American journal of disaster medicine最新文献

{"title":"Lessons from the first wave of COVID-19 in Italy: A collection of design strategies to face pandemic situations in healthcare facilities.","authors":"Andrea Brambilla,&nbsp;Erica Brusamolin,&nbsp;Alexander Achille Johnson,&nbsp;Francesco Scullica,&nbsp;Stefano Capolongo","doi":"10.5055/ajdm.2022.0437","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0437","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to provide metadesign indications for the improvement of healthcare facilities, emphasizing the role of spatial design in the management of epidemic health emergencies.</p><p><strong>Study design: </strong>A parallel mixed-method study including literature reviews, survey creation, and survey distribution was performed.</p><p><strong>Methods: </strong>Data were collected between August and October 2020 capturing information related to the first wave of the COVID-19 pandemic, utilizing a review of existing literature, a comparison of existing hospital planning guidelines and assessment tools, and distribution of a survey to analyze design changes within selected Italian hospitals.</p><p><strong>Results: </strong>Among the changes identified, the most frequently identified included the conversion of space into intensive care units, space expansion, and the usage of wayfinding strategies for the reduction of cross-contamination risks. There was limited attention given to solutions with a human-centered approach, and those that addressed physical and psycho-logical well-being of all users, including healthcare staff. The solutions were collected and systematized into a list of metadesign guidelines.</p><p><strong>Conclusions: </strong>The resulting indications represent a starting point for developing design solutions to aid healthcare facilities in facing future epidemics.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9512888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to improve the psychological well-being of healthcare workers in disasters, pandemics, and mass casualty events.","authors":"Romeo Fairley,&nbsp;Sharon E Mace,&nbsp;Kathy Lehman-Huskamp,&nbsp;Leah Gustafson Ista,&nbsp;Jennie Wang,&nbsp;Lillian Lockwood,&nbsp;Joshua Weil,&nbsp;Carl H Schultz","doi":"10.5055/ajdm.2022.0433","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0433","url":null,"abstract":"<p><strong>Objectives: </strong>This information paper will describe the current research and recommendations for improving healthcare worker's (HCW) mental health. Individual and organizational goals will be outlined with items broken up into the time frames of predisaster, during a disaster, and post-disaster.</p><p><strong>Methods: </strong>A team of subject matter experts reviewed the current literature utilizing a search of PubMed, Google Scholar, relevant article reference lists, and subject matter interviews.</p><p><strong>Results: </strong>Thirty-six distinct recommendations were identified and distributed into the time frames of predisaster, during a disaster, and post-disaster. Twenty-one of these are pertaining to organizational goals and factors. Fifteen recommendations are identified for individual HCWs.</p><p><strong>Conclusions: </strong>Additional institutional and government policies supporting the protection of HCW's mental health are required to reduce the stigma and fear, preventing frontline workers from seeking help with the psychological effects of disasters, mass casualty incidents, and pandemics. Further research dealing with ways to ameliorate the negative effects of the stress related to the duties and responsibilities of HCWs, which are exacerbated by disasters, is needed.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An overview of a successful COVID-19 vaccination campaign at a prominent Connecticut healthcare system.","authors":"Jane Keating,&nbsp;Mitali Vedula,&nbsp;Rocco Orlando,&nbsp;Keith Grant,&nbsp;Sarah Lewis","doi":"10.5055/ajdm.2022.0440","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0440","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic has required healthcare systems to adapt, innovate, and collaborate to protect public health through treatment, testing, and vaccination initiatives related to the virus. As the pandemic evolved, lessons learned early on through testing and treatment were applied to vaccination efforts. Hartford HealthCare (HHC) is one of the largest healthcare systems in New England and took an integral role in vaccinating patients throughout the region, thus providing one of the largest vaccination campaigns in Connecticut. Early planning for equipment and personnel, in addition to effective communication between providers and patients, was critical in accomplishing HHC's goal of rapidly providing access to COVID-19 vaccines. The efficient and effective response to the pandemic at HHC was led by the Office of Emergency Management, which worked to ensure continuity of patient care and physician excellence in the face of disaster. Initially, resources were directed to testing and treatment of the disease; as vaccine clinical trials announced successful outcomes, these efforts shifted to preparing for the storage and distribution of a mass number of vaccines. This manuscript details the factors that enabled success in HHC's vaccination campaign and serves to provide a useful template for similar healthcare systems for future pandemic response.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9512885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The lingering impact of Hurricane Katrina: Examining the physical health, mental health, and racial equity impacts of disaster response.","authors":"Christine Crudo Blackburn,&nbsp;Sayali Shelke","doi":"10.5055/ajdm.2022.0436","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0436","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the research discussed in this paper is to better understand the negative health outcomes resulting from Hurricane Katrina and the disaster response that followed. This understanding can inform future disaster response.</p><p><strong>Design: </strong>We conducted 10 in-depth interviews with individuals who lived in New Orleans at the time of Hurricane Katrina. We conducted thematic analysis on the interview content and identified patterns across all 10 interviews.</p><p><strong>Findings: </strong>Four primary patterns emerged across all interviews. These were: (1) Federal Emergency Management Agency's (FEMA) response to the crisis created greater physical and mental health hazards for interviewees; (2) Hurricane Katrina led to long-term mental health issues for interviewees, even those who evacuated before the storm; (3) displacement from homes following the storm typically resulted in overcrowded living conditions, which increased interviewees' risk of infectious disease; and (4) the discrimination faced by interviewees in the months and years following Hurricane Katrina had a profound and lasting impact on their well-being.</p><p><strong>Originality: </strong>Numerous studies have been conducted to understand the mental health impacts of disaster and a limited number have looked at the physical health impacts or the threat of infectious disease. This study is unique because it incorporates both mental and physical health impacts, but also examines how disaster response itself plays a role in health outcomes for survivors. Additionally, this paper also incorporates the role of racial inequities in disaster response and how those inequities impact survivor health.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health systems' resilience during the COVID-19 pandemic public health emergency: The role of existing community health structures in rural Malawi.","authors":"Juliet Charity Yauka Nyasulu,&nbsp;Mercy Dokiso Chirwa,&nbsp;Judgement Kumwenda,&nbsp;Maria Chikalipo","doi":"10.5055/ajdm.2022.0435","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0435","url":null,"abstract":"<p><p>The emergence of the COVID-19 pandemic has put health systems under enormous pressure, pushing for health systems' resilience. Malawi, mostly rural with hard-to-reach areas, had their first case in April 2020, amidst political turmoil. So far, much has been documented on how health systems contained the COVID-19 pandemic. This paper describes the role of community health system structures in ensuring health systems' resilience during the COVID-19 pandemic in rural Malawi. To highlight the role of community health structures in the Malawian health system, we developed and applied a framework on health systems' resilience through the community health system structures in a rural district in Malawi. Our data collection and analysis were informed by a desk review of government documents and other publications. We drew on authors' expertise and experience in Malawi community health, and joint reflections on the role played by community health structures in ensuring access to essential health services during the COVID-19 pandemic in Malawi. The desk review and experts' reflections have highlighted the strong Malawi community health strategy with a clear chain of command from national to community levels. The community health surveillance assistants and volunteers have shown to be the backbone of community health structures and positive service delivery, contributing to health systems resilience during the COVID-19 pandemic. Countries' existing health system structures are a key determinant of response to pandemics -regardless of the available resources. Even though Malawi's health system is under-resourced, the existing community-based health structures have shown to contribute to the health systems' resilience during the COVID-19 pandemic. The proposed framework in this paper is a great tool in allowing countries to reflect on having pre-existing health system structures to strengthen the health systems' resilience during such pandemics. Therefore, having independent disease prevention and control structures from national to community levels, as done in Malawi, can help countries to absorb the shocks of health system emergencies and maintain essential health services, the core business of the health system.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume 17, Number 1","authors":"American Journal of Disaster Medicine","doi":"10.5055/ajdm.2022.0422","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0422","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46686797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triaging patients prior to the arrival of the mass casualty: Emergency Severity Index equivalency to SALT disaster triage.","authors":"Bryan J Wexler,&nbsp;Barbara A Stahlman","doi":"10.5055/ajdm.2022.0426","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0426","url":null,"abstract":"<p><strong>Objective: </strong>To compare the Emergency Severity Index (ESI) and Sort Assess Life Saving Interventions Treatment and Transport (SALT) triage categories for an existing emergency department (ED) patient population.</p><p><strong>Design: </strong>A prospective, cross-sectional study.</p><p><strong>Setting: </strong>An academic-affiliated community teaching ED at a Level 1 Trauma Center.</p><p><strong>Participants: </strong>All patients presenting to the ED over 2 nonconsecutive 24-hour weekdays.</p><p><strong>Main outcome measures: </strong>The correlation between triage system classifications was assessed using the Spearman's rank correlation coefficient.</p><p><strong>Results: </strong>100 percent of ESI 5, 83.3 percent of ESI 4, and 70.4 percent of ESI 3 were categorized as Minimal under SALT. 70.8 percent of ESI 2 was categorized as Delayed, and 71.4 percent of ESI 1 designations correlated with Immediate. Spearman's rank correlation coefficient was 0.509 (p < 0.001).</p><p><strong>Conclusion: </strong>This study results suggest that ESI moderately correlates with SALT, particularly in lower acuity patients. This result may inform future protocol development for rapid triage of existing ED populations prior to the arrival of patients from a mass casualty event.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-perceived disaster preparedness in minority older adults: A cross-sectional study.","authors":"Minji Chae,&nbsp;Sumaita Choudhury,&nbsp;Jason Franco-Castano,&nbsp;Omolola E Adepoju","doi":"10.5055/ajdm.2022.0425","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0425","url":null,"abstract":"<p><strong>Objective: </strong>Evidence suggests that people of color, especially African Americans and non-White Hispanics, residing in low-income communities are the most vulnerable to natural disasters. This study assessed individual level of self-perceived disaster preparedness, disaster response actions, and sociodemographic predictors of disaster preparedness among older minority adults in Houston, Texas.</p><p><strong>Method: </strong>Working with Houston-area community-based organizations and senior-living centers, a cross-sectional survey, available in English and Spanish, was disseminated between November 2020 and January 2021.</p><p><strong>Participants: </strong>Five hundred and twenty-two older minority adults aged 55+ completed the electronic survey.</p><p><strong>Main outcome measure(s): </strong>The main outcome measure was the level of self-perceived preparedness regarding emergencies and disastersie, prepared vs not prepared-among the study participants.</p><p><strong>Results: </strong>Overall, about 58 percent of older minority adults did not perceive themselves to be prepared. Compared to individuals reporting annual incomes below $25,000, individuals reporting annual incomes between $25,000 and $74,999 were more likely to report being prepared [odds ratio (OR) = 2.28, 95 percent confidence interval (CI) = 1.29, 4.05]. Individuals who tested positive or had a close family member test positive for COVID-19 experienced 2.16 times higher odds of having self-perceived disaster preparedness than those who did not [OR = 2.16, 95 percent CI = 1.37, 3.42]. None of the other covariates were statistically significant.</p><p><strong>Conclusions: </strong>While we observed no differences in self-perceived disaster preparedness between African American and Hispanic older adults, our findings suggest the importance of prior experience/exposure to previous disasters and the role of socioeconomic status in self-perceived disaster preparedness in minority older adults.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of repeated military conflicts on civilian patterns of emergency medical services utilization: A retrospective cohort study.","authors":"Roman Sonkin,&nbsp;Eli Jaffe,&nbsp;Evan Avraham Alpert,&nbsp;Erik Zerath","doi":"10.5055/ajdm.2022.0428","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0428","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of repeated rocket attacks on a civilian population during successive military conflicts on the patterns of emergency medical services (EMS) utilization.</p><p><strong>Design: </strong>This retrospective cohort study (2008-2021) analyzed EMS data from one region of Israel characterized by intensive rocket attacks on a civilian population during four successive military conflicts. EMS activity for the periods prior to, during, and after the conflicts was compared. Data included call volume, type of calls (\"medical illness,\" \"motor vehicle collision (MVC),\" and \"other-injuries\"), and level of response (advanced life support (ALS) or basic life support (BLS)).</p><p><strong>Results: </strong>Compared to the Pre-Conflict period, there were statistically significant decreased volumes of calls during the 2008 (-20 percent), 2012 (-13 percent), and 2021 (-11 percent) military conflicts for \"medical illness\" and during the 2008 (-23 percent), 2012 (-30 percent), and 2021 (-31 percent) for \"MVC.\" Decreases in calls for \"medical illness\" were accompanied by decreased ALS dispatches (-28, -33, and -18 percent for 2008, 2012, and 2021, respectively). The number of calls returned to preconflict values during the Post-Conflict periods. No change was evidenced in numbers of calls during the 2014 military conflict.</p><p><strong>Conclusion: </strong>Military conflicts involving a civilian population were usually found to be associated with lower numbers of calls for the categories of \"medical illness\" and \"MVC.\" Less calls for \"medical illness\" were associated with fewer ALS dispatches. There was a rapid return of call volumes to preconflict levels shortly after a ceasefire was reached. The absence of change in calls during the 2014 conflict suggests involvement of habituation processes.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational modeling of first responders' willingness to accept radiation exposure during radiological or nuclear events.","authors":"Mary Sproull,&nbsp;Terri Rebmann,&nbsp;Austin Turner,&nbsp;Rachel Charney,&nbsp;Emmanuel Petricoin,&nbsp;Gregory D Koblentz,&nbsp;William G Kennedy","doi":"10.5055/ajdm.2022.0424","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0424","url":null,"abstract":"<p><p>Since the events of 9/11, a concerted interagency effort has been undertaken to create comprehensive emergency planning and preparedness strategies for the management of a radiological or nuclear event in the US. These planning guides include protective action guidelines, medical countermeasure recommendations, and systems for diagnosing and triaging radiation injury. Yet, key areas such as perception of risk from radiation exposure by first responders have not been addressed. In this study, we identify the need to model and develop new strategies for medical management of large-scale population exposures to radiation and examine the phenomena of radiation dread and its role in emergency response using an agent-based modeling approach. Using the computational modeling platform NetLogo, we developed a series of models examining factors affecting first responders' willingness to work (WTW) in the context of entering areas where radioactive contamination is present or triaging individuals potentially contaminated with radioactive materials. In these models, the presence of radiation subject matter experts (SMEs) was found to increase WTW. Degree of communication was found to be a dynamic variable with either positive or negative effects on WTW dependent on the initial WTW demographics of the test population. Our findings illustrate that radiation dread is a significant confounder for emergency response to radiological or nuclear events and that increasing the presence of radiation SME in the field and communication among first responders when such radiation SMEs are present will help mitigate the effect of radiation dread and improve first responder WTW during future radiological or nuclear events.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}