The current context has proved unequivocally that public health is one of the pillars of society, playing a determining role and being a balancing factor. This study aimed to provide additional evidence supporting the use of geographic information systems in and from public health. For the study, the authors use public data from the Transparency COVID-19 data set at the Romanian level, which they process with the QGIS application, to effectively determine the influence of the location of the vaccination centers, respectively the impact on the incidence of COVID 19. The research carried out, which generated 153 maps, allows the statement, that reports based on the geographical location of data collected from the public health system are easier to analyze and to evaluate the effectiveness of the decisions taken. By analyzing the evolution of some public health indicators, that are difficult to correlate through analytical relationships, this study offers, as the main finding, an additional argument for the use of geographic information systems in public health management. As the limitations of research in the simulation component are relevant, further research is needed to provide the necessary evidence to convince about the effectiveness of using geographic information systems to optimize outcomes in the public health system. For this reason, it is necessary that the data structures in the public system, to be built and collected in a comprehensive way, with an optimal level of granularity.

Epidemics are the most common natural phenomena that have occurred throughout the entire history of human society. Depending on the type of disease and the development of the collective immunity that society had acquired by then, the consequences of epidemics were usually very severe. Precisely because of this, the aim of the paper is a scientific description of the way in which the prescribed preventive measures should be applied from the epidemiological, security, economic, legal and other aspects, so that the society, through the mechanisms of the state, can defend and rehabilitate the consequences of an epidemic of an infectious disease. Eliminating the epidemic's impacts is a very difficult issue. In particular, there is an infectious illness epidemic that is spreading uncontrolled throughout society on the one hand. In order to introduce a quarantine that restricts the epidemic's progress and, if the quarantine lasts long enough, to end the epidemic, contact between members of the social group must be broken. On the other side, the cessation of communication between members of a social group also signifies the cessation of all facets of life in that society, including economic ties, education, growth of culture, scientific research, etc.

The COVID-19 pandemic struck unexpectedly, emergency services and chronic care institutions, including dialysis centers, were overloaded. An important problem was the care of positive COVID patients, but also the care of chronically dialyzed patients who presented emergencies. In our Hospital, which has become a COVID support for dialysis patients with severe forms of the disease, we had to care for PD patients with dialysis-related emergencies. We presented 2 cases of patients managed on an outpatient basis or 1 day hospitalization, treated successfully and without compromising the quality of the care provided. We used remote monitoring, we worked in a multidiscipli-nary team, we shortened the hospitalization of patients (and implicitly the risk of contact). In pandemic conditions, the advantage of PD was represented by the possibility of patient isolation, so that in the first 6 months of the pandemic, we recorded no deaths in this category of patients. In case of hemodialysis patients, in-fection and mortality rates were high. Although we expected an increase in the number of peritoneal dialysis patients in the post-pandemic period, this did not happen. We continue to plead for the popularization of the PD method among patients and doctors, which has proven its advantages under the conditions of the pandemic.

PurposeThis study was designed to characterize the psychometric properties of the Persian version of the Fear of Hospitalization Scale (P-FHS).Design and methodsIn order to evaluate the validity and reliability of the translated scale, a cross-sectional design was employed. Ten experts evaluated the content validity of the Fear of Hospitalization Scale (FHS) after it had been back-translated into Persian. With 612 patients having emergency surgery, construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The STROBE checklist for cross-sectional studies was followed.FindingsThe results of EFA (n = 306) showed that the fear of hospitalization had three factors. These three factors accounted for 45.28% of the total variance. Also, these factors were confirmed by CFA (n = 306) (root-mean-square error of approximation = (90%. confidence interval) = 0.050 [0.041, 0.058], goodness-of-fit index = 0.945, comparative fit index = 0.968, Non-Normal Fit Index = 0.948, incremental fit index = 0.968, Tucker-Lewis Index = 0.959). The coefficients of Cronbach’s alpha, McDonald’s omega, composite reliability, and maximum reliability for all three factors were greater than 0.7, demonstrating satisfied internal consistency.Practice implicationAccording to the published results, the P-FHS is effective at measuring hospitalization anxiety in patients undergoing emergency surgery. It is advised that nurses in Iranian culture use a legitimate and trustworthy technique to pinpoint the causes of hospitalization anxiety in patients undergoing emergency surgery to give optimal care.

Using measures for sustainable development and reducing the risk of disasters in order to protect the population, goods and the environment, is the duty of every state in the fight against the security challenges that disasters bring. Disaster risk reduction is a multidisciplinary policy designed to implement various measures to strengthen community resilience and preparedness for disasters. The region of Southeast Europe is recognized as extremely endangered by natural disasters. The countries of the region, especially their national risk management policies, continue to be based in part on solutions from earlier times. The subject of the research is focused on the analysis of disaster risk management policies in the countries of Southeast Europe, their comparison and review of similarities and differences. The countries of this region base their policies on similar solutions aimed at reducing the risk of disasters. There are shortcomings in the full implementation of the adopted international frameworks in the national risk management policies and normative-legal frameworks in certain countries of this region.

Patient safety is fundamental to healthcare. Adverse events particulary medication errors, cause harm to patients specially paediatric population in the emergency departament. Aim: To explore paediatric emergency nurses' perceptions of medication administration errors. Method: A qualitative, ethnomethodological, descriptive study. Data were collected through in-depth individual interviews with paediatric emergency nurses and analysed using Taylor and Bogdan's proposal. Results: Main categories extracted: 1) Safety culture transmitted by supervisors and safety groups. 2) Teamwork with good communication and a positive relationship. 3) Error management, the lack of formal support and negative feelings despite an understanding of the multifactorial nature of errors. The study identifies several challenges in the healthcare system. Emphasis on the per-ception of errors in terms of patient harm, while near misses or dose delays or omissions are not treated as errors. Conclusions: Although institutions have implemented safety culture strategies, nurses have not fully embraced them. Negative emotions and coping strategies are reported. There is a need to promote a positive safety culture and a safe working environment that encourages communica-tion within the team. Protocols could be adapted according to feasibility and perceived risk. The hospital should provide training in safe management and patient safety. This study was not reg-istered.

Abstract: Background: Trauma is the leading cause of morbidity and mortality in young patients, acute surgical conditions cause morbidity and mortality in patients of all ages. Computed tomography scan (CT) assist greatly in the investigation and management of these patients with blunt and penetrating trauma, facilitating early diagnosis and expedites early appropriate treatment of these patients. Acute non-traumatic surgical conditions also mimic non-surgical pathologies and differentiating the two is important because management is different and any delay in surgical intervention results in high morbidity and some may even result in mortality. Method: Literature review of the role of multidetector CT scan (MDCT) in managing acute surgical emergencies and trauma-diagnosis in the trauma patient and patients presenting with acute surgical emergencies. The focus is on the role of the MDCT in the management of these patients. Results highlight that the use of MDCT expedites management of these patients, allowing early surgical intervention and preventing unnecessary surgical interventions where the intervention is not indicated, based on the MDCT results. Conclusion: This paper emphasizes the important role that is played by the MDCT in the management of the above patients.

Purpose: A novel coronavirus, SARS-CoV-2 was identified as the cause of COVID-19 eventually led to the declaration of Public health emergency of international concern and a pandemic by WHO due to its exponential global spread. Present study was conducted to investigate the impact of second wave of pandemic on mental wellbeing and social behaviors among university students of Pakistan during this crucial period of COVID-19 infection. Methods: A cross-sectional analytical study was designed to evaluate the psychosocial impact during the current COVID-19 outbreak among the students of The Islamia University of Bahawalpur, Pakistan. Snowball sampling or chain referral sampling procedure was adopted to recruit the participants in the study. Verbal informed consent was taken from all participants before recruitment in the study irrespective of their gender, age and socioeconomic status. Results: Mental health of university students during COVID-19 epidemic was affected to a varying degree revealing that 26.66% were recorded to have mild, 27.15% moderate and 17.04% suffering from severe anxiety out of total 1029 students. Students who were residing in urban areas with parents and having a steady family income were negatively associated and found protective factors against anxiety. However, having a relative or an acquaintance infected with COVID-19 was an independent risk factor for experienced anxiety. Positively associated factors with the level of anxiety symptoms included economic stressors, effects on daily-life, and academic delays whereas social support was negatively correlated with anxiety in COVID-19 related stressors. Conclusion: Public health emergencies and such pandemic are exerting serious psychological impacts on university students. It is recommended that the higher authorities should plan better policies to reduce this impact for the provision of high quality and timely crisis-oriented psychological services to university students.

Mental health in Puerto Rico is a complex and multifaceted issue that has been shaped by the island’s unique history, culture, and political status. Recent challenges, including disasters, economic hardships, and political turmoil, have significantly affected the mental well-being of the population coupled with the limitations in the accessibility of mental health services. Puerto Rico has fewer mental health professionals per capita than any other state or territory in the United States. This comprehensive review examines the impact of disasters on mental health and mental health services in Puerto Rico. Given the exodus of Puerto Ricans from the island, the review also provides an overview of mental health resources available on the island as well as the continental United States. The review identifies efforts to address mental health issues, with the intent of gaining a proper understanding of the available mental health services, key trends, as well as observable challenges and achievements within the mental health landscape of the Puerto Rican population.

Background: Recent disasters have demonstrated gaps in employers’ preparedness to protect employees and promote their well-being in the face of emergencies and disasters affecting the workplace and their communities. Total Worker Health (TWH), a comprehensive perspective developed by the National Institute for Occupational Safety and Health, is a helpful framework for addressing employer preparedness. It includes attention to health and safety at work, and the promotion of the health and well-being of the employee in the context of social determinants of health, such as work-life balance. Methods: TWH concepts, including the domains of TWH and the TWH Hierarchy of Controls, were investigated for their relevance to protecting employees and promoting their well-being during and after crises such as weather disasters, pandemics, and acts of terrorism. Building upon TWH concepts, an employer preparedness framework and model is proposed. Findings: The Model emphasizes upstream prevention, workplace-community linkages, social and economic impacts, and employer leadership through a cyclical planning process. Conclusions/Application to Practice: The Model can assist employers in advancing their preparedness for all hazards through self-assessment and planning agendas based upon the proposed domains.

Objective: To describe the methodology used and the results found in the implementation of Lean in Emergencies in the Emergency sector of the Hospital de Clínicas of the Federal University of Uberlândia (HC-UFU), verifying the difficulties and particularities that involved the process, as well as the result obtained. Material and methods: For the comparison between the periods before (T1), contemporary (T2) and after (T3) the implementation of Lean, hospital data were used , and the indicators corresponding to 10 variables were analyzed: Male Hospitalization and Female Hospitalization; High Male and High Female; Male Transfer and Female Transfer, Male Death <24h and Female Death <24h; Male Death >24h and Female Death >24h and general occupancy rate. All raw data related to the 36 months of evaluation were provided by the HC-UFU Statistics sector in spreadsheets without identifying patients. The indicators were compared to each other in the three analyzed periods, with the study directed as follows: Previous stage - Pre -intervention (T1): considered between the months of April 2017 to March 2018, completing 12 months before the implementation of Lean; Intra-intervention stage - contemporary (T2): considered between the months of April 2018 to March 2019, in a total of 12 months which was the implementation period; Post-Intervention Stage (T3): later: considered between the months of April 2019 to March 2020, completing 12 months after the implementation of Lean. The Lean in Emergencies scores (NEDOCS and LOS) were only recorded during the period that the implementation team was able to record and were used only to demonstrate trend over time. Comparison of the indicators with those found in other hospital units that also implemented Lean was carried out based on bibliographical research. Results and Discussion: The analysis of the behavior of the indicators did not demonstrate effectiveness related to the implementation of the system in the emergency sector. The failure to obtain better indicators can be attributed to discontinuity in monitoring the project, the lack of involvement of the clinical staff and alignment with the needs of the staff training academy, the difficulty of understanding the project by local and regional public entities. geographical location where the hospital is located, and by users of the health system who were not properly informed about the development of the project. These aspects should be considered in future management projects that may be implemented in the hospital. Despite the result of the implementation of Lean in the emergency sector not having reached the expected goals, the attempt showed windows of opportunity for future action on points that can improve the hospital management process and that should be tested in the next experiences. Conclusion: The methodology followed for the implementation of Lean in Emergencies in the emergency sector of the hospital did not produce improvement in hospital indicators.

Objectives: Our objective was to assess employer preparedness to protect their employees’ health and safety and promote their well-being in the face of potential disasters in a sample of Northeast United States employers. We developed survey instrument and index based on our model of Total Worker Health® (TWH) Employer Preparedness.Methods: We conducted a 40-question on-line survey with the membership of the Northeast Human Resources Association (US). Human resource managers reported their perceptions of their employers’ preparedness in seven domains: planning, human resources policies, hazard reduction, training, staffing, communications, and resources for resilience. Respondents were categorized by size, sector and reach and their responses scored.Results: Seventy-six individuals representing a diverse group of employers responded to the survey. Mean preparedness was “moderate,” with almost an equal number reporting a high level of preparedness as no preparedness. Employers were most prepared for severe weather events and least prepared for acts of violence. There were no significant differences by sector, size, or reach, although the healthcare sector was more prepared than others.Conclusions: There is a range of TWH® Employer Preparedness among Northeast US employers. The survey and model are important tools that can aid employers in the face of growing threats to “business as usual.”

This pioneering study explores the geospatial and temporal patterns of natural and human-induced disasters from 1900 to 2024, providing essential insights into their global distribution and impacts. Utilizing the comprehensive international EM-DAT database, our analysis reveals significant trends and disparities in disaster occurrences and their widespread consequences. Results showed a dramatic escalation in both natural and man-made (technological) disasters over the decades, with notable surges in the 1991-2000 and 2001-2010 periods. A total of 25,836 disasters were recorded worldwide, of which 69.41% were natural disasters (16,567) and 30.59% were man-made (technological) disasters (9,269). The most significant increase in natural disasters occurred from 1961-1970, while man-made (technological) disasters surged substantially from 1981-1990. Seasonal trends reveal that floods peak in January and July, while storms are most frequent in June and October. Droughts and floods are the most devastating in terms of human lives, while storms and earthquakes cause the highest economic losses. The most substantial economic losses were reported during the 2001-2010 period, driven by catastrophic natural disasters in Asia and North America. Our research highlights Asia as the most disaster-prone continent, accounting for 41.75% of global events, with natural disasters making up 61.89% of these events. Oceania, despite experiencing fewer total disasters, shows a remarkable 91.51% of these as natural disasters. Africa is notable for its high incidence of man-made (technological) disasters, which constitute 43.79% of the continent's disaster events. Europe, representing 11.96% of total disasters, exhibits a balanced distribution but tends towards natural disasters at 64.54%. Examining specific countries, China, India, and the United States emerged as the most frequently affected by both natural and man-made (technological) disasters. The impact of these disasters has been immense, with economic losses reaching their highest during the decade of 2010-2020, largely due to natural disasters. The human toll has been equally significant, with Asia recording the most fatalities and Africa the most injuries. Particularly, the decade from 2001 to 2010 experienced the greatest economic losses, primarily driven by natural disasters in Asia and North America. These insights highlight the urgent need for tailored disaster risk management strategies that address the distinct challenges and impacts in various regions. By understanding historical disaster patterns, policymakers and stakeholders can better anticipate and manage future risks, ultimately safeguarding lives and economies.

One of the main problems for managing global crises is to clarify and reduces drivers of systemic weaknesses to face complex emergencies. This study here analyzes the relation between public debt, healthcare expenditures and fatality rates in the presence of pandemic crises, such as COVID-19. Statistical evidence, based on a sample of European countries, here shows that high public debt over time reduces health expenditures and increases the vulnerability of countries to face emergencies, such as COVID-19 pandemic crisis. Regression analysis with a log-log model suggests that when European countries experience a 1% increase in healthcare expenditure per capita, in general they have a 1.2% reduction in the COVID-19 fatality rate. Main implications of this study to reduce the systemic risk and vulnerability to environmental threats are that countries must reduce public debt with good governance and institutions without reducing the allocation of economic resources to the healthcare sector in order to improve the preparedness to unforeseen emergencies and crises, such as pandemics, natural disasters, conflicts, and other environmental threats.