bluuebunny/crossref_metadata_2025 huggingface dataset:
One Month in One Hundred Degrees: Caring for High-Risk Populations During Extreme Weather Events
Authors: Hurwitz Jacob
Published: June 2023

Introduction:

In August 2021, Hurricane Ida struck Louisiana as a near-category five storm, bringing massive devastation to the region’s healthcare infrastructure. In its aftermath, extreme heat coincided with record COVID-19 hospitalizations in the state, leaving minimal healthcare surge capacity remaining and medically vulnerable populations unprotected. Meanwhile, sparse pre-storm evacuations exposed prominent gaps in existing medical response plans designed to serve high-risk groups. Subsequently, Louisiana rapidly established a 250-bed alternative care site (ACS) within hard-hit New Orleans. This presentation highlights key considerations in the operation of the site and discusses which patient populations are most in need of medical support following tropical weather events.

Method:

The findings of this discussion are the result of after-action reviews, brief literature reviews, and the experiences of responders during Hurricane Ida. The presentation also draws on retrospective patient chart reviews from Louisiana’s prior alternative care sites.

Results:

Following Hurricane Ida, a post-storm alternative care site was rapidly established in New Orleans in partnership with a US Disaster Medical Assistance Team (DMAT). Operationalized in less than 72-hours, this site provided inpatient care to displaced persons with major chronic medical needs (e.g. home ventilators, hemodialysis, respiratory therapies), significant mobility impairment, wound care, and psychiatric illnesses. Incorporating Louisiana’s experience with a COVID-19 alternative care site, this facility far-exceeded the typical scope of medical shelters, simultaneously lessening medical surge on already-overburdened hospitals and meeting post-storm needs in the region.

Conclusion:

Following extreme weather events in metropolitan areas, traumatic injuries and acute illness comprise a small proportion of the medical needs after the event. Accordingly, disaster medical responses must prepare to treat large numbers of chronic illness exacerbations that result from a loss of access to primary care, home health support, and auxiliary services. This approach efficiently leverages resources into lifesaving interventions and protects healthcare systems during times of high stress.
Survey Activities in the Field of Healthcare in the Republic of Moldova Under the Ukraine Crisis by Japan International Cooperation Agency (JICA) 2nd Team
Authors: Nakamori Tomoki , Ooba Jiro , Takamura Yuki , Toyokuni Yoshiki , Morizane Masashi , Kasai Katsuya , Habano Yukiko
Published: June 2023

Introduction:

The Russian invasion of Ukraine began on February 24, 2022. UNHCR reported, as of April 6th, more than 4.3 million refugees have fled Ukraine, with 401,704 refugees arriving in the Republic of Moldova, around 100,000 of whom have remained in the country. JICA investigated whether Moldova's healthcare needs were burdened by accepting a large number of Ukrainian refugees, and examined the way to support them.

Method:

JICA dispatched the 3rd team as a survey team. The 2nd team consisted of two medical doctors, one nurse/midwife, one clinical engineer (CE), one Japan DMAT logistician, and two JICA staff. The dispatch period was three weeks when five major hospitals were visited in the capital, evaluating the current situation and the need for support for the future.

Results:

As of April 6, 2022, 3,853 people were staying in refugee accommodation centers, while the rest lived in ordinary Moldovan families. Evacuees, like Moldovan citizens, were covered by health insurance, and evacuees had access to medical care. Medical institutions were not overwhelmed by medical needs due to the Ukraine crisis. There was no epidemic of infectious diseases even at evacuation centers. However, since there was no system to share emergency information between hospitals, we held a disaster medical seminar to introduce the current situation of disaster support in Japan and supporting EMTCC.

Conclusion:

As a survey team, not only doctors but also nurses, midwives, and CEs surveyed, making it easier to understand the specific medical needs at medical facilities. Most of the evacuees stayed in ordinary Moldovan homes, and it is possible that avoiding a crowded environment at the evacuation shelters prevented the epidemic of infectious diseases.
Utilization of Regular Ships as Hospital Ships in a Disaster Situation: A Trial Report from Japan
Authors: Takada Yosuke , Nakamura Hiroshi , Kako Mayumi
Published: June 2023

Introduction:

Japan is an island nation surrounded by the ocean. Seventy percent of the country is mountainous, and there is no abundance of habitable flat land. Japan is a disaster-prone country, with an average of 25 typhoons per year occurring near Japan and 20% of the world's earthquakes of magnitude six or greater occurring in Japan. The Great East Japan Earthquake (2011) destroyed many medical facilities in coastal areas. The government is seeking ways to continue medical services using ships in preparation for future Nankai Trough Earthquakes. This study introduces the current status of studies for installing hospital ships in Japan.

Method:

Based on materials on hospital ships published by the Cabinet Office and reports on training exercises conducted by various organizations, this report summarizes the current status of studies on introducing hospital ships in Japan.

Results:

In 1991, a committee was established to gather domestic experts to study a multi-purpose ship, and various studies have been conducted intermittently. The current policy focuses on utilizing existing resources such as Self-Defense Force cargo ships, civilian car ferries, etc. The demonstration training for a hospital ship with the Self-Defense Force's field surgery system and the Red Cross Emergency Response Unit has been conducted. Other studies are underway to provide medical support to remote islands by ocean tugboats. Future issues for utilizing existing ships include 1) maintaining medical personnel and medical equipment and materials in times of disaster, 2) utilizing and maintaining ships during peacetime, and 3) establishing access to ships that are unable to dock at a port.

Conclusion:

Hospital ships in Japan are considered to utilize existing vessels rather than building new ones. However, there are unresolved issues, such as how to operate the ships during disasters, the cost of maintenance, and transporting patients from land.
Assessing Local Community Resilience Through Co-design Processes by an Australian Primary Health Network
Authors: Pettigrew Donna , Burns Penelope , Harding Joanne
Published: June 2023

Introduction:

The Sydney North Health Network (SNHN) covers an area of 350 square miles in Eastern Australia. It is one of 31 Primary Health Networks (PHNs) across Australia. The purpose of PHNs is to improve access to primary healthcare particularly those at risk of poor health outcomes. During disasters these vulnerable groups may be even more disadvantaged. As part of SNHN's role in enhancing the wellbeing, resilience, and preparedness of communities and primary healthcare providers during disasters, SNHN is focusing on recovery and resilience initiatives that build on local strengths, while addressing challenges.

Method:

The aim of this community engagement research was to determine the impact of recent extreme weather events on the community, and identify strategies to improve wellbeing, resilience and preparedness. The research was approached through a co-design process to explore assets, strengths and vulnerabilities within vulnerable community members during disasters, and to ascertain their perspective on their needs during disasters. SNHN funded a well-established local community organization to conduct surveys and focus groups with the SNHN community to inform future community-led programs to support individuals and communities in disasters.

Results:

Participants considered impacts on mental and physical health, children, the environment, and property as key challenges. Equally, they acknowledged they didn't start as a "blank slate", but came to the disaster with considerable individual and community strengths and assets, that enabled their resilience, including numerous resources to support social capital. Person-centered, community-inclusive planning, preparedness, and connectedness was seen as key solution.

Conclusion:

In order to promote and enhance the wellbeing, resilience, and preparedness of communities and primary healthcare providers, successful recovery and resilience initiatives should build on local strengths, while addressing challenges. Individuals and communities should be integral in designing programs to build their local resilience and wellbeing, as they know their attributes and strengths, and their needs.
Societal Disruption as a Disaster
Authors: Cuthbertson Joe
Published: June 2023

Introduction:

This research aims to review the impact of drug addiction, domestic violence and suicide in Australia through the lens of disaster risk reduction. This study explores whether drug addiction, domestic violence and suicide can be considered as disasters according to established thresholds and definitions; and whether contemporary health emergency and disaster risk management (HEDRM) practice can be adapted to support action to reduce the impact of these events and inform disaster risk reduction.

Method:

A literature review was conducted to explore drug addiction, domestic violence and suicide as societal disruptions causing disasters. Key Australian government reports describing deaths associated with suicide, domestic violence and drug addiction were identified, following which a constrained snowball sampling was applied to the bibliography of each document to gather further key articles and inform the evolution of the impact of these themes in Australia over the period 2000-2018. The search strategy included both peer reviewed and grey literature. We used the search terms ‘social disruption’, 'non-traditional', ‘drug addiction’, ‘domestic violence, ‘suicide’ and 'societal disruption' as key words and included articles if they demonstrated an analysis of the theme related to health impact related to disaster settings.

Results:

Utilizing the Australian Disaster Resilience Knowledge Hub and the international CRED criteria for a disaster, the impact on human health of drug addiction, domestic violence, and suicide upon the Australian population each meet the criteria of a disaster.

Conclusion:

Public health practice through the lens of the determinants of social disruption combined with activities that consider hazards, vulnerability, and exposure, can institute prevention, preparedness, response, and recovery programs to reduce the impact of drug addiction, domestic violence, and suicide.
Feasibility of Implementing the STEADY Wellness Program to Support Hospital Staff During the COVID-19 Pandemic
Authors: Korman Melissa , Steinberg Rosalie , Habib Mahiya , Tuka Andrea , Martin-Doto Catherine , Winter Kristen , Zaretsky Ari , Shadowitz Steve , Cocco Claudia , Ellis Janet
Published: June 2023

Introduction:

The COVID-19 Pandemic negatively impacted the mental wellbeing of healthcare workers worldwide. Many organizations responded reactively to their staff needs. The novel, evidence-informed Social Support, Tracking Distress, Education and Discussion Community (STEADY) program was implemented, with senior leadership support across a large hospital. STEADY is a multi-pronged program developed to mitigate occupational stress injury in healthcare workers and first responders. This project examined the feasibility of implementing STEADY across hospital units during a pandemic.

Method:

STEADY was implemented in five acute care units and across the rehab site of a large hospital. Data was collected on the five program components (drop-in peer support groups and critical incident debriefs, psychoeducation workshops, wellness assessments, peer partnering, community-building initiatives). Most peer support groups were facilitated by the program manager trained in peer support and one of six clinical staff.

Results:

The program was iteratively adapted to meet the needs of target units/groups. More than 300 sessions were run in ~one year, for an average of ~1.15 sessions per unit per week. With flexible adaptation to the mode of facilitation, ~75% of planned workshops and ~85% of peer support sessions were run. Three critical incident stress debriefs were held. The formal partnering program was offered via e-mail with minimal uptake. Ninety-five wellness assessments were completed by target end-users, with 36 personalized responses sent. Gratitude trees were posted in each unit for community-building. Eight target unit staff completed formal peer support facilitation training. Twenty additional groups across the organization requested STEADY programming support and ten requested gratitude trees.

Conclusion:

Results indicate that most components of the STEADY program were feasible to implement in hospital units during the pandemic. On-site, interactive programming was most engaging for end-users. Leadership support and flexible, continuous adaption by program leaders were identified as facilitators to program implementation and uptake.
Returning to Normal Life after Deployment: What Can Emergency Response Organizations Learn from the Military?
Authors: Brake Hans Te , Kennis Mitzy
Published: June 2023

Introduction:

Emergency service workers are confronted with serious risks for their health, well-being and functioning. In order to prevent consequences to them and their families, emergency organizations should provide optimal support after an intensive period of employment. In many countries, the military pays special attention to the transition of their personnel from deployment to home via post-deployment adaptation programs (PDAPs). The objective of this presentation is to provide a structured analysis of the military approach to post-deployment adaptation and to identify potential lessons for emergency services.

Method:

A systematic literature search was performed to find original peer-reviewed studies on PDAP in six databases (MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, PTSDPubs, and OpenGrey). The overall risk of bias of the articles was assessed using GRADE guidelines. The literature was analyzed guided by a program evaluation framework entailing different domains.

Results:

The search resulted in 1535 unique records that were screened for eligibility; 16 articles were included, of which only three showed low risk of bias. Most articles describe some form of third location decompression (N = 10) and also some agreement exists on how to adapt skills and cognitions after deployment (Battlemind; N = 4). The results suggest positive mental health effects and satisfaction of these elements.

Conclusion:

Empirical, high-quality evidence for PDAP is scarce. In addition, the existing literature reveals a lack of systematic method in describing the goals of PDAP and the ways of achieving these. Nevertheless, this study reveals promising elements that are in line with international guidelines, such as minimizing the level of exposure, intervention delivery and adjustment issues. We discuss how future research should incorporate these elements using a systematic approach.
Exploring the Experience and Well-being of Female Evacuees in Coastal Bangladesh through a Phenomenological Lens
Authors: Chowdhury Tazrina , Arbon Paul , Kako Mayumi , Steenkamp Malinda , Hutton Alison
Published: June 2023

Introduction:

Women in coastal Bangladesh face greater challenges while staying at evacuation centers during cyclone emergencies. This study explores the lived experience of women and their well-being as evacuees.

Method:

The research undertook a phenomenological approach to conduct in-depth interviews of nineteen women from three extremely vulnerable districts of coastal Bangladesh.

Results:

The interviews revealed that women experienced obstacles to maintaining hygiene, using the toilets and accessing privacy, and suffered distress as pregnant women, lactating mothers, and through menstruation, which affected them physically and hampered their mental health. Coming from a male-dominated socio-cultural background, female evacuees unaccompanied by male guardians experienced fear and uncertainty. Some participants recollected facing social pressure and overwhelming emotions as carers of children and elderlies, whereas some reconciled traumatizing incidents such as witnessing death. Such experiences led to anxiety, stress, and depression with either temporary or permanent trauma. Participants frequently mentioned panic attacks and stress-related physical issues such as heart palpitations, dizziness and light-headedness. However, spiritual beliefs and social bonds within the community enabled peace and optimism among the women. Findings highlight that certain factors determined women evacuees' experience of wellbeing. Social context of the women imposed burdens of responsibility and caused inaccessibility of resources to restore physical-mental wellbeing. The settings, infrastructures and environment of the evacuation centers were not women-friendly, which resulted in many negative experiences among the evacuees, greatly affecting their sense of wellness. However, participants could channel positive mindsets through prayers and spiritual faith. Women were able to access some resources and use these for their well-being through social bonding and connecting with the women within the shelters.

Conclusion:

Unconditional trust in a deity and sisterhood within communities have been two quintessential features of women, which played major roles in women’s experiences and molded their understandings of well-being in the cyclone shelters.
Patterns of Distress and Supportive Resource Use by Healthcare Workers During the COVID-19 Pandemic
Authors: Habib Mahiya , Korman Melissa , Steinberg Rosalie , DeSouza Jordana , Rothman Lorne , Bodley Janet , DiProspero Lisa , Gagliardi Lina , Ellis Janet
Published: June 2023

Introduction:

Healthcare workers (HCWs) are at increased risk of burnout, post-traumatic stress injury and suicide, compared to the public. Long-lasting increases in HCW distress are reported following pandemics. Such occupational stress can negatively impact individuals, organizations, and the overall healthcare system. Understanding HCW distress and needs can inform the development of resources to mitigate negative outcomes. Staff wellness data was gathered from a large academic health center during the COVID-19 pandemic, as part of a quality improvement project seeking to support staff wellbeing. Longitudinal trends of distress and preferences related to support were shared with leadership.

Method:

Monthly wellness assessments were sent to hospital staff via email. Assessments included screens for burnout, anxiety, depression and posttraumatic stress, questions regarding types of resources accessed, and open-ended questions regarding staff needs. Surveys were voluntary and confidential. Participants could provide their email to receive tailored resources based on individual results. Survey data was analyzed longitudinally to identify trends of distress over time.

Results:

A total of 2,518 wellness assessments were completed from April 2020-July 2021. An average of ~167 (range 17 – 946) HCWs responded per month and 638 staff provided their email addresses to receive a response; 497 of these completed assessments multiple times. The proportion of positive screens were, on average, 44%, 29%, 31% and 53%, for anxiety, depression, post-traumatic stress and burnout, respectively. Anxiety and post-traumatic stress scores decreased from April-August, then increased from September. The most reported source of support accessed was family/friends; ~40% of responders had not accessed formal mental health support.

Conclusion:

When COVID-19 cases decreased and stay-at-home mandates were lifted, HCW distress was reduced. Burnout trended upwards through the pandemic. Peer/family support remained favored compared to formal mental health support, suggesting the importance to HCW of social support. HCW reported a preference for convenient access to supportive resources.
The Asia Pacific Disaster Mental Health Network: Collaborative Research to Advance Mental Health and Community Resilience
Authors: Newnham Elizabeth , Dzidic Peta , Gibbs Lisa , Murray Virginia , Kayano Ryoma
Published: June 2023

Introduction:

The mental health consequences of health emergencies and disasters have the potential to be sustained and severe. In recognition, the 2018 Kobe Expert Meeting on Health Emergency and Disaster Risk Management (Health EDRM), prioritized mental health as one of the key research areas of Health EDRM, to be addressed in a multi-country research project supported by WHO (Kayano et.al., 2019). As climate change, growing urbanization, population density and viral transmission generate increasingly severe hazards, attention to mental health will be critical.

Method:

The Asia Pacific Disaster Mental Health Network was established in 2020 to foster advancements in mental health research and policy in the region. Building connections between researchers, practitioners and policy makers, the Network includes broad representation from interdisciplinary scholars and organizations across eight Asian and Pacific nations. A research agenda was designed in early meetings, and collaborative research projects were established.

Results:

The Network has supported the development of innovative disaster mental health research investigating community engagement in recovery, psychosocial interventions, and evaluation frameworks. A recent multilingual systematic review of more than 200 longitudinal studies identified the long-term trajectories of post-traumatic stress symptoms, depression and anxiety following disasters and pandemics (Newnham et al., 2022). Synthesized evidence of risks related to age, gender and disaster type were determined to inform intervention targets.

Conclusion:

The Asia Pacific Disaster Mental Health Network established a platform for scholarly connection, intervention planning and knowledge dissemination. This presentation will provide an overview of the Network’s activities, and research highlights that have identified targeted points for policy and practice.
The Prevalence of Violence Against Healthcare Workers in the Public Sector – A Trinbagonian Survey
Authors: Dookeeram Darren , Seetharaman Hariharan , Taylor Lake , Thomas Cassy , Thomas Kirtesha , Thompson Cherelle , Toppin Takiyah , Trim Jakeilia , Caton Kanisha , Stoute Sade
Published: June 2023

Introduction:

Violence against healthcare workers (HCWs) and lack of public trust threatens the foundation of the physician-patient relationship in Trinidad. The primary aim of this study was to determine the prevalence of violence against Trinbagonian HCWs in the public sector. Secondary objectives included determining risk factors for violence and mistrust between the public and providers.

Method:

A cross-sectional analysis of 434 Trinbagonian HCWs in the public sector was conducted using a modified World Health Organization (WHO) data collection tool, distributed via social media and administrative emails, and snowballed for two months. Fifteen semi-structured interviews were conducted regarding trust in the healthcare system with patients selected from various communities.

Results:

Of the 434 respondents, 45.2% experienced violence and 75.8% witnessed violence against HCWs in the past 2 years. Verbal abuse (41.5%) was most common. Perpetrators were patients (42.2%) and patients’ relatives (35.5%). Chi-square analysis highlighted that HCWs with the highest probability of being abused were aged 25-39 (63.8%), had 2-5 years of work experience (24.9%), specialized in emergency & internal medicine (48.6%), and cared for psychiatric & physically disabled patients (p-value <0.001). HCWs believed the threat of violence negatively impacted their performance (64.5%), and further action was necessary for mitigation (86.4%). Patients interviewed doubted physicians' altruism, competence (80%) and honesty (53.3%), expressed mistrust in their physician (46.7%), and cited poor infrastructure/management (66.7%) and dissatisfaction with care (60.0%) as factors that contributed to violence.

Conclusion:

Analysis revealed that violence against Trinbagonian HCWs in the public sector deteriorated patient experience and adversely affected psychological well-being, efficiency, and job satisfaction. Results suggested mistrust of HCWs by the population. Interventions should be instituted to support at-risk HCWs and educate the public to avoid recurrence.
Defining and Operationalizing Key Themes of High-quality Psychosocial Support Using the Concept Mapping Method:
Authors: Herpen Merel van , Dückers Michel , Boer Dolf de , Dorn Tina , Fassaert Thijs , Groot Janke de , Holsappel-Brons Jorien , Olff Miranda , Brake Hans te
Published: June 2023

Introduction:

International psychosocial support guidelines reflect consensus on support principles and interventions. However, no consensus exists on what recipients consider important elements of service delivery. Within two contexts – after a potentially traumatic event (PTE) and people with Spinal Muscular Atrophy (SMA)–the aims were to contribute to (1) understanding which psychosocial support aspects are considered important by recipients and relevant stakeholders; (2) developing instruments to test and integrate those aspects in practice, in order to evaluate the quality of psychosocial support from the recipient’s perspective.

Method:

Concept mapping was used to achieve consensus on key themes of psychosocial support. These were operationalized in surveys and pilot-tested, conforming to the Consumer Quality Index. This determines the importance and needs for improvement.

Results:

Concept mapping resulted in eight key themes within the PTE context and six in the SMA context. PTE survey (N= 132) results showed key themes “an approach that starts from the needs and capacities of the affected one” and “monitoring individuals affected and initiating follow-up where needed” were most important. Key theme “providing information on common emotional reactions” received the highest score of perceived need for improvement. SMA survey (N= 57) results showed key themes “an approach that incorporates all aspects of a human being” and “a respectful approach and awareness of personal boundaries” as most important. The perceived need for improvement of the key theme “availability and accessibility of quality information” was ranked the highest.

Conclusion:

The similarities between both contexts support the notion that there are universal aspects of psychosocial support. Simultaneously, the context-specific idiosyncrasies found underscore the necessity to adapt to context. The surveys have the potential to contribute to a growing toolbox of quality evaluation instruments.
Mental Health and Psychosocial Support Interventions to Mitigate COVID-19 Related Mental Health Problems: A Systematic Review of Reviews
Authors: Steen Charlie , Willems Andrea , Stene Lise , Weme David Nieuwe , Dückers Michel
Published: June 2023

Introduction:

The COVID-19 pandemic and the measures taken to contain it, have had a substantial effect on mental health of populations worldwide. Uncertainties about the future and one’s own health, as well as restrictive measures drastically altered people’s lives. To anticipate and mitigate the probable mental health impact, mental health and psychosocial support (MHPSS) interventions have been recommended and implemented. The objective of this systematic review is to provide an overview of different types of MHPSS interventions and the quality of the scientific evidence in the context of a pandemic.

Method:

A systematic search of interventions for reducing mental health problems or risks due to the COVID-19 pandemic was performed in November 2021 and repeated for new records in August 2022. APA PsycInfo, Embase, Ovid MEDLINE(R) ALL, EBM Reviews and Web of Science databases were systematically searched for relevant articles. The methodological quality of selected articles was assessed using the NHLBI Quality Assessment Tool for Systematic Reviews and Meta-Analyses.

Results:

A summary of the content and quality of MHPSS interventions during the COVID-19 pandemic is provided. The interventions could be clustered predominantly into existing MHPSS categories of “Basic aid”, “Information”, “Emotional and social support”, “Practical support” and “Health care”. Nevertheless, the evidence supporting the applicability and the effectiveness of such measures is limited when it comes to the mitigation of mental health problems.

Conclusion:

The clustered overview of different COVID-19 interventions points at strong similarities with interventions in general evidence-based MHPSS guidelines. However, there is a need to integrate more systematic monitoring, evaluation and research to appraise the applicability and effectiveness of MHPSS measures in future pandemics and other crises.
Determining the Impact of Hurricane Dorian & the Covid-19 Pandemic on Moral Distress in Emergency Medical Providers at the Rand Memorial Hospital
Authors: Storr Latoya , Hertelendy Attila , Hart Alex , Issa Fadi , Benham Todd , Ciottone Gregory
Published: June 2023

Introduction:

Cumulative disasters have been shown to influence mental and physical health in both responders and victims, with studies showing associations in rates of depression and Post Traumatic Stress Disorder. Systemic problems that impact patient care such as limited resources, overcrowding of emergency rooms, and staffing shortages can be morally challenging for healthcare workers. Andrew Jameton, in 1984 defined Moral Distress (MD) as the inability of a moral agent to act according to his or her core values and perceived obligations due to internal and external constraints. Unresolved MD can create significant long-term debilitating physical and mental damage. Emergency medical providers on the island of Grand Bahama had the unique experience of responding to both the aftermath of Hurricane Dorian and the Covid-19 Pandemic. The aim of this study is to determine the prevalence of Moral Distress (MD) in Accident & Emergency (A&E) Physicians, Nurses, and Emergency Medical Service (EMS) staff at the Rand Memorial Hospital (RMH) in the Bahamas.

Method:

This is a descriptive, qualitative, prospective cross-sectional study, utilizing a three-part survey sent to participants. Sociodemographic information, Hurricane Dorian & Covid-19 experiences, and responses to a validated modified Moral Distress Scale will be collected and uploaded to a secure, encrypted data management program. The data will be analyzed using the most current IBM SPSS statistical analysis package. Descriptive and Inferential statistics will be used to determine the impact of Hurricane Dorian & Covid-19 on MD and its associated sociodemographic factors.

Results:

Data collection and analysis are planned for completion by March 1, 2023.

Conclusion:

Addressing the causes of Moral Distress early can help improve healthcare systems’ resiliency by ensuring a healthy and supported workforce equipped with the resources to respond to future disasters.
An In-Depth Mixed-Method Study on Stress Exposure and Coping Strategies in Civilian and Military Prehospital Emergency Personnel from a Systemic Perspective
Authors: Van Puyvelde Martine , Van Herck Jolien , Van den Bossche Jeroen , Goethals Frederic , Gijbels Daisy , Pattyn Nathalie
Published: June 2023

Introduction:

Although prehospital emergency care in a civilian versus military context may differ in terms of working conditions and injuries, in both contexts the exposure to stressful and extreme events are present. Besides the continuous reports of post-traumatic stress symptoms, an alarming increase of burnout and suicide in (emergency) physicians is recognized as well. However, most of the research on this topic is either retrospective or peri-recovery, which might have an impact on the availability of information with regard to causes and underlying processes. Hence, in the current study, we conducted an in-depth study of well-functioning emergency caretakers, studying their profile while including their perspective on both their professional and personal context and the interconnectedness with their operational performance.

Method:

We used a mixed method approach, combining the results of a quantitative questionnaire and a thematic analysis of 23 in-depth semi-structured interviews to gain additional qualitative information. We interviewed well-functioning and operating prehospital emergency professionals, recruited in three different settings, i.e., a military hospital, a military Special Operations Surgical Team, and a civilian hospital in the capital city.

Results:

The quantitative part showed a preference for task-oriented coping. However, the interviews broadened this result, showing how the personnel are continuously seeking to find a balance between emotional connection and disconnection. Several risk-factors for mental injury were detected and the support and recognition from both the personal and professional environment showed to be crucial in finding a balance between job passion and the sacrifice of one's personal life.

Conclusion:

The interviews showed that a variety of interrelated underlying professional and personal factors are related with how emergency personnel perceive and cope with stress events. A systemic approach to prevent mental health problems is highly recommended.
Health Care Worker Wellness Interventions during the COVID-19 Pandemic
Authors: Jenkins J Lee , Sullivan Bridget , Hsu Edbert
Published: June 2023

Introduction:

The COVID-19 pandemic has not only put a strain on the health care system throughout the world but has had an extreme impact on health care workers caring for these patients on a daily basis. These workers have been isolated from their families and experienced significant stress and loss at work and home. Some health care workers experienced rationing of care, inadequate personal protective equipment, and found themselves without the resources needed to care for patients. This paper reports on a systematic review of wellness and stress interventions targeting healthcare workers during the COVID-19 pandemic.

Method:

A systematic review of Pubmed and SCOPUS articles published between January 1, 2020 and November 1, 2022 was conducted using the terms “healthcare worker”, “nurse”, “doctor”, “paramedic”, ”emergency medical technician”, “mental health”, “resilience”, “wellness”, “stress”, “sleep” , “intervention”, “Covid-19”, “coronavirus”, and “pandemic.” These results were imported into Covidence. Inclusion criteria were studies on interventions of healthcare workers. Exclusion criteria were papers not describing health care workers, papers not describing interventions, health care workers not caring for COVID19 patients, and papers not written in English.

Results:

A total of 26 papers were included in the analysis after the final screen. These papers were examined and sorted into groups based on the types of interventions on health care workers. The groups of interventions included 1. Psychological interventions, 2. Wellness or well-being interventions, 3. Work-related interventions, and 4. Pharmacologic interventions. Two studies were longitudinal in nature. The most common intervention was psychological (10), followed by work-related interventions (6).

Conclusion:

Psychological interventions were the most commonly deployed and included hotline establishment or speaking with a therapist. This was followed by wellness interventions such as exercise, sleep regulation, breathing exercises, and healthy eating. Fewer interventions were included in the work-related or pharmacologic categories. Data regarding effectiveness and feasibility of interventions was heterogenous.
Effects of Self-Affirmation on Mental Status During the Prolonged COVID-19 Pandemic
Authors: Seto Shuji , Okuyama Junko , Fukuda Yu , Ito Kiyoshi , Izumi Shin-Ichi , Imamura Fumihiko
Published: June 2023

Introduction:

Self-affirmation is known to buffer the development of anxiety symptoms into depressive symptoms, and a study during the early days of the COVID-19 pandemic revealed a role for this self-affirmation. In Japan, the COVID-19 pandemic has occurred repeatedly, and at this point (November 16, 2022), prior to an eighth wave. The possibility of ameliorating the psychological effects of this prolonged COVID-19 pandemic through efficient interventions targeting self-affirmation will be examined.

Method:

Study dates: June 25, 2020; September 25, 2020; February 10, 2021; November 24, 2021; February 7, 2022; August 31, 2022

Survey participants: Registered monitors of the research company (Neo Marketing Co., Ltd.) Each 1,000 respondents

Questionnaire:

1)

Attributes: gender, age, region, number of family members

2)

DASS-21 (Depression, Anxiety, Stress Scale-21)

3)

LSNS-6 (the Lubben Social Network Scale-6)

4)

Self-affirmation

CIPS (Clance Impostor Phenomenon Scale)

Rosenberg Self-Esteem Scale (Japanese version)

The self-affirmation scale (CIPS; Rosenberg Self-Esteem Scale) was measured from the 4th to the 6th survey.

Contribution of each factor to depressive symptoms:

The DASS-21 Depressive Symptom Scores from the 4th through 6th surveys were examined using Prediction One with the DASS-21 Anxiety Symptom Score, DASS-21 Stress Score, Connections Score, Rosenberg, and CIPS score as factors to determine their contribution.

Results:

At the time of the second survey (September 25, 2020), DASS-21 scores peaked and then declined. CIPS and Rosenberg Self-Esteem Scale scores showed no change from the 4th to the 6th session. The result of contribution of each factor to depressive symptoms by Prediction One showed anxiety symptoms contributed the most to depressive symptoms.

Conclusion:

A model in which self-affirmation prevents anxiety symptoms from progressing to depressive symptoms is reasonable until the 7th wave of the COVID-19 pandemic in Japan.
Developing a COVID-19 Vaccination Program for Seafarers in Cork
Authors: O’Brien Cian , Bourke Nicholas , O'Sullivan David , Fitzgerald Mary Rose
Published: June 2023

Introduction:

The pandemic brought to the fore the importance of maritime transport as an essential sector for the continued delivery of critical supplies and global trade in times of crisis. Timely vaccination of seafarers secures their health and enables the chain of infection to be broken with the international propagation of the virus via maritime traffic. As part of the COVID-19 vaccination program, the Health Service Executive in conjunction with the Port of Cork company developed a unique pathway for seafarers to access COVID-19 vaccinations once they arrived in Cork.

Method:

An Excel template was developed by HSE and Port of Cork that would capture key information for seafarers to avail of vaccinations. Once data was captured by the ship's Captain, it was sent to the shipping agent and reviewed by the HSE South Emergency Management Office. Once the data was validated it was sent to the vaccination center so that the seafarer's details could be entered onto the system. Once confirmed, travel arrangements were made from the vessel to the vaccination clinic ensuring a safe staffing level remained on the vessel.

Results:

A total of 84 seafarers registered for the seafarer's vaccination program. 70 of these seafarers received one or more doses in Cork City Hall Vaccination Centre with the remainder having received one dose in pharmacies in Cork City.

Conclusion:

This joint initiative developed by the HSE Emergency Management Office and the Port of Cork, the first seafarer's COVID-19 vaccination program in Ireland, ensured seafarers were allowed to avail of a COVID-19 vaccination when they arrived at the Port of Cork. This highlights the requirement for future vaccination programs to consider and incorporate the requirements of seafarers acknowledging the essential role they play in the global supply chain.
Distribution of Hyperbaric Oxygen Chambers for Noxious Gas Disaster
Authors: Wang Soon-Joo , Kang Pooreun
Published: June 2023

Introduction:

In this study, assuming a toxic gas-generating disaster situation requiring multiple hyperbaric oxygen chambers at the same time in Korea, the regional arrangement of hyperbaric oxygen chambers and its adequacy for toxic gas-generating disasters were investigated and analyzed based on medical institutions equipped with hyperbaric oxygen chambers.

Method:

It is assumed that all hospitals with hyperbaric oxygen chambers should be included theoretically if a large number of patients require hyperbaric oxygen treatment in the event of a toxic gas disaster. First, we received data from the manufacturer that provided the hyperbaric oxygen chambers, interviewed the persons in charge, and then contacted the relevant hospitals to check the placement in the second step. Afterwards, the deployment of hyperbaric oxygen chambers and population-based deployment status, the simultaneous capacity of hyperbaric oxygen treatment, and the ability to perform hyperbaric oxygen treatment in response to toxic gas disasters based on region were analyzed.

Results:

The annual number of hyperbaric oxygen chambers showed the first increase period in 2015 and the second increase period after 2019. Even when analyzed based on population-based, simultaneous capacity, and treatment performance, the distribution of hyperbaric oxygen therapy chambers was uneven especially in special areas.

Conclusion:

In preparation for future disasters, a regional arrangement plan for hyperbaric oxygen chambers should be established and implemented. The national monitoring system and the long-distance transport system should be established until proper distribution.
Early Clinician Exposure to the Physiologic Damage of Firearms: A Feasibility Study
Authors: O'Sullivan Jessica Walsh , Hwang Esther , Ackerman Jeremy
Published: June 2023

Introduction:

In comparison to many nations in the developed world, the United States has more cases of civilian ballistic injuries. Both low and high velocity firearm injuries are frequently encountered in American urban trauma centers, and physicians become familiar with these traumatic injury patterns. Physicians from other nations may rarely encounter such injuries. With an increase in international conflict, there is an increased need for clinicians to participate in international medical aid which may include patients with ballistic injuries. Clinicians with limited familiarity of such injuries may result in under-triage and delayed recognition of injury severity, resulting in increased morbidity and mortality of patients. This study aims to show that a course on ballistic injuries will improve clinician recognition of injury patterns and comfort levels managing these patients.

Method:

Clinicians participated in a course which was designed to introduce ballistic injury patterns. The course was reviewed and supported by emergency medicine physicians who work in a large level I trauma center in the Southeastern United States and serve in clinical roles with EMS and community law enforcement. Course content included demonstrations of firearm injuries by discharging weapons into gels and models designed to replicate human body tissue. Participants were surveyed prior to and after completing the course regarding their comfort with firearms and firearm related injuries.

Results:

Participants reported increased comfort level with the management of ballistic injuries. The course requires a full day of expert physician time, approximately US$600 in supplies if performing live demonstrations, and the cost of designated space for safe firearm discharge and use.

Conclusion:

This course or a similar course with pre-fired demonstration rounds proved to be feasible and beneficial for those who will likely encounter firearm injuries in their clinical environment. There are both quantifiable and perceived benefits for physicians.
Combined Trauma and CBRN Exposure
Authors: McIsaac Joseph
Published: June 2023

Introduction:

Whether it is COVID in New York, chemicals in Syria, or a radiological exposure from a dirty bomb or nuclear detonation, trauma is increasingly mixed with CBRN. Decontamination, isolation, and newer treatments all impact the patient as well as the physician. Military physicians regularly plan for these patients, but the civilian world has not. Civilian CBRN training has been spotty, at best. Our recent experience with COVID and the current threats of nuclear attack, emphasize the need to integrate CBRN exposure into our trauma treatment plans, both to help our patients and to protect the caregivers.

Method:

Literature review and US Department of Health and Human Services Guidelines.

Results:

A template for patient flow and treatment priorities is presented along with just-in-time references. Triage guidelines for trauma patients with Acute Radiation Syndrome (ARS) are also provided.

Conclusion:

Civilian preparation for managing the CBRN contaminated trauma patient starts with a mental model of treatment priorities and self-protection strategies. Just-in-time treatment references can provide additional support and confidence.
Utilizing AEMS (Assess-EOP-Map-Simulate) Algorithm to Assess and Spatially Link Prehospital Emergency Medical Services Resources in Road-Traffic Mass Casualty Incidents in Kumasi, Ghana
Authors: Richter Roxane , Flowers Thomas , Oduro George , Bonney Joe , Forson Paa , Oppong Chris , Cobbold Sonia , Richter Rainier
Published: June 2023

Introduction:

Due to the high number of road traffic accidents with acute injuries and fatalities–particularly in Mass Casualty Incidents (MCI) in low-resource urban sub-Saharan African cities–research was undertaken to create an evidence-based algorithm that could be used to assess and geospatially link EMS needs in Kumasi, Ghana, to trauma resources. Our examination showed that non-MCI fatalities was approximately 2.5%, however, MCI fatalities were found to be 1.8 times higher–at 4.3%, indicating significant opportunities in the planning, preparedness, care, and transport among MCI patient management.

Therefore, several studies (funded through Fulbright-Fogarty and Fulbright Specialist programs), supported the development of the A-E-M-S (Assess-EOP-Map-Simulate) Medical Mass Casualty Algorithm that began networking accident ‘hotspots’ to existing trauma-level capabilities and surge capacity competencies in eight specified Kumasi hospitals. This low-cost response model promises to be an innovative alternative to long-term infrastructure development and high-priced resource distributions. Use of GIS and UAV drones allowed response systems to geospatially locate, classify, shift, and/or augment resources as needed in conjunction with hotspots.

Method:

Sample sizes were averaged at 295 for all patients' ages, with only a sample size of 292 for adults at 95% confidence intervals, and a standard deviation of 0.5. A total of 300 road-traffic accident victims were collected at KATH A&E in February-May, 2017, utilizing handheld devices by four researchers 24/7 daily.

Results:

Our examination showed that non-MCI fatalities were approximately 2.5%, however, MCI fatalities were found to be 1.8 times higher–at 4.3%, indicating significant opportunities in the planning, preparedness, care, and transport among MCI patient management.

Conclusion:

To date–and in partnership with Kwame Nkrumah University of Science and Technology, Komfo Anokye Teaching Hospital, Ghana Medical Council, Health Services, National Disaster Management Organization, and others–over 306 Ghanaian healthcare providers from 80 different facilities have been trained in the AEMS program.