bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of Sub-National Policies for Making Hospitals Safe from Disasters: Study in Yogyakarta Province, Indonesia
Authors: Donna Bella , Ariani Madelina
Published: June 2023

Introduction:

Disaster and emergency management planning has an essential role to ensure that hospitals can continue to function in disaster response situations. However, there are several gaps for safe hospital policies and implementations between national and provincial/district level. The Special Region of Yogyakarta, as one of the provinces with high disaster risk in Indonesia, initiated a study to identify local policies needed for safe hospitals.

Method:

Focus Group Discussion (FGD) series were conducted with several hospitals representing private, public, academic, and military hospitals located in the first ring of Mount Merapi, an active volcano located on the border between Yogyakarta and Central Java Province. The FGD participants consisted of the Hospital Disaster Plan team, hospital task force of COVID-19, emergency department and hospital management team. Three FGD were carried out with different topics of discussion in each session. The topics were hospital experiences in implementing Hospital Disaster Plans during COVID-19, hospital incident command, coordination and networking. In addition, they also conducted advocacy and public consultation

Results:

The study that involved 12 hospitals and 40 persons, resulting in 11 specific additional policies for Yogyakarta safe hospital which include; six additional Standard Operating Procedure (SOP) in terms of donation management, volunteers’ recruitment and cost claim; one initiated Memorandum of Understanding (MoU) for surge capacity; conducting functional exercise rather than full scale ritual simulation with management scenario, as well as develop two plans for cyber-attack and business continuity plan.

Conclusion:

The pocketbook of Yogyakarta’s safe hospital will be useful for more than 70 hospitals in implementing and developing their hospital disaster plan, improving coordination among hospitals in the disaster phase, as well as a lesson-learned process for other regions to develop their local-based safe hospital policies.
Development and Implementation of Prioritized Care in a Tertiary Hospital Intensive Care Unit During the Sars-Cov-2 Pandemic
Authors: Boroli Filippo , Tassaux Didier , Paubel Annie-Claude , Lenoir Helene , Pugin Jerome , Hagon Olivier
Published: June 2023

Introduction:

In the event of a major event or disaster, the intensive care unit (ICU) should be able to offer an adapted and proportional response, within a limited time frame, to the influx of patients who can benefit from the technical facilities of the University Hospitals of Geneva. We developed an innovative approach to ICU care aimed to guarantee continuity by protecting healthcare staff from excessive fatigue and by tailoring the care provided from individualized care to the best care for the most people.

Method:

A modified organizational and systematic investigation method (MINOS, Paries - 2013) was used to elaborate an ICU security model; threats to activity shut down were identified and their prevention, recovery, and mitigation were planned. These actions were updated following the evolution of the crisis. Crew resources management (CRM) and bedside simulations were used in the implementation phase.

Results:

The ICU security model pillars were staff protection and patient management; the identified threats to activity continuity were lack of human resources, activity overload, medical errors, pressure sores and healthcare acquired infections; they were evaluated at intermediate or high risk to patients’ safety. The prioritized care plan was developed to control, recover, and mitigate these threats. It consisted in: adaptable level of ICU care, modular organization by cell, huddles, matrix for activities prioritization and controlled delegation method. Before implementation, 55 nurses and 46 doctors were trained by CRM courses and simulations. The pilot phase was deployed in one cell, from December 2021 to January 2022; 67 patients were admitted in the period; 13 adaptations to the original plan were introduced. No critical safety issues were reported.

Conclusion:

The prioritized care could be an adapted and proportional ICU response to a major event allowing the continuity of the activity while protecting staff from overload. Further tests are needed.
Deployed in Disaster: Exploratory Study of Personnel Deployed into Ontario Long-Term Care Homes during the COVID-19 Pandemic
Authors: Oldenburger David , Baumann Andrea , Crea-Arsenio Mary , Baba Vishwanath , Deber Raisa
Published: June 2023

Introduction:

The COVID-19 pandemic had a devastating impact on long-term care in Canada, exacerbating an existing crisis of staff shortages, inadequate infrastructure and funding, into a disaster. In response, the province of Ontario enacted emergency legislation and requested federal government support, resulting in the deployment of personnel from the Canadian Armed Forces and acute care hospitals into long-term care homes across the province. This exploratory study aims to develop a rich description of the long-term care context during the pandemic, deployed personnel's perspectives on providing care in the context, and identification of lessons learned while working during the pandemic.

Method:

Descriptive exploratory design with demographic questionnaire and semi-structured interviews will be used to understand the background and perspective of deployed personnel and managers on working in long-term care during the pandemic. Thematic analysis will be used to analyze the transcripts, organize codes, and identify and describe major themes. Findings will also be compared with disaster literature to understand how the perspectives of deployed personnel compare with existing disaster research.

Results:

21 interviews were initially conducted. Analysis of these interviews identified key challenges experienced by those deployed, including human resources, leadership and accountability, and policies and regulations. Perspectives and strategies for overcoming these challenges were also shared.

Conclusion:

The scale, duration, and context of the redeployment of personnel into long-term is unprecedented and has seen little research. This exploratory study shares the experiences of personnel who deployed into long-term care and helps identify lessons learned from overcoming challenges in the disaster context. These findings will be able to inform future disaster research and how to better prepare responders in the future.
A Hole in the Safety Net: Failures of the Initial COVID-19 Pandemic in Kentucky
Authors: Katirji Linda , Desai Sameer
Published: June 2023

Introduction:

The COVID-19 pandemic hit Kentucky in March of 2020. While around the world the pandemic had already reared its head and strained international hospital systems at their core, Kentucky hospitals remained wholly underprepared. University of Kentucky Hospital is a relatively resource rich hospital. However, utilization of these resources was severely misplaced and inefficiently distributed. This led to unnecessarily large upfront costs in an attempt to prepare for large volumes of patients that never actually came, as well as risk stratifying patients in a costly and unproductive way.

Method:

We reviewed the initial response to the COVID-19 pandemic from the University of Kentucky as well as specifically within the emergency department. This included all system-wide preparations as well as emergency medicine-specific COVID-19 protocols regarding risk stratification of patients, testing, and delivering results.

Results:

Initially the number of patients that would need to be hospitalized with COVID-19 as well as how to risk stratify or treat them was completely unknown. This led to multiple large issues within University of Kentucky's response to the pandemic. A 400-bed field hospital was constructed out of University of Kentucky’s football field and subsequently deconstructed two months later before ever being used, costing the hospital $6.7 million dollars. Lack of tests and knowledge about the disease in combination with over ordering labs and CT scans in an attempt to risk stratify. There was no reliable way to obtain COVID-19 testing or deliver the results and this led to increased non-sick patients presenting to the ED just for information.

Conclusion:

The COVID-19 pandemic highlighted many shortcomings of our hospital system and its preparedness for a pandemic or mass disaster. The silver lining of these failures was the implementation of system wide improvements in throughput and preparation within our emergency department.
Mapping Nurses’ Advanced Roles in Emergency Departments Globally
Authors: Lamberti-Castronuovo Alessandro , Franchini Roberta , Ragazzoni Luca , Molin Alberto Dal
Published: June 2023

Introduction:

It is widely recognized that there is an increasing demand for healthcare in emergency departments (ED) around the world as well as a global shortage of healthcare workers (HCWs). This has led to ED overcrowding, which increases risks of avoidable complications and suboptimal care provision. Since ED overcrowding impacts patients, staff and quality of care, new strategies are needed for optimizing patient throughput and reducing waiting times. One such strategy is to reconsider the specific roles and professional duties of different cadres of HCWs. Empowering nurses to take on some of the tasks historically performed by physicians is a promising solution for improving ED healthcare provision. However, nurses’ professional responsibilities and competencies differ significantly from country to country. There are few studies about best practices and how to effectively implement such task-shifting strategies. The aim of this study is to map the evidence published in the scholarly literature on nurses’ advanced roles in ED as a strategy for reducing overcrowding, facilitating ED throughput, and, ultimately, improving quality of care.

Method:

A mapping review was performed by searching the following databases: PubMed, Embase, Scopus and Web of Science.

Results:

A total of 168 studies were analyzed and the data were grouped according to the countries where advanced tasks were implemented. The type of tasks that were carried out were: autonomous management of patients with minor injuries, triage-based ordering of exams and administration of therapy and management of patient flow.

Conclusion:

In some high-income countries having nurses take on advanced roles is well-established, and it contributes to reducing overcrowding in ED. Further evidence is needed to assess the barriers and facilitating factors to implementing this strategy in other contexts.
Quality Improvement Project: Optimizing Compliance with NICE CG176 Head Injury CT Time Standards at Wexford General Hospital Emergency Department
Authors: Orsmond Brendan , Andrews Robin , Bilal Muhammad , Jordaan Phillip , Price Alexander , Kennedy Keith , Kleinhans Rochelle , Conradie Maria , Molloy Michael , Wickham Bryce , Kelly Paul
Published: June 2023

Introduction:

Head trauma is a high-risk presentation to the emergency department (ED). Preventing secondary brain injury through earlier diagnosis and intervention relies on timely access to head CT. Wexford General Hospital (WGH) ED uses NICE guidelines, which recommend specific timeframes for acquiring CT in head trauma. Following an audit demonstrating low compliance to NICE CG176 time standards in 2020 (34%), a quality improvement project was undertaken to optimize imaging pathways for head trauma.

Method:

94 head trauma CT scans were analyzed over a two-month period (June 14, 2022-August 14, 2022) from the NIMIS and IPMS databases to establish current time compliance and median wait times for CT.

Following the implementation of a head injury assessment proforma at triage to prompt earlier evaluation of high-risk head injuries, 108 head trauma CT’s were reviewed over a two-month period (August 15, 2022-October 15, 2022) to determine if these parameters improved.

Unpaired, two-tailed Mann-Whitney’s test was used to compare median wait times from triage to CT. Two-tailed Chi-square test was used to compare overall compliance rates.

Results:

Overall ED compliance to NICE time standards improved following implementation of the proforma (43% vs. 36%, p=0.401).

For CT scans that were indicated within one hour, there was a statistically significant decrease in median wait time from triage to CT (134mins vs. 186mins, p=0.046). There was also a decrease in median wait time for scans indicated within 8 hours; however, this did not reach the threshold for statistical significance (216mins vs. 275mins, p=0.230).

Conclusion:

Although there was an overall reduction in wait times for CT, this did not translate to a significant improvement in compliance rates to NICE CG176 time standards. This suggests that, despite earlier identification of these high-risk head injuries at triage, other systemic barriers to obtaining head CT are present and warrant further investigation.
Assessing Trends and Severity of Emergency Department Access Block by Measuring Median ED Length of Stay for Admitted Patients
Authors: Schwartz Dagan , Goldberg Avishay
Published: June 2023

Introduction:

The Emergency Department (ED) is the hospital’s main gateway, as well as the initial site for diagnosis and emergency medical care. In recent years, ED overcrowding is worsening in Israel and world-wide. Overcrowding has been shown to adversely affect patient service and care, fostering patient and caregiver dissatisfaction, as well as lowering quality of care and even increasing mortality. A main driver of ED overcrowding is ED patient boarding due to limited inpatient bed availability in conjunction with hospital policy. Measuring median length of ED stay (LOS) for admitted vs. discharged patients can serve as a simple indicator for the severity of the access block over time and between facilities.

Method:

ED operational data from the computerized system of four hospitals in Israel were collected over a year and analyzed. In parallel data was collected regarding hospital capacity and ED volumes. Data were analyzed using SPSS.

Results:

The Mean ED LOS was significantly higher for ED patients needing admission in all hospitals. Mean ED LOS for admitted vs. discharged patients was 227 min vs.431 in hospital A, 215 min vs. 222 in hospital B, 198 min vs. 440 in hospital C and 167 min vs. 190 in hospital D. The discrepancy in LOS for admitted patients was not related to the total hospital bed capacity or the hospital ED patient volume.

Conclusion:

ED boarding is a major challenge for ED's and hospitals worldwide and a significant contributor to ED overcrowding. A tool to assess boarding is proposed. The tool calculates the ratio of median ED LOS between patients admitted to the hospital and those discharged. Slightly higher LOS among those admitted is to be expected, considering the fact that they usually present with more complex medical problems. In this study the LOS ratios were 1.03, 1.12, 1.90 and 2.22.
Advancing Delivery of Emergency Care in Honduras: Creating a Reanimation Room
Authors: Argote-Araméndiz Killiam , Bárcenas Angel , Apolinar-Menéndez Hector , Ciliezar-López Elsa , Castro Fernando
Published: June 2023

Introduction:

Early recognition and treatment of critical clinical conditions have decreased morbidity and mortality in critically wounded and sick patients. Worldwide, Emergency Rooms (ER) are overcrowded, and the complexity and number of patients keep increasing. This phenomenon challenges health professionals when applying time-sensitive interventions generating unfavorable outcomes. Considering that the ER is the first point of contact for patients of Hospital Escuela, a 1306-bed, academic, tertiary care hospital in Honduras, we describe the creation of a Resuscitation Room (RR) to improve patient care in the ER.

Method:

Data from patients, including dates, source of admission, diagnosis, and outcomes, were recorded daily in a database from June 1, 2022, until October 31, 2022. Then the analysis and interpretation were made using Microsoft Excel.

Results:

In the five-month period, 1,118 patients were admitted to the RR, with 58% males, a 52-year-old mean, and October as the busiest month (33%). Most patients consulted between 0600 and 1800 hours (70%). The primary admission cause was a medical condition (71%), and shock (41%) was the most common type of emergency followed by trauma (25%). After stabilization, 86% of patients remained in observation areas of the ER, only 5% went to the operating theater, and 1% to the intensive care unit. The mortality rate was 5%, 48% trauma related.

Conclusion:

A RR meeting the minimal standards for space, trained staff, medical equipment, and consumable resources has been shown to be beneficial in improving interdisciplinary work in the ER. This RR has enabled life-threatening conditions to be recognized and treated rapidly while also promoting information gathering on critically wounded and sick patients and their outcomes. The need to standardize the clinical care to such patients has also been identified. Further efforts to protocolize the response are needed to improve patient care.
A Review of Policies Related to Internal Displacement in the Context of Disasters: An Australian Case Study
Authors: Krishna Revathi , Cross Suzanne , Spencer Caroline , Abrahams Jonathan , Archer Frank
Published: June 2023

Introduction:

According to the Internal Displacement Monitoring Centre (IDMC), more than 60% of the internal displacements recorded worldwide in 2021 were due to disasters. A conservative estimate by IDMC reports 65,000 new displacements between July 2019 and February 2020 as a result of the Black Summer bushfires and more than 42,000 displacements due to flooding in February and March 2022 in Australia. These are estimates as there are no consistent or consolidated data on those who are displaced in Australia affecting the measurement of the magnitude of displacement, and the knowledge of experience, impact and needs of displaced people to inform policy and practice. Thus, the aim of this study, as part of a larger project, is to review key international and Australian policies about data on internal displacement due to disasters.

Method:

We conducted a desk review of key international policies, such as the Sendai Framework for Disaster Risk Reduction and from the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA), as well as Australian policies such as the Australian Disaster Preparedness Framework, Emergency Management Arrangements Handbook and even state level emergency legislation/acts and plans to understand the data collection and supports and services provided to those who become displaced due to disasters.

Results:

This review found that both international and Australian policies lacked specific focus on internal displacement, despite it being a key issue. While international policies and procedures in low income countries exist, in particular where the international humanitarian system is operational, this review found that Australia lacked specific focus on internal displacement.

Conclusion:

Data on displacement due to disasters, including the number of people displaced, and the patterns of their displacement is critical to inform better policies on prevention, emergency planning, evacuation response and finally to improve the support that people who are experiencing displacement receive.
The Growing Needs of Internally Displaced People in High-income Countries: Extending the Scope of Internal Displacement
Authors: Cross Suzanne , Krishna Revathi , Spencer Caroline , Abrahams Jonathan , Archer Frank
Published: June 2023

Introduction:

The concept of disaster related internal displacement is typically seen as something that occurs in low-income countries and is rarely considered in the setting of high-income countries. This leads to a paucity of data to support contextually appropriate best practices to address displacement. This research, funded by the Australian government, explores the lived experiences of those faced with forced displacement from disasters in high-income countries and aims to improve outcomes for this vulnerable cohort.

Method:

The first phase of the research, guided by a broad-based Steering Group, included a rapid literature review and thematic analysis of peer-reviewed literature of disaster related, internal displacement in high-income countries, including Australia.

Results:

The peer reviewed literature review identified only 12 papers that met the inclusion criteria. The literature from Australia and other developed countries indicated that internal displacement is a prominent feature of disaster impacts and that needs are complex, dynamic and diverse. Common themes of need were revealed: the need for the development of an evolving displacement policy framework to support human rights; the co-creation, coordination and provision of timely and flexible support services, and on-going data collection and sharing. No displacement, specific frameworks, measurable thresholds, or central data registries exist at federal or state government levels in Australia to support these needs.

Conclusion:

Inclusive policies, practices, and resources are required in Australia to support assets of displaced people and address their unmet needs in disasters, which also remain largely unmet in other high-income countries. Australia can learn from all countries faced with the challenges of managing displacement and also share its own experiences. Furthermore, it is recommended that WADEM consider extending its current Position Statement relating to Refugees and Internally Displaced Persons to include high-income countries based on the findings of our study and other sources.
Advancing Delivery of Emergency Care in Honduras: Implementing a Triage System
Authors: Argote-Araméndiz Killiam , Yi Cristel , Juárez Sara , Melgar Fabiola , Crúz Raquel , Bautista-García Ico , Martínez-Pérez Javier , Rodlán-Córdoba María , Apolinar-Menéndez Hector
Published: June 2023

Introduction:

Overcrowding in the Emergency Room (ER) is a worldwide phenomenon affecting healthcare professionals' ability to apply life-saving interventions to critically wounded and sick patients. Implementing a routine triage system allows the early recognition and treatment of critical conditions such as polytrauma, difficulty in breathing, shock, and altered mental status. Furthermore, a triage system allows the prioritization of patients and the delivery of timely care. We describe the improvements in patient care for the critically ill through the implementation of a triage system in Hospital Escuela (HE), a 1306-bed, academic, tertiary care hospital in Honduras

Method:

Demographic data was recovered through paper triage forms from January 2020 until December 2021. From January 2022 to June 2022, the data was primarily recovered from digital triage forms. The data was consolidated, analyzed, and interpreted using Microsoft Excel.

Results:

During the thirty-month period, there were 161,848 triage consults, with 2.7% being critically wounded and sick patients, classified “red” according to the triage system. Most cases were triaged as yellow (53%), followed by green (23.6%), and then orange (15.8%). Some triage forms (5%) did not assign classifications. One-third (33.4%) of consults were diverted from the ER to the Triage and Urgent Care Room (SATU for the acronym in Spanish). Trauma-related cases accounted for 26.2% of the consults with 3.6% of the overall being weapon wounded.

Conclusion:

Implementing a triage system in HE enhanced the recognition and treatment of critically wounded and sick patients. This system has improved patient flow and the use of clinical space in the ER by diverting low-acuity patients to the SATU. Multi-disciplinary collaboration among healthcare professionals has also improved and the need to create a centralized Resuscitation Room was recognized.
Humanitarian Aid in Disaster Management; A Developing Country's Experience, Nigerian Red Cross Society Lagos State Branch Perspective
Authors: Kolawole Victoria
Published: June 2023

Introduction:

Humanitarian aid is an important part of an emergency response to Disasters and crises situations. When a community or a country is hit by disasters, urgent responses are needed to save lives and provide for the basic needs of the people affected. Humanitarian actors like the Nigerian Red Cross Society, play a vital role in these urgent actions and the aid they provide is fundamental to crisis responses. Responses to humanitarian emergencies involve the mobilization of resources.

The Nigerian Red Cross Society, Lagos State Branch carried out some humanitarian actions for Lagos State populace during the peak of the Covid 19 pandemic in the year 2020 and also in 2021 with the support of well meaning Nigerians, IHS, and the British Red Cross who donated, supported and sponsored the activities.

The offshoot of the COVID-19 operation which subjected us to an extremely helpless corner, was the high magnitude of the most vulnerable people crying out for food in different suburbs and slums of Lagos following the State’s lockdown.

Method:

Humanitarian assistance was delivered based on assessed needs, and according to the humanitarian principles of humanity, neutrality, impartiality and independence, which is the fundamental principles of the Red Cross movement. The methodology of the Humanitarian Aid used includes the following:

1. Rapid Assessment

a. Criteria to be used

b. Questionnaire Guide

c. Checklist

d. Rapid Assessment Form

2. Compilation of Information obtained from the Rapid Assessment carried:

3. Validation of Data

4. Data Analysis

5. Delivery

Results:

The outcome was to limit the impact of Covid 19 and help people return to normal. The anticipated effect of the intervention on the members of the communities was achieved.

Conclusion:

Nigerian Red Cross Society Lagos State Branch’s humanitarian investments have been able to save lives, reduced suffering and restored human dignity.
COVID, Co-Ventilation, and Cross-contamination
Authors: McMahon Jonathan , Doukas Donald , Hanuscin Christopher , Quale John , Eason Julie , Asrat Habtamu , Bhatt Isha , Silverberg Mark , Paladino Lorenzo
Published: June 2023

Introduction:

During the COVID-19 pandemic, consideration was given to co-ventilating multiple patients on a single ventilator. Prior work had shown that this procedure was possible by ventilating four adult-size sheep for twenty-four hours, and other groups had performed this maneuver during dire circumstances. However, no investigation had examined the safety regarding cross-contamination. The purpose of our studies was to investigate if an infection could spread between individuals who were being co-ventilated.

Method:

Four sterile two-liter anesthesia bags were connected to a sterilized ventilator circuit to simulate the co-ventilated patients’ “lungs.” The circuit utilized Heat and Moisture Exchange filters and bacterial/viral filters, which were strategically inserted to prevent the transmission of infectious droplets. Serratia marcescens was inoculated into “lung” number one. The circuit was then run for 24 hours, after which each “lung” and three additional points in the circuit were cultured to see if S. marcescens had spread. These cultures were examined at 24 and 48 hours to assess for cross-contamination. This entire procedure was performed a total of four times.

Results:

S. marcescens was not identified in lungs two, three, or four or the three additional sampling sites on the expiratory limb of the tubing at 24 and 48 hours in all four trials.

Conclusion:

Cross-contamination between co-ventilated patients did not occur within 24 hours utilizing the described ventilator circuit configuration.
The Vaccinodrome: How to Set up the Largest Mass Vaccination Center in Europe.
Authors: Viault Benoit , Houze-Cerfon Vanessa , Zerdoud Léa , Bounes Vincent
Published: June 2023

Introduction:

Covid-19 pandemic had a massive impact on the capabilities of the healthcare system. The development of the vaccines and the setup of the vaccination program of the general population required an important coordination and organizational work, from an already worn-out system.

The implementation of mass vaccination centers is known as the most efficient way of vaccinating rapidly and efficiently a large part of the population, but requires a non-negligible amount of resources. For Covid-19 vaccination, time sustainability was an important challenge to consider due to the timespan needed between boosters; unfortunately, most of the models presented up to 2020 are short duration systems.

A mass vaccination center (MVC) organizational model was proposed and staffed with only two health care workers on a daily basis, with a more than 10,000 shots a day capacity over a seven-month duration.

Method:

The MVC was under the supervision of one medical coordinator, one nurse coordinator and one operational coordinator. Students (both in health and non-health studies) were the most important part of the human resources. Data concerning the population vaccinated, the number and the type of vaccines used were routinely recorded.

Results:

From March 28 to October 20, 2021, 501,714 vaccines were administered at the MVC. A mean rate of 2951 ±1804 doses was injected per day with a staff of 180 ±95 persons working every day. The peak was reached with 10,095 injections in one day. The average time spent by a patient in the MVC was 43.2 ± 15 minutes. The average time to be vaccinated was 26 ±13 minutes.

Conclusion:

Provided with adequate supervision, an optimized organization and adequate training, the use of a student workforce allows for the implementation of a functional, efficient, and sustainable mass vaccination center.
The Application of Information Technology in Preventing and Controlling COVID-19 Pandemic: A Bibliometric Study
Authors: Li Yue , Li Ji , Cao Chunxia , Fan Haojun
Published: June 2023

Introduction:

Information Technology has been applied to respond to the coronavirus disease 2019 (COVID-19), which has attracted increasing attention. However, there is still no comprehensive bibliometrics study in the global publications on the application of Information Technology in COVID-19. This study aimed to investigate the current research status of Information Technology in preventing and controlling the COVID-19 pandemic.

Method:

Relevant literature published between 2020 and 2022 was downloaded from Web of Science Core Collection (WoSCC) databases. Key search terms included COVID-19, big data, artificial intelligence, internet of things, cloud computing, etc. The data elements were as follows: year, countries/territories, institutions, authors, journals, research areas and citations of publications. Statistical methods and knowledge domain maps were applied to conduct contribution and collaboration, co-occurrence and co-citation analysis using VOSviewer. COOC software was used to construct the two-mode matrix, conduct hierarchical cluster analysis of high-frequency keywords and journals, and identify keywords of bursts.

Results:

A total of 10,962 articles were retrieved. The most frequent country and institution were USA (2,423, 22.10%) and the University of California System (212, 1.934%), respectively. The research areas were included but not limited to computer science (2,198, 20.051%), engineering (1,421, 12.963%) and public environmental occupational health (1,032, 9.414%). Three research hotspots were identified: (i) Internet-based social and psychological surveys; (ii) Distance education, telecommuting and telemedicine; (iii) Artificial intelligence-assisted diagnosis of COVID-19 patients. The clustering results of a two-mode matrix showed that research had the most frequent interaction with health, social media and information technology. According to co-citation analysis, a total of four clusters of journals had been obtained (clinical medicine, medicine, computer science and engineering, and public health). The keywords of burst were computer-based learning, general public, student-centered learning, etc.

Conclusion:

Information technology has played an important role in the response to COVID-19, which belongs to the interdisciplinary field.
Impact of Early Phase DMAT Support Using Natural Disaster Support Techniques for Hospitals Experiencing COVID-19 Outbreak in Japan.
Authors: Akahoshi Kouki , Kondo Hisayoshi , Wakai Akinori , Yajima Yuichi , Matsuda Hiroki , Toyokuni Yoshiki , Koido Yuichi
Published: June 2023

Introduction:

Hospitals experiencing a COVID-19 outbreak are in a similar situation to those affected by natural disasters, with a breakdown in command and coordination, shortage of personnel and supplies, and increased stress among staff. In Japan, when a COVID-19 outbreak occurs, the first step is for the hospital or health center to respond. However, if the local authorities are unable to respond, the Ministry of Health, Labour and Welfare dispatch Disaster Medicine Assistance Team (DMAT) by request of the local government to facilitate early recovery. This study will examine the effectiveness of early phase support by DMAT.

Method:

Patients and healthcare workers in 31 hospitals supported by DMAT after an outbreak occurred between April 2020 and January 2021 were included in the study. Attack rate and case fatality rate for patients and the attack rate for healthcare workers were analyzed for each of the two groups: those that started support less than ten days after the first positive case and those that started support more than ten days after the first positive case.

Results:

For hospitals that started support in less than ten days, the attack rate was 27.9%, the case fatality rate was 17.4% for patients, and the attack rate for healthcare workers was 9.7%. For hospitals that took more than ten days to start support, the attack rate was 44.8%, the case fatality rate was 23.1% for patients, and the attack rate for healthcare workers was 14.3%. The attack rate (p<0.001) and case fatality rate (p=0.011) for patients and attack rate for healthcare workers (p<0.001) were significantly lower in hospitals that started support in less than ten days.

Conclusion:

Early intervention of DMAT support using natural disaster support techniques for hospitals experiencing an outbreak reduced the attack rate and case fatality rate for patients and healthcare workers.
Climate, Weather Extremes and Health: Latest WHO-WMO Resources and Tools for Health Emergency Managers
Authors: Borries Rosa von , Shumake-Guillemot Joy , Nairn John , Murray Virginia , Abrahams Jonathan
Published: June 2023

Introduction:

As populations worldwide are experiencing more frequent and intense weather and climate extremes, many professionals of the WADEM community are at the frontline of managing compounding and cascading impacts on physical and mental health. Vulnerable, isolated, and marginalized people are the most affected by climate and weather threats. The elderly and children faced 3.7 billion more life-threatening heatwave days in 2021 than annually in 1986-2005 increasing the need for emergency care on a large scale.

Method:

The World Health Organization (WHO) and World Meteorological Organization (WMO), together with partners from health agencies, climate services, academia and other sectors are collaborating to accelerate the use of climate, weather and environmental science and services for better health protection. A selection of key resources and tools will be highlighted that can be used by the WADEM community to better understand, anticipate, and manage health risks from extreme weather and climate.

Results:

Participants will learn about the new WHO-WMO ClimaHealth Portal, a global knowledge and action hub with huge potential for facilitating learning and action to better protect health from climate risks. Tools and resources include the Global Heat Health Information Network (GHHIN) Checklist and Technical Brief for improved heatwave preparedness and response in the context of COVID-19, and a new WHO Guidance Document on Measuring the Climate Resilience of Health Systems providing a framework and indicators for assessing and protecting health systems from climate threats.

Conclusion:

As extreme weather intensifies, integrated climate-informed services for the health sector including multi-hazard early warning systems and action plans, as well as strengthened partnerships between the health community and hydrometeorological services are indispensable to further restrict adverse health impacts. Accelerating the uptake and upscale of existing tools and resources is urgently needed to meet the increasing health and societal challenges caused by climate change and weather extremes.
Quarantine Facility Model of Care Toolbox
Authors: Stephens Dianne , Sheedy Angela , Vermeulen Lisa , Anderson Allan
Published: June 2023

Introduction:

The COVID-19 pandemic public health strategy to reduce community transmission in Australia included unprecedented use of quarantine facilities to separate those at risk and those with the infection from the rest of the community. No standardized approach to quarantine facilities existed resulting in different models of care emerging across the country. The Northern Territory Howard Springs Quarantine Facility was a large-scale quarantine and isolation operation which hosted over 33,000 domestic and international arrivals with zero COVID-19 transmission recorded from residents to staff for the duration of its operation. The facility was deemed the gold standard model of care and the aim of this project was to distill the important elements of that model of care into an evidence-based tool kit for future use as an open access, online resource. The toolkit was a result of intense data and information analysis including resident, staff and leadership surveys, policies and procedures and results of audits of the facility during its operation.

Method:

This project to develop an online, open access evidence-based toolkit forms part of the Translational Research to Improve Health Outcomes project funded by the Australian Government’s Medical Research Future Fund. The methodology included mixed methods with an underpinning grounded theory approach to analyze de-identified audit data and information from the quarantine and isolation facility operational period. Staff and leadership team surveys were conducted to explore experiences of site functions and infrastructure. A (non-experimental) descriptive design allowed collation and statistical analysis of information recognizing the variables in the data and information.

Results:

The toolbox includes a resident centered quarantine care model, infection, prevention and control strategies for health professionals and non-health staff, quarantine communication model and presentation of core challenges (rapid recruitment, environmental factors, workforce resilience).

Conclusion:

The resulting online web resource presents evidence-based core strategies and resources for implementation in future pandemics.
The Usage of a COVID-19 Contact Tracing Electronic Platform in Greece: Exploring Opportunities, Challenges, and Data on SARS-CoV-2 Infectivity.
Authors: Bistaraki Angeliki , Stefanopoulos Nikolaos , Roussos Sotirios , Sypsa Vana
Published: June 2023

Introduction:

Contact tracing is a core public health tool used to interrupt the transmission of pathogens, including SARS-CoV-2. To increase the effectiveness of contact tracing, Greek health authorities used an electronic platform to aid traditional manual contact tracing to track individuals who have come in close contact with identified COVID-19 patients.

Method:

Contact tracing was implemented from the beginning of the pandemic in Greece. The aim was to identify and quarantine all the contacts of confirmed cases. The electronic database was designed following all the security protocols and national regulations on the use and protection of personal data. To assess factors associated with infectivity and susceptibility to infection in this analysis, we used contact tracing data with a sampling date between October 1 to December 9, 2020.

Results:

During the sampling period, 29,385 laboratory-confirmed SARS-CoV-2 cases and 64,608 traced contacts were identified. A median number of two persons were traced per index case. The secondary attack rate was 17.4% (95% CI: 17.0-17.8). Contacts aged 0–11 and 12–17 years were less susceptible to infection than adults 65 years or older (odds ratio (OR) [95% CI]: 0.28 [0.26–0.32] and 0.44 [0.40–0.49], respectively). Index cases aged 65 years or older were more likely to infect their contacts than other adults or children/adolescents.

Conclusion:

Contact tracing is a key strategy to interrupt chains of transmission and to promote early diagnosis. The data collected in this process could be used to estimate epidemiological parameters of interest and to better understand factors associated with infection and susceptibility to infection. Precautions are necessary for individuals 65 or older as they have higher infectivity and susceptibility in contact with their peers.
The Potential Environmental Implications of Infection Control Prevention During the COVID-19 Pandemic: Waste Generation from a Level 2 Trauma Center in Maine, USA.
Authors: Klein Kelly , Saber Deborah , Trumbo Jennifer , Kakkad Astha
Published: June 2023

Introduction:

Hospital waste in the United States (US) generates 7,000 tonnes of waste daily. During the pandemic, hospitals had to increase the amount of personal protective equipment (PPE) worn by healthcare providers. The aim of this study was to compare pre and present COVID-19 waste generation amounts in comparison with hospital census and PPE purchased.

Method:

This research examined the solid waste generated at a level II trauma center from January 2018-December 2021. Data examined included: the amount of solid waste generated, monthly patient census, COVID-19 census, policy changes, and the amount of purchased PPE pre and during the pandemic.

Results:

PPE product numbers purchased varied with a noticeable increase in mask and gown ordering. The number of admitted COVID-19 patients peaked at 46. Hospital waste tonnage fluctuated but did not show a statistically significant change.

Conclusion:

The COVID-19 pandemic has caused hospitals to increase their PPE posture to help safeguard its employees and patients. In our hospital setting, the use of PPE increased and overall hospital census decreased. This has profound implications for not only the hospital’s revenue, but also with less census volume, there was curiously the same amount of hospital waste generated. This work needs to be continued in other healthcare PPE heavy settings, to better understand the downstream consequences of infectious diseases on responsible hospital waste management and environmental sustainability.
Bushfire and Biodiversity Disaster Risk Reduction Tool: A Community-Led Values-Based Bushfire Risk Management Project with Multi-Agency Support to Develop Strategies to Protect Biodiversity and Manage Bushfire in Upper Beaconsfield, Victoria, Australia
Authors: Spencer Caroline , Cross Suzanne , Archer Frank
Published: June 2023

Introduction:

This Australian-first project explored residents’ values about living in one of Australia’s extreme bushfire risk areas. The project team developed the Upper Beaconsfield Bushfire and Biodiversity Tool (UPB&BT) which delivers tailored local information for residents living in the area. Designed to empower residents to make informed decisions, this user-friendly, online tool visualizes a community’s devastating bushfire history, reveals residents’ values about living in this area, and provides evidence-based actions to protect biodiversity and manage bushfire fuels on private property.

Method:

Structured decision-making methodology informed the survey design to elicit residents’ values about biodiversity protection and bushfire risk reduction, by inviting approximately 3000 residents to complete the survey. This community-led project applied a participatory approach by inviting collaboration between government, agencies, universities, and community representatives.

Results:

Key results revealed 75% of respondents valued nature and lifestyle. 51% saw bushfire risk as an important factor for managing vegetation on private land, while 65% either mow or slash to manage vegetation. Synthesized data informed the content of the UPB&BT, which sourced evidence-based knowledge or specialists’ expertise to provide tailored content and actions that met residents’ diverse values. This included the consequences of chosen actions, which helps residents understand the impact of their decisions. However, results identified confusion in roles and responsibilities.

Conclusion:

This ground-breaking community-led, government-funded project joined with government, agencies, universities, and community representatives to develop a new bushfire and biodiversity tool to help residents understand biodiversity protection and bushfire management in their local community. Results aim to empower residents to make their own evidence-based and informed choices about managing their properties, thereby contributing to the community good. They decide what is important and identify available actions and their potential consequences. Other communities could replicate this process to localize their own disaster risk reduction strategies.
The Knowledge and Training Needs of Disaster Medicine among Healthcare Professionals and Medical Students in Makkah City: A cross-sectional study
Authors: Altirkistani Bsaim , Dairi Mohammad , Bahha Reeman , Babkier Ahad , khizanah Ruba Abu , Alabdulwahab Saleh , Alsulimani Loui , Masri Taha
Published: June 2023

Introduction:

Disaster medicine aims to prevent and respond to devastating events. Health professionals need to understand their role in disaster management to effectively respond when disasters occur. The aim of the study is to assess the knowledge level, preparedness, and the training gaps regarding disaster medicine among health professionals and medical students/interns in Makkah (Mecca) city.

Method:

This is an online-based cross-sectional study design conducted in Makkah City. Physicians, nurses, and medical students/interns were included. Continuous variables were reported as means and confidence intervals. While categorical variables were reported as frequencies and percentages. Data were analyzed by Chi-square and Anova test as appropriate.

Results:

Of the 651 participants, the mean age was 27.69 (95% CI 28.13 to 27.24) with 360 (55.30%) participants being males. The mean average score of disaster medicine knowledge was 7.90 (95% CI 8.29-7.51) for medical students/interns, 8.12 (95% CI 8.77-7.47) for nurses, and 4.85 (95% CI 5.21-4.49) for physicians (P <0.0001). The majority of participants selected first-aid skills and triage and evacuation as crucial aspects to be covered in learning disaster medicine, 406 (62.4%) and 373 (57.3%) respectively.

Conclusion:

In this study, the level of knowledge regarding disaster management is average among the healthcare population. Certain aspects of disaster medicine are needed to be focused on such as first-aid skills and triage and evacuation. Incorporating disaster medicine as part of training programs is a demand.