bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integration and Disjuncture within the Israeli Health System During COVID 19 Pandemic
Authors: Arama Daniel Elbo , Cohen Odeya , Davidovitch Nadav 
Published: June 2023

Introduction:The Israeli health system had a critical role in leading the response to the COVID-19 pandemic facing a wide-range of challenges following the length and the unique characteristics of this health emergency. This study evaluated the weaknesses and strengths of the different parts of the system, relying on WHO building blocks to promote better coping with large-scale health emergencies.Method:The experiences of 13 high-level senior experts in the Israeli health system who directly managed COVID-19 were examined, using in-depth semi-structured interviews conducted during 2021. Critical and snowball sampling were used to select participants. Interviews were recorded and transcribed. Data analysis was conducted using ATLS.TI 22 software and reviewed by peers. The interviews were analyzed using the thematic analysis method. A theme expresses a broad central idea that tends to appear and reoccur in the analytical material in different forms of expression. Specifications and ideas were discussed among the researchers while engaging in repeated rereading of the transcriptions until saturation was achieved with the final themes.Results:The role of the Ministry of Health in integrating the health response and importance of spokespersons providing professional information increase trust as a crucial role of community health services in emergencies having political tensions reflected in the medical response. The Israeli Health system differ from hospital systems abroad by the relationships between preparedness during routine and emergency response. The importance of trust was highlighted.Conclusion:The study demonstrates a deep understanding of the way the Israeli health system dealt with the pandemic, revealing needs, resources, weaknesses and strengths. The results offer a rare opportunity to learn how integration of service-delivery can be improved within the health system in all levels. These lessons should be translated to advance better handling of future emergencies.
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.