Reviewing of Published Studies on Health risk Management in Emergency and Disaster

Background: The need for comprehensive and more serious management of disasters and, consequently, the need for knowledge and how to use it in order to reduce the risk of disasters has increased. The importance of this issue is such that in 2016, the World Health Organization launched a research network related to health risk management in disasters. Accordingly, this study was conducted to review articles published in the field of health in emergency and disaster. Methods: In this study, the narrative review method has been used. The accessible articles published in the field of health Risk Management (health EDRM) from 2000 to 2019 were reviewed. Databases including Web of Science, PubMed, Google Scholar, Science Direct, Scopus, Medline, Magiran and SID were used. 24 studies had the inclusion criteria that were selected and analyzed. Data analysis was a qualitative content analysis in the form of components of health risk management in emergency and disasters. Results: Among the 24 studies reviewed, 21 articles were in English and 3 articles were in Persian. In addition, most of these studies were published in 2019. The articles were analyzed and reported in the form of components and functions of health risk management in emergency and disasters, published in 2019 by the World Health Organization. Conclusion: Studies show that the focus of most studies is on policies, strategies and legislation, planning and coordination, and less attention is paid to the components of risk communication and health services. Also, there are many research gaps and it is suggested that more research be done with more precise guidance

Iranian nurses' experience of essential technical competences in disaster response: A qualitative content analysis study.

BACKGROUND Today disasters are a part of many people's lives. Iran has a long history of disaster events and nurses are one of the most significant groups within the Iranian disaster relief operations, providing immediate and long-term care for those affected by the disaster. However, the technical competence of Iranian nurses and their training for this work has received little attention. This article presents the results of a study that aims to explore this context. MATERIALS AND METHODS A qualitative study was conducted using in-depth interviews to collect data from 30 nurses, who were deliberately selected from the health centers affiliated to the Isfahan University of Medical Sciences. Themes were identified using the conventional qualitative content analysis. The trustworthiness of the study was supported by considering the auditability, neutrality, consistency, and transferability. The study lasted from 2011 to 2012. RESULTS Data analysis undertaken for the qualitative study resulted in the identification of five main themes, which included: (1) Management competences, (2) ethical and legal competences, (3) team working, and (4) personal abilities and the specific technical competences presented in this report. CONCLUSIONS This report presents an overview of the nursing technical capabilities required for Iranian nurses during disaster relief. It is argued that additional competencies are required for nurses who care in high-risk situations, including disasters. Nurses need to prepare themselves more effectively to be responsible and effective in nursing care

Role of hospitals in recovery from COVID-19: Reflections from hospital managers and frontliners in the Eastern Mediterranean Region on strengthening hospital resilience

BackgroundCOVID-19 highlighted the critical role that hospitals play throughout the prolonged response and continuous recovery stages of the pandemic. Yet, there is limited evidence related to hospitals in the recovery stage, particularly capturing the perspectives of hospital managers and frontliners in resource-restrained and humanitarian settings.ObjectiveThis paper aims to capture the perspectives of hospital managers and frontliners across the Eastern Mediterranean Region on (1) the role of hospitals in recovering from COVID-19, (2) Hospitals' expectations from public health institutions to enable recovery from COVID-19, (3) the Evaluation of hospital resilience before and through COVID-19, and (4) lessons to strengthen hospital resilience throughout the COVID-19 recovery.MethodsA multi-methods approach, triangulating a scoping review with qualitative findings from 64 semi-structured key-informant interviews and survey responses (n = 252), was used to gain a deeper context-specific understanding. Purposeful sampling with maximum diversity supported by snowballing was used and continued until reaching data saturation. Thematic analysis was conducted using MAXQDA and simple descriptive analysis using Microsoft Excel.FindingsIn recovering from COVID-19, hospital managers noted hospitals' role in health education, risk reduction, and services continuity and expected human resource management, financial and material resource mobilization, better leadership and coordination, and technical support through the provision of updated clinical evidence-based information from their public health institutions. Qualitative findings also indicated that hospital managers attributed considerable changes in hospitals' resilience capacities to the pandemic and suggested that strengthening hospitals' resilience required resilient staff, sustainable finance, and adaptive leadership and management.ConclusionHospitals are the backbone of health systems and a main point of contact for communities during emergencies; strengthening their resilience throughout the various stages of recovery is critical. Hospitals cannot be resilient in silos but rather require an integrated-whole-of-society-approach, inclusive of communities and other health systems actors

Triage Systems in Mass Casualty Incidents and Disasters: A Review Study with A Worldwide Approach

BACKGROUND: Injuries caused by emergencies and accidents are increasing in the world. To prioritise patients to provide them with proper services and to optimally use the resources and facilities of the medical centres during accidents, the use of triage systems, which are one of the key principles of accident management, seems essential. AIM: This study is an attempt to identify available triage systems and compare the differences and similarities of the standards of these systems during emergencies and disasters through a review study. METHODS: This study was conducted through a review of the triage systems used in emergencies and disasters throughout the world. Accordingly, all articles published between 1990 and 2018 in both English and Persian journals were searched based on several keywords including Triage, Disaster, Mass Casualty Incidents, in the Medlib, Scopus, Web of Science, Pubmed, Cochrane Library, Science Direct, Google scholar, Irandoc, Magiran, Iranmedex, and SID databases in isolation and in combination using both and/ or conjunctions. RESULTS: Based on the search done in these databases, twenty different systems were identified in the primary adult triage field including START, Homebush triage Standard, Sieve, Care Flight, STM, Military, CESIRA Protocol, MASS, Revers, CBRN Triage, Burn Triage, META Triage, Mass Gathering Triage, SwiFT Triage, MPTT, TEWS Triage, Medical Triage, SALT, mSTART and ASAV. There were two primary triage systems including Jump START and PTT for children, and also two secondary triage systems encompassing SAVE and Sort identified in this respect. ESI and CRAMS were two other cases distinguished for hospital triage systems. CONCLUSION: There are divergent triage systems in the world, but there is no general and universal agreement on how patients and injured people should be triaged. Accordingly, these systems may be designed based on such criteria as vital signs, patient's major problems, or the resources and facilities needed to respond to patients’ needs. To date, no triage system has been known as superior, specifically about the patients’ clinical outcomes, improvement of the scene management or allocation of the resources compared to other systems. Thus, it is recommended that different countries such as Iran design their triage model for emergencies and disasters by their native conditions, resources and relief forces

Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Earthquakes are renowned as being amongst the most dangerous and destructive types of natural disasters. Iran, a developing country in Asia, is prone to earthquakes and is ranked as one of the most vulnerable countries in the world in this respect. The medical response in disasters is accompanied by managerial, logistic, technical, and medical challenges being also the case in the Bam earthquake in Iran. Our objective was to explore the medical response to the Bam earthquake with specific emphasis on pre-hospital medical management during the first days.</p> <p>Methods</p> <p>The study was performed in 2008; an interview based qualitative study using content analysis. We conducted nineteen interviews with experts and managers responsible for responding to the Bam earthquake, including pre-hospital emergency medical services, the Red Crescent, and Universities of Medical Sciences. The selection of participants was determined by using a purposeful sampling method. Sample size was given by data saturation.</p> <p>Results</p> <p>The pre-hospital medical service was divided into three categories; triage, emergency medical care and transportation, each category in turn was identified into facilitators and obstacles. The obstacles identified were absence of a structured disaster plan, absence of standardized medical teams, and shortage of resources. The army and skilled medical volunteers were identified as facilitators.</p> <p>Conclusions</p> <p>The most compelling, and at the same time amenable obstacle, was the lack of a disaster management plan. It was evident that implementing a comprehensive plan would not only save lives but decrease suffering and enable an effective praxis of the available resources at pre-hospital and hospital levels.</p

History and Structure of the Fourth Leading Emergency Medical Service in the World; a Review Article

Over forty-three years have passed since the foundation of pre-hospital emergency care system in Iran. Considering the changes that have taken place in recent years in pre-hospital emergency and limited studies in this area, the present review aimed to describe the history, organizational structure, combination of workforce, dispatch system, medical direction and innovations in the pre-hospital system of Iran.  The present paper also discusses the strengths and weaknesses of the current system

Evaluating the Knowledge and Attitude of Service Providing Personnel of Sari Regarding First Aid; a Cross-Sectional Study

مقدمه: داشتن اطلاعات کافی در زمینه آگاهی و نگرش افراد جهت هرگونه برنامه‌ریزی و مداخلات آموزشی مناسب با هدف فراگیری کمکهای اولیه در جامعه ضروری می باشد. مطالعه حاضر در سال 1394جهت بررسی دانش و نگرش نیروهای خدماتی شهر ساری درباره کمکهای اولیه و در چهار گروه شغلی پلیس، رانندگان تاکسی، رانندگان اتوبوس و آتش‌نشانان انجام شد. روش کار: این مطالعه از نوع مقطعی بوده و جامعه پژوهش شامل رانندگان تاکسی و اتوبوس شهری، پلیس و آتش‌نشانان شهر ساری در سال 1394 بود. نمونه‌گیری بصورت تصادفی ساده طبقه‌بندی شده و با حجم نمونه 500 نفر انجام شد. دانش و نگرش مشارکت کنندگان با استفاده از پرسشنامه محقق ساخته و با نرم‌افزار SPSS ویرایش 22 مورد تجزیه تحلیل قرار گرفت. يافته ها: تعداد 500 نفر با میانگین سنی51/.8 ±32/40 (حداقل 28 و حداکثر 60) سال که همگی مرد بودند در این مطالعه شرکت کردند. افراد شرکت کننده در مطالعه دارای میانگین بعد خانوار 8/13 ± 1/4 بودند. میانگین نمره نگرش 8/51 ± 2/11 بود. بیشترین فراوانی نمره کسب شده در نگرش برابر با 12 بود و بیشترین امتیاز نگرشی نیز مربوط به سازمان آتش نشانی و خدمات ایمنی با میانگین امتیاز 8/17 و کمترین امتیاز نیز مربوط به رانندگان تاکسی سازمان تاکسیرانی با میانگین امتیاز 2/11 از حداکثر نمره 20 بود. متوسط نمره آگاهی بدست آمده 7/42 ± 2/7 بود. بالاترین میانگین آگاهی مربوط به آتش نشانی با امتیاز 6/11 و کمترین آن مربوط به تاکسی رانی با امتیاز 1/7 از حداکثر نمره 20 بود. نتيجه گيری: نتایج مطالعه نشان داد که سطح آگاهی و نگرش نیروهای ارائه کننده خدمات به مردم در مورد کمکهای اولیه مناسب نبوده و آموزشها در این زمینه مطلوب نمی‌باشد که جهت ارتقا آن نیاز به برنامه‌ریزی مدون، کلاسهای بازآموزی و آموزشهای بدو و حین خدمت با تمرکز بر افزایش مهارت می‌باشد.Introduction: Having sufficient data regarding the knowledge and attitude of individuals towards any planning and appropriate educational interventions with the aim of learning first aid in society is essential. The present study was performed in 2015 for evaluating knowledge and attitude of service providing personnel of Sari, Iran, regarding first aid in 4 occupational groups of police, taxi driver, bus driver, and firefighter. Methods: This study is a cross-sectional one and the study population consists of city taxi and bus drivers, police and firefighters of Sari, Iran, in 2015. Sampling was done via simple random method and with a sample size of 500 individuals. Knowledge and attitude of the participants was evaluated using a questionnaire designed by the researchers and via SPSS software version 22. Results: A total of 500 individuals with an average age of 40.32 ± 8.51 (at least 28 and a maximum of 60) years, all men, participated in this study. Participants of the study had a mean family dimension of 4.1 ± 13.8. Mean attitude score was 11.2 ± 51.8. The highest frequency of obtained score in attitude belonged to 12 and the highest attitude score belonged to firefighting and safety services organization with the mean score of 17.8 and the lowest score belonged to taxi drivers of taxi driving organization with the mean score of 11.2 from the maximum possible score of 20. Mean knowledge score obtained was 7.2 ± 42.7. The highest mean of knowledge belonged to firefighters with the mean score of 11.6 and the lowest score belonged to taxi drivers with the mean score of 7.1 from the maximum possible score of 20. Conclusion: The results of the study showed that level of knowledge and attitude of those providing service to people was not proper regarding first aids and trainings in this regard is not desirable. To improve it, there is a need for schedule planning, retraining classes and trainings at the beginning and during service with concentration on improving the skills.

Are older people more vulnerable to long term impacts of disaster?

Background: Despite the growing interest in the study of disasters, there is limited research addressing the elderly population that lead to prejudiced beliefs that older adults are more vulnerable to disasters than younger adults. This study aimed to compare positive mental health between elderly and young earthquake survivors. Method: Data for this study, consisting of 324 earthquake survivors, were obtained from a population-based cross-sectional survey conducted in Iran, 2015. The long-term effect of earthquake was assessed using the Mental Health Continuum-Short Form questionnaire. A one-way multivariate analysis of covariance (MANCOVA) using SPSS (version 22) was used in data analysis. Results: Older adults scored significantly a higher level of overall positive mental health (mean [M]=34.31, standard deviation [SD]=10.52) than younger age group (M=27.48, SD=10.56, t=-4.41; P<0.001). Results of MANCOVA revealed a statistically significant difference between older and young adults on the combined positive mental health subscales (F(3,317)=6.95; P<0.001), after controlling for marital status, sex, and employment status. Conclusion: The present findings showing a higher level of positive mental health among elderly earthquake survivors compared with their younger counterparts in the wake of natural disasters suggest that advancing age per se does not contribute to increasing vulnerability

Exploring barriers and challenges in protecting residential fire - related injuries: a qualitative study

Background: Building fires can be a great threat to the safety of residents, and can lead to economic and social damage. Exploring the views of stakeholders is a great source for understanding the factors that affect fires. The purpose of this study was to explore stakeholders’ experiences of unintentional fire-related injuries in residential buildings in Iran. Methods: This qualitative study was carried out using grounded theory. The study was conducted in Iran, in 2017. The study participants consisted of 25 people including stakeholders who had practical experience/or were knowledgeable in the field of preventing and fighting building fires. Purposeful and theoretical sampling were used for data collection. Data were analyzed based on constant comparative analysis and according to recommendations by Strauss and Corbin. Results: "Lack of a comprehensive approach to prevention of fire-related injury" emerged as a core variable which impacted on residents' safety against fires. The findings were classified into four groups of challenges related to the structure of building, socio-economic challenge, residents of the building and rescue services. Conclusions: Based on participants` experiences, unintentional fire-related injuries in residential buildings are affected by cultural context and economic, social and geographical factors. Improving the safety against unintentional fire-related injuries in residential buildings requires multidisciplinary operations including both change and improvement of the building construction and change in the beliefs and practices of residents to increase safety against fires

Representation of Disasters in School Textbooks for Children with Intellectual Disabilities in Iran:A qualitative Content Analysis

School textbooks are one of the main sources for teaching and learning in an education system. This study aims to investigate the representation of disasters in school textbooks for the children with intellectual disabilities (ID) in the education system in Iran. This study uses a qualitative content analysis method. All school textbooks for students with ID in the education year 2019-2020 in Iran were collected. Among the whole 164 textbooks, 18 had content about hazards. Data were analyzed qualitatively by MAXQDA 2018 software. Textbooks in most grades cover the topic of disasters triggered by natural hazards including geophysical (earthquakes), hydrological (floods), climatological (extreme temperatures, and drought), meteorological (storms/wave surges) and biological (epidemics and insect/animal plagues). Moreover, there are various topics of disaster risk management in the textbooks including mitigation, preparedness, and response. Natural hazards are well covered in school textbooks for students with ID in Iran. However, more content about sheltering in disasters, reunification, as well as disasters’ response and recovery will help children with ID in Iran to perform better during and after disasters. Moreover, the textbooks in several grades provide some debates on the prevention and the spread of infectious diseases for preparedness against epidemics. The COVID-19 pandemic and the significance of preparedness of vulnerable groups against pandemics evidence that school textbooks are a key means to transfer the information of preparedness in emergencies of all sorts to all children including children with ID