Pt: 1 Road to Resilience Research Summit: Disaster to Social and Environmental Resilience

Pt: 1 Road to Resilience Research Summit: Disaster to Social and Environmental Resilience


– Good morning everybody,
if I could have you all take a seat, we’re on
a, we have a great list of speakers today. We’re on a pretty tight schedule, so I wanna try to get
this thing kicked off. Well, it’s a terrific turnout. Thank you all for being here this morning. Good morning. I’m Mark McIntosh, I’m the Vice President for Research and Economic Development for the UM system and Vice Chancellor for Research and Economic Development here on the Columbia
campus and it’s my pleasure to welcome you to this,
our latest installment of the University of
Missouri Research Summits that we tie every opportunity we get to an upcoming Board of Curators meeting. This month we’re featuring
faculty who will discuss, as you can, well you can’t see it now. There was a title up there. Road to Resilience, Disaster to Social and Environmental Resilience and I want to express my
gratitude to all the faculty who have shown up here
today to give us a glimpse of their research in this particular area and especially I wanna thank Sheila Grant and the staff, Jeff Sossamon
and the rest of the staff that put this program together and they have done a terrific job. So the research summits
as you probably know were established last
year as quarterly summits to have faculty give TED
Talk types of presentations, five-minute overviews
and glimpses of research. And the real goal of this is
to get our faculty together and so that they can see that there is a significant
breadth of research expertise around the University of Missouri system that we wanna try to bring
together and coordinate and have faculty learn about each other and look for opportunities to collaborate. And this is a project, like I said, that got started last year and we already can see the benefits of faculty
beginning to work together to put in cross-disciplinary
types of research projects for state and federal funding. This particular research
theme, The Road to Resilience, turns out to be very timely
at this point in time. If you look at the situation that we’re in here in the Midwest, heavy
snow melt, frequent spring and summer rains, and
very destructive storms. They’ve created very
challenging conditions for the people, for the
animals, and for the crops around Missouri and
the Midwest as a whole. Many of our citizens across
the state will continue to be affected for some time by this current set of conditions due to ongoing river flooding and devastating infrastructure damage. So the Universities here
and in the UM system now have an opportunity to
dedicate their expertise to providing support for
those citizens affected by these disasters through
your research expertise, through your engagement
and extension programs and through offices throughout the state to bring this expertise to the citizens. Collaboration within a community like this and collaboration with our
community organizations really will underpin our
ability to bring benefit to the state as a whole. So the talks today will
center around disaster, social and environmental resilience. Experts will present a snapshot
of their latest findings. The purpose of which, as I
said, is to allow the system to create opportunities to collaborate and bring our expertise
to bear on the problems that our citizens face. I’d also like to welcome
representatives from The Emergency Management Team
for the city of Columbia, delegates from FEMA, members
of the Missouri Department of Commerce, Missouri
SEMA representatives, and representatives from
the Missouri Department of Mental Health. Welcome to the University. We really appreciate you being here. We hope that you come
away from this event today with a look at the
research expertise around the University of Missouri
system that might be useful to you in your everyday jobs
in dealing with the problems that you’re dealing with right now. Finally, throughout the
day, we will provide times for questions and answers as well as networking opportunities. In these summits, we emphasize
the power of connection. Bringing faculty and
community members together to stimulate discussion
and develop relationships that lead to problem-solving
opportunities. I encourage you to
introduce yourselves around to all of your colleagues
here as we continue to build collaborations that are vital to continuing these outreach efforts. Our professional development teams have also collected a significant catalog of funding opportunities that
we will share with you all. And these are opportunities that we hope that you will take advantage
of and so thank you to our research grant writers
and development network for putting together some
very important information. Again, welcome to today’s summit. We know that you will find these Silent. So, I’m cut off. I hope you can still hear me. So it’s time to get the program started. Let me introduce to you, Sheila Grant. Sheila is the Associate
Vice Chancellor for Research and Strategic Initiatives
here at the UM campus and, as I said, she and
her team have put together this program for you today, so Sheila. (audience clapping) – So, good morning
everyone and welcome again. I’m very happy to see this big turnout on a very important topic. Again, we’re gonna see a
number of speakers today. They have some wonderful presentations. Now what we’re gonna do,
you notice in the program that we’ve divided into
three different sessions. So after each session, we’re gonna invite the speakers
back up here to take a seat and then we’re gonna have a
question and answer session. So if you could hold your
questions off until the end of the session, we would appreciate it and it would help us keep on time as well. So that being said, I’m going to introduce our
first speaker, Dr. Orton. She is an Associate Professor
in the Department of Civil and Environmental Engineering here at MU. Oh, thanks Sarah. – So I’m gonna talk about the disaster
resilience of structures. And so structures are
gonna be really important in our lives. They’re where we live. They’re where we work. They’re how we connect goods
and services and people across the country. If a disaster happens, then
the structures can be damaged and they can fail and that is
gonna have a serious impact on our lives. Now you might think that the solution is to simply prevent structural
failure, and that’s easy. I can prevent structural failure. But it’s not really a solution. I don’t think anybody is
gonna wanna live in a bunker. What the solution really is, is to achieve some structural resiliency. And in order to achieve
that structural resiliency, we have to evaluate the
cost and the performance and the level of the event. The cost is more than just
the initial building costs. You wanna see, you wanna also evaluate the environmental impacts of the building and the
maintenance costs of the buildings. If there is an event that
damages the building, you’re gonna also want to
evaluate the repair costs and how much down time is
there when that building is not usable or that
bridge is not usable. There is also the social impact. How do people feel when
their house is destroyed and they have to live someplace else? You know, there is a big impact there. There is also the transportation impact. If goods and services can’t go across the bridges because
they are damaged or destroyed, that has a huge impact. So all of these costs
are important to evaluate and they depend on the
performance of the structure which is more what I do. And performance is more
than just strength. Strength is certainly very important, but it is also the
serviceability, the deflections of the structure. If the building moves so much
that the doors can’t open, it’s not a very good
building anymore, right? You also worry about the deterioration, the current state of the building. If the reinforcement is corroded, then it’s not gonna
perform as you would expect during an event. All this performance is dependent
on the level of the event. I may want a very good
performance in minor, more frequent events. You know, a minor earthquake,
I want the building to be just fine, maybe put on some plaster and it’s all good. In your major earthquake, you can accept a little more damage. I’m gonna allow that
building to be damaged, but I’m going to prevent the
collapse of the building. So all of these things are tied together and with dividing those
factors, we can start to achieve a structural
resiliency in our buildings. Now what I do, mostly, is in
the structural side of things. Evaluating the strength and
the capacity of the building. All the work that I am doing
is looking at the division between when the building
starts to be damaged and when it actually starts to collapse. We can allow damage in a building, but we want to prevent the collapse. So this project here is
actually a concrete slab on just some columns. It’s a three-inch thick
slab and then you see all the weights that we put on it and then the test was evaluating
the collapse of that slab. It took me three times,
putting more and more weight on to get that thing to
actually collapse, okay? Buildings are a lot stronger
than we think they are. But some aren’t. You have to evaluate
where is the strengths and the weaknesses to
really be able to define where is damage versus
going into collapse. And buildings that are
weak, we want to evaluate if we can fix the building,
if we can improve the capacity of the buildings. Things like adding CFRP to these slabs to improve the blast performance. There’s all kinds of new
materials coming out, new manufacturing methods,
new things we can do to improve the capacity of the building that we can investigate and improve our structural resilience. With our experimental
techniques, we are also evolving the analytical methods. Zhi Chin, one of my colleagues
in structural engineering, works on the analytical side
and he’s developing multi-phase and multi physics-based approaches for analyzing blast and impact. He’s also developed a
material point method, a continuum-based particle
method for extreme loading cases. These methods allow us to
analyze that very non-linear, very extreme-type behavior
so we can define the behavior of the structure under the extreme events. Glenn Washer, another
one of my colleagues, works on evaluating buildings. And so he’s done a lot of
work on using thermal images where you can detect the
delaminations in a bridge deck and see where the damage
is and then that way, we can evaluate the in-place
behavior of the building. We have also worked on
ultrasonic stress measurements. It’s a simple little
ultrasonic tool you put on a piece of steel or we are
trying to work on concrete, too, that can actually determine
the actual level of stress. So you essentially go up to
the column, put that on there, it’s like okay, this is
over-stressed or is it not? Early-stage research here. All of this stuff is helping
us to define the performance of the structure. If we can, I lost my conclusion slide. If we can define the
performance of the structure and evaluate the costs,
then we can achieve our structural resiliency. We can achieve structures that are going to suffer less damage
and recover more quickly from disasters. (applause) – Thanks Sarah. So our next speaker is Dr.
Dara, who is a Professor in the Department of Civil
and Environmental Engineering here at Mizzou. – Disasters and transportation
have a long history. So in Homer’s Odyssey,
if you look at the story of Odysseus going back home to Ithaca, he angers Poseidon, the
god of the seas and oceans and flooding and so forth
and he incurs the wrath and all kinds of storms and
he loses most of his crew and the ship and what’s a
otherwise short trip back home, takes a 10-year delay. All right so, and fast-forward
to the current times, 2005, the picture you see on your left, is that of Hurricane Katrina
that hit the Gulf Coast. The New Orleans and the Gulf Coast states and that resulted in
large-scale evacuations or a million and a half people evacuated, either mandatory or voluntary evacuations. Significant delays, hours
and hours of delays, vehicle breakdown incidents, and so forth. To your right, you see some of the events that hit close to home in
the recent five years or so, we have had major flooding
events in our state. The top picture is from
2015 in the St. Louis area when we had the flooding and
many roads were under water. And the bottom picture is
from two or three weeks ago in St. Joe where Interstate 29 was closed for almost two months, right? So that’s a major Interstate
traffic federal aid highway that’s not open to public
because it was underwater, right? So what we do at MU in
transportation research is we’ve been looking at a few
things related to disasters and their impacts on transportation. So for over 10 years, my
group has been working with different emergency agencies, state transportation agencies. I will give you a couple of examples. What you see up there is
the work we have been doing for the State of Virginia working on their emergency evacuation models, building large-scale models to test different traffic control strategies, different evacuation
strategies and so forth. More recently we’ve been working with some social scientists
from other universities, systems engineers to study how evacuees their perception of evacuation success versus an agencies
perception of how successful an evacuation has been. So we are looking at that
through a NSF-funded study and more recently we started
to look at events in our state and particularly in the Midwest
on how do we better prepare for flooding preparation
and recovery procedures. I will give you a couple of examples. What you see on the screen
is a map of a portion of southeast Virginia. So you will see on the left-hand side, the bottom right is Virginia
Beach, Hampton Roads area, about close to two million population. If there is any hurricane
hitting the Atlantic Coast and there is an evacuation
order, they would all evacuate further west or not right towards Richmond or they would go north
towards Washington D.C. areas. On the right-hand side
is a simulation model, a large-scale simulation
model that we created on MU campus to mimic how
the evacuation process would go on if there were to be such an evacuation order given by the governor. So what you see here is the zoomed-in view of Virginia Beach area we
are loading the traffic as they start to evacuate
and they start leaving. Now they are approaching
Hampton roads area, York. There is a big naval base right there and then eventually they make
it to their destinations, be it public shelters
or their friends houses, in hotels, and so forth. And what you also see is as time goes by, we are loading more and more
demand onto the road network and it’s at capacity. That’s where you start seeing
congestion, bottlenecks, incidents and so forth and
then the response becomes that much harder. We also measure some of
the self-effectiveness when it comes to how the network is doing, how an agency is doing in terms
of handing the evacuation. We track what’s called clearance times, time to get people to safety. How many people are on the road network at any given time during
the evacuation process? What are the effects of incidents? How do we clear them quickly? We recently started applying
some of those same techniques to things happening in our state, be it earthquake response
planning for the boot-heel or the St. Louis region
how do we plan routing, diversion strategies, and so forth? And also similar applications
for flooding events. As of this morning I heard
that Missouri 141 in St. Louis which carries upwards of
20,000 vehicles is closed for traffic, right? So that’s a big arterial
road that supports economy and jobs in that region. I want to close by making
a plug for a working group that we started on MU
campus a few months ago, Disasters and Resilience Working Group. So far we have a few
faculty and researchers from three different colleges, but we are reaching out to others also. We just put in, as of
9:00 a.m. this morning, our first collaborative proposal
to Department of Energy, we call it SAMARITAN, it’s about incorporating alternative
fuel vehicles for response to flooding events that we
have had all over the state. So if you are interested,
please, agencies or other faculty across the system, we are open. Our goal is to go after bigger grants, like Dr. McIntosh said earlier, to strengthen the UM systems’
expertise in this area of disasters and resilience. So thank you very much for your time. (applause) – Okay, thank you Praveen. Our next speaker is Dr. Beard. He is an Associate Professor
of Computer Science and Electrical Engineering at UMKC. – Today I’m going to
discuss with you the idea of how we can take advantage
of smartphone, tablet, head-mounted display technology
for disaster response. And I wanna think about the idea of a fully enabled first responder. If you think about the fact
that we have many cameras that are possibly available throughout our environment today. So let’s look at the
issue of a fire scenario. So think about what we would
have possibly available through cameras. We could have cameras that
could give us locations of occupants either the exit/entry points of the buildings or maybe internal cameras that could give us a sense of
where people are or should be. We also have the possibility
of looking at the extent of the fire, the movement
of the firefighters, body cameras on the
individual firefighters to see what they’re seeing. So we want to be able to take
advantage of those cameras. We also have a lot of other information that could be available, building plans, locations of hazardous
chemicals, medical records. And then we have this world of sensors which, in our area, we are
calling the internet of things. You could have sensors everywhere. Temperature sensors,
hazardous chemicals, smoke. You could have sensors on
the occupants of the building if there’re people with medical issues or you could have sensors
on each of the firefighters. You want to take
advantage of all of those. So not only in a fire scenario, but there are many other
types of scenarios, hurricanes, earthquakes,
we could look at police. We could look at EMS. We could look at a lot
of different workers. So what I want to talk to you about is what I’m sort of thinking
about is three key areas of research. So first of all, how do
we get this information to the responder, the right information to the first responder? So we have some cognitive issues. Where the first responder
could easily be overloaded with all the potential cameras
they could be looking at and also in terms of other information, they could be confused,
all kinds of fatigue that could be added to them. So we want to make sure we
get the right information to those. We also want to analyze
all of this big data that is available. We have this information
related to the locations of the occupants, the spread of the fire, maybe we have ability to
predict that fire spread. We could even maybe change the plans on how they would search the building. The one I want to talk
to you about is my area, is communicating effectively. So we want to look at
first of all the key area for emergency response
is voice communication and it will continue to
be that way for a while. So voice communication
needs to be protected. It needs to be very reliable. So anything innovative we try to do, we need to make sure that the
work can be done reliably. We wanna take advantage of
fifth generation cellular. I have several students
who work for Sprint in their headquarters in Kansas City and they’re all in the midst of announcing their new, big, 5G plans. So what does 5G do for us? Well, 5G is going to provide
much higher data rates, ultra-reliable communication, and ability to have
massive internet of things. So we wanna take advantage of that. One of the biggest advantages
is easily being able to distribute video. So video from the cameras,
video to the first responders. Also we want to keep in mind that most emergency
organizations do not use our current cellphone technology. They are currently rolling
out a 4G first net system. That system, though, has
very limited capacity. So we want this to be able to
be used by first responders, but they have to be able to trust it. So here’s the idea that we wanna work on and that’s the idea of
highly configurable systems that respond to the disaster situations, respond to the first responders
and the needs of those who need to be rescued. We need to be able to use machine learning that can dynamically find
reliable sets of network resources that can provide what
those first responders need in terms of performance,
in terms of reliability, in terms of the
information that they need. We need to be able to connect to multiple communication towers to provide physical resiliency. We need to be able to provide
coverage into basements and other difficult-to-reach areas ’cause that’s where they need to go. So we need to be able to do that. We need to tailor, another
area of machine learning would be to tailor each of
the first responders’ needs to the information that
is available to them. In a sense you have
this automated assistant that is coming along side saying, hey, you need to look at this. Or hey, watch out for that. And everything we do needs to be trusted by our first responder organizations. So the idea, then, some exciting results we have in terms of reliable connections, wireless signal choices
based on human factors, machine learning to enhance
the wireless signal reception. Learning-enabled highly
configurable 5G systems will greatly enhance the
first responder capabilities as long as we can provide that to them in a reliable way that helps them, not necessarily gets in the way of what they are trying to do. Thank you. ((audience clapping) ) – Okay, our next speaker is Dr. Chen. He is an Associate Professor of Civil and Mechanical Engineering. Did we go too fast? Too fast. How’s this? – Okay stop. – There we go, right there. And he is from UMKC. – Only one page. (mumbling) There’s only one slide. I can just talk through without it. Well that will be a bummer. I have lots of nice videos. I can just talk about it. So many of you have seen the cover story of AFC’s report card. Basically AFC has assigned a D+ grade to national civil infrastructure systems. D+ means huge demand for the
federal and state governments to reinvest in the civil
infrastructure systems. And also D+ can be directly interpreted as low-resilience. So what is a low-resilience system? Basically for civil infrastructure system, if it has a low-resilience,
it would have less reliability of safety level. It would have a longer recovery
time when hit by disaster and ultimately would lead
to higher economic cost on the societal systems. So if we, for my research,
if we further elaborate on the notion of resilience,
we have been looking at power structures which is one particular infrastructure under general infrastructure systems. For power structure, we actually
have a very recent example. We went to the Jefferson City tornado. So I have some nice video there. On the second day of the
Jefferson City tornado, so when we went there,
we were flying drones, we were using smartphones
to capture images around the neighborhood
and many pole structures were hit by the tornado wind. You can see the pole were
fallen and the conductor, transformers dropped to the ground. But to my surprise, actually,
the local utility companies and their crew were already
working in the field which was the second day of the disaster. This at least to me, this
means that it is favorable and safe to say, the power
structure in Jefferson City are resilient. But on the other hand,
to a modeler like me, if you want to model resilience, it is such a challenging task because it encompasses
variables, parameters not only from technical
and physical dimensions, but from societal, economic,
and organizational dimensions. So actually there was a
dilemma actually proposed by Professor Bruno out of Buffalo, he said you know nobody
cares about this resilience until it occurs, right? So when it occurs actually,
you can evaluate resilience by observing of the slowly or
either rapid recovery process. So we can comprehend what is resilience. It’s actually to overcome,
to resolve this dilemma, and also to overcome the
challenge of resilience. The notion of resilience
derives from many dimensions. So we have been looking at one particular, very specific infrastructure system, the rural power structures. If you look at any rural power structure, you can actually drive on the highway, you can see the rural power structures actually feature linear distribution. Which basically means
it has zero redundancy and also most rural
structures have been serviced for many, many years that means
they are highly vulnerable to many types of disaster events. So we took on this challenge
in our recent work, we have developed a fully analytical and actuative mathematically
attractive framework and basically we use it
to measure resilience. I have some nice applause
there, so basically now to this end we can quantitatively and analytically to predict the resilience of any rural system, which looks like a linear distribution of poles and conductors. We can consider many physical
realistic parameters. Oh yeah, this is a rural power structure. Thanks so much. Okay, thanks so much. So we (mumbles) we treat it
as a minimum spanning tree. And we developed this
quantitative assessment framework. So by now, by looking at the
two poles, right, we can say, well, we can make a predictive assessment about that rural power system. So here we can consider some
socio-economic parameters such as resourcefulness
and we can consider the physical aging parameters. So my takeaway message here is if you use first-principal
based quantitative resilience modeling framework
where we consider mechanics, you consider the caustics and incentives you can create a decision-making tool for predicting and for reading resilience before the disaster occurs. Going back to the ,this is the video, going back to the Jefferson City tornado, so we were flying drones and
for this apartment complex, it took us 30 minutes to cover that area. However, it took me almost a
week to come up with this nice, 3D mapping products. If you look at the
before and after, right, it’s very compelling to see the damage for different buildings, right? From the roof damage and you can even tell the tornado track. But if you were a first
responder, you were asking me, where is the real-time
situation awareness? Because I cannot just hand over to you 1GB of remote sensor image data. I said, well I have done the
job and it was just data here. Because 1GB of data is just very hard to analyze in real time. So we took on this challenge. In our recent work, we developed this AI or this Artificial-Intelligence aided or deep-learning aided
framework based on big data which is big disaster scene data. So the story here is we
developed a AI-aided engine. That has a comparable
performance as human intelligence in terms of recognizing the disaster type and the disaster-induced damage levels. So those are my takeaway messages for disaster resilience assessment. You can take first-principles
based approach where you use mechanics
and certainty treatment and cost formulation. You can develop a predictive framework for marrying resilience
for infrastructure systems, which can become a predictive tool which can become
disaster-preparedness tool. Another message is advanced motion sensing and AI technologies can be
used in disaster response. Further you need, let’s
say 5G and edge computing, so you can really make it a real-time situation awareness tool and for post-disaster
resilience assessment. Sorry about the little
incident at the very beginning. – [Man] Check, check, check. – But it’s kind of sweet. – [Man] Check, check, check. At the very beginning So this is the report card. This is the kind of
definition of resilience. So this is Jefferson City,
fallen poles due to the tornado. Okay, thanks so much. – [Man] Okay. (applause) – Like Mark said, that was
good resilience on that. (laughing) So (speaking off mic) So I’m gonna ask our
speakers to come back up and we have time for Q&A. So we’re gonna have you
guys sit right here. Jeff, do we have a microphone
for any of our audience? I think I can(mumbles) We’re missing one of (mumbles) – [Woman] I had a question
for the first speaker and some of the evaluations
that are being done looking at resilience of structures. I was thinking more recently about some of the
mid-continent earthquakes that have been happening. They are very, very low-magnitude, but they are very frequent. Is there work or effort on
evaluation structural resilience in terms of a high-frequency
of low-stress events? – Most of the work for
high-frequency, low-stress is aimed at making sure the structure doesn’t exhibit much damage. And so this performance-based design, you’re trying to ensure
that your structure is not gonna be damaged during those very minor earthquakes. And most of the really minor
magnitude three or four, earthquakes they don’t do anything anyway. (speaking off mic) – Not normally. – [Woman] Hello, my
question is for Dr. Beard. Could you tell me at what
stage your research is at? Is it in the idea stage or
are you actually implementing some sort of communication technology or you’re just looking at
how to put it together? – We have put together some pieces related to how to handle failures
in the wireless system and to be resilient in
multiple connections and how to optimize for efficiency. We’ve come up with, we’ve
used machine learning for some of the signal processing aspects of what we’re doing. So we haven’t really gone to the point of processing the different video feeds that could be brought
to the first responder. That’s something, that’s really more of a collaborative effort I
think we would need to do. – Hi, we’re here from UMSL College of Nursing and so we’re interested in healthcare and I am
actually thinking of Dr. Dara and Dr. Beard in terms of
the disaster preparedness and the flow away or in
a particular direction. I’m wondering if you or
any of your colleagues have looked at specifically
healthcare places, institutions, hospitals,
and the flow either to out to the community
for healthcare needs or into hospitals specifically. Just wondering if you’ve
had that experience on your faculty research teams. – I have not had that. – Yeah for us, we have looked at primarily routing emergency vehicles
to different destinations. Yeah, that we have done,
but not once they arrive at the hospitals or the care facilities we haven’t looked at. But yeah, those are very
important destinations. So are our public shelters and so forth. So we are interested
in routing algorithms, traffic assignment within the
network to such destinations including hospitals and public shelters. – Hello, Rebecca Johnson, I’m a Professor of the
Sinclair School of Nursing and the College of
Veterinary Medicine here and I wonder if all of you
or any of you would care to comment on the importance
of the human factor in any of these systems
because it seems to me, you can develop amazing systems but if the underlying human
factor that is people’s capacity to respond in these situations
is negatively impacted, it strikes me as difficult for
the systems to be effective. – Yeah I can speak for
my research at least, we rely heavily on
sociology, social scientists on our teams to get survey-based data where they interview households. They go talk to people. They present a variety of scenarios. Would you evacuate under these situations? Would you leave early, later? Different types of storms and so forth and then where we come in is
once they collect the data, we build all our fancy
models and then simulate to see how those decisions play themselves within the traffic and so forth. – As far as communication
systems, a lot of my talk was about the first
responder and what happens with them and trying to
respond to situations. And the biggest challenge
with the cellphone systems is they are not built for resiliency. They are built mainly for coverage. They are built for as
many people to be able to use their phone when they can. If it doesn’t work,
people should be patient and usually are. But for a first responder to
be confident and to be able to not worry about the communication part of what they are doing is very important so they can really do their work. – I’m a civil infrastructure engineer by developing some social
science component in my research. So basically we use crowdsourcing
data for disaster response and crowdsourcing basically means for people who are either
threatened or not threatened by the disaster can, let’s say, send a tweet to kind of Facebook
and upload a youtube video. But so those platform already exists. Like Google crowdsourcing mappings, so basically, it’s kind of collector of all our crowd basic information. But there is one major research gap. When you look at all those data, right, then you are not structured and for these center makers, for first responders is do a big, is let’s do some, one more step to say, well, I wanna make this data based on those in agnostic data. So we are currently doing some research including the one I just presented. So you have to build some
disaster scene learning engine, you’ll have to tell, what is it or what is the water level? What are your intense day for flooding? How can I extract the water
depth level from a single image? So this is our current
research we are doing. And furthermore, we want to
understand the damage, right? It’s a causality process and again there’s also data
coming from the people. And of course if you’re
talking about crowdsourcing some prophecy issue for
that, I have no idea. It’s tempting. Okay, thanks. – Yeah, I have a question. I work for the city of Columbia and I was wondering how
you involve public policy both researchers as well
as financial researchers? Because all the research being done, if we are not involving into our process for designing a more
resilient infrastructure or planning so that we can
both respond but also prevent, knowing that it falls within our systems if we need to change or also just like how it can incorporate so that we can make better decisions. – In my research, most
projects have what we call technical view panels. Hey Barb. And they are from local
agencies, cities, counties, you have a state emergency
management agency, state DLTs and so forth. So who are responsible
for not just response but infrastructure
maintenance to make sure the signals are working properly, to make sure the roads
are accessible and so on. So yeah, we do work closely
with, many, many stakeholders because they are the ones
not only giving us the data to build our models, but
also the users of our, what our conclusions,
guidance we come up with. So we do work closely with them on the transportation side of things. – On the structural side, it all comes down to the building codes. And so we do our research. We say this is the way
you should do your design. And eventually after years and years it gets adopted into the building code and then hopefully the building
gets built that way we hope. – Patsy Carter, department of Psychiatry, University of Missouri, Columbia. Dr. Beard kind of follow
up for the prior question. You talk about the physical
and mental conditions of the first responders. Can you talk in a little bit more detail about specifically what
you’re looking at there? – Just specifically the idea that we have a lot of information we could provide to the first responders. They could see the body cameras
of all of their colleagues that are going into a building. They could see any cap of both past videos in terms of who is
coming into the building, who is coming out. The commanders may have
different sets of videos that they look at. So a lot of it is this idea of information I think overload is probably
too much of a colloquial term, but what happens to a person when they have all this
information available? Does it almost paralyze them in terms of knowing what to even ask for? I’m going into the building, I’d like to know where the people are. I’d like to know what
the smoke conditions are. Where’s the fire, all these things. What’s the most important
thing for me to know right now as compared to what I might need to know a few seconds later? A lot of that comes down to the training that the firefighters go through. I was surprised it was
only a couple of years ago, one of the larger suburbs of Kansas City, I was talking to their fire chief. And I said, well, when you
come up to the building, do you have the plans? He goes, “Oh, that’d be great. “But no, we don’t have the plans.” Well how do you find people? We feel, we go around to the wall, we feel on the floor for people. So you could imagine if you change that to use the camera capabilities you have, that’s a big change for them. So to what extent can you train that and to what extent do the firefighters have to be more adaptive to technology? And of course, younger people, I don’t think of myself as too old, but they can do so much
of what they deal with, can handle many different
information sources at the same time. – Sorry I have to switch
to my animal hat now and ask to what extent any of the models are taking into account the
management of companion animals, herd animals. For example, we learned that
in the fires in California, horses, race horses, fine
horses were simply turned out to fend for themselves because
of lack of preparation, lack of a plan. We learned in Hurricane Katrina and fortunately subsequent
to Hurricane Katrina or that people were not evacuating because their pets
couldn’t go to the shelters and fortunately now that has changed. To what extent do your models
take into account that factor? – Yeah, that’s a very
important consideration. Unfortunately in our current models that we simulated so far, we don’t have the data on re-run based on what we call demand data. We just don’t know how many evacuees would like to move with their pets or would like to stay
put or move not too far because of obvious reasons. Maybe go to a public shelter and whatnot. We just don’t have that level
of detailed resolution data to put into our models to
study how that plays a role. So unless there are some
surveys done and so forth, so yeah, we are working
with, like I said earlier, some social scientists but that’s something we
haven’t looked at yet. – Any more questions? (speaking off mic) – Questions for me from department of bio
engineering and food science. When disasters happen,
getting safe, nutritious food becomes a very big challenge and reaching vulnerable
people like infants, children, pregnant women. Do you have any insights about that? – I do not, but maybe my colleagues. I’m sorry. – I’m sorry too. Anyone who wants (mumbles) – [Man] Not an answer. (speaking off mic) – But that’s the next proposal
I’m working with Kiruba on. We are on. – I have a question
having to do with the 5G and a game changer for population areas but my understanding is
that it may be even slower to get into the rural
population in Missouri because of the need to build
towers to extend the network. To what extent have you been, or would you be interested in working in the Mizzou leadership to
expand broadband coverage into the rural areas where some of the disasters occur, but there is not currently good coverage? – I’m very sensitive to that. I actually have some good friends that live only a mile outside the city limits of Belton, Missouri,
which is just on the right on the edge of Kansas City and their coverage is next to nil. So we’re not talking a 100 miles or even 20 miles from a major, usually cell phone networks
are built along highways. So the major highways, people can still think
of my coverage is great. But in terms of rural areas, that’s definitely be questioned. And with 5G, some of the technologies make the coverage area smaller, meaning you’d need more towers, which would definitely
exacerbate the rural problems. So that would be very
interesting to look into. – I’m Dr. Walsh from architectural studies and at one point in time I worked for FEMA in the aftermath of an
earthquake in California. I was very interested in all the lectures but Dr. Dara I had a question for you. I understand you use agent-based modeling in your work, is there
any ability to determine whether that would suggest
people need to be trained better how to respond? ‘Cause I know one of the difficulties in agent-based modeling
is that getting a fit between what you’ve
modeled to the computer and to how people actually behave, whether they’re panicking
or behaving logically. I’m wondering if that
leads to any suggestion that the public needs
to be better informed about how to not to cause
a traffic jam for example, or how to actually get
through this crisis. – Yeah that’s asking for too much, (laughing) Not the cause of traffic jam from, by running the models but yeah, we do have some
levels of driver behavior within the agent attributes
that we could change, that’s more on aggressiveness
to lane changing and how closely they follow each other, what percent of time they stick to their actual
routes and so forth. But yeah, the things you raised,
which are very important, it’s hard to model all
aspects of driver behavior. – [Man] I was wondering if you use the idea that (speaking off mic) – Well, yes. (laughing) We’ll just stop there. Yeah. – [Woman] And if we’re trying to work with (speaking off mic)) – Hey, I was just curious
with the transportation model, does it take into account
the infrastructure studies? We had the report on the D+ for current infrastructure maintenance. We’ve got the power
lines that might be down. We’ve got bridges that fail, especially, during one of these incidents, one of these hazards,
it could be a hurricane a tsunami, a tornado, things fail. Power lines are down. That affects infrastructure, people’s ability to move around. I’m just curious if your
model takes that into account. – Yeah. So we do look at a few, what
we call sensitivity analysis or what if scenarios where you take away major tunnel or a bridge and so forth and then re-route your traffic around it to see where the new bottlenecks
are located and so on. And most agencies, state agencies also have what they call
designated evacuation routes. So those are usually the ones
that get more reinforcements. There’s more support. If you run out of gas, your
chances of getting some help are greater if you are
using one of those routes versus a local road with
very little traffic, that doesn’t receive more support. So yeah, we do look at the
prioritization of the roads that we simulate and also
some of the critical junctions or intersections that play a bigger role, which if they were to fail. So yeah. – Yeah I think this was
really a great discussion. Let’s thank our speakers for tonight. (audience clapping) – Okay. So that’s the end of the first session. So we can go ahead and get
started on the second session, which is social resilience. I know, put this back. And our first speaker in this
session is Dr. Parker Oliver, professor of Family and
Community Medicine at MU. (mumbles) – Got It. Great. Thank you very much. I look forward to sharing
our research with you today. It’s a completely different shift for you. We’re gonna talk about research that builds resilience in people, specifically in caregivers
who are caring for the dying. Resilience is actually a
learned ability to adapt to a disaster or crisis and perhaps there’s no more
difficult personal crisis than when you’re faced with
the dying of your loved one, especially when that happens
unexpectedly or suddenly. And I’m not sure anyone’s
ever quite prepared for that. Our research looks at
improving that experience and improving the lives of those people who are giving selflessly
in order to do that. Specifically our research
occurs in hospice. Now you may be familiar
with the English hospice, which is a setting, but in this country, hospice happens in the
home and it’s a health care that is available to
terminally ill patients who are no longer
pursuing curative therapy and expected to live six
months or less easily said, except the average length of time, the people are receiving hospice care in this country is 60 days. So our research has to happen quickly. The care is at home and it’s care delivered by
primarily loving family members 24 hours a day, seven days a week, disasters or no disasters. What do we know about these caregivers? First, they receive no
special training for this and yet they are providing the care that our physicians and our nurses actually train years to do. Pain management, assessment
of pain, dressing of wounds, administration of medications and just keeping track of all
of those, symptom management, nutritional management, all of the above. We also know that 40% of those
upon admission to hospice are clinically anxious and depressed as they are facing and
anticipating the loss of someone that they loved dearly. We know that these
caregivers are isolated, be they in rural areas or
just down the street from you. What happens is the social
systems and the social support distance themselves because
people don’t know how to help and caregivers don’t
know how to ask for help. We know that caregivers die earlier and they have more chronic diseases than those who do not deliver care and most of all, what we know is that
there is little evidence or little ways that have been tested in order to help these individuals. The focus has always been on the patient rather than family-centered care and our work focuses on
these family members. We’ve been working for, my team has been working
on this for a long time. We started with NIH funding in 2006. This problem crosses
disease categories at NIH and so consequently we’ve
been lucky enough to be funded through three institutes. Again we create brief,
technology enhanced interventions in order to build resilience, by building social support and knowledge, improving problem solving, creating meaning within
that caregiving experience and improving pain management. We’re currently conducting two of the largest clinical trials ever held in the hospice setting. The first one is called ACCESS. It’s Access for Caregivers of
Cancer Patients for Education and Social Support funded by
the National Cancer Institute. We’re doing this in
seven Missouri hospices, both rural and urban across the state. And we’re delivering
three specific components to that intervention. First is online support groups, Facebook. And so some of the coverage issues that you talked about with technology, actually we’ve been very lucky and not run across that even
in some of the most rural parts of the state. Older individuals may not
necessarily understand that they have the internet but they know they got Facebook because they watch the
grandkids’ pictures. And so what we’re trying
to do is to reach out with this public platform and they have private secure groups and help caregivers talk to one another, so that that social isolation decreases and they share their own experiences and they share their own hints. The second component is
through educational videos. We’ve created a dramatic story using telanovela technology
to educate caregivers on how to take care of their loved one, but also how to take care of themselves. And finally, we use web conferencing, specifically Zoomnow to
bring those caregivers into their hospice team meeting where the professionals are meeting and the caregivers get
to be a part of that and they can participate in decisions related to their loved ones’ care. This builds resilience and
by increasing social support, increasing knowledge, reducing
anxiety and depression, and improving caregiver health. Our second clinical trial focuses on resilience
through problem solving. And this is a partnership with the University of Pennsylvania. We use web conferencing
to do three virtual visits to help caregivers learn how
to solve even basic problems, which they identify. And we also help them to focus on some of the positive aspects to caregiving which actually there’s been
very, very little research done. Again we’re building resiliency through improving the
quality of their life and reducing their anxiety. So what comes next? After you test these
behavioral interventions, what’s most important is that they get out into the real world. And so the next piece that
we’ll have to function after we finish the trials
is how do we implement this? How does that get into
the dying person’s home in southwest Missouri or even
down the street in Columbia? We’re also building two
additional interventions. I’m happy to say that we’re on edge today because we had another
proposal reviewed this week through the National Institute on Aging that’s gonna focus on a
very special population and that’s the caregivers of
hospice Alzheimer’s patients. These people have unique
and special level of care because they’ve cared for
people for a very long time. They’re not in hospice for that long, but they have had a long road
to get where they’re going. And so we’re going to
use photo elicitation and the use of photos to
help them find meaning in this experience during active
caregiving and bereavement. And then lastly, we’re
designing an intervention we call Ready to Care, which is gonna focus specifically on the needs of rural caregivers, specific to pain management. Pain management in the rural
areas is even more difficult than it is in the urban areas. And so this particular project, which is currently being reviewed sometime in the next six
months, wIll focus on that area. The bottom line is that
our behavioral research is building resilience of a different kind for people to respond to
disasters of a different nature. And it’s something that’s
gonna happen to everyone in this room, death and taxes, right? And so it may not be because of a flood or because of a natural disaster, but it is occurring during those as well. And so one thing we have not done a lot of good job in hospice is preparing people who are
already in fragile situations to do that as well. Thank you. (audience clapping) – Okay. Our next speaker is Dr. Williams, who is an associate professor
of Psychology at UMKC (mumbles) – Hi, good morning. And thank you all for coming today. I appreciate everyone for
organizing this important summit and I’m excited to see everyone here and to hear about all the different angles that folks are approaching this work from. So thank you so much. and we look forward to
talking a little bit. And I think that building
on what our last speaker talked about, certainly an important piece of making sure that we bolster resilience in disaster survivors is going to be making
sure that we provide care for those who lose loved ones
in the wake of a disaster. Because certainly this is
something that can take a toll, many parts pound ways on survivors. And so I’m gonna talk to you a little bit about some of the work that
my team and I are working on with our colleagues in Kansas city, to try and improve implementation
of early intervention for survivors of sudden
and traumatic loss. Okay. Now, one of the things that we know that sudden and traumatic
loss is actually quite common and this includes disaster-related losses, but certainly is not limited
to disaster-related losses. But like other kinds of traumatic loss, disasters often involve
an element of suddenness and unexpectedness that can often create some intense complications for survivors who are grieving the death of a loved one, right? But just like disaster losses may include that element of suddenness and unexpectedness that can
really create some complications in the mourning process for survivors, many other types of sudden
and unexpected losses will involve those same sort
of elements of suddenness, unexpectedness, homicide, suicide, motor vehicle crashes, accidents, right? So there are many, many kinds of traumatic and unexpected losses. And when we look at national data day, data that was collected as
part of the DSM filled trials in 2013, as many as 51% of American adults reported that they had lost a loved one at some point in their life unexpectedly, whether to natural or
unexpected forms of sudden loss. So when we think about the impact of this, this is particularly important
from a health perspective because we know that
sudden and traumatic loss can increase risk for complications and bereavement in a variety of ways. Certainly not limited to post
traumatic stress disorder, which I know we have some other speakers that are gonna talk about
a little bit later today. Some other common sort of
complications that we see are major depressive disorders. Something that we now call
prolonged grief disorder, which seems to be a complication that can occur a lot with
major depression and PTSD, substance use disorders, so you name it. There are a lot of
complications that can come as a result of experiencing these sudden and unexpected losses. One of the things that’s
concerning about that though is that many surviving
family members and friends of individuals who die in
a sudden unexpected death, despite any complications that may occur actually never get connected to care and never actually
received mental health care down the road. And that’s particularly concerning when we think about sort of what we can do to do the most of bolster resilience in some of these folks, but
when they do seek treatment, they’re most likely to do it in the first few weeks after the death or the disaster occurs. So the best evidence we have suggests that most of these folks, when they do seek care from
mental health professionals for emotional difficulties that
are resulted from the loss, that tends to be in that
first eight weeks or so. But again when they report
seeking mental health services from folks, they’re often
not seeking services from mental health professionals per se. Most of the time folks
are seeking supports from paraprofessional providers
like chaplains, right? Law enforcement victim advocates, maybe I go back to the
nurses, the social workers that I met somewhere on site, right? So if folks are seeking care, they’re going to the folks
that they’re closest to, that they’ve already
had some contact with, and it’s not psychologists, right? And it’s not counselors
usually down the road. Sometimes when those complications become sort of overwhelming for folks, they might eventually get
referred for specialty care. But we’re not the frontline providers when it comes to providing
care for acutely bereaved and suddenly bereaved individuals. So one of the things that’s
particularly important I think when we think about
treatment implications is if folks are seeking services and most likely to seek
services in that first few weeks when the distress may be most overwhelming and most difficult for them, right? And they’re seeking it from folks that may be paraprofessional providers, we need to be thinking about
how to develop interventions that can help bolster
resilience in recovery that are appropriate for the needs folks are gonna have in
that first few weeks, which again is very different from what people may need when they seek formal mental health services. And there need to be interventions that can be easily tailored and adapted for folks across a variety
of professional backgrounds and professional identities, that we can easily train people in and that are cost effective,
that aren’t too time intensive. So we need to be thinking about how to build these kinds of interventions. And fortunately we don’t
have to start from scratch. Actually, after the World Trade Center, disasters in Katrina, the
National Center for PTSD and the National Child
Traumatic Stress Network developed a couple of interventions. One psychological first aid, which is a model that’s
intended to be delivered in the first 24 to 48 hours
after a disaster happens. But as a next step they
developed a protocol called skills for psychological recovery. And skills for psychological recovery is just a slightly more
intense intervention that sort of was designed to help mitigate known risk factors for a
lot of those complications and mental health functioning that can come after disaster
or after losing a loved one. And so this intervention
was designed to be delivered in the first few weeks or
months after a disaster happens, including disasters or situations
where a loved one may die suddenly or unexpectedly, delivered in three to five sessions is sort of built on the idea that we can sort of enhance resilience by teaching folks some basic skills that have been studied across different kinds of interventions, based on cognitive behavioral treatments for a variety of different
mental health problems and skills that are likely to be useful for people across a whole
spectrum of sort of needs, right, regardless of what they’re experiencing. So not just folks that are experiencing the
most intense distress, but even folks who may experience subclinical levels of distress who may be at risk for more
chronic problems down the road. So sort of the main idea
behind this intervention is that we go in, we find
out what folks need, right, we sort of do a sort of
a mini-needs assessment to see what they most need from us, what resources they’re lacking, what’s bothering them the most and been most difficult for them. And this is based on
conservation of resources theory, which generally says
that one of the reasons some folks won’t recover
following disaster or sudden traumatic death and we’ll go on to develop
more intensive complications is because they may lack the
ability to naturally focus on restoring those things
and addressing those things on their own just because of
the cascade of other needs that often happen when we
lose secondary resources after a disaster or a death
or a trauma takes place. So if we can help people sort of address a lot of those
other sort of resource losses and a lot of those other stressors using skills like problem solving, helping people begin to
re-engage in meaningful things in their life, right, reach out to things that are meaningful, learn how to manage reactions
to trauma-related cues or stressors if appropriate. Sort of promote helpful thinking and make sure that they’re connected to strong social support networks, right? We’re gonna help sort of give
them the skills they need, bolster their own natural resilience and hopefully set them on a trajectory towards recovery that mitigates the need for longterm mental health care. So one of the things that our
team is interested in doing and that we’ve worked on for
the past couple of years, the National Center and some other folks have actually done a really good job of looking at models of
how to implement skills for psychological recovery. It’s been implemented in
a variety of situations both nationally and internationally, but there’s not a lot of outcome data to show us sort of how effective it is in terms of putting folks more
on that path towards recovery and sort of how feasible it is to implement this in community, how acceptable it is to
suddenly bereaved folks in particular. So we just completed data
collection on a pilot study and an open trial in Kansas City to look at the feasibility
and acceptability of implementing this intervention, with suddenly in traumatically
bereaved families. So most of the folks that
we included in the study were within three months of
a sudden traumatic death. The vast majority were homicide survivors, urban homicide survivors in the city, all and we had a handful of
folks who had lost loved ones to suicide, a couple of folks who had lost loved ones
in motor vehicle crashes and having just finished data collection. And this is actually doesn’t include some of the last few folks
that came through this study. But one of the things that we’ve seen that I think is extremely encouraging is that even after five sessions, we’re seeing moderate to large
effects in terms of changes, when we look at PTSD symptoms, when we look at depressive symptoms, I don’t have this on here,
but we also see large effects in terms of prolonged brief symptoms. And I don’t have data here for the three month follow-up piece that we included in here as well. But it looks like that’s
all held there too, right? So to be able to get
these kinds of effects with relatively brief,
cost-effective interventions, I think sort of points us towards a couple of bigger picture
things that I wanna say when I just leave us with a message that I’ve leave you with,
which is that I think evaluating and disseminating cost-effective early
interventions for trauma survivors can go a long, long way
to enhance resiliency and reduce unnecessary
suffering for folks, right? So the more that we can make these kinds of early
interventions available to people when they need them the most,
when they want them the most and when they’re most
likely to seek them out, we can have a big impact on the the course of this long and difficult journey for people. And so the next step for us, we’re actually working to embed SPR into a larger trauma response team at Level One Trauma Center in Kansas City that serves over a thousand
traumatically injured people every year, including some
200 non-fatal gunshot victims and their families. So we’re embedding this and this system, we’re working with that hospital and folks from Jackson County and the city to be able to begin offering this. And so we’re really excited
about that as the next step. And of course in the way of research, I think this also points
to some larger trials that we’d like to see done down the road. And we’re hopeful that we’ll get there. So thank you so much. Look forward to talking
with everybody about it and hearing more about your other work. So thank you so much. (audience clapping) – Our next speaker is Dr. Johnson, who is a professor in the
Sinclair School of Nursing in the College of Veterinary Medicine. I was hoping Rebecca could bring like one of your companion animals. (laughing) – Brandon University buildings say we ignore that in the
best(speaking off mic) This is interesting because
this is not my slide. Okay. Jeff I didn’t know you were
going to change the slide. Sorry. Thank you very much for the privilege of speaking with you today. I think that resilience
is a very important factor to build in people so that we can then have
people respond appropriately and most beneficially
to systems, with systems and all of the kinds of disasters that we’ve discussed today. The concept of our work
is based on one, health. Which is that we can learn a great deal by studying the interrelationship between humans and animals. That is, we can learn about how diseases occur similarly and differently. How both animals and
people respond differently or similarly to treatments
and even more importantly how they respond to stress. And in this case, that’s what
we’re talking about today. So we have engaged for many years in a program of research around post-traumatic stress disorder with military veterans. Post-traumatic stress is a
major problem for veterans when they returned from deployment or even if they have not been deployed. But it’s also a problem for people who have experienced trauma such as a natural disaster,
such as loss of a loved one or other known traumas such
as abuse in their childhood or in their present life. So we were looking in
this particular study and I’m only presenting just a snippet, five minutes, seven
slides, very challenging. Tell your whole life
story in five minutes. I felt like saying while I came, I lived and I’m about to retire and I’ll die and that would take care of it, five. I don’t need five slides
for that, but whatever. Okay. Seven slides we were given. It’s very generous Sheila. So the idea of this
randomized control trial with wait lists control group was to look at elder Vietnam veterans. And many of these Vietnam veterans have not received or have
been unable to conquer post-traumatic stress resulted from a time when we were not all that loving and kind and generous to veterans when
they returned from deployment. One of the veterans in this study told me about how he was spat
upon in a church gathering when he returned from his
military service in Vietnam. So we have a very different situation in the context that they came from and we can’t separate responses
to disasters and trauma and resilience from the context
in which the person exists and from what they came. So we engaged them in a six-week, one hour a week
therapeutic riding program. Therapeutic horseback riding
is gaining in popularity. In fact, it’s going
ballistic in popularity. If you understand the
basis of why this works, you know that it impacts
four of the five senses. So we have touch, we have sight, we have sound and we have smell. If you’ve ever smelled a
horse, I think it’s beautiful. I know some people think
it’s gross but that’s okay. That probably isn’t the
intervention for them. But we engage all four of the five senses in one felt swoop in one intervention. And thus what happens is the
stimulation of the HPA axis and we get stress reduction
and heart rate reduction and cortisol reduction, a number of things that are deleterious
change and in good ways and another, a number of
things that are beneficial such as oxytocin release
change in beneficial ways. So in this particular
little snippet of data I’m showing you, we use the standardized
and well validated PCLM which is a measurement
of post-traumatic stress. It’s used in clinical practice very widely in both VA but also outside. And one of the big problems
with this whole phenomenon is that people do not
go and seek treatment because PTSD is stigmatized. If you admit that you have a problem, particularly when you’re
supposed to be a resilient, strong battle-hardened soldier, it’s not necessarily a good thing for you or you don’t think it is. But what about the other side of the lead? We study, try to, in most of
our instance in our research, look at both ends of the lead because we believe that one health is a construct that
does cut across species. So we wanted to look at in this instance, what were the outcomes for the horses who were being, who they’re
human to me I guess, that were being ridden by highly stressed, very tense US military veterans with known diagnoses of PTSD, which was fairly resistant treatment. So if we look at the numbers of horses that are slaughtered alone, we can see that there is a
potential repurposing for animals that could be slaughtered. Most of the animals that work
in therapeutic riding centers and there’s a massive
growth in these centers, are retired animals who
stopped working as horses for police or as resources or
in various other capacities and they could be retired
to potentially help people in a different way and live
out their natural life. So we looked at, in
this case, five horses. We looked at them pre,
post multiple measures and we drew blood for
serum cortisol levels. Here are the findings. You can see the veterans
are the yellow circle, the findings are up to your right, the horses, they are gray circle, the findings are over to the left. And then I put in the potential
community implications of such findings. And I will say that we
were pretty thrilled with the results with the veterans because we were able to have
not only a statistically significant decrease in their
PTSD levels at three weeks, that’s three, one-hour sessions,
which is rather exciting, but also cumulative outcome at six weeks. So what we had, not only was the statistical significance but the clinical significance and that is more important for those of us social scientists who really wanna know how people are functioning. And what we found in these veterans is that they were engaging
in external activities to their families that they
began volunteering places. In fact, after this study, many of them volunteered
for the riding stable and continued on with their riding and reached out to help other people. So we saw reduction in this
PTSD in these stress levels bearing out not only in our
stats but in their lives. And that’s what really matters to us. What about the other end of the lead? Well, the horses had some stress. Yes, they did. It was not statistically significant, cortisol increase, however, it
was consistent with working. So that means that it was not over any clinically important levels. So a veterinarian would not be concerned if horses exhibited this
degree of cortisol increase in general terms and think there would be any need for treatment. So they’re working, it’s work. It’s not just play or
standing around in a pasture but that it is not
deleterious to their health. So what can we say of these implications? So horses can be re-purposed. I love it when there’s a little doodad. This is so much fun. I’m tempted to start pointing
at people in the audience. And we can say for the veterans, as I said, there was
clinical significance changes in their lives, not just in our numbers. And then what can we say
maybe about the community? We need to look at these factors. Can we have savings in cost care? I wouldn’t ever take away
cognitive behavioral therapy or medication pharmacokinetic
therapy with any patient. However, might this type
of complimentary therapy augment and assist that
therapy is a question, could we reduce workplace costs if people are missing less time because they feel less stressed because they aren’t so
panicked walking into work? And what are the costs to the families? And we did not measure that in this study, but this is very important because what we see in a
lot of military veterans, is family degeneration subsequent to the symptoms of this really extraordinarily
profound condition. Here’re some of our
publications of this work. It’s always interesting
when you work on both ends ends of the lead to have a publication and equine veterinary science. That was a first for me
as a nurse, human nurse. And so the implications for resilience, I would argue that you can’t
have a successful response to natural disasters. Two systems put in place
to address such phenomenon, such traumatic phenomenon. If you don’t have people whose psyches and capacity is functional
enough to be able to work with a system rather than against or to only practice avoidance. And if you look at the
cost of treatment of PTSD, this is only in the first year and it’s known that PTSD
exists over multiple years. Many times it doesn’t occur
immediately after deployment. It occurs years later, onset years later, and it can hit with a major wallop and costs a great deal
of money in health care. But PTSD is not just for veterans. We must be aware that first
responders to natural disasters, that children, that teachers, that people who are having, now veterinarians are highest
suicide rate of professions, people who work in stressful situations develop PTSD and might
there be an implication for them to go out and ride
horses to have the benefit. Furthermore, the VA has
recognized the potential of this intervention by including therapeutic horseback riding and large scale national trials that are really supportive
of complimentary therapy. And the VA here by the way
through recreation therapy pays for the tuition for veterans to go and have this riding therapy. So I appreciate your attention and I’m always delighted
to show you our team. We have a fabulous team and it’s a privilege to work with them. Thank you very much. (audience clapping) – Hey, our next speaker is Dr. Houston who is a professor of
Communications here at MU. – Well, if you’re a disasters
and resilience researcher, this day is right up your alley. And so this is right up my alley. I’m excited that this has
been brought together, thanks to Sheila and Chris and others who’ve advocated for this probably and I know was crucial in kind
of getting this idea going. And so I’m thrilled to be here. I’m gonna talk broadly today
about disaster communication using social and mobile media. So I’m really gonna hit several things that have been already talked about and kind of provide a broad perspective. So we know that natural
and human-caused disasters have a lot of impacts on
individuals and communities. So when we think about natural disasters, we’re talking about tornadoes and floods. When we’re talking about
human-causes disasters we might be talking about mass shootings, terrorist attacks, chemical spills, but these events have
significant impacts on us, right? First and foremost, they may injure and kill humans and animals. Secondly, they can have
vast economic effects. They can destroy businesses, they can interrupt economic productivity, they can have environmental effects, so they can destroy buildings,
they can destroy ecosystems. And as we’ve heard in the
last couple of points, they can have significant
psychological impacts on people. A large number of people can have ongoing, traumatic reactions and
depression from these events. So there’s a lot going
on in terms of impact. And so we sort of need
to bring all resources to bear in response. One of the resources that’s critical is disaster communication. And that’s what I study. Disaster communication is essential to good disaster response and ameliorating some of these impacts and good disaster
communication occurs before, during, and after an event. Now we know that effective
disaster communication can prevent disasters. It can reduce the effect of disasters. We also know that bad communication may be the cause of a disaster
or make a disaster worse. So disaster communication is critical in terms of this disaster lifespan from before, during, and after. One of the challenges of
course during the disasters is communication becomes very important, but our communication infrastructure may be severely damaged. And so some of the tools that we turn to may not be operating as intended. So we need a robust disaster
Communication ecology is how we think about it. Sort of all hands on deck in
terms of communication tools. The communication tool I want to just provide
a highlight about today in terms of sort of
summarizing some of our work, are social and mobile media. And so this really builds
on kind of the 5G discussion earlier this morning. Now the cool thing about
social and mobile media is that, it is a form of media that’s accessible to everyone. So when you think about broadcast TV, which might be very
important during disasters, only people who run the network have access to that platform. Only SEMA and FEMA have
access to emergency alerts. But we all have access to social media and so all people from
citizens, organizations, can be part of this disaster
communication process. We also know that people at the event can use social and mobile
media to communicate during a disaster but
also those further away can use these tools to help communicate. And that can actually
help with the response by having sort of some resources from a way the event aiding in
the communication processes. Just as in normally
when a disaster occurs, we get people from outside
the community coming to help. We might have these
disaster communication folks using social mobile media in the same way. Now we conducted a systematic review of the disaster social media literature. This is both the academic and
the professional literatures and we identified 13 different uses of social and mobile
media during a disaster, before disaster and after disaster. So across the disaster span and I obviously don’t have
time to review all 13 of these, but I wanna talk about three
in a little bit of detail because they illustrate recent
work that we’ve been doing. But what I also wanna point out is there’s a lot of opportunity here, but when we talk about
using disaster social media relative to an event,
we need to be specific about what we’re doing ’cause we might be talking about a bunch of different things. Okay, the three sort of uses
of disaster social media that I just wanna mention today and again this is kind of where
we’ve been working recently. The first is we can use
social and disaster media to detect and signal disasters. Again this might have some
utility and some connection to the 5G discussion before, so people can post, hey, I just witnessed a terrorist attack. I just felt an earthquake. And the interesting thing about this is that on these network technologies, they’re so powerful that here’s
a Washington DC earthquake that occurred about three years ago. Here’s the path of the seismic
outflow from the events. And these colored regions are where people are tweeting
about the event occurring. So we’ve got tweets out
here about the event that are occurring faster
than the event itself. And so this is just an
illustration of the power of this, but this network approach to communication and information has some
utility in understanding what’s going on. I had two more slides that aren’t there. So I’ll just tell you that
a couple other functions of social media that we can use or to provide situational awareness. So we’ve got a lot of social
and online crowdsource tools. Again this has been mentioned in some of the earlier presentations where people can post what’s
going on, post what’s needed. And so the citizens who are
near and far from the event can provide a sort of
snapshot of what’s going on. The final thing I’ll say is
that we can use social media to reconnect people affected by disaster. So following the 2011 Joplin Tornado, they had a very effective Facebook page that a lot of you are aware of where people who were
displaced from the event and maybe no longer living in Joplin or no longer where they
were before the event could reconnect with each other,
could connect with services and could connect with resources. And so building these online spaces that can provide for robust
recovery in the longterm are very important. And doing this work ahead of
an event, before it’s needed, establishing those spaces
so people know about it is something that we’re really working on and thinking about,
particularly in this time of sort of partisan and
polarized online spaces. How can we have more connective helpful, resilient online spaces? The final thing I’ll say
is that we have a disaster and community crisis center
here at the university others are the Joplin Facebook page. Thank you. But even more importantly
is our, well yeah, can you go back one? So the last thing I’ll
say is that, sorry Jeff. Yeah, perfect. Look at the plug for our websites. The most important slide of the day. so dcc.missouri.edu, we have
a center here in Columbia that’s focused on disasters
and community crisis. It’s interdisciplinary. It focuses a lot on
disaster communication, disaster mental behavior in public health. We’ve got a line of
federal and state funding over the years. So this is another resource
that is potentially connective in terms of future
proposals down the line. So thanks for your time and I
appreciate you including me. (audience clapping) – Okay our next speaker is Dr. Gearhart, who’s an assistant professor
of Social Work at UMSL. We got back on online. – How’s that half of the room doing? I feel like we’re really far away. All right, well I’m gonna
share some of my work going on in Ferguson and
I’m sure all of us here, much like many people across
the United States and the world are familiar with Ferguson and the tragic death of Mike Brown and the civil unrest that followed. Considerably fewer people are well aware of the development that’s
been happening since including the Ferguson Empowerment Center, which that burning building right there and the burnt-out records here is where this building now stands. And extra special shout out
for the folks at MU extension for being part of this partnership. A lot of the work that in quotes I’ll be sharing today come from that but in the three themes
I’m touching on today is resilience, rebuilding and rebranding. And in terms of resilience, I’m glad earlier speakers touched on, that resilience is
something that both happens in response to an acute event, but then also something
that’s built up over time. And in Ferguson you get both. There are people talking about
intergenerational poverty, intergenerational racism,
intergenerational trauma but then there’s obviously
still a very traumatic event that happened and when
it’s a social disaster, particularly one that involves
people who are perceived as being there to help, there is this tension
that needs to be processed and worked out. Like good intentions and rushing
in and going, going, going does not create space for people to really take in what
happened and move on. It feels more like you’re being acted upon instead of worked with. And I think if there’s something
that’s makes the difference between doing good work
and doing good work well, it’s building in that
time to have that process. And I’m happy to say that
the folks at the center have been doing that. And then in terms of rebranding, strong sentiment of people
talk about Ferguson, but do you actually know? We hear rumors that are
rooted in experiences, it could be 50 plus years old. Do we actually know about these areas that we are talking about? Because at the end of the day, fewer people know about the development that’s happening and almost nobody knows about the assets that we have. It is true that when
it comes to businesses, there is a surplus of liquor stores, beauty stores and fast food restaurants. Crime is still an issue,
varying based on areas, on seasons, but at the same time there’s also so many strengths. If you take a gander on the city walk, you have hidden gems of green space. In my mind a lot of people
say Soulard has the best farmer’s market in the metro area, for me Ferguson does, tons of local businesses including my personal favorite
Ferguson Brewing Company, the best red ale I’ve had in my life, consistent high quality product and when your product is
beer, that makes me happy. But we don’t hear about that
and we don’t talk about that. So I think the goal of my research is to generate more research
questions because job security. But that being said, a
participant at the center said, Ferguson is a mirror of our culture. We all have a Ferguson. I can talk about the
Ferguson’s of Cleveland where I grew up. I can talk about the Ferguson’s as Chicago where my boss got his PhD. I can talk about them
in a myriad of cities. And I want us to have
discussions around places like Ferguson, right? I argue that the people
of Ferguson are resilient in part because they have to be. Why is that? How did we get here and
do we care enough to act in terms of rebuilding? How do we balance this
immediate need for action and this desire to do with
the geological timescale of the problems that we are working with? Like we have to do something now, but we also have to recognize we didn’t just plop here in 2019. When it comes to rebranding, how do we develop realistic
appraisals of areas and people that result in calls to action? There’s something disheartening when I give this talk locally
or touch on Ferguson locally, people go, yeah, it’s not as
bad as the media says it is. And then we sit on our hands and move on. It’s like, how do we recognize it? Yes, it’s not as bad
as the media portrays, but we should still care. There are still issues and
it’s still our community. I had responded to talk about
on an international travel. Said I’m from Ferguson. Person’s like, ah. I said I was from St.Louis, person didn’t hear about the cardinals. Now they may have heard about the blues ’cause of the Stanley Cup, but like they hadn’t heard about us and they said, well,
actually I’m from Ferguson. And then they go, oh, I’ve heard of that. And then the story of Ferguson is how do we create authentic dialogue around the topics that need to happen, our past and our present of racial and income segregation and exclusion and in a way that lets
us take responsibility and then build a better future? And that work’s still very much ongoing. I’m doing a much more
intentional deep dive of police-resident
relationships in Ferguson with the UMIB grant. Thank you for that by the way. And I got 10 seconds left,
so y’all want to hear a joke? Why the chicken cross the road? Oh damn we’re out of time. (audience laughing) (audience clapping) – Okay, our next speaker is Dr. Hurley, who is a professor of history at UMSL. – In the midst of a grueling heat wave that engulfed the city of St.Louis, temperatures above 90 degrees
for nearly seven weeks in the summer of 1901. Estelle Nidell decided to end her life. The 19-year old woman was
homeless and destruct, tossed to the streets by her lover and spurned by a mother who
objected to her taste in men, a despondent Nidell headed
to the Compton Hill Reservoir to put a permanent end to her misery. A long the way, however, she
collapsed from heat exhaustion in a field of tall grass. Four days later, a pastor
by discovered her body, carried her to a nearby hospital where she was nursed back to health. Newspaper reports acknowledged the fortuitous circumstances
of her collapse. The cooling properties of lush vegetation had most likely saved her life. The fortuitous circumstances
of Estelle Nidell’s survival highlight ways in which adaptive responses to extreme weather events have intersected with changes in the urban landscape. In 1901 citizens of St.Louis had access to acres of
open-vegetated space and natural water features to which citizens who wanted
to persevere unlike Nidell could avail themselves. Most of these natural cooling features would disappear over
the subsequent decades due to intensive urban development. These kinds of relationships between urban development
and the social impacts of extreme weather lay at
the core of my research on urban resilience in
historical perspective. St.Louis heat wave of 1901 was one of a multitude
of extreme weather events that have required St.Louisans to mobilize emergency services and spend enormous sums of money on repair and rehabilitation and improvise ways to
keep the core functions of the city operating. But with a few exceptions
such as the flood of 1993, these natural disasters have received very
little academic scrutiny. Yet these events reveal
patterns of vulnerability, resilience and adaptation
that we increasingly recognize as critical aspects of the urban condition in the context of global climate change. So these are the two
central research questions that guide my research. And one element explores
the urban landscape, the changing urban landscape
and its intersection with the social impact of
extreme weather events. And the other aspect involves
changing social organization of cities over time. And these two are very much interrelated. To give an example of how
social organization matters, one can look at the tornado of 1927 , second deadliest tornado
in the city’s history resulting in 78 deaths and
several hundred injuries occurred in September of 1927 and tore a seven-mile path of destruction through some of the most
densely populated neighborhoods in the city. Among those neighborhoods
where Ellard Seville and the Finney Avenue district, which had recently become home to upwardly mobile African-Americans and their nascent business establishments, educational institutions
and civic cornerstones. In the days and weeks
following the cataclysm and this emerging network
of organizations and leaders sprang into action
mobilizing their resources on behalf of a constituency that had very little reason to trust the white-dominated public
and private agencies that were directing
citywide relief efforts. And the spontaneous and
often heroic efforts of those organizations and leaders not only guaranteed a quick
rebound of the community, but provided an
opportunity to push forward an agenda of racial advancement that would have profound
consequences for decades to come. Portal college played a key role in that community relief
and recovery effort. Portal college was a large, complex that was located in the heart of the Ellard Seville neighborhood
where the tornado hit. And it was associated with Annie Malone and her enterprise of cosmetic products where they were not
only manufactured here, but this was the place where
her sales force was changed. And it had all sorts of resources that could be brought to
bear on the relief effort for housing homeless
refugees from the storm, feeding hungry populations
and helping re-settle people. So these are just some
of the weather events that have picked my interest
and that I’m investigating. some of the data that I’ve collected has been used in community
planning exercises to assist neighborhood-based organizations plan for more resilient communities. And I also hope that my
research will contribute to a more general conversation about the meaning of resilience by emphasizing the subjective experience of those who lived
through disruptive events. This perspective reminds us
that communities and groups rarely aim to bounce back
to some initial state but rather to advance
particular social goals that changed drastically over time. (audience clapping) – So now we’re gonna do the Q&A session. So I’m gonna ask my speakers
to come back up here and take a seat. – Hi, my name is Rebecca Estis and I work at Columbia
Boone County public health. And speaking to Dr. Williams
on the early intervention for sudden and traumatic loss. The opioid epidemic that we’re
experiencing in Missouri. We’re just, that’s kind of
rocketing into everyone’s vision. And I think that when you
mentioned the Trauma One Hospital, I thought it would be a
great point of intervention but just wondering how, if you’ve looked into that at all as a specific traumatic loss and working with organizations that are trying to combat that epidemic. – Yeah. – No it’s a great question. And for the purposes of
the work that we’ve done, at least in particularly
in terms of the pilot work that we’ve done, looking at skills for psychological recovery, we have made that option available and we will offer that to folks who are bereaved by sudden unexpected overdose-related deaths. And one of the challenges that I think we sometimes run into, especially in serving that population and embedding something like this in medical center settings, is that a lot of times
folks may never have contact with acute medical
providers in the hospital if the loved one died
outside the hospital, right from an overdose-related deaths. So one of the challenges that
I think we have to think about is while we will reach a broader, we’ll reach more survivors
of a variety of types of unexpected and non-anticipated deaths by embedding services where
acute medical care is provided. But when a death occurs off site, right, a lot of times folks
may never have contact with those folks. So there has to be more
pro-active outreach. And I think that’s why one of the things that we’ve attempted to do in the past, for example, when we’ve done
early intervention models in the past and I work
with some colleagues at the Medical University
of South Carolina to develop and implement these
kinds of step care models, we’ll often work with law
enforcement victim advocates, crisis chaplaincy organizations and others who are actually
responding to death scenes in the community, right? So that we can actually reach those folks who otherwise may never come in for care where we’re working on embedding
some of those services now. So I think we have to embed care at a lot of different points and to that makes sure that
we’re coordinating better between agencies that
are all probably working with some of the same survivors
and same family members, because that can be really difficult and can be a barrier to care when families are trying to
coordinate different services across different disconnected
providers, right? So I think doing a better job of just making sure that all of us who are doing this important work are actually coordinating together and improving that coordination
and extending the reach of where our programs go and
taking the mountain community where they’re needed is something that we’ll have to make sure we’re doing when we’re thinking about how to train and disseminate these kinds of models. But I think it’s absolutely appropriate for many of the families that are bereaved by the tragedy of a sudden
and unexpected death, particularly overdose-related deaths. Absolutely. – My name is Sharon White
Lewis and I’m from UMKC. And this question is
also for Dr. Williams. We know that for instance
,with the Joplin Tornado, 135 nurses were called by
Show-Me-Response to respond but there was no training
for them on debriefing or the trauma that they saw. Is your program also focused
on the first responders, the nurses, healthcare workers
that are giving the care because, for instance, we know a fireman that was at 911 had to pick up a little girl
and she had a head injury, so he knew that he couldn’t do anything to allow her to survive and
he had so much negative energy passed towards him that he
eventually committed suicide. So they have an
extraordinarily amount of need for this kind of program. And I was just wondering
if you include them. – This last Saturday
actually we just completed a training for surgery
social workers and nurses at the Level One Trauma Center where we’re gonna be doing some work to hopefully sort of embed
this stepped-up model and to the hospital and the
training that we offered them was psychological first aid, right, Which I think can be more appropriate for some of our first responders. Again, particularly in that
just immediate 24, 48, 72 hours after first witnessing a traumatic event, a lot of times these single contacts won’t necessarily be
sufficient to completely sort of put folks on a path to recovery but they can be important
bridges and linkage to care for the next step of care that you need. But to answer your question, yes, we absolutely work with
a lot of fantastic nurses and a lot of folks that
are first responders. We’ve actually trained first responders. I’ve worked with police
officers in the past on some of these sort of
single contact interventions. And it’s something that can
be done by almost anyone, with the reasonable
amount of training, right? So absolutely. And I think that I would love
to see these kinds of efforts more widely disseminated,
more trainings offered. – I had a question for Dr. Parker on, you had mentioned very briefly that some of the rural
communities had more challenges in terms of pain management. I just wondered if you
could expand on that a bit. – You know, the opioid
crisis takes a different look when you’re talking about dying
patients and their families. And we have to be careful
as we address that crisis that we don’t hamper those who need those very effective drugs. And in the rural areas you
see a lot of the illegal use of those things and a
lot of those problems and including other drugs as well. And yet we have socially isolated
families that are in need. And so you get communities
where you have you have myths around how you administer
those pain medications and you have a caregiver
who’s very socially isolated. So how do we teach them that balance and how do we teach the
community not to stereotype and not to think poorly of individuals? We’ve a lot of work about pain management and the difficulties that caregivers have and the fears that they have, that they’re gonna kill somebody because they’re gonna treat their pain and when is somebody in pain versus when they’re not in pain. And those things all get amplified. And then there’s this big stereotype about living in the rural areas and with some of those poverty and those other issues that come to that. So that’s the focus of the, some of our future work is
how to make those decisions and how to help caregivers
do assessment appropriately and report and access those narcotics when they’re needed and
where they’re needed. – This is pretty much for the panel but specifically for those who are talking about different interventions. I’m wondering if you
have thought about this in the bigger context
of the organizational and environment through which
you’re doing these things. For example, in hospitals. Having hospitals that are
actually trauma-informed in the sense of understanding
what their staff are going through and being
able to be supportive. ‘Cause too often we find individuals, whether it’s doing an intervention or providing support to anybody that their actual organizations
are not supportive of them. And we have high staff
turnovers and things like that. So wondering if you
could put your research, maybe in a bigger context of
what we can do in that area. – I’d just like to say that implementing any tested intervention is the real key and none of us should do this
work if we don’t have a plan to figure out how to
actually make that happen within whatever organization. And so now as we solicit how
you design an intervention, how you test an intervention and then there’s how you
disperse that intervention into the real world. And so you make it really good point. – Yeah. I just like to say that the world doesn’t just revolve around horses. The human-animal interaction world and animal-assisted intervention world has largely developed
around the use of canines. Canines visiting people in hospitals. We have a multi-site randomized trial, which I couldn’t report on
here from three hospitals around mid Missouri indicating that this is a
very beneficial intervention and it can happen in any facility, assuming there are standards, so you always have to have standards around any intervention. And so yes, AJI human animal interaction is widely applicable across
a variety of settings. Been used in schools, in nursing homes, in hospitals as I said, but also in alternative locations
such as in food pantries where people are coming and
going and highly stressed and have their whole range of
trauma, in community centers, in community health centers
like the family health centers that provide low-cost care for people. (speaking off mic) – Kind of what I’m thinking about is you mentioned
schools for example, and what, bringing therapeutic
dogs or canines in, but if you’ve got a school
that is highly punitive, that doesn’t understand
the trauma or experiences that their students have had, it doesn’t matter really what you bring in if that environment is not trauma-informed and I think to the point
about the research, it’s been kind of difficult
to get that research really because it is so
nebulous, so to speak. But we do know what their
components of organizations about their human resource policies, their addressing staff stress and giving them breaks
and supports and benefits, understanding how we
hire, terminate, train all of those things are critical to creating healthy environments that then can actually
support those individuals who may be experiencing
this primary trauma. So just wondering if any of that has been a part of the
studies or consideration and communities as well for
– We have not studied the readiness of people in these settings. We have studied staff
outcomes, however, for example, in the prison system in 19 of
the 21 prisons in Missouri, dogs are being trained by
offenders living there. And that has, we found
a significant impact on job satisfaction and health of staff. So you can see environment’s
changing over time. And if you see that that is working, then you have a lot of work to do to help people see how to
implement those programs effectively to maximize
the benefits on the staff. – And just to kind of as a quick aside, you could imagine MU extension
being a important cog in trauma-informed communities
across the state, right? And think about PFA and SPR
and that sort of mechanism. So there is a lot of potential from an NMU system perspective. – And I’ll speak as a community organizer in the field of social work. Part of it is also just recognizing that it applies to us
in the work that we do, simply because trauma
wasn’t that big of a thing 20, 30 years. It wasn’t talked about as much. Definitely not practice like
from a practice standpoint. And then trauma-informed
cares relatively recent given what we know about it. As a community organizer
trauma wasn’t mentioned in any of my classes, but the communities that
we are working with, there’s tons of it. And one of the cries from the providers in this is, we are seeing a lot of trauma and we don’t have the
skills to deal with it. Only one person who has ’cause that’s, they had more
of a direct social work role earlier in their career. But it’s like recognizing that is a need I think is a critical first step. – Okay, we have time
for one more question. – Just a quick to all of you but specifically to Dr. Hurley, has any focus been given to
working with the organizations that could be providing those supports after a disaster about
continuity of operations or business continuity plans? Because the expectation
does sort of fall on them, their day to day providing a human service and now the human service has increased. And people who were like
borderlined are now in crisis mode. So if they were recovering from alcoholism or they were recovering
from domestic violence, that now their situation
has been exasperated and if the, either the
building, the structure where they went to get that care or that staff is now unavailable, how that kind of just starts to snowball. Do you, anything about? – Short answer is no. (laughing) That has not been, my
involvement in sharing and collaborating with communities has been in the realm of planning and primarily of working with
neighborhood organizations, on land use planning to create landscapes and also organizational capabilities to deal with these issues but not so much with
professional organizations. – Okay, I think it’s time for lunch. So let’s thank our speakers one more time. (audience clapping) Great session.

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