Data Sources for Improving Estimates of the Global Burden of Injuries: Call for Contributors

Kavi Bhalla and colleagues invite individuals and organizations to provide local injury data sources to help inform estimates of the global burden of injuries

Application of operations research in studies of ambulatory care services

published_or_final_versionCommunity MedicineDoctoralDoctor of Philosoph

Confidence in Health-Services Availability during Disasters and Emergency Situations—Does it Matter?—Lessons Learned from an Israeli Population Survey

The association between health and community resilience is well established in the literature. However, maintaining continuity of healthcare services during emergencies, and their contribution in the context of community resiliency have not been sufficiently studied. This study aims to explore the relationship between the public’s confidence in the availability of healthcare services during and following emergencies, and community resilience. A cross-sectional study was conducted among 3478 Israeli adults, using the Conjoint Community Resilience Assessment Measurement (CCRAM) tool. Associations between confidence in health services availability during emergencies, socio-demographic variables, and community resilience as measured by the CCRAM score were analyzed. The results revealed that confidence in the availability of health services positively correlated with community resilience score (r(3377) = 0.580, p < 0.001), and that it contributed significantly to increasing resilience (OR = 2.67, 95% CI (2.4–2.9), p < 0.001). Maintaining continuity of healthcare services during emergencies has effects beyond the provision of medical treatment. For instance, the confidence of the population in the availability of these services contributes to community resilience. In turn, this finding can be translated into practical resilience building actions and to facilitate community health

Striving to be resilient: What concepts, approaches and practices should be incorporated in resilience management guidelines?

Resilience management guidelines address disruptions, changes and opportunities, facilitate anticipation, adaptation, flexibility and provide a foundation for an effective crisis response. The objective and novelty of the study were to propose a holistic framework that enables to evaluate and prioritise concepts, approaches and practices that should be incorporated into European guidelines for resilience management. Based on a modified Delphi process, 51 items achieved a consensus of > 80%. 84% of the items (n = 43) were ranked as important; 13.7% (n = 7) as essential; one ranked as somewhat important. The identified items encompass eleven categories as follows: 1) collaboration [11 items]; 2) planning [8 items]; 3) procedures [8 items]; 4) training [6 items]; 5) infrastructure [5 items]; 6) communication [3 items]; 7) governance [3 items]; 8) learning lessons [2 items]; 9) situation understanding (awareness) [1 item]; 10) resources [2 items]; and 11) evaluation [2 items]. The identified concepts, approaches and practices seem to be applicable to a wide range of domains and critical infrastructures, such as crisis management, air traffic management and healthcare, due to their generic and abstract characteristics. Important in the Delphi process is the engagement of potential end users in the development of resilience management guidelines to align this development to their needs. Therefore, the Delphi process involved policy and decision-makers, as well as practitioners and other personnel representing different critical infrastructures and academia, in prioritising concepts aimed at achieving resilient organisations, entities or communities. © 2017 Elsevier Inc. All rights reserved.acceptedVersio

Healthcare workers’ willingness to respond following a disaster: a novel statistical approach toward data analysis

Abstract Background The willingness of healthcare workers (HCW) to respond is an important factor in the health system’s response capacity during emergencies. Although much research has been devoted to exploring this issue, the statistical methods employed have been predominantly traditional and have not enabled in-depth analysis focused on absenteeism-prone employees during emergencies. The present study employs an innovative statistical approach for modeling HCWs’ willingness to respond (WTR) following an earthquake. Methods A validated questionnaire measuring knowledge, perceptions, and attitudes toward an earthquake scenario was distributed among Israeli HCWs in a hospital setting. Two regression models were employed for data analysis – a traditional linear model, and a quantile regression model that makes it possible to examine associations between explanatory variables across different levels of a dependent variable. A supplementary analysis was performed for selected variables using broken line spline regression. Results Females under the age of forty, and nurses were the most absenteeism-prone sub-groups of employees (showed low WTR) in earthquake events. Professional commitment to care and perception of efficacy were the most powerful predictors associated with WTR across all quantiles. Both marital status (married) and concern for family wellbeing, designated as statistically significant in the linear model, were found to be statistically significant in only one of the WTR quantiles (the former in Q10 and the latter in Q50). Gender and number of children, which were not significantly associated with WTR in the linear model, were found to be statistically significant in the 25th quantile of WTR. Conclusions This study contributes to both methodological and practical aspects. Quantile regression provides a more comprehensive view of associations between variables than is afforded by linear regression alone. Adopting an advanced statistical approach in WTR modeling can facilitate effective implementation of research findings in the field

An Integrated and Interdisciplinary Model for Predicting the Risk of Injury and Death in Future Earthquakes.

A comprehensive technique for earthquake-related casualty estimation remains an unmet challenge. This study aims to integrate risk factors related to characteristics of the exposed population and to the built environment in order to improve communities' preparedness and response capabilities and to mitigate future consequences.An innovative model was formulated based on a widely used loss estimation model (HAZUS) by integrating four human-related risk factors (age, gender, physical disability and socioeconomic status) that were identified through a systematic review and meta-analysis of epidemiological data. The common effect measures of these factors were calculated and entered to the existing model's algorithm using logistic regression equations. Sensitivity analysis was performed by conducting a casualty estimation simulation in a high-vulnerability risk area in Israel.the integrated model outcomes indicated an increase in the total number of casualties compared with the prediction of the traditional model; with regard to specific injury levels an increase was demonstrated in the number of expected fatalities and in the severely and moderately injured, and a decrease was noted in the lightly injured. Urban areas with higher populations at risk rates were found more vulnerable in this regard.The proposed model offers a novel approach that allows quantification of the combined impact of human-related and structural factors on the results of earthquake casualty modelling. Investing efforts in reducing human vulnerability and increasing resilience prior to an occurrence of an earthquake could lead to a possible decrease in the expected number of casualties

“In the Middle, between Anxiety Victims and PTSD, There Are People That Have Some Kind of a Disorder That Has No Name Yet” Insights about the Traumatic Stress Consequences of Exposure to Ongoing Threat

Current diagnostic criteria for post-traumatic stress disorder (PTSD) do not include symptoms resulting from exposure to ongoing traumatic stress. Thus, existing assessment tools do not fully capture stress symptoms associated with exposure to threats that extend over months or years. We aimed to enumerate the symptoms associated with ongoing exposure to stress and to evaluate the need for a new comprehensive tool designed to assess traumatic stress in these situations. Study methods included focus group sessions, interviews, and a content expert’s workshop. Thematic analysis yielded three main themes: 1. PTSD in its current definition does not capture the whole “traumatic picture” observed in ongoing exposure to threat, 2. Some DSM-5 criteria are not applicable in ongoing exposure to threat, 3. The need for a new tool or modifications of commonly used assessment tools. This study supports the notion that PTSD assessment practices are lacking when assessing traumatic stress in ongoing exposure to threat and highlights the need for a new tool specifically designed for these situations

MATCHING DIGITAL INTERVENTION AFFORDANCES WITH TASKS: THE CASE OF ZOOM AND WHATSAPP MENTAL HEALTH INTERVENTION FOR SENIORS DURING THE COVID-19 PANDEMIC

During the first COVID-19 wave, we conducted a Zoom and WhatsApp digital group intervention that promoted community-dwelling older individuals’ mental health. Based on the media richness theory (MRT) and affordances approach, in this study we used netnography to explore how Zoom and WhatsApp technological affordances/constraints matched intervention tasks and increased intervention performance. We identified four Zoom and WhatsApp affordances: temporality, interactivity, multimediality, and portability. Empirically, our findings indicate how an information-rich media (i.e., high levels of multimediality) can be helpful in conducting complicated intervention tasks, whereas information-lean media (i.e., ongoing communication through text messages) can support simple tasks such as remote intervention management. Theoretically, our study expands on previous MRT media characteristics with the affordances approach and examines how the match between media affordances and task characteristics contributes to intervention performance. We offer recommendations for the research and design of future digital interventions

Studies included in meta-analysis of human-related risk factors for injury and death in earthquakes.

<p>Studies included in meta-analysis of human-related risk factors for injury and death in earthquakes.</p