Discriminatory health systems and inequalities in service provision inevitably create barriers for certain populations in a health emergency. Persons with disabilities have been disproportionately ...affected by the COVID-19 pandemic. They commonly experience three increased risks - of contracting the disease, of severe disease or death, and of new or worsening health conditions. These added risks occur due to a range of barriers in the health sector, including physical barriers that prevent access to health facilities and specific interventions; informational barriers that prevent access to health information and/or reduce health literacy; and attitudinal barriers which give rise to stigma and exclusion, all of which add to discrimination and inequality. Furthermore, national health emergency preparedness and planning may fail to consider the needs and priorities of persons with disabilities, in all their diversity, thus leaving them behind in responses. This commentary discusses the importance of inclusive health systems strengthening as a prerequisite for accessible and comprehensive health emergency preparedness and response plans that reach everyone. Lessons learned relating to disability inclusion in the COVID-19 pandemic can inform health systems strengthening in recovery efforts, addressing underlying barriers to access and inclusion, and in turn improving preparedness for future health emergencies.
Environmental emergencies are characterized by high uncertainty, complex evolution, and potential for serious damage, thus posing enormous pressure and difficulties to the emergency responses of ...enterprises and governments. Improving the efficiency and quality of emergency decision-making constitutes the primary focus of today's research in this field. This study systematically analyzes the scenario evolution mechanism of environmental emergencies with a multi-dimensional scenario space method, and key scenario factors are identified from disaster-inducing factors, disaster-bearing factors, disaster-pregnant environments, and emergency actions. Based on these, an emergency decision-making model for environmental emergencies (EEEDM) is constructed based on case-based reasoning (CBR). First, different matching algorithms are designed for accurate numerical data, fuzzy semantic data, and symbolic data. The similarity between the target scenario and the historical scenario is calculated, and the historical scenario similarity set is built according to the given threshold value. Finally, the emergency action plan of the scenario is modified with its utility value evaluated. A solution that applies to the target scenario is then obtained. Additionally, the decision-making model proposed in this paper is validated by an example of environmental emergencies. The results show that this model is scientific and reasonable, and it can better realize the multi-dimensional expression and fast matching of the scenarios and meet the decision requirements of “scenario-response”. In practice, the model is capable of providing support for relevant departments' emergency decision-making.
•A new emergency decision-making model of environmental emergencies is proposed.•The scenario evolution mechanism of environmental emergencies is revealed.•The key algorithms in case-based reasoning are designed.•The proposed emergency decision-making model is validated by a typical example.
This report characterizes patients presenting for psychiatric emergencies during the COVID-19 pandemic and describes COVID-19-related stressors.
Patients seen for emergency psychiatric evaluation ...during the height of the COVID-19 period (March 1-April 30, 2020; N = 201) were compared with those in the immediate Pre-COVID-19 period (January 1-February 28, 2020; N = 355), on sociodemographic characteristics, psychiatric diagnoses, symptoms, and disposition. Patients tested positive for COVID-19 were compared with those that tested negative on the same outcomes. Prevalence and nature of COVID-19-stressors that influenced the emergency presentation were rated.
The most common psychiatric diagnoses and presenting symptoms during both periods were depression and suicidal ideation. Comparing the Pre-COVID-19 and COVID-19 periods, a significant decline in emergency psychiatric volume was observed in children and adolescents (C/A), but not adults. COVID-19 period C/A patients had more new onset disorders and were more likely to be admitted to inpatient care, but were less likely to present with suicide attempts, impulse control disorders and agitation/aggression. Adults were more likely to have no access to outpatient care, present with anxiety disorders, and were also more likely to be admitted for inpatient care. COVID-19 directly affected the psychiatric emergency in 25% of patients, with the more severe stressors triggered by fear of COVID infection (including psychosis), actual COVID infection in self or family members, including death of a loved one. COVID-positive patients were more likely to have psychosis, including new-onset, and were less likely to be depressed/suicidal compared to their COVID-negative counterparts.
This report demonstrates the need for emergency psychiatric services throughout the COVID-19 pandemic and the need for clinical and diagnostic COVID-19 screening of psychiatric emergency patients. New and severe pathology underscore the need for enhanced outpatient access to tele-mental health, crisis hotline and on-line psychotherapeutic services, as well as psychiatric inpatient services with capacity to safely care for COVID-19 patients.
to understand the changing roles of nurses in labor division organization in hospitals from the Manchester Triage System implementation in an emergency hospital.
this is an ethnographic study that ...used different production techniques and data analysis.
the Manchester Triage System organized flows and places resulting in quality of care and changes in work processes. Conflict relationships related to disagreements in risk stratification were present.
the traditional roles of nurses have been transformed, but it cannot be said that there was a structural change in their position in labor division organization in hospitals. The frontiers of autonomy, therefore of increasing the professionalization of nurses, are neither fixed nor stable, expanding or contracting according to the micropolitical changes in the governance of care.
Burns are a significant cause of morbidity and mortality in children. While the majority of pediatric burns are not life-threatening, they can have a significant impact on a child's physical and ...psychological health. They pose a major social and financial burden, particularly in developing countries. The management of pediatric patients with thermal injuries requires a complex and multifaceted approach. Pediatric burns constitute approximately 40-50% of all reported cases of severe burns. The most common etiologies of pediatric burns include scalds, contact burns, flames, and chemicals. From 80% to 90% of burns occurred at home and were accidental. Despite advancements in treatment, severe burns can lead to life-threatening complications, such as sepsis, multisystem organ failure, and hypermetabolic response or even death. This article aims to provide a literature-based overview of pediatric burn trauma, outlining its unique characteristics, etiology, epidemiology, classification, and initial management.
Major earthquakes often result in incalculable environmental damage, loss of life, and threats to health. Tremendous progress has been made in response to many medical challenges resulting from ...earthquakes. However, emergency medical rescue is complicated, and great emphasis should be placed on its organisation to achieve the best results. The 2008 Wenchuan earthquake was one of the most devastating disasters in the past 10 years and caused more than 370 000 casualties. The lessons learnt from the medical disaster relief effort and the subsequent knowledge gained about the regulation and capabilities of medical and military back-up teams should be widely disseminated. In this Review we summarise and analyse the emergency medical rescue efforts after the Wenchuan earthquake. Establishment of a national disaster medical response system, an active and effective commanding system, successful coordination between rescue forces and government agencies, effective treatment, a moderate, timely and correct public health response, and long-term psychological support are all crucial to reduce mortality and morbidity and promote overall effectiveness of rescue efforts after a major earthquake.
This article describes the historical emergence of vital systems security, analyzing it as a significant mutation in biopolitical modernity. The story begins in the early 20th century, when planners ...and policy-makers recognized the increasing dependence of collective life on interlinked systems such as transportation, electricity, and water. Over the following decades, new security mechanisms were invented to mitigate the vulnerability of these vital systems. While these techniques were initially developed as part of Cold War preparedness for nuclear war, they eventually migrated to domains beyond national security to address a range of anticipated emergencies, such as large-scale natural disasters, pandemic disease outbreaks, and disruptions of critical infrastructure. In these various contexts, vital systems security operates as a form of reflexive biopolitics, managing risks that have arisen as the result of modernization processes. This analysis sheds new light on current discussions of the government of emergency and ‘states of exception’. Vital systems security does not require recourse to extraordinary executive powers. Rather, as an anticipatory technology for mitigating vulnerabilities and closing gaps in preparedness, it provides a ready-to-hand toolkit for administering emergencies as a normal part of constitutional government.
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