Hospital management model for biological hazards: A qualitative content analysis study.

BACKGROUND: Biological hazards such as epidemic, pandemic, and bioterrorism are the most probable types of emergencies and disasters, which cause a high rate of mortality and morbidity. Hospitals have an important role in reducing the consequences of biological hazards. Given this, we set out the present study to design a model for managing biological hazards in hospitals. METHODS: A qualitative content analysis study was performed using in-depth semistructured interviews with 40 experts. We selected participants through purposeful sampling; also, we interviewed experienced experts, policy makers, and managers in the field of hospital management regarding biological hazards. The study setting was Iran Ministry of Health and hospitals as well as other relevant organizations responsible for hospital management in biological hazards. We analyzed the data concurrently using the method recommended by Graneheim and Lundman. RESULTS: After collecting and analyzing the data obtained from the interviews, we extracted the dimensions of our model in the form of four themes, including mitigation, preparedness, response, and recovery. CONCLUSION: Based on the results of the present study, we believe that a comprehensive and practical model for hospital preparedness regarding management of biological hazards is essential. The model of hospital preparedness in biological hazards leads to an effective response and reduces the physical, psychological, social, and economic consequences of biological hazards.

Developing a Roadmap for Mass Vaccination of COVID-19 in Iran: A Qualitative Study.

BACKGROUND: Nowadays, the Covid-19 pandemic is 1 of the most important challenges worldwide, especially in terms of health. The most important strategy to prevent and control the Covid-19 pandemic is mass vaccination. This study aimed at developing a roadmap for the mass vaccination of COVID-19 in Iran. METHODS: The current study was conducted using a qualitative approach with a content analysis method. In the first step, the review of literature and documents was carried out by a search in scientific databases. In the next step, the data were amassed via in-depth and semi-structured interviews with experts who were selected purposefully, including policymakers, health care workers, and managers. After this, 3 multidisciplinary expert panels for roadmap development were held. RESULTS: Based on the literature review, interviews, and 3 stages of an expert panel, the final roadmap was developed with 5 dimensions. These included outcomes, planning and preparation, strategies, and preparation, implementation, monitoring, and evaluation. CONCLUSIONS: This roadmap was developed to improve mass vaccination during the COVID-19 pandemic. According to our findings, it is strongly recommended that the vaccination roadmap with all the above-mentioned features and comprehensive structure should be applied to mitigate the consequences of the COVID-19 pandemic.

Identifying the Preparedness Components for Sexual Violence in Natural Disasters: A Systematic Review.

Background: The probability of sexual violence in areas affected by natural disasters may increase. An increase in the rate of unwanted pregnancies and subsequent intentional abortions, physical and mental injuries, and death can be the consequences of sexual violence. One of the characteristics of natural disasters is their unpredictability and ambiguity. Since decisions must be made quickly during the response, there must be adequate planning in advance, and preparedness in the community will reduce surprises in the responding organizations. This study aimed to identify the factors affecting the preparedness against sexual violence in natural disasters. Methods: In this study, an electronic search was performed in the MEDLINE (PubMed), Scopus, Web of Science, and ProQuest databases. Other search resources, such as Science.gov, Scienceopen.cond Meta-search engines, organizational websites, including UNICEF, UNFPA, and IFRC, as well as key journals and the International Disaster and Risk Conference were hand-searched from 1/1/1990 to 8/29/2021. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was used to select the studies, and the findings were finally analyzed by thematic analysis method using MAXQDA10 software. Results: A total of 40 papers out of a total of 2978 studies were considered in this analysis. Macropolicies, empowerment, contextualization, management and organization, command community-based, and responsive planning were the five primary categories that were found. Conclusion: Preparedness measures are highly important to respond promptly and effectively to sexual violence and should be integrated into disaster preparedness programs. The findings of this study can be used by disaster response managers and policymakers in developing and improving preparedness programs.

Integrated operations for natural disaster management: A systematic Review.

Background: This study aimed to conduct a systematic review of models describing the integrated logistics operations performed as a response to natural disasters, with the hope to identify the challenges and limitations of healthcare systems in natural disaster management. Methods: A systematic literature search was carried out in PubMed/Medline, Scopus, Google Scholar, and bibliographies of retrieved articles using MeSH headings and keywords such as natural disaster, logistics, model. A total of 98 publications were identified through the search process. Seven potentially relevant articles met the inclusion criteria. The key demographic, clinical, and pathological information of all qualified studies were extracted from the full-text articles. Results: Among the seven included studies, six had either model data or considerations on distribution methods. Storage, human resources, infrastructures, primary priority items, coordination of organizations, and information and communication with the media were also the focus of studies. The articles were mainly from Iran (n=2), the United States (n=2), and Indonesia (n=2). The models presented in the studies has mainly focused on a specific aspect of disaster management, such as smart government development, use of military services, people with logistic training and/or medical team model. Conclusion: This study systematically highlighted the crucial points that should be considered in managing natural disasters including human resources, infrastructure, storage, priority items, distribution, access system, coordination of organizations, information, and communication with the media. In this regard, we prepared a comprehensive comparison of possible models and logistics.

Developing a hospital preparedness checklist to assess the ability to respond to the COVID-19 pandemic.

BACKGROUND: During epidemics and pandemics, health systems, and especially hospitals, face many challenges in the management of patients and staff. Hospital preparedness measures are critical for hospitals to respond effectively to the admission and management of COVID-19 patients. Ministry of health policy for pandemics must cover the ability of hospitals to respond to COVID-19. AIMS: The aim of this study was to develop a checklist for evaluating the preparedness of hospitals to respond to the COVID-19 pandemic. METHODS: We searched for and reviewed available evidence, including the literature and guidelines presented by related organizations. Due to the COVID-19 outbreak, face-to-face interview was not possible so we used telephone and video connections, mobile applications and email for unstructured interviews. Checklist development was carried out by a multidisciplinary panel of experts. RESULTS: After applying the opinions of the experts, the final checklist had 2 main domains: measures at national and measures at hospital level. Preparedness at national level was categorized into 3 aspects that are implemented by the health ministry. Preparedness at hospital level was categorized in 24 subgroups. CONCLUSION: Hospital preparedness for admission and management of COVID-19 patients is essential. A checklist for the assessment of hospital preparedness for COVID-19 patient management and hospital management was designed and developed. Our preparedness assessment checklist is an expanded tool that provides clear and practical guidance that can be adapted for any hospital admitting COVID-19 patients.

A global systematic review, meta-analysis and health risk assessment on the quantity of Malathion, Diazinon and Chlorpyrifos in Vegetables.

It is widely believed that an increasing trend in the production and consumption of vegetables has led to a dramatic rise in the use of pesticides potentially threatening the health of consumers around the world. This systematic study along with meta-analysis has mainly centered on the evaluation of the quantity of three well-known pesticides namely, Malathion (MLT), Diazinon (DZN) and Chlorpyrifos (CPF) in vegetables. In this regard, a comprehensive literature search has been performed over the last decade (January 1, 2011 to June 21, 2020) within the scientific databases including PubMed, Web of Science, and Scopus. Of 1239 articles identified through the database screening, 22 plus 37 data report were retained and included in the meta-analysis phase. Additionally, the probabilistic human health risks for the consumers due to the intake of CPF, DZN and MLT from eating vegetables were estimated by the Monte Carlo Simulated (MCS) method. According to the findings, the maximum quantities of MLT, DZN and CPF in the vegetables were observed in Pakistan (222 µg/kg, 95%CI = 214.94-229.08), Thailand (245.00, 95% CI = 235.2-254.8) and South Korea (440 µg/kg, 95% CI = 437.19-442.81), while the lowest concentration levels were reported in China (1.7 µg/kg, 95% CI = 1.56-1.84), Poland (0.57, 95% CI = 0.46-0.68) and Poland (5.78 µg/kg, 95% CI = 4.40-7.12), respectively. The results of the Egger's and the Begg's tests revealed that no bias with regard to the potential publication was observed. Finally, non-carcinogenic risk assessment results demonstrated that the exposure to the studied pesticides thorough vegetables consumption could not threaten the health of consumers.

Hospital Preparedness Measures for Biological Hazards: A Systematic Review and Meta-Synthesis.

BACKGROUND: Biological hazards are one of the most important and common types of hazards in emergencies and disasters. Hospital preparedness measures for biological hazards are essential for a proper response and mitigation of its effects. The aim of this systematic review is to investigate hospital preparedness measures for biological hazards. METHODS: For this research, electronic databases including Web of Science, PubMed, ScienceDirect, Scopus, ProQuest, Google Scholar, and Cochrane Library from March 1950 to June 2019 were searched. Key words such as hospital, emergency department, preparedness, plan, management, and biological hazards were used in combination with the Boolean operators OR and AND. A thematic synthesis approach through the use of MAXQDA software was applied to analyze the data. RESULTS: In total, 5257 articles were identified, in which 23 articles meet the inclusion criteria for entering the process of final analysis. The findings showed three main administrative, specialized, and logistical issues regarding preparedness measures for biological hazards in hospitals. CONCLUSION: Hospital preparedness for biological hazards is one of the most important hospital disaster plans. Results of this systematic review present valuable advice for policy-makers and hospital managers to prepare and enhance hospital performance against biological hazards.

Health, safety, and education measures for fire in schools: A review article.

Fire buildings is considered as one of the most common and the most devastating disasters and emergencies. Saving school buildings against incidents such as fire is very important since students are so vulnerable to incidents especially fire. The most school classes were devoid of safety conditions and oil-burning heaters were used. Such a condition has increased the risk of disaster and is considered as a serious menace for students' lives. The present study conducted with aim of review the Health, Safety and Education Measures for Fire in Schools. To this purpose, we selected suitable keywords some articles published in Scientific Information Database of PubMed, Web of Science, Scopus, and ProQuest were searched. The search was limited to reviewed articles in English and Persian language published between 1970 and 2019, based on inclusion and exclusion criteria. Furthermore, the selected articles were reviewed for relevant citations. The reviewing of articles was conducted by two member of research team independently. The primary search found 194 relevant studies. After eliminating the duplicates and articles which were not related to the review of the abstract, 51 references were identified for inclusion. Finally, 13 articles were selected after screening and evaluated by two authors to final review main factors and dimensions of schools' health, safety and education include the rules and laws, allocating sufficient budgets, education the teachers, students and their families, exercise, risk analysis, intersectional relations, fire extinguishing equipment, early warning system, and also optimization and reformation of heating system. Applying these new approaches prevents disasters and increases the level of preparedness in case of fire occurrence.

The importance of education on disasters and emergencies: A review article.

Disasters and emergencies have been increasing all over the world. Todays, with technological advancement, acquiring knowledge and its application in the realm of action is regarded as the only effective way for prevent disasters or reducing its effects. The present study aimed to review the importance of education and the effect of different methods of education on disaster risk reduction and preparedness in vulnerable people. To this aim, some articles indexed in Database of PubMed, Web of Science, Google Scholar, Scopus, Science Direct, and ProQuest were searched. The search was limited to reviewed articles in English published between 1990 and 2017. In addition, the selected articles were reviewed for relevant citations. The conducted studies were reviewed by two researchers independently. The primary search generated 128 relevant references. After eliminating the duplicates and articles which were not related to the review of the abstract, 41 references were identified for inclusion. After reviewing more, 31 references, which failed to meet inclusion index, were excluded from the study. Disaster education aims to provide knowledge among individuals and groups to take actions to reduce their vulnerability to disasters. During the last decades, the issue that trained people can be prepared for disasters and responding well has been extensively investigated. Based on the results, disaster education is a functional, operational, and cost-effective tool for risk management. Based on some evidence, it is important for vulnerable people to learn about disasters. There are different methods to educate vulnerable people, but no method is better than others. Trained people can better protect themselves and others. In this regard, planning and designing comprehensive educational programs are necessary for people to face disasters.

Monitoring of airborne asbestos fibers in an urban ambient air of Shahryar City, Iran: levels, spatial distribution, seasonal variations, and health risk assessment.

Asbestos, as with other pollutants in the air, has adverse effects on the health of human beings and animals. Today, the relationship between presence of asbestos fibers in the air breathed by humans and developing serious diseases such as lung cancer (asbestosis) and mesothelioma has been proven. This study was designed and conducted within the time period of August 2017 and June 2018 to determine the concentration of asbestos fiber in the ambient air of Shahryar City and to evaluate their health effects for the general population of the city. For this purpose, samples were taken from four points, and overall 32 air samples were taken along the year. The samples were then analyzed by the phase contrast microscopy (PCM) method. Also, to investigate the type of asbestos and for more accurate counting of fibers, SEM analysis was utilized. Finally, based on the EPA IRIS method, the health effects resulting from asbestos risks were also evaluated. The results of this study indicated that the mean annual concentration of asbestos fiber in the ambient air of Shahryar City was obtained as 0.0019 f/ml PCM and 0.0072 f/ml SEM. Furthermore, the most polluted point was S1 point (0.0119 -0.0026 f/ml, PCM), while the lowest concentration was related to S4 point (0.001 f/ml PCM-0.0021 f/ml SEM). The mean annual risk resulting from airborne asbestos fiber in the ambient air of Shahryar City for all samples was obtained as 1.72 × 10-6 to 2.2 × 10-4, which was higher than the recommended risk range in some points.

Estimation of Short-term Mortality and Morbidity Attributed to Fine Particulate Matter in the Ambient Air of Eight Iranian Cities.

Amongst the various pollutants in the air, particulate matters (PM) have significant adverse effects on human health. The current research is based on existing epidemiological literature for quantitative estimation of the current health impacts related to particulate matters in some selected principal Iranian megacities. In order to find the influence of air pollution on human health, we used the AirQ software tool presented by the World Health Organization (WHO) European Centre for Environment and Health (ECEH), Bilthoven Division. The adverse health outcomes used in the study consist of mortality (all causes excluding accidental causes), due to cardiovascular (CVD) and respiratory (RES) diseases, and morbidity (hospital admissions for CVD and RES causes). For this purpose, hourly PM10 data were taken from the monitoring stations in eight study cities during 2011 and 2012. Results showed annual average concentrations of PM10 and PM2.5 in all megacities exceeded national and international air quality standards and even reached levels nearly ten times higher than WHO guidelines in some cities. Considering the short-term effects, PM2.5 had the maximum effects on the health of the 19,048,000 residents of the eight Iranian cities, causing total mortality of 5,670 out of 87,907 during a one-year time-period. Hence, reducing concentrations and controlling air pollution, particularly the presence of particles, is urgent in these metropolises.

The association of hospital emergency admissions due to respiratory-cardiovascular diseases and acute myocardial infarction with air pollution in Tehran during 2005-2014.

Background: Air pollution is one of the main reasons for disease and emergency hospitalizations. Therefore, air pollution control and hospital preparedness are of paramount importance. This study was conducted to determine the association of air pollutant levels with the rate of hospital emergency admissions due to respiratory and cardiovascular diseases and acute myocardial infarction in Tehran during the last decade. Methods: This was a cross sectional study. At first, information on hourly concentration of air pollutants was gathered from Tehran Environmental Protection Agency and Air Quality Control Company. Raw data and meteorological parameters were used in Excel format to prepare an input file. The number of emergency hospital admissions due to pollutant exposure was assessed using the AirQ2.2.3 model. Results: Results of this study revealed that there were 54 352 cases of emergency hospitalizations due to respiratory diseases in a relative risk of 1.0048 [1.0008-1.0112] and 20 990 cases of emergency hospitalizations due to cardiovascular diseases in a relative risk of 1.009[1.006-1.013] during 2005-2014. In addition, 3478 patients were admitted to the emergency department because of acute myocardial infarction with RR of 1.0026 [1.0026-1.0101]. Conclusion: This study demonstrated that a high percentage of hospital emergency admissions was because of respiratory and cardiovascular diseases. Moreover, it was found that acute myocardial infarction could be due to the high level of air pollution and could increase admissions to the emergency department. Therefore, appropriate measures are needed to reduce air pollution and increase hospital preparedness.