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Brody S, Loree S, Sampson M, Mensinkai S, Coffman J, Mueller MH, Askin N, Hamill C, Wilson E, McAteer MB, Staines H. Searching for evidence in public health emergencies: a white paper of best practices. J Med Libr Assoc 2023; 111:566-578. [PMID: 37312802 PMCID: PMC10259619 DOI: 10.5195/jmla.2023.1530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Objectives Information professionals have supported medical providers, administrators and decision-makers, and guideline creators in the COVID-19 response. Searching COVID-19 literature presented new challenges, including the volume and heterogeneity of literature and the proliferation of new information sources, and exposed existing issues in metadata and publishing. An expert panel developed best practices, including recommendations, elaborations, and examples, for searching during public health emergencies. Methods Project directors and advisors developed core elements from experience and literature. Experts, identified by affiliation with evidence synthesis groups, COVID-19 search experience, and nomination, responded to an online survey to reach consensus on core elements. Expert participants provided written responses to guiding questions. A synthesis of responses provided the foundation for focus group discussions. A writing group then drafted the best practices into a statement. Experts reviewed the statement prior to dissemination. Results Twelve information professionals contributed to best practice recommendations on six elements: core resources, search strategies, publication types, transparency and reproducibility, collaboration, and conducting research. Underlying principles across recommendations include timeliness, openness, balance, preparedness, and responsiveness. Conclusions The authors and experts anticipate the recommendations for searching for evidence during public health emergencies will help information specialists, librarians, evidence synthesis groups, researchers, and decision-makers respond to future public health emergencies, including but not limited to disease outbreaks. The recommendations complement existing guidance by addressing concerns specific to emergency response. The statement is intended as a living document. Future revisions should solicit input from a broader community and reflect conclusions of meta-research on COVID-19 and health emergencies.
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Affiliation(s)
- Stacy Brody
- , Reference & Instruction Librarian, Himmelfarb Health Sciences Library, George Washington University, School of Medicine and Health Sciences, Washington, DC, United States
| | - Sara Loree
- , Medical Library Manager, St. Luke's Health System, ID, United States
| | - Margaret Sampson
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | | | - Jennifer Coffman
- , Science and Engineering Research Librarian, University of Virginia, Charlottesville, VA, United States
| | | | - Nicole Askin
- , WRHA Virtual Library, University of Manitoba, Winnipeg, MB, Canada
| | - Cheryl Hamill
- , South and East Metropolitan Health Services, Perth, Australia
| | - Emma Wilson
- , The University of Edinburgh, Centre for Clinical Brain Sciences, Edinburgh, Scotland
| | - Mary Beth McAteer
- , Virginia Mason Medical Center, Jones Learning Center, Seattle, WA, United States
| | | | - Best Practices for Searching During Public Health Emergencies Working Group
- Cheryl Hamill, FALIA, AALIA (CP) Health, , 0000-0002-6069-1806, South and East Metropolitan Health Services, Perth, Australia; Maureen Dobbins, RN, PhD, 0000-0002-1968-6765, McMaster University, Canada; Amy M Claussen, MLIS, 0000-0003-3996-1055, University of Minnesota, United States; Kavita Umesh Kothari, MPH, 0000-0002-0759-5225, Health Information Consultant, Kobe, Japan; Caroline De Brún, PhD, 0000-0002-5185-0043, UK Health Security Agency, United Kingdom; Sarah Young, 0000-0002-8301-5106, Carnegie Mellon University, United States; Sarah E Neil-Sztramko, PhD, 0000-0002-9600-3403, McMaster University, Canada; Shaila Mensinkai, MA, MLIS, Librarian Reserve Corps, Canada; Emma Wilson, 0000-0002-8100-7508, The University of Edinburgh, Scotland; Robin M Featherstone MLIS, 0000-0003-2517-2258, CADTH Canadian Agency for Drugs and Technologies in Health (present affiliation); Cochrane Central Executive Team (sponsor), Toronto, Canada; Margaret Sampson, MLIS, PhD, AHIP, 0000-0003-2550-9893, Children's Hospital of Eastern Ontario Research Institute, Canada; Heather Staines, PhD, MA, 0000-0003-3876-1182, Delta Think, United States; Martha Knuth, MLIS, 0000-0003-4264-1642, Centers for Disease Control and Prevention, United States
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Aliyu AA. Public health ethics and the COVID-19 pandemic. Ann Afr Med 2021; 20:157-163. [PMID: 34558443 PMCID: PMC8477289 DOI: 10.4103/aam.aam_80_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 04/28/2021] [Accepted: 08/05/2021] [Indexed: 11/07/2022] Open
Abstract
Health is a human right anchored in values as a basic necessity of life. It promotes the well-being of persons, communities, economic prosperity, and national development. The coronavirus disease-2019 (COVID-19) pandemic caught the world unaware and unprepared. It presented a huge challenge to the health and economic systems of every country. Across the spectrum of human endeavor and liberty, several ethical questions have been raised with regard to its management, particularly the public health control measures. Decisions for pandemic control measures are made under difficult circumstances driven by urgency and panic, with uncertainties and complexities for public goods over individual rights. Global solidarity in controlling the pandemic is being tested. National governments have the responsibility to protect public health on the grounds of common good. Political considerations should not be the basis for decision-making against the best available epidemiological data from pandemic disease dynamics. Hence, the need to adhere to the values of honesty, trust, human dignity, solidarity, reciprocity, accountability, transparency, and justice are major considerations. A literature search was conducted for the publications from academic databases and websites of health-relevant organizations. I discuss the ethical questions and challenges of the COVID-19 pandemic in the context of public health control measures using the standard ethical principles of respect for autonomy, beneficence, nonmaleficence, and social (distributive) justice. It is observed that, at the country level, the World Health Organization (WHO) guidelines are used to control the pandemic. As WHO through the COVAX strategy distributes the vaccines to less developed countries, a lot still needs to be done to address the complex bottlenecks of allocation and distribution. There is a need to ensure acceptable and transparent system that promotes cooperation, equitable access, and fair distribution of vaccines on a global scale.
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Affiliation(s)
- Alhaji A. Aliyu
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
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3
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Malinga T, Wiysonge CS, Ndwandwe D, Okeibunor JC, Talisuna AO. A scoping review of the impact of long-distance truck drivers on the spread of COVID-19 infection. Pan Afr Med J 2021; 38:27. [PMID: 33777295 PMCID: PMC7955595 DOI: 10.11604/pamj.2021.38.27.26691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/08/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction long-distance truck drivers have been identified as a high-risk group for coronavirus disease (COVID-19) infection. Thus, the aim of this scoping review is to map out the existing evidence on the impact of long-distance truck drivers on the spread of COVID-19 and measures that countries can implement to mitigate this route of spread in the African region. Methods we searched the PubMed database and the website of the World Health Organization (WHO) in March 2020 for eligible studies. Results the search strategy identified 669 citations, of which six met the inclusion criteria. The most frequently reported interventions were maintaining hand hygiene, social distance, testing truck drivers, regulation of trade and transport e.g. only trucks with the food, medical supplies, fuels, agricultural supplies will be allowed to operate in interstate operations and regulating and controlling trucks carrying essential goods and services e.g. truck drivers are required to declare their final destination and are urged to stop only at designated points. Two studies from the African region reported about border closures and entry and exit screening, two studies from the US reported about the threat for public safety and risks and mitigation plans and 2 guidelines reported about harmonisation and facilitation of cross border in the context of the COVID-19 outbreak. Conclusion this review highlights the countries response to mitigate the impact of the pandemic by implementing measures to facilitate safe cross-border trade and adopting regional harmonization of trucking regulations.
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Affiliation(s)
- Thobile Malinga
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,Department of Global Health, Stellenbosch University, Cape Town, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
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4
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Hashemi A, Bahmani F, Saeedi Tehrani S, Forouzandeh M, Koohpayehzadeh J, Ashrafi M, Khalajzadeh MR, Motevalian SA. Ethical considerations and interdisciplinary approach to research on COVID-19 pandemic: The response of Iran University of Medical Sciences. Med J Islam Repub Iran 2020; 34:87. [PMID: 33306052 PMCID: PMC7711043 DOI: 10.34171/mjiri.34.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Indexed: 11/05/2022] Open
Abstract
Background: Research ethics committees are comprised of policymakers, supervisors, and decision-makers and aim at increasing adherence to professional ethics standards in conducting health-related research. The existential philosophy of these committees is to preserve the patients’ health, maintain and promote public trust in health care providers, protect the rights of both patients and health care providers, and promote organizational ethics. However, this task can be complex and challenging during a public health emergency. Research ethics committees set the standard of research in the emergency situations through defining which research has the potential to promote the quality of response to a public health emergency.
Methods: This study aims at collecting and classifying the valuable experiences of the research ethics committee members and reviewers during the early days of the COVID-19 epidemic in Iran University of Medical Sciences, one of the major universities in Tehran. It provides a basic understanding of the key concepts and challenges in reviewing and approving research by research ethics committees and the recommendations to overcome these challenging issues.
Results: To accelerate the review process of COVID-19 research proposals, the scientific, methodological and ethical review panel was integrated as a large committee called ‘IUMS Corona Research Team’. The first meeting was held on March 7, two weeks after the official announcement of the first case of the disease and is continued once a week. A total of 130 projects have been discussed and evaluated in this committee, among which 83 proposals were approved after modification.
Conclusion: An interdisciplinary approach supports a flexible and effective scientific and ethical review of research leading to more protection of research subjects as well as promotion in the treatment and management of the pandemic ahead.
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Affiliation(s)
- Akram Hashemi
- Department of Medical Ethics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahmani
- Department of Medical Ethics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Saeedi Tehrani
- Department of Medical Ethics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Forouzandeh
- Department of Medical Ethics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Jalil Koohpayehzadeh
- Community Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mortaza Ashrafi
- Department of Medical Ethics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Reza Khalajzadeh
- Department of Medical Ethics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Abbas Motevalian
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran
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Abstract
European and international regulation of human health research is typified by a morass of interconnecting laws, diverse and divergent ethical frameworks, and national and transnational standards. There is also a tendency for legislators to regulate in silos—that is, in discrete fields of scientific activity without due regard to the need to make new knowledge as generalisable as possible. There are myriad challenges for the stakeholders—researchers and regulators alike—who attempt to navigate these landscapes. This Delphi study was undertaken in order to provide the first interdisciplinary and crosscutting analysis of health research regulation, as it is experienced by such stakeholders in the UK context. As well as reinforcing existing understandings of the regulatory environment, Delphi participants called for greater collaboration, and even co-production, of processes involved in health research regulation. On the basis of this research, we offer insights about how health research regulation can become a matter with which a wider range of stakeholders—including researchers, regulators, publics and research sponsors—can engage. The evidence supports the normative claim that health research regulation should continue to move away from strict, prescriptive rules-based approaches, and towards flexible principle-based regimes that allow researchers, regulators and publics to co-produce regulatory systems serving core principles. By unpacking thorny concepts and practices at the heart of health research regulation—including the public interest and public engagement—our results have the potential to situate and breathe life into them. The results also demonstrate that while proportionality is well-recognised as a crucial element of flexible regulatory systems, more must be done to operationalise this as an ethical assessment of the values and risks at stake at multiple junctures in the research trajectory. This is required if we are to move beyond proportionality as a mere risk-management tool. Compliance culture no longer accurately reflects the needs and expectations of researchers or regulators, nor does it necessarily produce the best research. Embracing uncertainty—both as a human practice and a regulatory objective—may represent the brighter future for health research.
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Smith J, Sears N, Taylor B, Johnson M. Serious games for serious crises: reflections from an infectious disease outbreak matrix game. Global Health 2020; 16:18. [PMID: 32151263 PMCID: PMC7063729 DOI: 10.1186/s12992-020-00547-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/12/2020] [Indexed: 12/03/2022] Open
Abstract
Background While there is widespread recognition of global health failures when it comes to infectious disease outbreaks, there is little discussion on how policy-makers and global health organizations can learn to better prepare and respond. Serious games provide an underutilized tool to promote learning and innovation around global health crises. In order to explore the potential of Serious Games as a policy learning tool, Global Affairs Canada, in collaboration with the Department of National Defense and academic partners, developed and implemented a matrix game aimed at prompting critical reflection and gender-based analysis on infectious disease outbreak preparedness and response. This commentary, written by the core development team, reflects on the process and outcomes of the gaming exercise, which we believe will be of interest to others hoping to promote innovative thinking and learning around global health policy and crisis response, as well as the application of serious games more broadly. Main body Participants reported, through discussions and a post-game survey, that they felt the game was reflective of real-world decision-making and priority-setting challenges during a crisis. They reflected on the challenges that emerge around global health co-operation and outbreak preparedness, particularly noting the importance of learning to work with private actors. While participants only sporadically applied gender-based analysis or considered the social determinants of health during the game, post-game discussions led to reflection on the ways in which equity concerns are put aside during a crisis scenario and on why this happens, offering critical learning opportunities. Conclusion Matrix games provide opportunities for policy-makers and health professionals to experience the challenges of global health co-operation, test ideas and explore how biases, such as those around gender, influence policy-making and implementation. Due to their flexibility, adaptability and accessibility, serious games offer a potentially powerful learning tool for global health policy-makers and practitioners.
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Affiliation(s)
- Julia Smith
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11802, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Nathan Sears
- Political Science, University of Toronto, Toronto, Canada
| | - Ben Taylor
- Department of National Defense, Government of Canada, Ottawa, Canada
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Munung NS, Nembaware V, de Vries J, Bukini D, Tluway F, Treadwell M, Sangeda RZ, Mazandu G, Jonas M, Paintsil V, Nnodu OE, Balandya E, Makani J, Wonkam A. Establishing a Multi-Country Sickle Cell Disease Registry in Africa: Ethical Considerations. Front Genet 2019; 10:943. [PMID: 31649726 PMCID: PMC6795756 DOI: 10.3389/fgene.2019.00943] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/05/2019] [Indexed: 12/03/2022] Open
Abstract
Sickle cell disease (SCD) is one of the most prevalent genetic conditions in sub-Saharan Africa. It is a chronic, lifelong disease often characterized by severe pain. However, SCD has received little investment terms of health research, though there is currently a growing pool of SCD data from health and research facilities in different countries. To facilitate research on SCD in Africa, the SickleInAfrica consortium has established a SickleInAfrica registry. The registry will store a systematic collection of longitudinal data from persons with SCD across sub-Saharan Africa, and currently, participants are being enrolled in Ghana, Nigeria, and Tanzania. In establishing this registry, the SickleInAfrica consortium decided to actively identify and anticipate possible ethical issues that may arise in the development and management of the registry. This was motivated, in part, by the near absence of well documented ethical issues for registry research in Africa, more-so for registries enrolling participants across multiple countries and for a genetic condition. The consortium aims to establish standards for the equitable use of data stored in the registry. This paper presents a comprehensive report on the ethical considerations that came up in setting up a genetic disease registry across multiple African countries and how they were addressed by the SickleInAfrica consortium. Major issues included: active involvement of patients in the initiation and management of the registry; questions of assent and re-consent; the importance of ensuring that fears of exploitation are not replicated in African–African research collaborations; and the importance of public engagement in the management of registries. Drawing on this experience, SickleInAfrica plans to set up an ethics helpdesk for genetic disease registries and research in Africa.
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Affiliation(s)
- Nchangwi Syntia Munung
- Department of Medicine, University of Cape Town, Cape Town, South Africa.,SickleInAfrica Data Coordinating Centre (SADaCC), University of Cape Town, Cape Town, South Africa
| | - Victoria Nembaware
- SickleInAfrica Data Coordinating Centre (SADaCC), University of Cape Town, Cape Town, South Africa.,Division of Human Genetics, University of Cape Town, Cape Town, South Africa
| | - Jantina de Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Daima Bukini
- Sickle Cell Programme, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Furahini Tluway
- Sickle Cell Programme, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Marsha Treadwell
- Department of Hematology/Oncology, UCSF Benioff Children's Hospital Oakland, California, United States.,Department of Pediatrics, UCSF School of Medicine, California, United States
| | - Raphael Zozimus Sangeda
- Sickle Cell Programme, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.,Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gaston Mazandu
- SickleInAfrica Data Coordinating Centre (SADaCC), University of Cape Town, Cape Town, South Africa.,Division of Human Genetics, University of Cape Town, Cape Town, South Africa
| | - Mario Jonas
- SickleInAfrica Data Coordinating Centre (SADaCC), University of Cape Town, Cape Town, South Africa.,Division of Human Genetics, University of Cape Town, Cape Town, South Africa
| | - Vivian Paintsil
- Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Obiageli E Nnodu
- Center for Sickle Cell Disease Research and Training, University of Abuja, Abuja, Nigeria
| | - Emmanuel Balandya
- Sickle Cell Programme, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Julie Makani
- Sickle Cell Programme, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Ambroise Wonkam
- SickleInAfrica Data Coordinating Centre (SADaCC), University of Cape Town, Cape Town, South Africa.,Division of Human Genetics, University of Cape Town, Cape Town, South Africa
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Drevin G, Mölsted Alvesson H, van Duinen A, Bolkan HA, Koroma AP, Von Schreeb J. "For this one, let me take the risk": why surgical staff continued to perform caesarean sections during the 2014-2016 Ebola epidemic in Sierra Leone. BMJ Glob Health 2019; 4:e001361. [PMID: 31406584 PMCID: PMC6666802 DOI: 10.1136/bmjgh-2018-001361] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/28/2019] [Accepted: 06/01/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction Routine health service provision decreased during the 2014–2016 Ebola virus disease (EVD) outbreak in Sierra Leone, while caesarean section (CS) rates at public hospitals did not. It is unknown what made staff provide CS despite the risks of contracting EVD. This study explores Sierra Leonean health worker perspectives of why they continued to provide CS. Methods This qualitative study documents the experiences of 15 CS providers who worked during the EVD outbreak. We interviewed surgical and non-surgical CS providers who worked at public hospitals that either increased or decreased CS volumes during the outbreak. Hospitals in all four administrative areas of Sierra Leone were included. Semistructured interviews averaged 97 min and healthcare experience 21 years. Transcripts were analysed by modified framework analysis in the NVivo V.11.4.1 software. Results We identified two themes that may explain why providers performed CS despite EVD risks: (1) clinical adaptability and (2) overcoming the moral dilemmas. CS providers reported being overworked and exposed to infection hazards. However, they developed clinical workarounds to the lack of surgical materials, protective equipment and standard operating procedures until the broader international response introduced formal personal protective equipment and infection prevention and control practices. CS providers reported that dutifulness and sense of responsibility for one’s community increased during EVD, which helped them justify taking the risk of being infected. Although most surgical activities were reduced to minimise staff exposure to EVD, staff at public hospitals tended to prioritise performing CS surgery for women with acute obstetric complications. Conclusion This study found that CS surgery during EVD in Sierra Leone may be explained by remarkable decisions by individual CS providers at public hospitals. They adapted practically to material limitations exacerbated by the outbreak and overcame the moral dilemmas of performing CS despite the risk of being infected with EVD.
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Affiliation(s)
- Gustaf Drevin
- Centre for Research on Health Care in Disasters, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Alex van Duinen
- Faculty of Medicine and Health Sciences, Department of Cancer Research and Molecular Medicine, NTNU Fakultet for ingeniorvitenskap og teknologi Trondheim, Trondheim, Norway.,Department of Surgery, Sankt Olavs Hospital Universitetssykehuset i Trondheim, Trondheim, Norway
| | - Håkon A Bolkan
- Faculty of Medicine and Health Sciences, Department of Cancer Research and Molecular Medicine, NTNU Fakultet for ingeniorvitenskap og teknologi Trondheim, Trondheim, Norway.,Department of Surgery, Sankt Olavs Hospital Universitetssykehuset i Trondheim, Trondheim, Norway
| | - Alimamy P Koroma
- Department of Obstetrics and Gynecology, Princess Christiana Maternity Hospital, Freetown, Sierra Leone
| | - Johan Von Schreeb
- Centre for Research on Health Care in Disasters, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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