bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Characterization of the Burden from Mandated COVID-19 Public Health Reporting on a Small Independent Hospital in New York City
Authors: Daniel Pia , Arquilla Bonnie , Roblin Patricia , Kaufman David , Cato Kenrick , Senathirajah Yalini 
Published: June 2023

Introduction:Public health agencies’ ability to monitor outbreaks requires government mandated reporting from healthcare institutions, with consequences for noncompliance. This study aims to characterize the burden on acute care hospitals from government reporting requirements during COVID-19 pandemic.Method:A retrospective study over a 14-month period (April 27th, 2020 to June 10th, 2021) during the COVID-19 pandemic examining the log of changes and requirements of the Health and Human Services (HHS) Teletracking, an online system for hospital reporting. We interviewed 33 individuals including hospital leadership, clinical directors, and infection control personnel in a New York City (NYC) small independent hospital (SIH).Results:During the study period, reporting requirements increased from five daily reports to 29 daily reports across eleven different agencies, all with separate reporting systems. Reporting schedules varied from several times a day to intermittently. Typically, new reporting requirements were conveyed to institutional contacts at 8 AM with a required deadline of 1 PM the same day. The continuous changes reportedly made it difficult to develop stable data gathering and workflow processes. There was a reported lack of clarity around new data elements’ definitions and different agencies employed different variables for the same measure. There were hospital penalties for missing deadlines, leading to clinical staff being diverted from patient care to meet reporting needs.Conclusion:The study shows significant reporting barriers and diversion of resources away from the frontline to supply data collection during disasters. There is significant redundancy in reporting agencies and in reporting systems, each with different reporting frequencies, and variable definitions of data elements. The public health needs of a disaster response would be better served with a more coordinated, efficient system to share information without further straining the healthcare system.
Required Functions of Information Gathering and Processing for Health, Medical, and Welfare Coordination Headquarters for Disasters in Japan
Authors: Ojima Toshiyuki , Takasugi Tomo , Haraoka Tomoko , Tonai Shuji , Miyagawa Shoko , Ichikawa Manabu , Hattori Kiyoko , Okuda Hiroko , Yi Tai-young , Tomio Jun 
Published: June 2023

Introduction:The Ministry of Health, Labor, and Welfare of Japan have suggested local governments establish Health, Medical, and Welfare Coordination Headquarters at the time of disaster. Gathering and processing information is one of the key functions of the headquarters. The study aims to clarify the required functions of information for the headquarters.Method:A series of interview surveys and observations were conducted, including for local governments and experts in disaster response. The contents were analyzed and required standard functions and procedures had been extracted.Results:The most important aspect of information gathering is its use in decision-making in matching needs and demands with resources. Needs and demands are based on damage and situation of the casualties. Resources can be categorized into human, material, financial, and informational. Because the headquarters have to process much information, it is important to clarify the objective and strategy of disaster response. The headquarters gather various quantitative and qualitative information using information and communication technology, telephone, meeting and other methods. Qualitative information can be categorized as: expected, surprising (unexpected), and unusual (rare) contents. For expected contents, quantification or estimation of needs from information in normal time or limited information immediately after the disaster and displaying or further analyzing by geographic information systems is useful. By surprising contents or case reports, additional responses or strategies will need to be reviewed.Conclusion:The procedure, including information gathering and decision-making, follows the OODA (observe, orient, decide, act) loop. According to our mail survey of all 47 prefectural local governments in 2019, 89% were planning to establish the headquarters. However, only 36% had prepared a manual. Using the results of this study, a standard strategic manual for the operations of the headquarters is being developed and brushed up.
Transforming Disaster and Emergency Health Policy for Contemporary Hazard Threats–a Multi-country Review
Authors: Finnigan Gerard 
Published: June 2023

Introduction:Strengthening national disaster management legislation and policy is critical for preventing and reducing catastrophic health effects from the growing threat of natural hazard disasters. Although evaluations of the effectiveness of legal and policy instruments are rarely published, similar approaches continue to be applied universally by governments to align their response to disaster impacts. This study analyzed and contrasted the effect of disaster legislation and policy on the emergency health and medical response to six complex natural hazard disasters, including typhoon, earthquake, flood, smoke haze, thunderstorm asthma and the COVID-19 pandemic.Method:The study applied qualitative multi-case study methodology and used a standardized program logic model to synthesize and analyze the effect of national disaster legislation and policy on emergency health and medical responses. Events were case-bounded by date, more than 9,000 casualties, and local emergency responses provided health and medical care.Results:Four themes emerged critical to health system response. Where legislation and policy provided clear separation of powers, systems delineated roles and responsibilities, provided clarity and process for assessment, resource acquisition, and operational mandates. Policies that created dedicated local networks and included non-health related organizations, accelerated coordination of crucial health functions for rapid mobilization and prioritization for affected populations. In all but one case, the hazard was closely monitored, already affected communities, and catastrophic risk to life understood, before the declaration and statutory powers were invoked.Conclusion:Using ‘declarations’ as the legal instrument to initiate ‘whole of government’ resources in disasters requires urgent review, especially where advanced hazard monitoring systems exist. Disaster and emergency health policy should support action orientated toward exposure mitigation, inclusion of non-traditional health actors and partnership building. International policy mechanisms are required to address emerging health threats not locally prioritized and advance regional cooperation agreements when the impact of hazards harm populations outside geographic boundaries.
Descriptive Analysis of Northern Triangle Disasters in the EM-DAT Database: 1900-2022.
Authors: Dickason Robert , Hertelendy Attila , Hart Alexander , Ciottone Gregory 
Published: June 2023

Introduction:Since 1900, disasters in the Northern Triangle of Central America—Guatemala, Honduras, and El Salvador—have caused over one-hundred-thousand deaths, affected millions of people, and caused billions of dollars of damages. As climate change causes increasingly frequent severe weather events, the catastrophic effects of disasters are likely to contribute to poverty and political and economic instability in the region leading to greater levels of migration out of the Northern Triangle.Method:This study provides a descriptive analysis of all disasters recorded in the EM-DAT database affecting Guatemala, Honduras, and El Salvador between 1900-2022. Disasters are analyzed by frequency, severity, financial cost, distribution by country, burden of death, affected and financial cost by country, and type of disasters most prevalent in each country. These trends are then graphed over the time period of the database.Results:EM-DAT records 359 disasters in the Northern Triangle between 1900 and 2022. Meteorologic events (floods and storms) were the most common types of disaster (44%), followed by transport accidents (13%). Meteorologic events and earthquakes were the most severe, as measured by deaths (62% of total deaths caused by disasters), people affected (60%), and financial cost (86%). Guatemala had the greatest number of disasters (45%), deaths (68%), and affected people (52%). The financial costs of the disasters were evenly distributed between the three countries.Conclusion:Meteorologic disasters are the most common and most severe type of disaster in the Northern Triangle. Earthquakes and transport accidents are also common. As climate change causes more severe storms in the region, disasters are likely to increase in severity as well. Governments and aid organizations should develop disaster preparedness and mitigation strategies to lessen the catastrophic effects of these coming disasters. Missing data in the EM-DAT dataset limits the conclusions of this study to general trends
Triage at Mass Gathering Events: Not an Emergency Department, and Not (Necessarily) a Disaster
Authors: Munn Matthew , Scholliers Annelies , Gogaert Stefan , Bistaraki Angeliki 
Published: June 2023

Introduction:Triage at mass gathering events (MGEs) has no standard protocol that is widely accepted and applied uniformly across event types and locations. This investigation describes the current state of published literature as it applies specifically to the triage of patient presentations at MGEs, and identifies key roles and important limitations of triage methods in use at events.Method:A literature review search strategy was employed (previously published, Turris et al, 2021) to search for event case reports published for the period from 2010-2022. Included papers were reviewed and data were extracted for all references to triage; authors were contacted for any missing details. Data extraction looked specifically for the following (if available) : triage mention, triage scale used, triage categories with patient counts, triage training and any information on clinical dispositions subsequent to triage assignment.Results:A total of 60 papers were included (Data extraction in progress, numbers to be finalized for presentation). Of these papers, a minority even made mention of triage, very few specified the triage scale used, and almost none described any triage training. Only a handful of case reports contained counts of patient presentation by triage categories. A couple of papers mentioned triage scales that were event type specific (sports, etc).Conclusion:Published literature to date contains limited details and agreement on triage methods in use at MGEs. Methods are largely from the emergency and disaster domains. Triage utility appears generally to be limited to designating location and provider, and for a snapshot of acuity post event. The use of triage scale has not been solely predictive of the need for transfer to hospital.
Review of Canadian Legislation on Mass Gathering Medical Response
Authors: Pigeon Marc-Antoine , Hertelendy Attila , Hart Alexander , Hsueh Jennifer , Ciottone Gregory 
Published: June 2023

Introduction:Mass gatherings have become more frequent since the beginning of the 21st century. In Canada alone, music festival and sporting event industries will each represent yearly revenues over one billion USD by 2025. Such events require adequate medical planning, as they are associated with a greater prevalence of injuries and incidents than daily life, despite most participants having few comorbidities. Most often, the responsibility of medical planning lies with event producers. This study aims to compare the existing legislative requirements for mass gathering medical response in the ten provinces and three territories of Canada.Method:This study is a cross-sectional descriptive study of legislation. Lists of legislative requirements were obtained by contacting via email or phone the emergency medical services (EMS) directors and Health Ministries of all the provinces and territories of Canada, and asking about any legislation or provision within existing laws regarding mass gatherings. Simple statistics were performed to compare legislation across provinces and territories.Results:Data collection and analysis are planned to be completed by December 31, 2022. Initial data collection and analysis revealed that none of the seven provinces who answered our emails have provincial legislations. Two referred to specific provisions in the Public Health laws of their province, though nothing specifically refers to mass gatherings. One confirmed that mass gathering medical response was a municipal/local concern to be addressed by the event producers and the locality where the event takes place, and one referred to guidelines published in 2014.Conclusion:Although some provinces and territories referred to provisions contained in public health legislation, none of the provinces reached to date could list specific legislation on mass gathering medical response. If this trend continues through full data analysis, it will highlight once more the need to provide more standardized guidance to organizers and municipalities in planning medical response.
Standards of Medical Planning and Response for Emergency Medical Teams During Mass Gatherings: A Systematic Review
Authors: Spaepen Kris , Lajolo Camila , Wang Ninlang , Salio Flavio , Hubloue Ives 
Published: June 2023

Introduction:Mass gathering events (MGE), organized or unplanned, can attract sufficient attendees to strain the planning and response resources of the host community, state, or nation, thereby delaying the response to emergencies. MGEs also have the potential to cause a mass casualty incident. But MGE can also lead to improvements in the organization of local emergency medical services or public health that form the legacy of that MGE. Emergency medical teams (EMTs) could be deployed to ensure health security as a surge in MGE. But these EMTs should be built on guiding principles and core standards. However, to the best of our knowledge, there are no standards on medical planning and response during any type of MGE (e.g., sports, religious, or festivals).Method:A systematic review was performed in accordance with current guidelines, using six databases, namely Medline (via the PubMed interface), Scopus, Embase, Cochrane Library, ScienceDirect, and CINAHL, as well as literature sourced by Google Scholar and The Journal of Prehospital and Disaster Medicine. Studies published on minimum standards or medical planning and response during MGE from 2002-2022, written in English, were selected and assessed for eligibility by two reviewers.Results:From a total of 20,159 articles, 138 were screened, and 32 were assessed for eligibility. Two were only abstracts, and the others did not contain any description of minimal standards available for medical planning or response in different types of MGE.Conclusion:No studies were found that describe any form of standards for medical planning and the response of emergency medical teams in different types of mass gathering events (e.g., sports, religious, festivals). There is a need for minimum standards for emergency medical teams deploying as a surge in mass gathering events.
Building the Evidence Base to Update the Key Public Health Considerations for Mass Gatherings Evaluation and Legacy
Authors: Chen Gina , Endericks Tina 
Published: June 2023

Introduction:Leaving a viable public health legacy and sustainable improvements in health infrastructure and capacity should be key for mass gatherings (MGs). Legacy includes improvements in health systems, health behaviors and delivering future MGs. Legacy planning and evaluation should be considered early in planning however, they are often neglected due to lack of funding to support, embed learning and maintain a sustainable legacy, and often favored over the event running smoothly.Building on the Public Health for Mass Gatherings: Key Considerations (KC2) (2015), an updated literature review will identify new evidence for evaluating MGs and their legacy. This review will inform the development of updated resources to reflect the changing global health landscape and learning from MGs hosted during COVID-19, which can inform ways of better embedding legacy and evaluation in planning and post-event.Method:A systematic literature review methodology will be used. Electronic databases will be searched for relevant publications and grey literature of a wide range of MGs globally, focusing on evaluations, MG legacies, and impacts. Searches for specific technical areas e.g., surveillance, will also take place.Results:The literature review undertaken to develop the KC2 chapter identified limited publications. The increased interest in this field, should lead to an improved evidence base while recognizing evidence for long-term evaluation and legacy impact may still be more restricted due to the challenges of undertaking these studies. Recent literature will likely reflect work undertaken to deliver MGs during COVID-19, which will be included to identify good practice and transferable learning.Conclusion:Key findings of the review will be published, and the evidence base will be used to update the evaluation and legacy chapter of the KC2. There are also plans to develop a MG evaluation and legacy tool that will be applicable beyond the major high-profile funded events.
Necessity and Feasibility of Medical Containers in Nankai Trough Mega Earthquake
Authors: Maebayashi Kiyokazu , Nakata Keiji , Tanaka Ayako , Syowa Naoki , Takada Takamitsu 
Published: June 2023

Introduction:In Japan, there is an 80% probability that the Nankai Trough Mega Earthquake will occur within 30 years, and a tsunami of more than 30 meters is expected to hit the Pacific coast, killing more than 320,000 people and devastating many towns. This study clarifies the necessity and feasibility of a high-performance medical container developed by Showa to fill the gap in medical care during a large-scale disaster, especially after the sub-acute stage.Method:1) Simulation of the damage to disaster center hospitals in the event of the Nankai Trough Mega Earthquake.2) To clarify the feasibility of immediate response, a demonstration experiment was conducted by combining and installing ten units of medical containers.Results:1) Of the prefectures where the death toll from Nankai Trough Mega Earthquake is estimated to be 5,000 or more, 119 disaster center hospitals located in cities and towns with coastlines were examined to determine if they were in the tsunami inundation zone. The results showed that 44 hospitals, or about 37%, were inundated and their medical functions were likely to be paralyzed.2) Ten containers of medical treatment rooms, ICUs, CTs, power supplies, and oxygen could be assembled in seven days. This is by far the shortest time compared to the more than two months it takes for a temporary hospital.Conclusion:It is clear that medical containers can fill the void of medical care in the event of Nankai Trough Mega Earthquake.
Considering the Use of Mobile Medical Containers in the Event of Natural Disasters
Authors: Nakata Keiji , Maebayashi Kiyokazu , Tokumaru Shuji 
Published: June 2023

Introduction:In recent years, Japan has been hit by a number of natural disasters including the Great East Japan Earthquake, the Kumamoto Earthquake, the heavy rains in western Japan, and the heavy rains in Kumamoto to name a few. In each of these events, a number of hospitals located within the disaster areas were damaged and ceased to function, leading to difficulties in providing regional medical care. This presentation examines the effectiveness of mobile medical containers in handling such situations in the future.Method:This study organizes lessons learned from past disasters as well as the merits of and challenges facing current mobile medical containers while looking into the future.Results:When the Great East Japan Earthquake occurred, assembly-and-installation type temporary health clinics were constructed, but due to the numerous Japanese laws and regulations, it took almost three months for these to be delivered. On the other hand, current mobile medical containers are already in use in countries such as Tonga and Senegal and have the following advantages: (1) High mobility and easy installation, (2) Expandability as necessary, and (3) Durability for long-term use.Conclusion:Despite challenges such as clarification of legal handling, electricity, water supply and drainage, we consider mobile medical containers to be effective alternative medical facilities in the event of disasters.
Conceptual Framework for the Adoption of Innovative Health Technologies In Response to Health Emergencies
Authors: Leone Ryan , Hanfling Dan 
Published: June 2023

Introduction:Rapid developments in healthcare technology can significantly improve the quality, availability, and immediacy of care in health emergency events; however, without a cohesive framework to conceptualize the interplay between emerging technologies, we risk creating silos, ignoring applications, and reducing interoperability between innovations.Method:This framework was developed after reviewing the current literature regarding new technologies in healthcare assessment and delivery, discussing relevant innovations with experts, and analyzing global market trends in emerging health technology capabilities.Results:Innovative health technologies deployed in disaster settings can be grouped by their relevance to (1) Disease and Injury Surveillance and Detection, (2) Population Protection, (3) Responder Protection, and (4) Disease and Injury Management. The first category encompasses technologies that help characterize the severity and scope of an event at its onset, utilizing a network of wearable devices, sensors, remote infectious disease sampling, and other tools. Once an incident occurs, technologies aimed at Population Protection are necessary to preserve the well-being of unaffected citizens. Scaled-up on-demand manufacturing for prophylactic medical countermeasures and needle-free delivery mechanisms for pre-treatments against CBRN threats will be paramount. Healthcare and emergency responders require additional support before and during incident response, especially just-in-time training through virtual and augmented reality, biometric monitoring, next-generation personal protective equipment, and enhanced communications capabilities. Finally, delivering care to patients in healthcare emergencies will require optimized allocation of scarce resources based upon acuity and survivability. Effective healthcare service delivery can be bolstered using Telehealth, autonomous patient transport, drone delivery, robotic and haptically guided care delivery, and decision support tools.Conclusion:To effectively manage the successful adoption and implementation of innovative tools applicable to health emergencies, areas of impact and utility should be comprehensively categorized. This framework guides emergency managers, policymakers, and innovators alike to understand how individual developments coalesce in the larger context of disaster prevention, response, and recovery.