bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adolescents Exposed to Cumulative Natural Disasters: A Comparison Between their Realities in Rural and Urban Areas
Authors: Pouliot Eve , Maltais Danielle , Gervais Christine , Tardif-Grenier Kristel , Simard Ann-Sophie , Gauthier Pascal , Maltais-Dufour Olivia , Hamel Ariane 
Published: June 2023

Introduction:Over the past years, the Outaouais region (Quebec, Canada) and their residents have had to endure no less than five natural disasters (floods, tornadoes). These disasters are likely to have a variety of consequences on the physical and mental health of adolescents, as well as on their personal, family, school and social lives. The experiences of teenagers are also likely to vary depending on whether they live in rural or urban areas.Method:Data were collected via a self-administered questionnaire in February 2022. A total of 1307 teenagers from two high schools participated in the study by completing an online survey. The questionnaire measured various aspects of the youth's mental health using validated tests, such as manifestations of post-traumatic stress, anxiety and depression, as well as the presence of suicidal thoughts and self-harm. Other aspects of the youth's experience were measured, including their level of social support, school engagement, alcohol and drug use, and coping strategies.Results:One third of young students (n=1307) were experiencing depressive symptoms and suicidal thoughts, as well as significant daily stress. More than 25% of the students had moderate or severe anxiety and thoughts of self-harm. These problems were significantly more prevalent among youths with prior exposure to a natural disaster. The study data also revealed that youths living in rural areas had a more worrying profile than those living in urban areas.Conclusion:Similar to other studies (Ran et al., 2015; Stratta et al., 2014), our research data revealed that youths living in rural areas presented a more concerning profile than those residing in urban areas. It therefore seems important, in future studies and services, to focus more specifically on these teenagers to better understand their needs and to develop adapted services more likely to meet them.
The Advancement of the Scientific Study of Prehospital MCI Response from TIIDE to NIGHTINGALE: A Scoping Review
Authors: Weinstein Eric , Cuthbertson Joseph , Herbert Teri Lynn , Bortolin Michelangelo , Magalini Sabina , Gui Daniele , Helou Mariana , Faccincani Roberto , Ragazzoni Luca , Caviglia Marta 
Published: June 2023

Introduction:The European Union Horizon 2020 research and innovation funding program awarded the NIGHTINGALE grant to develop a toolkit to support first responders engaged in prehospital (PH) mass casualty incident (MCI) response. To reach the projects’ objectives, the NIGHTINGALE consortium adapted the Translational Science (TS) process. The aim of this study is to perform the first TS (T1) phase PRISMA scoping review to extract data that will be used to guide the creation of the initial evidence-based second TS phase (T2) modified Delphi statements for a subsequent study.Method:The consortium was divided into three work groups (WGs) MCI triage, Prehospital Life Support and Damage Control (PHLSDC) and Prehospital Processes (PHP). Each WG conducted simultaneous literature searches following the PRISMA extension for scoping review with a common research strategy sharing MCI related search terms and then terms specific for each WG. Final included articles went through data extraction based on identified themes and sub-themes from PH MCI response literature to be used to create the future statements.Results:The initial search yielded 925 total references to be considered for a title and abstract review (PH Triage 311, PHLSDC 329, PHP 285), then 483 articles for a full reference review (MCI Triage 111, PHLSDC 216, PHP 156) and 155 articles for the database extraction process (MCI Triage 27, PHLSDC 38, PHP 90).Conclusion:The progression of the study of prehospital MCI response enabled NIGHTINGALE partners to methodically obtain information that will contribute to each WG’s creation of initial T2 modified Delphi statements.
Test Characteristics of Stool Color for Predicting Infection with Vibrio Cholerae in Patients with Acute Diarrhea
Authors: Gainey Monique , Qu Kexin , Garbern Stephanie , Nasrin Sabiha , Alam Nur , Schmid Christopher , Nelson Eric , Levine Adam 
Published: June 2023

Introduction:Recurring outbreaks of cholera coupled with lack of laboratory diagnostic capacity in low resource settings fuels clinicians’ reliance on clinical case definitions and highlights the importance of accurate diagnostic guidelines. While “rice-water” stool color is the hallmark predictor of cholera, few have examined the diagnostic accuracy of this assessment. This study assesses the sensitivity, specificity and positive and negative predictive value (PPV; NPV) of classifying stool color as “rice”, “clear” (i.e. watery) or “rice or clear” stool by either the patient or nurse for diagnosing cholera.Method:From March 2019-2020, a random sample of patients presenting to the International Centre for Diarrhoeal Diseases Research, Bangladesh with acute diarrhea who had a stool sample obtained were included in this analysis (N=2135).Results:Of the 1198 (56.1%) of patients that had culture growth, 641 (53.5%) were positive for Vibrio cholerae. “Rice” stool was reported by 518 (23.8%) patients and 640 (29.5%) nurses, while “clear” stool was reported by 1081 (49.8%) patients and 353 (16.3%) nurses. When observed by nurses, both “rice” (76%) and “clear” (85%) stool were reasonably specific but not very sensitive for cholera (44% and 20%, respectively). The combined “rice or clear” colored stool had the best balance of sensitivity (65%) and specificity (61%) with a PPV of 42% and NPV of 80%. When reported by patients, “rice” stool had high specificity for cholera (76%) but low sensitivity (25%), while “clear” stool had both poor sensitivity (54%) and specificity (51%).Conclusion:Current international guidance that recommends classifying watery (clear) stool as cholera in outbreaks may still miss many patients with culture confirmed cholera even when the stool color is observed by trained health professionals and is likely not useful at all self-reported by patients. The combination of “rice or clear” diarrhea may provide somewhat more accurate assessments.
Hospital Workforce Education and Training for Emergency Management and Disaster Response in Complex Settings.
Authors: Gowing Jeremy , Mather Carey , Elmer Shandell , Cummings Elizabeth 
Published: June 2023

Introduction:Understanding how to best prepare hospital staff for disasters or emergencies is critical, as there is increasing frequency and scope of these events. Considerations include: identifying key staff, their roles, strategies to support continuity of care, delivery mode of education, and resource allocation.Method:Participants experienced in disasters and major emergencies or preparation at three tertiary referral teaching hospitals were purposively selected during 2016 and 2019. An interpretive paradigm and case study design enabled the exploration of perspectives concerning effective and preferred methods for preparedness. Fifty-five allied health professionals, medical practitioners, and nurses participated in semi-structured interviews; and support staff participated in focus groups.Results:Key findings: 1. Recognition that allied health professionals and support staff are essential and must be included in disaster or major emergency preparation and plans. 2. Factors that increase the likelihood of staff deciding to be absent from work include: perception of danger, insufficient understanding of responsibilities, and hospital preparation is perceived inadequate. Staff understanding their role has a positive influence for attendance and coping during disasters. 3. Preferred and most effective method of disaster preparedness is practical learning, combined with other preparation methods. Online learning as the major mode was unpopular. 4. Challenges of inadequate resources limits managers’ ability to facilitate staff preparation and care delivery during disasters. Resources affect method, duration and multidisciplinary inclusion in disaster preparation.Conclusion:This research found disaster preparedness in hospitals is critical. Site and occupation specific differences need to be addressed. To mitigate impacts of disasters or major emergencies, preparation must include identification of required resources. Disaster preparedness and management must be inclusive of multidisciplinary staff, including allied health and support staff. Facilitation of role understanding to promote continuity of care during disasters or major emergencies is imperative to promote staff participation and effectiveness in response to disasters.
Le Grand Départ 2019 - health care management during a major planned event in the heart of Brussels (Belgium)
Authors: Spaepen Kris , Hubloue Ives 
Published: June 2023

Introduction:Mass gathering events (MGE), can attract sufficient attendees to strain the planning and response resources of the host community, state, or nation, thereby delaying the response to emergencies. The organization of such a MGE can be even more problematic when the event continues across much of downtown (including hospitals) and makes some parts of the city inaccessible. The aim of this study was describing the health care management of the Grand Départ of the Tour de France, July 6-7th, 2019. On both days, the stages drew crowds of 300,000 attendees, adding a quarter of the regular number of inhabitants of Brussels (1,2 million) and closing parts of downtown Brussels.Method:Data were retrospectively collected from the in-event health services (coordinated by the University Hospital Brussels). Data regarding medical interventions, as well as data generated by the advanced medical posts (AMP) were recorded and handed to us after anonymization. For analysis, patients were divided into two groups: those seen by first-aid responders and paramedics (triage code green) and those seen and treated by health professionals (emergency nurses and physicians) (triage codes yellow or red).Results:During the event, three AMPs were established along the route of the stage as were six ambulances, three mobile medical crews (one emergency nurse and one physician), and seven mobile first aid teams. Over the two days, 84 patients were seen; 80 green codes (95,2%), 3 yellow (3,6%), and one red (1,2%) resulting in a patient presentation rate of 0.28/1,000. In total eight patients were transported to hospital for further diagnosis and treatment (ambulance transfer rate: 0.02/1,000).Conclusion:In-event health services for this event proved adequate according to the number of attendees and the severity of the patients. No hospital reported disruptions to their standard operational capacity.
What Has Changed? A Bibliometric Analysis and Visualization of Research in Mild Traumatic Brain Injury
Authors: Liu Tao , Li Ji , Cao Chunxia 
Published: June 2023

Introduction:People around the world are affected by traumatic experiences, ranging from collective events like natural disasters, mass violence, war, terrorism and to personal, even "everyday life" traumas such as road traffic accidents and the sudden football attack. The mTBI caused by traumatic events is a significant public health international matter. There is a greater demand for mTBI research from all cultures and societies. This paper attempts to explore the research status, focus and challenges by using a bibliometric analysis on mild traumatic brain injury (mTBI).Method:Publications on mTBI were retrieved from the Web of Science Core Collection by the title advanced search strategy from January 1, 2000, to October 31, 2022. Articles and reviews were included, and no language restrictions were applied. Microsoft Excel, RStudio, VOSviewer, and CiteSpace were used to extract, integrate and visualize the bibliometric information.Results:A total of 3,464 documents were retrieved from 2000-2022, with a general upward trend despite slight fluctuations in annual publications. The USA had an overwhelmingly dominant position in terms of both the number of publications (n = 2 028) and citations (n = 63 287). The Department of Veterans Affairs (n = 380) and Veterans Health Administration (n = 370) were the most productive institutions. Collaborations in cross-national, cross-institutional and different authors were weak. Iverson GL was the leading scholar and the Journal of Neurotrauma and Brain Injury were the most influential journals. Based on keyword co-occurrence analysis, the research focus could be divided into four clusters: epidemiology and prevention, characterization of mTBI, outcome assessment and prognosis.Conclusion:The mTBI research has drawn increasing attention over the years. However, the research on mTBI is still relatively limited and challenging, and collaborations that cross national, institutional, disciplinary, and sector boundaries are important to the advancement of improving mTBI worldwide.
Challenge for the Green Response: Reduction of Impact on the Environment by Emergency Medical Team
Authors: Nakade Masaharu 
Published: June 2023

Introduction:Environmental degradation and climate change can lead to humanitarian crises and undermine humanitarian operations. Therefore, Emergency Medical Teams should try to reduce environmental impacts.Method:Collaborative development with companies was started by trimming the weight of tents, improving lights, and introducing renewable energy to our emergency medical unit to reduce greenhouse gas emissions.Results:The mechanism of the medical tent, and materials was changed. The weight of tents was cut by 30%. The final goal is to develop an 8 x 6 meter tent which is set up by four women.Light-weight and low-power tent light was created. It is 50% weight and 60% power consumption of our conventional light.All the power of the emergency clinic was run by renewable energy. introducing a 1 x 2 m, 5,5kg solar panel that produces 350 Wh/day. If 18 panels were put on the tent roof, they produce 6,300 Wh. This is equivalent to the power consumption of a standard household in Japan, and it is estimated this can cover the power consumption of the patient department of the emergency clinic. Experimental tests will now be conducted.Conclusion:Nowadays, even emergency medical teams are required to reduce their impact on the environment on the field. Therefore, trying to reduce the greenhouse gas emissions from the emergency medical team. The challenge is still on the way, but marching steadily.
Introducing Advanced Paramedics into the Rural General Practice Team in Ireland – General Practitioners Attitudes
Authors: Feerick Fintan 
Published: June 2023

Introduction:As Ireland's population increases and chronic disease becomes more prevalent, demand for limited general practice services will increase. Nursing roles within a general practice are now considered to be standard, yet alternative non-medical professional roles are under-explored within an Irish context. Non-medical personnel such as Advanced Paramedics (APs) may have the capability to provide support to general practice.Method:A sequential explanatory mixed methodology was adopted. A questionnaire was designed and distributed to a purposeful sample of GPs attending a rural conference followed by semi-structured interviews. Data was recorded and transcribed verbatim and thematically analyzed.Results:In total n=27 GPs responded to the survey and n=13 GPs were interviewed. The majority of GPs were familiar with APs and were receptive to the concept of closely collaborating with APs within a variety of settings including out-of-hours services, home visits, nursing homes, and even roles within the general practice surgery.Conclusion:GP and AP clinical practice dovetail within many facets of primary care and emergency care. GPs believe that current models for providing rural general practice care are unsustainable, and they realize the potential of integrating APs into the general practice team to help support services into the future. These interviews provide a detailed insight into the opinions of rural general practitioners in Ireland on healthcare provision and the clear necessity for support and change.
Challenges and Complexities of Providing Emergency Medical Services During Covid-19 Pandemic in Nepal
Authors: Maharjan Ramesh , Thapaliya Sabin , Tamang Prasun , Maharjan Rashmisha 
Published: June 2023

Introduction:During the Covid-19 Pandemic, the Department of Emergency Medicine is the one of most busy in Nepal. Challenges and complexities of providing emergency medical service during the waves of the Covid-19 pandemic in Nepal were analyzed.Method:Three years (2020 – 2022) of data was analyzed from Covid patients registered in Tribhuvan University Teaching Hospital (TUTH), Institute of Medicine for reference with National Data of Ministry of Health and Population, Government of Nepal.Results:On November 15, 2022, there were 5,969,338 Covid PCR tests and 1,452,639 Covid Antigen tests in Nepal with 1,000,826 (16.8%) PCR, 152,197 (10.5%) being positive. The cure rate was 98.7% (988,316 cases). There were 12,019 mortalities with 1.2% case fatality. In TUTH 2020 – 2022 records; 3,794 total severe Covid-19 patients were admitted; In the first year, only two patients (1M:1F); In the second year 2,056 patients 1.8M:1F and in the third year 1,736 with 1.1M:1F. The age groups with the first wave vs the second wave were 6.42% vs 5.47% of 0-20 years; 24.22% vs 26.84% of 21-40 years; 30.57% vs 30.87 of 41-60 years and 38.57% vs 36.87% of above 60 years. The hospital mortality rate was 751 (19.8%). Challenges were due to resource limitation, limited PPE, scarcity of oxygen, medication, and ventilators. In TUTH, all levels of emergency management and various definite care were provided 24/7 hours in the pandemic period. There are a lot of challenges in Pre-Hospital Emergency Care Service due to a limited number of designated Advance Ambulances during transportation of severe Covid patients. With these challenges and complexities, there were six deaths of their own hospital staff due to severe Covid-19.Conclusion:The challenges and complexities of providing emergency medical services during the Covid-19 pandemic in Nepal have been overcome with teamwork and activation of the emergency care system in Nepal.
Starting Points for Promoting Disaster Resilience in Home Nursing Care in Germany–A Participatory Development Process
Authors: Ewers Michael , Lessines Sanne , Kibler Angelina , Gröbe Sebastian , Köhler Michael 
Published: June 2023

Introduction:In Germany, more than 3.3 million people in need of long-term care are receiving home care. Although not all of them use professional home care providers, their services are essential especially to those who need skilled nursing care and medical-technical assistance in addition to everyday support–such as approximately 30,000 people who receive home mechanical ventilation. Little is known about the disaster resilience of home care infrastructures and ways to strengthen them. A research consortium called AUPIK, funded by the German Federal Ministry of Education and Research from 2020-2023, sought to close this gap.Method:A participatory process was initiated as part of the AUPIK project based on results of a multi-perspective empirical baseline analysis which resulted in a first draft text about measures to promote disaster resilience in home care. 37 representatives of home nursing care providers and community health-care services, professional boards, scientific and education institutions participated in a web-based survey on the draft text, followed by two digital group discussions. Finally, the gradually revised, condensed and consented starting points were published and distributed.Results:Eight starting points were defined. Among others, there is an urgent need to strengthen risk awareness and resource management among home care providers, to promote individual disaster competence and preparedness among all parties involved and, not least, to strengthen community-based networking initiatives between home care providers, emergency and disaster organizations and local authorities. Institutions or persons who should take responsibility for implementation at different levels are addressed directly.Conclusion:The final version of the starting points represents a consensus on urgently needed initiatives to promote disaster resilience in home nursing care in Germany. The participatory development process should support commitment on the part of all stakeholders and thus promote effective implementation of disaster resilience initiatives in home nursing care.
Lodgers, Boarders, Trolley Patients; A Growing Challenge in Emergency Departments (ED). Zero Tolerance for Trolleys or Zero Tolerance for Zero Trolleys; A Crude Examination of Progressive Capacity Issues in an Irish Emergency Department.
Authors: Conradie Maria , Smit Marco , Abraham Ria , van der Vegte Andrea , Bilal Muhammad , Orsmond Brendan , Andrews Robin , van Rensburg Rochelle Janse , Taqvi Sayed Yousuf Raza , Jordaan Phillip , Dowle Aishleigh , Vythilingam Darshini , Wickham Bryce , Kelly Thomas , Molloy Michael 
Published: June 2023

Introduction:The Health Information and Quality Authority (HIQA) Tallaght Report of 2012 found care of lodged admitted patients on ED trolleys was undermined in terms of quality and safety. HIQA advised the practice of lodging in ED adjacent hospital corridors should be discontinued entirely. This message was reiterated during the pandemic. Some lodged patients may spend the total duration of their admission on an ED trolley. ED has 15 Adult rooms, seven pediatric rooms, two minor injury rooms, one procedure room and two resus bays. The aim was to calculate the annual number of days when no admitted patients were lodged on trolleys in ED.Method:A descriptive study using data available from nationally issued reports on patients allocated to trolleys to the ED of Wexford General Hospital from January 2019-September 2022. Data was collected from national HSE daily SBAR reports. “Lodged patients” were those present in ED admitted but for whom no ward bed existed at 0745 daily.Results:Data was collected for 1,369 days, 90 days were excluded due to missing data sets, and data were included for 1,279 days. 290 days were recorded in 2019 with no lodged patients, 126 in 2020, 55 in 2021, and only 11 days in 2022 with no lodged patients. In 2022 the average number of lodged patients was six (Range 0-19). A total of 47 days had a lodged count of ten or greater.Conclusion:Despite a strong recommendation from HIQA to terminate the practice of ED patient lodging, this has not been implemented. During the COVID-19 pandemic, there had been a reduction in the overall number of patients visiting the ED. This contributed to the reduction in trolley-lodged patients however post-COVID pandemic there has been a surge in attendance with a clear deficit in bed capacity.