45.)] TJ ET
BT 43.553 47.358 Td /F1 9.8 Tf  [(CDC. Monitoring health effects of wildfires using the biosense system--San Diego County, California, October 2007. MMWR )] TJ ET
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BT 26.250 716.762 Td /F1 9.8 Tf  [(https://www.emdat.be/. Accessed April, 2010.)] TJ ET
BT 26.250 697.357 Td /F1 9.8 Tf  [(25.)] TJ ET
BT 43.553 697.357 Td /F1 9.8 Tf  [(Yang C, Yang J, Luo X, Gong P. Use of mobile phones in an emergency reporting system for infectious disease )] TJ ET
BT 26.250 685.452 Td /F1 9.8 Tf  [(surveillance after the Sichuan earthquake in China. Bull World Health Organ. 2009;87\(8\):619-623.)] TJ ET
BT 26.250 666.048 Td /F1 9.8 Tf  [(26.)] TJ ET
BT 43.553 666.048 Td /F1 9.8 Tf  [(Knowlton K, Rotkin-Ellman M, King G, et al. The 2006 California heat wave: impacts on hospitalizations and emergency )] TJ ET
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BT 43.553 634.738 Td /F1 9.8 Tf  [(Cookson ST, Soetebier K, Murray EL, et al. Internet-based morbidity and mortality surveillance among Hurricane Katrina )] TJ ET
BT 26.250 622.833 Td /F1 9.8 Tf  [(evacuees in Georgia. Prev Chronic Dis. 2008;5\(4\):A133.)] TJ ET
BT 26.250 603.429 Td /F1 9.8 Tf  [(28.)] TJ ET
BT 43.553 603.429 Td /F1 9.8 Tf  [(Dyer CB, Regev M, Burnett J, Festa N, Cloyd B. SWiFT: a rapid triage tool for vulnerable older adults in disaster situations. )] TJ ET
BT 26.250 591.524 Td /F1 9.8 Tf  [(Disaster Med Public Health Prep. 2008;2\(Suppl 1\):S45-50.)] TJ ET
BT 26.250 572.119 Td /F1 9.8 Tf  [(29.)] TJ ET
BT 43.553 572.119 Td /F1 9.8 Tf  [(Ghosh TS, Patnaik JL, Vogt RL. Rapid needs assessment among Hurricane Katrina evacuees in metro-Denver. J Health )] TJ ET
BT 26.250 560.214 Td /F1 9.8 Tf  [(Care Poor Underserved. 2007;18\(2\):362-368.)] TJ ET
BT 26.250 540.810 Td /F1 9.8 Tf  [(30.)] TJ ET
BT 43.553 540.810 Td /F1 9.8 Tf  [(Holt JB, Mokdad AH, Ford ES, Simoes EJ, Mensah GA, Bartoli WP. Use of BRFSS data and GIS technology for rapid public )] TJ ET
BT 26.250 528.905 Td /F1 9.8 Tf  [(health response during natural disasters. Prev Chronic Dis. 2008;5\(3\):A97.)] TJ ET
BT 26.250 509.500 Td /F1 9.8 Tf  [(31.)] TJ ET
BT 43.553 509.500 Td /F1 9.8 Tf  [(Jhung MA, Shehab N, Rohr-Allegrini C, et al. Chronic disease and disasters medication demands of Hurricane Katrina )] TJ ET
BT 26.250 497.595 Td /F1 9.8 Tf  [(evacuees. Am J Prev Med. 2007;33\(3\):207-210.)] TJ ET
BT 26.250 478.191 Td /F1 9.8 Tf  [(32.)] TJ ET
BT 43.553 478.191 Td /F1 9.8 Tf  [(Pierce JR, Jr., Pittard AE, West TA, Richardson JM. Medical response to hurricanes Katrina and Rita: local public health )] TJ ET
BT 26.250 466.286 Td /F1 9.8 Tf  [(preparedness in action. J Public Health Manag Pract. 2007;13\(5\):441-446.)] TJ ET
BT 26.250 446.881 Td /F1 9.8 Tf  [(33.)] TJ ET
BT 43.553 446.881 Td /F1 9.8 Tf  [(Ridenour ML, Cummings KJ, Sinclair JR, Bixler D. Displacement of the underserved: medical needs of Hurricane Katrina )] TJ ET
BT 26.250 434.976 Td /F1 9.8 Tf  [(evacuees in West Virginia. J Health Care Poor Underserved. 2007;18\(2\):369-381.)] TJ ET
BT 26.250 415.572 Td /F1 9.8 Tf  [(34.)] TJ ET
BT 43.553 415.572 Td /F1 9.8 Tf  [(Sharma AJ, Weiss EC, Young SL, et al. Chronic disease and related conditions at emergency treatment facilities in the New )] TJ ET
BT 26.250 403.667 Td /F1 9.8 Tf  [(Orleans area after Hurricane Katrina. Disaster Med Public Health Prep. 2008;2\(1\):27-32.)] TJ ET
BT 26.250 384.262 Td /F1 9.8 Tf  [(35.)] TJ ET
BT 43.553 384.262 Td /F1 9.8 Tf  [(Stephens KU, Sr., Grew D, Chin K, et al. Excess mortality in the aftermath of Hurricane Katrina: a preliminary report. )] TJ ET
BT 26.250 372.357 Td /F1 9.8 Tf  [(Disaster Med Public Health Prep. 2007;1\(1\):15-20.)] TJ ET
BT 26.250 352.953 Td /F1 9.8 Tf  [(36.)] TJ ET
BT 43.553 352.953 Td /F1 9.8 Tf  [(Stone G, Lekht A, Burris N, Williams C. Data collection and communications in the public health response to a disaster: )] TJ ET
BT 26.250 341.048 Td /F1 9.8 Tf  [(rapid population estimate surveys and the Daily Dashboard in post-Katrina New Orleans. J Public Health Manag Pract. )] TJ ET
BT 26.250 329.143 Td /F1 9.8 Tf  [(2007;13\(5\):453-460.)] TJ ET
BT 26.250 309.738 Td /F1 9.8 Tf  [(37.)] TJ ET
BT 43.553 309.738 Td /F1 9.8 Tf  [(Taylor MM, Stokes WS, Bajuscak R, et al. Mobilizing mobile medical units for hurricane relief: the United States Public )] TJ ET
BT 26.250 297.834 Td /F1 9.8 Tf  [(Health Service and Broward County Health Department response to hurricane Wilma, Broward County, Florida. J Public Health )] TJ ET
BT 26.250 285.929 Td /F1 9.8 Tf  [(Manag Pract. 2007;15\(5\):447-452.)] TJ ET
BT 26.250 266.524 Td /F1 9.8 Tf  [(38.)] TJ ET
BT 43.553 266.524 Td /F1 9.8 Tf  [(Cretikos MA, Merritt TD, Main K, et al. Mitigating the health impacts of a natural disaster-the June 2007 long-weekend storm )] TJ ET
BT 26.250 254.619 Td /F1 9.8 Tf  [(in the Hunter region of New South Wales. Med J Aust. 2007;187\(11-12\):670-673.)] TJ ET
BT 26.250 235.215 Td /F1 9.8 Tf  [(39.)] TJ ET
BT 43.553 235.215 Td /F1 9.8 Tf  [(Cretikos M, Eastwood K, Dalton C, et al. Household disaster preparedness and information sources: Rapid cluster survey )] TJ ET
BT 26.250 223.310 Td /F1 9.8 Tf  [(after a storm in New South Wales, Australia. BMC Public Health. 2008;8\(195\).)] TJ ET
BT 26.250 203.905 Td /F1 9.8 Tf  [(40.)] TJ ET
BT 43.553 203.905 Td /F1 9.8 Tf  [(Hope K, Merritt T, Eastwood K, et al. The public health value of emergency department syndromic surveillance following a )] TJ ET
BT 26.250 192.000 Td /F1 9.8 Tf  [(natural disaster. Commun Dis Intell. 2008;32\(1\):92-94.)] TJ ET
BT 26.250 172.596 Td /F1 9.8 Tf  [(41.)] TJ ET
BT 43.553 172.596 Td /F1 9.8 Tf  [(Schnitzler J, Benzler J, Altmann D, Mucke I, Krause G. Survey on the population's needs and the public health response )] TJ ET
BT 26.250 160.691 Td /F1 9.8 Tf  [(during floods in Germany 2002. J Public Health Manag Pract. 2007;13\(5\):461-464.)] TJ ET
BT 26.250 141.286 Td /F1 9.8 Tf  [(42.)] TJ ET
BT 43.553 141.286 Td /F1 9.8 Tf  [(Englande AJ, Jr. Katrina and the Thai Tsunami - water quality and public health aspects mitigation and research needs. Int )] TJ ET
BT 26.250 129.381 Td /F1 9.8 Tf  [(J Environ Res Public Health. 2008;5\(5\):384-393.)] TJ ET
BT 26.250 109.977 Td /F1 9.8 Tf  [(43.)] TJ ET
BT 43.553 109.977 Td /F1 9.8 Tf  [(Ablah E, Tinius AM, Konda K, Synovitz C, Subbarao I. Regional Health System Response to the 2007 Greensburg, Kansas, )] TJ ET
BT 26.250 98.072 Td /F1 9.8 Tf  [(EF5 Tornado. Disaster Med Public Health Prep. 2007;1\(2\):90-95.)] TJ ET
BT 26.250 78.667 Td /F1 9.8 Tf  [(44.)] TJ ET
BT 43.553 78.667 Td /F1 9.8 Tf  [(CDC. Carbon monoxide exposures after hurricane Ike - Texas, September 2008. MMWR Morb Mortal Wkly Rep. )] TJ ET
BT 26.250 66.762 Td /F1 9.8 Tf  [(2009;58\(31\):845-849.)] TJ ET
BT 26.250 47.358 Td /F1 9.8 Tf  [(45.)] TJ ET
BT 43.553 47.358 Td /F1 9.8 Tf  [(CDC. Monitoring health effects of wildfires using the biosense system--San Diego County, California, October 2007. MMWR )] TJ ET
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15.000 33.072 577.500 743.928 re W n
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BT 26.250 759.976 Td /F1 9.8 Tf  [(23.)] TJ ET
BT 43.553 759.976 Td /F1 9.8 Tf  [(Public Safety Canada. Canadian Disaster Database. 2010; https://www.publicsafety.gc.ca/prg/em/cdd/srch-eng.aspx )] TJ ET
BT 26.250 748.071 Td /F1 9.8 Tf  [(Accessed October 21, 2010.)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(24.)] TJ ET
BT 43.553 728.667 Td /F1 9.8 Tf  [(Centre for Research on the Epidemiology of Disasters. The International Disaster Database: EM-DAT. 2010; )] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(https://www.emdat.be/. Accessed April, 2010.)] TJ ET
BT 26.250 697.357 Td /F1 9.8 Tf  [(25.)] TJ ET
BT 43.553 697.357 Td /F1 9.8 Tf  [(Yang C, Yang J, Luo X, Gong P. Use of mobile phones in an emergency reporting system for infectious disease )] TJ ET
BT 26.250 685.452 Td /F1 9.8 Tf  [(surveillance after the Sichuan earthquake in China. Bull World Health Organ. 2009;87\(8\):619-623.)] TJ ET
BT 26.250 666.048 Td /F1 9.8 Tf  [(26.)] TJ ET
BT 43.553 666.048 Td /F1 9.8 Tf  [(Knowlton K, Rotkin-Ellman M, King G, et al. The 2006 California heat wave: impacts on hospitalizations and emergency )] TJ ET
BT 26.250 654.143 Td /F1 9.8 Tf  [(department visits. Environ Health Perspect. 2009;117\(1\):61-67.)] TJ ET
BT 26.250 634.738 Td /F1 9.8 Tf  [(27.)] TJ ET
BT 43.553 634.738 Td /F1 9.8 Tf  [(Cookson ST, Soetebier K, Murray EL, et al. Internet-based morbidity and mortality surveillance among Hurricane Katrina )] TJ ET
BT 26.250 622.833 Td /F1 9.8 Tf  [(evacuees in Georgia. Prev Chronic Dis. 2008;5\(4\):A133.)] TJ ET
BT 26.250 603.429 Td /F1 9.8 Tf  [(28.)] TJ ET
BT 43.553 603.429 Td /F1 9.8 Tf  [(Dyer CB, Regev M, Burnett J, Festa N, Cloyd B. SWiFT: a rapid triage tool for vulnerable older adults in disaster situations. )] TJ ET
BT 26.250 591.524 Td /F1 9.8 Tf  [(Disaster Med Public Health Prep. 2008;2\(Suppl 1\):S45-50.)] TJ ET
BT 26.250 572.119 Td /F1 9.8 Tf  [(29.)] TJ ET
BT 43.553 572.119 Td /F1 9.8 Tf  [(Ghosh TS, Patnaik JL, Vogt RL. Rapid needs assessment among Hurricane Katrina evacuees in metro-Denver. J Health )] TJ ET
BT 26.250 560.214 Td /F1 9.8 Tf  [(Care Poor Underserved. 2007;18\(2\):362-368.)] TJ ET
BT 26.250 540.810 Td /F1 9.8 Tf  [(30.)] TJ ET
BT 43.553 540.810 Td /F1 9.8 Tf  [(Holt JB, Mokdad AH, Ford ES, Simoes EJ, Mensah GA, Bartoli WP. Use of BRFSS data and GIS technology for rapid public )] TJ ET
BT 26.250 528.905 Td /F1 9.8 Tf  [(health response during natural disasters. Prev Chronic Dis. 2008;5\(3\):A97.)] TJ ET
BT 26.250 509.500 Td /F1 9.8 Tf  [(31.)] TJ ET
BT 43.553 509.500 Td /F1 9.8 Tf  [(Jhung MA, Shehab N, Rohr-Allegrini C, et al. Chronic disease and disasters medication demands of Hurricane Katrina )] TJ ET
BT 26.250 497.595 Td /F1 9.8 Tf  [(evacuees. Am J Prev Med. 2007;33\(3\):207-210.)] TJ ET
BT 26.250 478.191 Td /F1 9.8 Tf  [(32.)] TJ ET
BT 43.553 478.191 Td /F1 9.8 Tf  [(Pierce JR, Jr., Pittard AE, West TA, Richardson JM. Medical response to hurricanes Katrina and Rita: local public health )] TJ ET
BT 26.250 466.286 Td /F1 9.8 Tf  [(preparedness in action. J Public Health Manag Pract. 2007;13\(5\):441-446.)] TJ ET
BT 26.250 446.881 Td /F1 9.8 Tf  [(33.)] TJ ET
BT 43.553 446.881 Td /F1 9.8 Tf  [(Ridenour ML, Cummings KJ, Sinclair JR, Bixler D. Displacement of the underserved: medical needs of Hurricane Katrina )] TJ ET
BT 26.250 434.976 Td /F1 9.8 Tf  [(evacuees in West Virginia. J Health Care Poor Underserved. 2007;18\(2\):369-381.)] TJ ET
BT 26.250 415.572 Td /F1 9.8 Tf  [(34.)] TJ ET
BT 43.553 415.572 Td /F1 9.8 Tf  [(Sharma AJ, Weiss EC, Young SL, et al. Chronic disease and related conditions at emergency treatment facilities in the New )] TJ ET
BT 26.250 403.667 Td /F1 9.8 Tf  [(Orleans area after Hurricane Katrina. Disaster Med Public Health Prep. 2008;2\(1\):27-32.)] TJ ET
BT 26.250 384.262 Td /F1 9.8 Tf  [(35.)] TJ ET
BT 43.553 384.262 Td /F1 9.8 Tf  [(Stephens KU, Sr., Grew D, Chin K, et al. Excess mortality in the aftermath of Hurricane Katrina: a preliminary report. )] TJ ET
BT 26.250 372.357 Td /F1 9.8 Tf  [(Disaster Med Public Health Prep. 2007;1\(1\):15-20.)] TJ ET
BT 26.250 352.953 Td /F1 9.8 Tf  [(36.)] TJ ET
BT 43.553 352.953 Td /F1 9.8 Tf  [(Stone G, Lekht A, Burris N, Williams C. Data collection and communications in the public health response to a disaster: )] TJ ET
BT 26.250 341.048 Td /F1 9.8 Tf  [(rapid population estimate surveys and the Daily Dashboard in post-Katrina New Orleans. J Public Health Manag Pract. )] TJ ET
BT 26.250 329.143 Td /F1 9.8 Tf  [(2007;13\(5\):453-460.)] TJ ET
BT 26.250 309.738 Td /F1 9.8 Tf  [(37.)] TJ ET
BT 43.553 309.738 Td /F1 9.8 Tf  [(Taylor MM, Stokes WS, Bajuscak R, et al. Mobilizing mobile medical units for hurricane relief: the United States Public )] TJ ET
BT 26.250 297.834 Td /F1 9.8 Tf  [(Health Service and Broward County Health Department response to hurricane Wilma, Broward County, Florida. J Public Health )] TJ ET
BT 26.250 285.929 Td /F1 9.8 Tf  [(Manag Pract. 2007;15\(5\):447-452.)] TJ ET
BT 26.250 266.524 Td /F1 9.8 Tf  [(38.)] TJ ET
BT 43.553 266.524 Td /F1 9.8 Tf  [(Cretikos MA, Merritt TD, Main K, et al. Mitigating the health impacts of a natural disaster-the June 2007 long-weekend storm )] TJ ET
BT 26.250 254.619 Td /F1 9.8 Tf  [(in the Hunter region of New South Wales. Med J Aust. 2007;187\(11-12\):670-673.)] TJ ET
BT 26.250 235.215 Td /F1 9.8 Tf  [(39.)] TJ ET
BT 43.553 235.215 Td /F1 9.8 Tf  [(Cretikos M, Eastwood K, Dalton C, et al. Household disaster preparedness and information sources: Rapid cluster survey )] TJ ET
BT 26.250 223.310 Td /F1 9.8 Tf  [(after a storm in New South Wales, Australia. BMC Public Health. 2008;8\(195\).)] TJ ET
BT 26.250 203.905 Td /F1 9.8 Tf  [(40.)] TJ ET
BT 43.553 203.905 Td /F1 9.8 Tf  [(Hope K, Merritt T, Eastwood K, et al. The public health value of emergency department syndromic surveillance following a )] TJ ET
BT 26.250 192.000 Td /F1 9.8 Tf  [(natural disaster. Commun Dis Intell. 2008;32\(1\):92-94.)] TJ ET
BT 26.250 172.596 Td /F1 9.8 Tf  [(41.)] TJ ET
BT 43.553 172.596 Td /F1 9.8 Tf  [(Schnitzler J, Benzler J, Altmann D, Mucke I, Krause G. Survey on the population's needs and the public health response )] TJ ET
BT 26.250 160.691 Td /F1 9.8 Tf  [(during floods in Germany 2002. J Public Health Manag Pract. 2007;13\(5\):461-464.)] TJ ET
BT 26.250 141.286 Td /F1 9.8 Tf  [(42.)] TJ ET
BT 43.553 141.286 Td /F1 9.8 Tf  [(Englande AJ, Jr. Katrina and the Thai Tsunami - water quality and public health aspects mitigation and research needs. Int )] TJ ET
BT 26.250 129.381 Td /F1 9.8 Tf  [(J Environ Res Public Health. 2008;5\(5\):384-393.)] TJ ET
BT 26.250 109.977 Td /F1 9.8 Tf  [(43.)] TJ ET
BT 43.553 109.977 Td /F1 9.8 Tf  [(Ablah E, Tinius AM, Konda K, Synovitz C, Subbarao I. Regional Health System Response to the 2007 Greensburg, Kansas, )] TJ ET
BT 26.250 98.072 Td /F1 9.8 Tf  [(EF5 Tornado. Disaster Med Public Health Prep. 2007;1\(2\):90-95.)] TJ ET
BT 26.250 78.667 Td /F1 9.8 Tf  [(44.)] TJ ET
BT 43.553 78.667 Td /F1 9.8 Tf  [(CDC. Carbon monoxide exposures after hurricane Ike - Texas, September 2008. MMWR Morb Mortal Wkly Rep. )] TJ ET
BT 26.250 66.762 Td /F1 9.8 Tf  [(2009;58\(31\):845-849.)] TJ ET
BT 26.250 47.358 Td /F1 9.8 Tf  [(45.)] TJ ET
BT 43.553 47.358 Td /F1 9.8 Tf  [(CDC. Monitoring health effects of wildfires using the biosense system--San Diego County, California, October 2007. MMWR )] TJ ET
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0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(9)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET

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BT 26.250 748.071 Td /F1 9.8 Tf  [(46.)] TJ ET
BT 43.553 748.071 Td /F1 9.8 Tf  [(Akbari ME, Farshad AA, Asadi-Lari M. The devastation of Bam: an overview of health issues 1 month after the earthquake. )] TJ ET
BT 26.250 736.167 Td /F1 9.8 Tf  [(Public Health. 2004;118\(6\):403-408.)] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(47.)] TJ ET
BT 43.553 716.762 Td /F1 9.8 Tf  [(Carr SJ, Leahy SM, London S, Sidhu S, Vogt J. The public health response to Los Angeles' 1994 earthquake. Am J Public )] TJ ET
BT 26.250 704.857 Td /F1 9.8 Tf  [(Health. 1996;86\(4\):589-590.)] TJ ET
BT 26.250 685.452 Td /F1 9.8 Tf  [(48.)] TJ ET
BT 43.553 685.452 Td /F1 9.8 Tf  [(Chen KT, Chen WJ, Malilay J, Twu SJ. The public health response to the Chi-Chi earthquake in Taiwan, 1999. Public )] TJ ET
BT 26.250 673.548 Td /F1 9.8 Tf  [(Health Rep. 2003;118\(6\):493-499.)] TJ ET
BT 26.250 654.143 Td /F1 9.8 Tf  [(49.)] TJ ET
BT 43.553 654.143 Td /F1 9.8 Tf  [(Daley WR, Karpati A, Sheik M. Needs assessment of the displaced population following the August 1999 earthquake in )] TJ ET
BT 26.250 642.238 Td /F1 9.8 Tf  [(Turkey. Disasters. 2001;25\(1\):67-75.)] TJ ET
BT 26.250 622.833 Td /F1 9.8 Tf  [(50.)] TJ ET
BT 43.553 622.833 Td /F1 9.8 Tf  [(De Bruycker M, Greco D, Lechat MF, Annino I, De Ruggiero N, Triassi M. The 1980 earthquake in Southern Italy--morbidity )] TJ ET
BT 26.250 610.929 Td /F1 9.8 Tf  [(and mortality.[Erratum appears in Int J Epidemiol 1985 Dec;14\(4\):504]. Int J Epidemiol. 1985;14\(1\):113-117.)] TJ ET
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BT 43.553 591.524 Td /F1 9.8 Tf  [(Helminen M, Saarela E, Salmela J. Characterisation of patients treated at the Red Cross field hospital in Kashmir during the )] TJ ET
BT 26.250 579.619 Td /F1 9.8 Tf  [(first three weeks of operation. Emerg Med J. 2006;23\(8\):654-656.)] TJ ET
BT 26.250 560.214 Td /F1 9.8 Tf  [(52.)] TJ ET
BT 43.553 560.214 Td /F1 9.8 Tf  [(Pawar AT, Shelke S, Kakrani VA. Rapid assessment survey of earthquake affected Bhuj block of Kachchh District, Gujarat, )] TJ ET
BT 26.250 548.310 Td /F1 9.8 Tf  [(India. Indian J Med Sci. 2005;59\(11\):488-494.)] TJ ET
BT 26.250 528.905 Td /F1 9.8 Tf  [(53.)] TJ ET
BT 43.553 528.905 Td /F1 9.8 Tf  [(Roces MC, White ME, Dayrit MM, Durkin ME. Risk factors for injuries due to the 1990 earthquake in Luzon, Philippines. Bull )] TJ ET
BT 26.250 517.000 Td /F1 9.8 Tf  [(World Health Organ. 1992;70\(4\):509-514.)] TJ ET
BT 26.250 497.595 Td /F1 9.8 Tf  [(54.)] TJ ET
BT 43.553 497.595 Td /F1 9.8 Tf  [(Yang, C; Yang, J; Luo, X; Gong, P. Use of mobile phones in an emergency reporting system for infectious disease )] TJ ET
BT 26.250 485.691 Td /F1 9.8 Tf  [(surveillance after the Sichuan earthquake in China. Bull World Health Organ. 2009. 87:619-23.)] TJ ET
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BT 26.250 748.071 Td /F1 9.8 Tf  [(46.)] TJ ET
BT 43.553 748.071 Td /F1 9.8 Tf  [(Akbari ME, Farshad AA, Asadi-Lari M. The devastation of Bam: an overview of health issues 1 month after the earthquake. )] TJ ET
BT 26.250 736.167 Td /F1 9.8 Tf  [(Public Health. 2004;118\(6\):403-408.)] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(47.)] TJ ET
BT 43.553 716.762 Td /F1 9.8 Tf  [(Carr SJ, Leahy SM, London S, Sidhu S, Vogt J. The public health response to Los Angeles' 1994 earthquake. Am J Public )] TJ ET
BT 26.250 704.857 Td /F1 9.8 Tf  [(Health. 1996;86\(4\):589-590.)] TJ ET
BT 26.250 685.452 Td /F1 9.8 Tf  [(48.)] TJ ET
BT 43.553 685.452 Td /F1 9.8 Tf  [(Chen KT, Chen WJ, Malilay J, Twu SJ. The public health response to the Chi-Chi earthquake in Taiwan, 1999. Public )] TJ ET
BT 26.250 673.548 Td /F1 9.8 Tf  [(Health Rep. 2003;118\(6\):493-499.)] TJ ET
BT 26.250 654.143 Td /F1 9.8 Tf  [(49.)] TJ ET
BT 43.553 654.143 Td /F1 9.8 Tf  [(Daley WR, Karpati A, Sheik M. Needs assessment of the displaced population following the August 1999 earthquake in )] TJ ET
BT 26.250 642.238 Td /F1 9.8 Tf  [(Turkey. Disasters. 2001;25\(1\):67-75.)] TJ ET
BT 26.250 622.833 Td /F1 9.8 Tf  [(50.)] TJ ET
BT 43.553 622.833 Td /F1 9.8 Tf  [(De Bruycker M, Greco D, Lechat MF, Annino I, De Ruggiero N, Triassi M. The 1980 earthquake in Southern Italy--morbidity )] TJ ET
BT 26.250 610.929 Td /F1 9.8 Tf  [(and mortality.[Erratum appears in Int J Epidemiol 1985 Dec;14\(4\):504]. Int J Epidemiol. 1985;14\(1\):113-117.)] TJ ET
BT 26.250 591.524 Td /F1 9.8 Tf  [(51.)] TJ ET
BT 43.553 591.524 Td /F1 9.8 Tf  [(Helminen M, Saarela E, Salmela J. Characterisation of patients treated at the Red Cross field hospital in Kashmir during the )] TJ ET
BT 26.250 579.619 Td /F1 9.8 Tf  [(first three weeks of operation. Emerg Med J. 2006;23\(8\):654-656.)] TJ ET
BT 26.250 560.214 Td /F1 9.8 Tf  [(52.)] TJ ET
BT 43.553 560.214 Td /F1 9.8 Tf  [(Pawar AT, Shelke S, Kakrani VA. Rapid assessment survey of earthquake affected Bhuj block of Kachchh District, Gujarat, )] TJ ET
BT 26.250 548.310 Td /F1 9.8 Tf  [(India. Indian J Med Sci. 2005;59\(11\):488-494.)] TJ ET
BT 26.250 528.905 Td /F1 9.8 Tf  [(53.)] TJ ET
BT 43.553 528.905 Td /F1 9.8 Tf  [(Roces MC, White ME, Dayrit MM, Durkin ME. Risk factors for injuries due to the 1990 earthquake in Luzon, Philippines. Bull )] TJ ET
BT 26.250 517.000 Td /F1 9.8 Tf  [(World Health Organ. 1992;70\(4\):509-514.)] TJ ET
BT 26.250 497.595 Td /F1 9.8 Tf  [(54.)] TJ ET
BT 43.553 497.595 Td /F1 9.8 Tf  [(Yang, C; Yang, J; Luo, X; Gong, P. Use of mobile phones in an emergency reporting system for infectious disease )] TJ ET
BT 26.250 485.691 Td /F1 9.8 Tf  [(surveillance after the Sichuan earthquake in China. Bull World Health Organ. 2009. 87:619-23.)] TJ ET
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BT 43.553 748.071 Td /F1 9.8 Tf  [(Akbari ME, Farshad AA, Asadi-Lari M. The devastation of Bam: an overview of health issues 1 month after the earthquake. )] TJ ET
BT 26.250 736.167 Td /F1 9.8 Tf  [(Public Health. 2004;118\(6\):403-408.)] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(47.)] TJ ET
BT 43.553 716.762 Td /F1 9.8 Tf  [(Carr SJ, Leahy SM, London S, Sidhu S, Vogt J. The public health response to Los Angeles' 1994 earthquake. Am J Public )] TJ ET
BT 26.250 704.857 Td /F1 9.8 Tf  [(Health. 1996;86\(4\):589-590.)] TJ ET
BT 26.250 685.452 Td /F1 9.8 Tf  [(48.)] TJ ET
BT 43.553 685.452 Td /F1 9.8 Tf  [(Chen KT, Chen WJ, Malilay J, Twu SJ. The public health response to the Chi-Chi earthquake in Taiwan, 1999. Public )] TJ ET
BT 26.250 673.548 Td /F1 9.8 Tf  [(Health Rep. 2003;118\(6\):493-499.)] TJ ET
BT 26.250 654.143 Td /F1 9.8 Tf  [(49.)] TJ ET
BT 43.553 654.143 Td /F1 9.8 Tf  [(Daley WR, Karpati A, Sheik M. Needs assessment of the displaced population following the August 1999 earthquake in )] TJ ET
BT 26.250 642.238 Td /F1 9.8 Tf  [(Turkey. Disasters. 2001;25\(1\):67-75.)] TJ ET
BT 26.250 622.833 Td /F1 9.8 Tf  [(50.)] TJ ET
BT 43.553 622.833 Td /F1 9.8 Tf  [(De Bruycker M, Greco D, Lechat MF, Annino I, De Ruggiero N, Triassi M. The 1980 earthquake in Southern Italy--morbidity )] TJ ET
BT 26.250 610.929 Td /F1 9.8 Tf  [(and mortality.[Erratum appears in Int J Epidemiol 1985 Dec;14\(4\):504]. Int J Epidemiol. 1985;14\(1\):113-117.)] TJ ET
BT 26.250 591.524 Td /F1 9.8 Tf  [(51.)] TJ ET
BT 43.553 591.524 Td /F1 9.8 Tf  [(Helminen M, Saarela E, Salmela J. Characterisation of patients treated at the Red Cross field hospital in Kashmir during the )] TJ ET
BT 26.250 579.619 Td /F1 9.8 Tf  [(first three weeks of operation. Emerg Med J. 2006;23\(8\):654-656.)] TJ ET
BT 26.250 560.214 Td /F1 9.8 Tf  [(52.)] TJ ET
BT 43.553 560.214 Td /F1 9.8 Tf  [(Pawar AT, Shelke S, Kakrani VA. Rapid assessment survey of earthquake affected Bhuj block of Kachchh District, Gujarat, )] TJ ET
BT 26.250 548.310 Td /F1 9.8 Tf  [(India. Indian J Med Sci. 2005;59\(11\):488-494.)] TJ ET
BT 26.250 528.905 Td /F1 9.8 Tf  [(53.)] TJ ET
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BT 26.250 497.595 Td /F1 9.8 Tf  [(54.)] TJ ET
BT 43.553 497.595 Td /F1 9.8 Tf  [(Yang, C; Yang, J; Luo, X; Gong, P. Use of mobile phones in an emergency reporting system for infectious disease )] TJ ET
BT 26.250 485.691 Td /F1 9.8 Tf  [(surveillance after the Sichuan earthquake in China. Bull World Health Organ. 2009. 87:619-23.)] TJ ET
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