Environmental disasters, migration and displacement. Insights and developments from L'Aquila's case

Prehospital emergency performance in iran

The recent increase in the number of disasters over the world has once again brought to the agenda the question of preparedness of the hospitals, which are the most necessary units of healthcare pillar to resist these disasters. The COVID-19 epidemic disease, which has affected the whole world, has caused a large number of people to die in some countries simply because of the inadequate and incomplete planning and lack of readiness of hospitals. For this reason, determining the disaster preparedness level of hospitals is an important issue that needs to be studied and it is important in terms of disaster damage reduction. In this study, a fuzzy hybrid decision-making framework is proposed to assess hospital disaster preparedness. The framework covers three important decision-making methods. For the first phase, Intuitionistic Fuzzy Analytic Hierarchy Process (IF-AHP) is used to assign relative weights for several disaster preparedness criteria considering uncertainty. Secondly, Intuitionistic Fuzzy Decision Making Trial and Evaluation Laboratory (IF-DEMATEL) is applied to identify interrelations among these criteria and feedback. Finally, via the VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method, priorities of hospitals regarding disaster readiness are obtained. A case study involving the participation of 10 Colombian tertiary hospitals is carried out to show the applicability of this fuzzy hybrid approach. 

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A fuzzy hybrid decision-making framework for increasing the hospital disaster preparedness: The colombian case

Background: The unique characteristics of each emergency situation and the necessity to make prompt decisions cause emergency medical services (EMS) staff's ethical conflicts and moral distress. Objectives: This study aimed to explore EMS staff's experiences of the factors behind their moral distress. Methods: This qualitative study was conducted on 14 EMS staff using the conventional content analysis. Data were collected through unstructured and semi-structured interviews. Each interview was started using general questions about moral issues at workplace and barriers to professional practice. The five-step content analysis approach proposed by Graneheim and Lundman was used for data analysis. Results: The factors behind EMS staff's moral distress were categorized into 13 subcategories and 5 main categories. The main categories were staff's lack of knowledge and competence, inability to adhere to EMS protocols, restraints on care provision, ineffective interprofessional communications, and conflicts in value systems. The subcategories were, respectively, inadequate knowledge and experience, working with incompetent colleagues, artificial services, working in unpredictable situations, lay people's interference in care provision, resource and equipment shortages, barriers to early arrival at the scene, obligatory obedience to the system, poor interprofessional interactions, inadequate interprofessional trust, refusal of care, challenges in obtaining consent, and challenges in telling the truth. Conclusion: EMS staff experience moral distress at work due to a wide range of factors. Given the negative effects of moral distress on EMS staff's physical and mental health and the quality of their care services, strategies are needed to prevent or reduce it through managing its contributing factors.

Factors behind moral distress among Iranian emergency medical services staff: A qualitative study into their experiences

Background: Equitable promotion of health indicators requires cooperation among different sectors more than ever. The "Health in All Policies" (HiAP) approach contributes to this process through strengthening intersectoral collaboration. To implement this approach at a national scale, indicators of health-oriented performance from various organizations, and their measurement methods, need to be precisely defined. The aim of present study was to design a toolkit for implementing HiAP in Iran. Methods: A review of literature and documents, as well as conducting semi-structured interviews and focus group discussions were undertaken to collect data for this qualitative study. Content analysis was applied to the collected data and the results were placed in three categories: criteria, sub-criteria and indicators; implementation processes; and implementation requirements. Results: The toolkit aims to achieve various objectives, including intersectoral excellence and the systematic development of intersectoral collaboration. In the process section, reports on measures taken by organizations are assessed by a three-member audit committee. The top three organizations, in terms of intersectoral cooperation in achieving public health goals, are introduced in a Health Week. Requirements for success in achieving the HiAP approach include financial resources to implement the HiAP, a database, an electronic method for submitting reports, training courses, monitoring and annual reporting of relevant indicators, and formulating regulations in order to assess organizations. Conclusion: Justification and training in various organizations to support the implementation of health-oriented measures, providing an annual ranking of organizations, and encouraging the organizations can contribute to the institutionalization of the toolkit through the SupremeCouncil for Health and Food Security. It is recommended that a Secretariat of sustainable development to be established under the Plan and Budget Organization (PBO) of the Islamic republic of Iran to monitor portfolio indicators.

https://hpp.tbzmed.ac.ir/PDF/hpp-10-244.pdf

Designing a toolkit for the assessment of Health in All Policies at a national scale in Iran.

Background and purpose: Prehospital emergency medical service (EMS) is an important part of the health care system. Today, the need for integrated emergency care services and delivering qualified preventive and care services felt more than before in accidents and emergencies. This survey aimed to investigate the views of emergency medical personnel on the concept and nature of preventive and care services and current challenges in delivering these services in prehospital EMS centers in Golestan province, Iran. Materials and methods: A qualitative study was done with 16 emergency medical personnel working in EMS sites in Golestan province using purposeful sampling. Data was collected by semi- structured interview guide and framework analysis was implemented to analyze the data. Results: Two general themes were identified including 1) the concept of preventive and care services in the EMS and 2) the challenges in providing qualified services in the EMS sites in Golestan province. Also, five sub-themes and 12 subclasses were determined. Conclusion: To enhance and promote services, the EMS system of Golestan province need reforms in organizational structure, laws and administrative regulations, training programs, the system of monitoring and evaluation of personnel, also provision of equipment and manpower and provision of personnel amenities to improve the staff performance. Furthermore, it is necessary to boost emergency services at the community level through training people and enhancing collaboration and participation with other organizations.

http://jmums.mazums.ac.ir/article-1-5824-fa.pdf

Concept and Challenges of Delivering Preventive and Care Services in Prehospital Emergency Medical Service: A Qualitative Study

* Corresponding Author: Ahmad Reza Raeisi, PhD. Address: Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail: raeisi@mng.mui.ac.ir Background: All parents know that keeping their child at home is already difficult, but when the child goes to school, new challenges and hazardous situations will emerge. Preparing children for such situations is one of the tasks of the education system. This study investigated the efficacy of operational first aid training courses in preschool children.

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The Efficacy of Operational First Aid Training Course in Preschool Children

Introduction: Casualties of natural dangers and the risks resulting from improvement of technology are increasing. One of the human responses to these dangers is migration. The purpose of this study was to investigate the relationship between migration and natural hazards. Methods: The method used in this study was qualitative research and methods used in this paper are based on library research and documentation and analyzing migration based on the sociological theories of migration. We also tried to gather required evidences due to sociological look at the migration after Bam's earthquake on January 2003. Finding: The findings of this study suggest that in many cases the relationship between migration and environmental risks and ecological characteristics of the type of risk there. Conclusion: The results indicate that environmental factors play an important role in forming the decision made to emigrate especially among those who are most vulnerable. Immigration control after natural disasters should identify factors threatening social and economic environment, and create new opportunities for people affected by planned.

Studying the effect of natural hazards on human migration (Case Study of Bam earthquake 2003)

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Mass Casualty Response to Mine Explosion: A Case Report in Iran

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Ali Mohajervatan

Papers

Concept and Challenges of Delivering Preventive and Care Services in Prehospital Emergency Medical Service: A Qualitative Study

The Efficacy of Operational First Aid Training Course in Preschool Children

Studying the effect of natural hazards on human migration (Case Study of Bam earthquake 2003)

Mass Casualty Response to Mine Explosion: A Case Report in Iran

Health sector’s flood response plan: A comprehensive review