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1.
Health Secur ; 20(3): 238-245, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35675667

RESUMO

During the COVID-19 pandemic, academic health centers suspended clinical clerkships for students. A need emerged for innovative virtual curricula to continue fostering professional competencies. In March 2020, a multidisciplinary team from the University of Nebraska Medical Center had 2 weeks to create a course on the impact of infectious diseases that addressed the COVID-19 pandemic in real time for upper-level medical and physician assistant students. Content addressing social determinants of health, medical ethics, population health, service learning, health security, and emergency preparedness were interwoven throughout the course to emphasize critical roles during a pandemic. In total, 320 students were invited to complete the survey on knowledge gained and attitudes about the course objectives and materials and 139 responded (response rate 43%). Students documented over 8,000 total hours of service learning; many created nonprofit organizations, aligned their initiatives with health systems efforts, and partnered with community-based organizations. Thematic analysis of qualitative evaluations revealed that learners found the greatest value in the emphasis on social determinants of health, bioethics, and service learning. The use of predeveloped, asynchronous e-modules were widely noted as the least effective aspect of the course. The COVID-19 pandemic introduced substantial challenges in medical education but also provided trainees with an unprecedented opportunity to learn from real-world emergency preparedness and public health responses. The University of Nebraska Medical Center plans to create a health security elective that includes traditional competencies for emergency preparedness and interrogates the social and structural vulnerabilities that drive disproportionately worse outcomes among marginalized communities. With further evaluation, many components of the curriculum could be broadly scaled to meet the increasing need for more public health and health security medical education.


Assuntos
COVID-19 , Defesa Civil , Doenças Transmissíveis , Currículo , Humanos , Pandemias/prevenção & controle
2.
J Radiol Prot ; 42(2)2022 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-35613560

RESUMO

Appropriate training of the related personnel is one of the most important aspects in nuclear and radiological emergency preparedness and response. The use of simulation training could provide the trainees learning experience of a lifelike, hands-on scenario without associated radiation safety restrictions. In this study, we established a radiation field simulation system that includes two separate parts. For small-area radiation field simulation, a set of simulation sources and detectors was designed based on ultra wide band distance measurement technology. For large-area field simulation, a Gaussian plume model was used to simulate the dispersion of released radioactive aerosols and calculate the consequent radiation field. Also, a Global Position System positioning and wireless transmission technique was used for simulation instruments' data acquisition. This system could create a verisimilar but also safe and radiation-free environment and can be used in the training of nuclear emergency first responders, rescue teams or radiation protection personnel.


Assuntos
Defesa Civil , Planejamento em Desastres , Socorristas , Proteção Radiológica , Liberação Nociva de Radioativos , Radiologia , Humanos , Liberação Nociva de Radioativos/prevenção & controle
3.
Health Secur ; 20(S1): S60-S70, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35544310

RESUMO

Research is foundational for evidence-based management of patients. Clinical research, however, takes time to plan, conduct, and disseminate-a luxury that is rarely available during a public health emergency. The University of Nebraska Medical Center (UNMC) developed a single institutional review board (IRB), with a vision to establish a rapid review resource for a network focused on clinical research of emerging pathogens in the United States. A core aspect of successful initiation of research during a pandemic or epidemic is the ability to operationalize an approach for rapid ethical review of human subject research and conduct those reviews at multiple sites-without losing any of the substantive aspects of ethics review. This process must be cultivated in anticipation of a public health emergency. US guidance for operationalizing IRB review for multisite research in a public health emergency is not well studied and processes are not well established. UNMC sought to address operational gaps and identify the unique procedural needs of rapid response single IRB (RR-sIRB) review of multisite research by conducting a series of preparedness exercises to develop and test the RR-sIRB model. For decades, emergency responder, healthcare, and public health organizations have conducted emergency preparedness exercises to test requirements for emergency response. In this article, we describe 2 types of simulation exercises conducted by UNMC: workshops and tabletops. This effort represents a unique use of emergency preparedness exercises to develop, refine, and test rapid review functions for an sIRB and to validate readiness of regulatory research processes. Such processes are crucial for conducting rapid, ethical, and sound clinical research in public health emergencies.


Assuntos
Defesa Civil , Socorristas , Comitês de Ética em Pesquisa , Humanos , Pandemias , Saúde Pública , Estados Unidos
4.
Artigo em Alemão | MEDLINE | ID: mdl-35412104

RESUMO

Forms of good risk and crisis communication in radiation protection must always be seen in relation to the societal handling of the different radiation topics about which the communication takes place. Risk and crisis communication are usually regarded as different communication disciplines. The article provides insight into the complexity of communication in the field of radiation protection in different contexts. Special characteristics of the respective form of communication and the possible uses of these forms of communication are described.


Assuntos
Defesa Civil , Proteção Radiológica , Comunicação , Alemanha
5.
Front Public Health ; 10: 883281, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35433604

RESUMO

Civilian populations that are more prepared for emergencies are more resilient. Ample research has been carried out over the last three decades to identify the factors that contribute to public readiness to emergencies and disasters and enhance societal resilience. However, the analysis did not achieve an in-depth comprehension of the types of contributing factors, namely, contextual vs. target aspects. A cross-sectional study that explored attitudinal factors among civilian populations took place during the months of January-February 2021. Diverse representative samples (N ≥ 500 each) of adults from eight countries (Italy, Romania, Spain, France, Sweden, Norway, Israel, and Japan) were engaged. The primary outcomes of this study were individual and societal resilience as well as emergency preparedness. The results suggest that in most countries, levels of trust are relatively high for emergency services and health services, and relatively low for politicians. In the overall sample, the individual preparedness index, which delineates the compliance with general household adjustment recommendation for emergencies, averaged at 4.44 ± 2.05SD (out of 8). Some variability was observed between countries, with some countries (e.g., Spain, Norway, and Italy) reporting higher preparedness rates than others (e.g., Japan). In the overall sample, levels of individual resilience were mediocre. Multivariate analysis showed that the following variables are predictors of societal resilience: trust (ß = 0.59), social norms and communality (ß = 0.20), individual resilience (ß = 0.05), individual preparedness (ß = 0.04), risk awareness (ß = 0.04), and age (ß = 0.03). The results of this study show that there are commonalities and differences between societies across Europe and beyond concerning societal resilience at large, including preparedness, individual resilience, and risk perception. Despite socio-cultural driven differences, this study shows that societies share varied characteristics that may contribute toward a common model for assessing societal resilience and for explaining and predicting resilience and readiness.


Assuntos
Defesa Civil , Planejamento em Desastres , Desastres , Estudos Transversais , Emergências , Humanos
6.
J Emerg Manag ; 20(2): 157-173, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35451051

RESUMO

Each year theme parks can see up to 20 million patrons, but often little effort is put into planning for an emergency evacuation. In this study, we built a multiagent simulation model using AnyLogic® 8.5.1. The model was based on a preliminary design of a theme park provided by AOA Builds, Orlando. This research had two goals: the first was to compare evacuation time when the park is full (1) using only the main guest gate and (2) using all seven available exits. The second goal was to model first responder response time between various start and end locations within the park. Using only the main gate, evacuation took an average of 14 minutes and 51 seconds. Using all seven gates results in an average evacuation time of 11 minutes and 58 seconds. This was due to a gate being overwhelmed causing a delay in overall evacuation time. If that gate is not included in the calculation, the average evacuation time drops to 6 minutes and 44 seconds. For the purpose of measuring response times, four starting locations were chosen with the guidance of a subject matter expert. These locations included response teams positioned at the front gate, at a police station, at the service area behind a main attraction, and mobile patrol walking around the park. Based on our testing, walking around the park was the best option in terms of response time, using the main gate was 53.7 percent faster than other options and, using all seven gates, was 60.7 percent faster during an evacuation using all seven exits.


Assuntos
Defesa Civil , Análise de Sistemas , Humanos , Recreação
7.
Int J Circumpolar Health ; 81(1): 2049055, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35285421

RESUMO

This is the first systematic review to explore health risks on Svalbard. We have analysed data retrieved from 18 articles that met eligibility criteria and present a mixed-methods quantitative and qualitative narrative synthesis. Norwegian and Russian inhabitants on Svalbard were compared with the respective mainland populations, and we found no evidence of an increased risk for or prevalence of diseases. The rate of injuries caused by snowmobile accidents were significantly higher, but this was outweighed by a correspondingly lower rate of other injuries. A small unique risk for injuries inflicted by polar bears was confirmed. We identified knowledge gaps concerning how health care and emergency preparedness are organised.


Assuntos
Defesa Civil , Ursidae , Animais , Regiões Árticas , Humanos , Noruega/epidemiologia , Prevalência , Svalbard
8.
Eur J Health Law ; 29(1): 79-102, 2022 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-35303725

RESUMO

Governance is a critical upstream tool in public health emergency preparedness, for it provides structure to emergency response. Pandemics, singular public health emergencies, pose challenges to inherently fragmented federal governance systems. Understanding and utilizing the facilitators of response embedded within the system is critical. In its examination of how contemporary federal systems addressed fragmentation in the face of the Covid-19 pandemic, this article uses two mitigation measures, community masking and vaccination administration to compare elements of federal system mechanics in the United States and Germany's respective pursuits of public health goals. With particular focus on federal-state power-sharing, it analyzes the division and application of federal-state authority, therein examining mechanisms of executive expediency, as well as the cooperation of multilevel actors. Comparing the jurisdictions identifies inter-federal coordination, availability of exigency mechanisms, and federal guidance as facilitators of public health goal achievement.


Assuntos
COVID-19 , Defesa Civil , COVID-19/epidemiologia , COVID-19/prevenção & controle , Alemanha , Humanos , Pandemias/prevenção & controle , Saúde Pública , Estados Unidos/epidemiologia
10.
JAMA Surg ; 157(4): e217419, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35107579

RESUMO

IMPORTANCE: There is substantial variability among emergency departments (EDs) in their readiness to care for acutely ill and injured children, including US trauma centers. While high ED pediatric readiness is associated with improved in-hospital survival among children treated at trauma centers, the association between high ED readiness and long-term outcomes is unknown. OBJECTIVE: To evaluate the association between ED pediatric readiness and 1-year survival among injured children presenting to 146 trauma centers. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective cohort study, injured children younger than 18 years who were residents of 8 states with admission, transfer to, or injury-related death at one of 146 participating trauma centers were included. Children cared for in and outside their state of residence were included. Subgroups included those with an Injury Severity Score (ISS) of 16 or more; any Abbreviated Injury Scale (AIS) score of 3 or more; head AIS score of 3 or more; and need for early critical resources. Data were collected from January 2012 to December 2017, with follow-up to December 2018. Data were analyzed from January to July 2021. EXPOSURES: ED pediatric readiness for the initial ED, measured using the weighted Pediatric Readiness Score (wPRS; range, 0-100) from the 2013 National Pediatric Readiness Project assessment. MAIN OUTCOMES AND MEASURES: Time to death within 365 days. RESULTS: Of 88 071 included children, 30 654 (34.8%) were female; 2114 (2.4%) were Asian, 16 730 (10.0%) were Black, and 49 496 (56.2%) were White; and the median (IQR) age was 11 (5-15) years. A total of 1974 (2.2%) died within 1 year of the initial ED visit, including 1768 (2.0%) during hospitalization and 206 (0.2%) following discharge. Subgroups included 12 752 (14.5%) with an ISS of 16 or more, 28 402 (32.2%) with any AIS score of 3 or more, 13 348 (15.2%) with a head AIS of 3 or more, and 9048 (10.3%) requiring early critical resources. Compared with EDs in the lowest wPRS quartile (32-69), children cared for in the highest wPRS quartile (95-100) had lower hazard of death to 1 year (adjusted hazard ratio [aHR], 0.70; 95% CI, 0.56-0.88). Supplemental analyses removing early deaths had similar results (aHR, 0.75; 95% CI, 0.56-0.996). Findings were consistent across subgroups and multiple sensitivity analyses. CONCLUSIONS AND RELEVANCE: Children treated in high-readiness trauma center EDs after injury had a lower risk of death that persisted to 1 year. High ED readiness is independently associated with long-term survival among injured children.


Assuntos
Defesa Civil , Centros de Traumatologia , Adolescente , Criança , Serviço Hospitalar de Emergência , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Estudos Retrospectivos
11.
J Public Health Manag Pract ; 28(4): E711-E718, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35121711

RESUMO

OBJECTIVE: A radiological emergency such as the detonation of a radiological dispersal device would have catastrophic health, environmental, and economic consequences. Community assessments can provide useful information about radiological and other emergency preparedness at the household level. Tools such as logic models can be applied to link data collected in a community assessment to planned activities and targeted outcomes. This study sought to answer how public health departments can use the results of a community assessment to improve preparedness for radiological and other types of emergencies and to present a sample logic model demonstrating how questions asked in a community assessment can be used to drive intended outcomes. DESIGN: Surveys were fielded in 2019 to professionals with experience in radiological emergency preparedness, state and local health and emergency management, and journalism. Questions included the role of health departments in radiological emergency preparedness, the operationalization of results from a community assessment for preparedness, and information sharing in a radiological emergency. Descriptive statistics and a modified framework approach were used for open-ended questions. RESULTS: Nearly three-fourths of state/local officials reported that it would be at least somewhat difficult (73%; 11 of 15 state/local officials) for a local health department to operationalize the results of a community health assessment for radiological emergency preparedness. Potential barriers included competing priorities, lack of funds, and limited staff. Resources such as pretested communication materials, tailored messaging, and technical tools and training can assist health departments and emergency management agencies in using the information collected from a community assessment. CONCLUSIONS: To address implementation challenges in operationalizing the results of a community assessment, officials can use tools such as logic models to illustrate how the information gathered from a community health assessment will create an intended preparedness outcome and to advocate for funds for this type of assessment.


Assuntos
Defesa Civil , Planejamento em Desastres , Comunicação , Planejamento em Desastres/métodos , Humanos , Saúde Pública/métodos , Inquéritos e Questionários
12.
South Med J ; 115(2): 158-163, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35118507

RESUMO

OBJECTIVES: Training healthcare workers in disaster preparedness has been shown to increase their willingness and ability to report to work during disasters. Little is known, however, about the relation between sociodemographic, household, and workforce characteristics and the desire for such training. Accordingly, this study aimed to assess healthcare workers' desire for additional workforce preparedness training, and the determinants that influence the need for such training, for three types of disasters (natural, pandemic, manmade). METHODS: The US Department of Veterans Affairs (VA) Preparedness Survey was a random, anonymous, Web-based questionnaire fielded nationwide (October-December 2018). Multivariate, logistic regression analyses were conducted. RESULTS: In total, 4026 VA employees, clinical and nonclinical, responded. A total of 61% of respondents wanted additional training for natural, 63% for pandemic, and 68% for manmade disasters. VA supervisors (natural: odds ratio [OR] 1.28, pandemic: OR 1.33, manmade: OR 1.25, P < 0.05) and clinicians (natural: OR 1.24, pandemic: OR 1.24, manmade: OR 1.24, P < 0.05) were more likely to report the need for additional training. Those who reported that they understood their role in disaster response were less likely to report the need for training (natural: OR 0.25, pandemic: OR 0.27, manmade: OR 0.28, P < 0.001), whereas those who perceived their role to be important during response (natural: OR 2.20, pandemic: OR 2.78, manmade: OR 3.13, P < 0.001), and those who reported not being prepared at home for major disasters (natural: OR 1.85, pandemic: OR 1.92, manmade: OR 1.94, P < 0.001), were more likely to indicate a need for training. CONCLUSIONS: Identifying which factors encourage participation in disaster preparedness training can help hospitals and other healthcare providers create targeted training and educational materials to better prepare all hospital staff for future disasters.


Assuntos
Defesa Civil/educação , Pessoal de Saúde/educação , Determinação de Necessidades de Cuidados de Saúde/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Defesa Civil/estatística & dados numéricos , Feminino , Pessoal de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Inquéritos e Questionários , Estados Unidos , United States Department of Veterans Affairs/organização & administração , United States Department of Veterans Affairs/estatística & dados numéricos
13.
Niger J Clin Pract ; 25(1): 27-32, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35046191

RESUMO

BACKGROUND: The disaster situations call upon the effective and speedy response from the nurses. The link to self-perceived competence in disaster preparedness remains unclear, although there is strong support for competence in nursing practice to ensure safe patient care. AIMS: The study aims to evaluate the self-perceived competence and familiarity of nurses at personal and professional levels concerning disaster preparedness. Cross-sectional exploratory design was employed. A sample of 350 nurses from five government hospitals in Medina was surveyed using an emergency preparedness information questionnaire. PATIENTS AND METHODS: IBM SPSS (Statistical Package for Social Sciences) for Windows, Version 21.0, was used for analyzing the data. RESULTS: Nurses perceived inadequate preparation for emergencies. The unit area had no impact on their self-perceived competence and familiarity. CONCLUSIONS: Female nurses, non-Saudi staff, and years of work experience were perceived to increase nurse competence in disaster preparedness. The managers can create activities to enable nurses to learn and view their disaster preparedness concerns.


Assuntos
Defesa Civil , Planejamento em Desastres , Desastres , Enfermeiras e Enfermeiros , Estudos Transversais , Feminino , Hospitais Públicos , Humanos , Inquéritos e Questionários
14.
Nurs Open ; 9(2): 908-919, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34994079

RESUMO

AIM: The review aimed to present a synthesis of nurses' preparedness for infectious disease and the components of emergency preparedness. DESIGN: Narrative synthesis. METHODS: A systematic search and screening for relevant studies were conducted to locate the relevant articles. The included studies were examined for scientific quality using the Mixed Methods Appraisal Tool. The findings of included studies were synthesized by a narrative synthesis approach. RESULTS: Totally 15 studies were included, and 4 themes associated with nurses' preparedness for pandemic were identified: knowledge and skills, psychological preparation, external resources, and attitude and intention. CONCLUSIONS: Most nurses express a positive willingness to respond to epidemics, although they do not believe they are adequately prepared. Some measures should be taken for improving nurses' emergency preparedness, including providing ongoing training, protective equipment, safe working environment and psychological intervention, improving nurses' resilience and accelerating the sharing of scientific information about epidemics.


Assuntos
Defesa Civil , Pandemias , Surtos de Doenças/prevenção & controle , Humanos , Narração , Pandemias/prevenção & controle
17.
Am J Nurs ; 122(2): 62-63, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-35085157
18.
Artigo em Inglês | MEDLINE | ID: mdl-35055651

RESUMO

The main purpose of this paper is to point out a new approach in evaluating the preparedness of the population of a selected city for civil protection and its response to emergencies. Using new approaches, it evaluates a subjective questionnaire survey in combination with the objective state thanks to a mathematical approach and its subsequent verification on a specific example. The proposed approaches are then verified by experimental surveys in the selected city. The result is a highly adaptable tool that can be set up and adapted to different situations and different types of questionnaires to address the preparedness and safety of the population for emergencies. Thanks to this tool, it is possible to evaluate the subjective opinions of the population and thus gain insight into the assessment of the city's preparedness for emergencies. Subsequently, we can set the prevention and preparedness of the population in the city on the basis of the obtained outputs, which potentially has a fundamental influence on the response after the occurrence of an emergency. Improving preparedness in the area of civil protection shall not only be reflected in the response and minimization of the consequences of the emergency, but also in the emotional security of the population.


Assuntos
Defesa Civil , Planejamento em Desastres , Emergências , Humanos , Inquéritos e Questionários
19.
Nurs Forum ; 57(2): 305-310, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34741537

RESUMO

BACKGROUND: Household emergency preparedness, at the individual and family micro-level, is often identified as below national disaster preparedness standards. AIMS: Conceptual clarity of household emergency preparedness is foundational for disaster preparedness research, theory construction, and instrument use. MATERIALS & METHODS: Adhering to Walker and Avant's (2019) concept analysis method, the purpose of this paper is to outline the concept of household emergency preparedness by identifying the uses of the concept, the defining attributes, antecedents, consequences, and empirical referents. Literature sources were identified using the Cumulative Index for Nursing and Allied Health (CINAHL), ProQuest Central, PsycInfo, PubMed, and government websites. CONCLUSION: Concept clarification is critical for future selection of research designs involving multidisciplinary community-based interventions for household emergency preparedness, as well as to understand how preparedness efforts at the individual and family micro-level may influence larger disaster preparedness system outcomes.


Assuntos
Defesa Civil , Formação de Conceito , Humanos
20.
Can J Cardiol ; 38(2): 279-291, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34863912

RESUMO

While COVID-19 is still ongoing and associated with more than 5 million deaths, the scope and speed of advances over the past year in terms of scientific discovery, data dissemination, and technology have been staggering. It is not a matter of "if" but "when" we will face the next pandemic, and how we leverage technology and data management effectively to create flexible ecosystems that facilitate collaboration, equitable care, and innovation will determine its severity and scale. The aim of this review is to address emerging challenges that came to light during the pandemic in health care and innovations that enabled us to adapt and continue to care for patients. The pandemic highlighted the need for seismic shifts in care paradigms and technology with considerations related to the digital divide and health literacy for digital health interventions to reach full potential and improve health outcomes. We discuss advances in telemedicine, remote patient monitoring, and emerging wearable technologies. Despite the promise of digital health, we emphasise the importance of addressing its limitations, including interpretation challenges, accuracy of findings, and artificial intelligence-driven algorithms. We summarise the most recent recommendation of the Virtual Care Task Force to scaling virtual medical services in Canada. Finally, we propose a model for optimal implementation of health digital innovations with 5 tenets including data management, data security, digital biomarkers, useful artificial intelligence, and clinical integration.


Assuntos
Tecnologia Biomédica , Defesa Civil/métodos , Telemedicina/métodos , Inteligência Artificial , Tecnologia Biomédica/normas , Tecnologia Biomédica/tendências , COVID-19/epidemiologia , Tecnologia Digital , Humanos , Melhoria de Qualidade , SARS-CoV-2
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