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Fischer J, Barbois S, Quesada JL, Boddaert G, Haen P, Bertani A, Duhamel P, Delmas JM, Lechevallier E, Piolat C, Rongieras F, Tresallet C, Balandraud P, Arvieux C. Early Evaluation of a New French Surgery Course in the Best Practice of Dealing With Major Incidents and Mass Casualty Events. JOURNAL OF SURGICAL EDUCATION 2023; 80:1253-1267. [PMID: 37429782 DOI: 10.1016/j.jsurg.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/11/2023] [Accepted: 06/11/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE The main objective of this study is to evaluate the impact of a nationwide 5-month course aimed to prepare surgeons for Major Incidents through the acquisition of key knowledge and competencies. Learners' satisfaction was also measured as a secondary objective. DESIGN This course was evaluated thanks to various teaching efficacy metrics, mainly based on Kirkpatrick's hierarchy in medical education. Gain in knowledge of participants was evaluated by multiple-choice tests. Self-reported confidence was measured with 2 detailed pre and post training questionnaires. SETTING Creation in 2020 of a nationwide, optional and comprehensive Surgical Training in War and Disaster Situation as part of the French surgery residency program. In 2021, data was gathered regarding the impact of the course on participants' knowledge and competencies. PARTICIPANTS The study included 26 students in the 2021 cohort (13 residents and 13 practitioners). RESULTS Mean scores were significantly higher in the post-test compared to the pre-test, showing significant increase in participants' knowledge during the course: 73,3% vs. 47,3% respectively (p ≤ 0.001). Average learners' confidence scores to perform technical procedures showed at least a +1-point increase on the Likert scale for 65% of items tested (p ≤ 0.001). 89% of items showed at least a +1-point increase on the Likert scale when it came to average learners' confidence score on dealing with complicated situations (p ≤ 0.001). Our post-training satisfaction survey showed that 92% of all participants have noticed the impact of the course on their daily practice. CONCLUSION Our study shows that the third level of Kirkpatrick's hierarchy in medical education was reached. This course therefore appears to be meeting the objectives set by the Ministry of Health. Being only 2 years old, it is on the road to gathering momentum and further development.
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Affiliation(s)
- Juliette Fischer
- Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, Grenoble, France.
| | - Sandrine Barbois
- Inria, CNRS, Grenoble INP, LJK, University Grenoble Alpes, Grenoble, France; Department Of Digestive and Acute Care Surgery, Edouard Herriot Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 university, Lyon, France
| | - Jean-Louis Quesada
- Clinical Pharmacology Unit, INSERM CIC1406, Grenoble Alpes University Hospital, Grenoble, France
| | - Guillaume Boddaert
- Department of Thoracic and Vascular Surgery, Percy Military Academic Hospital, Clamart Cedex, France
| | - Pierre Haen
- Department of Maxillofacial Surgery, Laveran Military and Academic Hospital, Marseille, France
| | - Antoine Bertani
- Department of Orthopaedics and Trauma, Edouard Herriot Hospital, Lyon, France
| | - Patrick Duhamel
- Department of Plastic surgery, Percy Military Academic Hospital, Clamart, France
| | - Jean-Marc Delmas
- Department of Neurosurgery, Percy Military Academic Hospital, Clamart, France
| | - Eric Lechevallier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, AP-HM, Conception Academic Hospital, Marseille, France
| | - Christian Piolat
- Department of Paediatric surgery, Grenoble Alpes University Hospital, Grenoble , France
| | - Frédéric Rongieras
- Department of Orthopaedics and Trauma, Edouard Herriot Hospital, Lyon, France
| | - Christophe Tresallet
- Department of Digestive, Bariatric and Endocrine Surgery, APHP, Avicenne Academic Hospital, Sorbonne Paris Nord University, Bobigny France
| | - Paul Balandraud
- Department of General Surgery, Sainte-Anne Military Academic Hospital, Toulon, France
| | - Catherine Arvieux
- Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, Grenoble, France
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Akay A. The local and global mental health effects of the Covid-19 pandemic. ECONOMICS AND HUMAN BIOLOGY 2022; 45:101095. [PMID: 35092869 PMCID: PMC8750697 DOI: 10.1016/j.ehb.2021.101095] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 10/29/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
This paper investigates the mental health effects of the local and global level Covid-19 pandemic among the UK population. To identify the effect, we use a high-quality dataset and an original strategy where we match the previous day's confirmed pandemic cases to a four-month panel of individual mental health information observed during the interview next day. The approach suggested in this paper aims to identify the average mental health effect on the overall population for the first and second waves of the pandemic. Using a linear fixed-effects model specification, we report robust findings that the average mental health in the UK is substantially reduced by the local and global pandemic. The total reduction in the average mental health of the UK population during our sampling period (April - June, 2020) is about 1.5% for the local and 2.4% for the global cases, which sum up to a 3.9% reduction. Extrapolating the total reduction in average mental health during the first wave of the pandemic (February - September, 2020) sums up to 2.8% while the effect is as large as 9.6% for the first and second waves together, which covers roughly a year since the start. An extensive robustness check suggests that the findings are stable with respect to alternative pandemic datasets, measures, estimators, functional forms, and time functions. The characteristics of the most vulnerable individuals (e.g., elderly, chronic illness, and job security concerns) and their household conditions (e.g., living alone and no private space) are explored. The paper discusses on the implications of the results.
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Affiliation(s)
- Alpaslan Akay
- University of Gothenburg, Sweden; Universidad Antonio de Nebrija, Spain.
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Kirschenbaum A. Reducing patient surge: community based social networks as first responders. NATURAL HAZARDS (DORDRECHT, NETHERLANDS) 2021; 108:163-175. [PMID: 33776208 PMCID: PMC7985742 DOI: 10.1007/s11069-021-04674-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
A major challenge for health services worldwide is in providing adequate medical care during mass disasters. The ongoing COVID-19 pandemic highlights this difficulty. Patient surge, a consequence of most types of disasters that contribute to trauma experiences, is a primary factor in disrupting such care as it is composed of worried well persons and those experiencing psychosocial trauma that can severely disrupt and overwhelm effective acute hospital based health care. We review the literature and propose a potential solution framework to reduce such a surge that relies on exploiting community social networks as first responders. We utilize and integrate literature based evidence on patient surge, community disaster behaviors and community based informal social networks to examine reasons for patient surge to hospitals. We then propose that leveraging community based social networks as a potent deterrent for non-critically injured, especially those who have experienced psychosocial trauma or the worried well, from seeking hospital care during ongoing disasters. By emphasizing the social capital inherent in community based social networks, this perspective posits an alternative cost-effective means of reducing patient surge.
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Zitting KM, Lammers-van der Holst HM, Yuan RK, Wang W, Quan SF, Duffy JF. Google Trends reveals increases in internet searches for insomnia during the 2019 coronavirus disease (COVID-19) global pandemic. J Clin Sleep Med 2021; 17:177-184. [PMID: 32975191 DOI: 10.5664/jcsm.8810] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
STUDY OBJECTIVES The 2019 coronavirus disease (COVID-19) has become a global health and economic crisis. Recent evidence from small samples suggest that it has increased mood and sleep disturbances, including insomnia, around the world. This study aimed to estimate the effect of COVID-19 on insomnia levels worldwide and in the United States during the acute phase of the pandemic. METHODS We analyzed search query data recorded between January 2004 and May 2020 from Google Trends and Google Keyword Planner for the search term "insomnia". RESULTS The number of search queries for insomnia has increased over the past decade and is greater than the number of search queries for other major sleep disorders. The COVID-19 pandemic increased search queries for insomnia both worldwide and in the United States, with the number in the United States increasing by 58% during the first 5 months of 2020 compared with the same months from the previous 3 years. There is a robust diurnal pattern in insomnia search queries in the United States, with the number of queries peaking around 3 am and the overall pattern remaining stable during the pandemic. CONCLUSIONS These results highlight the impact the COVID-19 pandemic has had on sleep health and the urgent need for making effective interventions accessible. Future studies will be needed to determine whether the increase in insomnia symptoms will persist and lead to higher rates of chronic insomnia in the population.
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Affiliation(s)
- Kirsi-Marja Zitting
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Heidi M Lammers-van der Holst
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Robin K Yuan
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Wei Wang
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Stuart F Quan
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jeanne F Duffy
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
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Mental health consequences for survivors of the 2011 Fukushima nuclear disaster: a systematic review. Part 1: psychological consequences. CNS Spectr 2021; 26:14-29. [PMID: 32192553 DOI: 10.1017/s1092852920000164] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To integrate scholastic literature regarding the prevalence and characteristics of the psychological consequences faced by survivors of the 2011 Fukushima earthquake/tsunami/nuclear disaster, we conducted a systematic review of survivor studies concerning the Fukushima disaster. In August 2019, four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI) were used in the literature search. Peer-reviewed manuscripts reporting psychological consequences, either in English or Japanese, were selected. A total of 79 studies were selected for the review. Twenty-four studies (30.4%) were conducted as part of the Fukushima Health Management Survey-large-scale cohort study recruiting the residents of the entire Fukushima prefecture. Study outcomes were primarily nonspecific psychological distress, depressive symptoms, post-traumatic stress symptoms, and anxiety symptoms. The rates of high-risk individuals determined by the studies varied significantly owing to methodological differences. Nevertheless, these rates were mostly high (nonspecific psychological distress, 8.3%-65.1%; depressive symptoms, 12%-52.0%; and post-traumatic stress symptoms, 10.5%-62.6%). Many studies focused on vulnerable populations such as children, mothers of young children, evacuees, and nuclear power plant workers. However, few studies reported on the intervention methods used or their effect on the survivors. As a conclusion, high rates of individuals with psychological conditions, as well as a wide range of mental conditions, were reported among the Fukushima nuclear disaster survivors in the first 8 years after the disaster. These findings demonstrate the substantial impact of this compound disaster, especially in the context of a nuclear catastrophe.
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A. Crane M, Levy-Carrick NC, Crowley L, Barnhart S, Dudas M, Onuoha U, Globina Y, Haile W, Shukla G, Ozbay F. The Response to September 11: A Disaster Case Study. Ann Glob Health 2014; 80:320-31. [DOI: 10.1016/j.aogh.2014.08.215] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Ni J, Reinhardt JD, Zhang X, Xiao M, Li L, Jin H, Zeng X, Li J. Dysfunction and post-traumatic stress disorder in fracture victims 50 months after the Sichuan earthquake. PLoS One 2013; 8:e77535. [PMID: 24204861 PMCID: PMC3812228 DOI: 10.1371/journal.pone.0077535] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 09/03/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the effectiveness of a rehabilitation intervention on physical dysfunction (PDF) and post-traumatic stress disorder (PTSD) in fracture victims 50 months after the Sichuan earthquake of 2008 and to identify risk factors for PTSD. METHODS This is a retrospective cohort study. Four hundred and fifty-nine earthquake-related fracture victims from Mianzhu city, Sichuan Province who did not qualify for disability pension participated. Two hundred and forty-five subjects received regular rehabilitation and 214 did not. Muscle strength, joint range of motion (ROM),sensory function, and sit-to-stand balance capacity were evaluated to assess PDF. The PTSD Checklist-Civilian Version (PCL-C) was administered to screen for PTSD. An ordinary least square regression was used to predict PTSD, and a logistic regression was used to predict PDF. In addition a Least Angle Regression (LARS) was carried out for PTSD to study the effects of rehabilitation and PDF at the same time. RESULTS Unadjusted and adjusted group differences in physical dysfunction (p<0.01) and PTSD prevalence (p<0.05) were significant in favor of the rehabilitation group. In addition, being female, average or above family income, having witnessed death and fearfulness were found risk factors for PTSD symptoms 50 months after the earthquake. Both PDF and rehabilitation were selected predictors by LARS demonstrating opposite effects. CONCLUSION PDF and PTSD were significantly reduced by the rehabilitation intervention. Future medical intervention strategies should consider rehabilitation in order to assist survivors in dealing with both physical and psychological effects of natural disaster.
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Affiliation(s)
- Jun Ni
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Rehabilitation Medicine, The Affiliated Hospital of Nantong University, Nantong, China
- Caring For Children Foundation, Hong Kong, China
| | - Jan D. Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu and Hong Kong Polytechnical University, China
- Committee for Rehabilitation Disaster Relief, International Society for Physical and Rehabilitation Medicine, Geneva, Switzerland
- Department of Human Functioning Science, Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Xia Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Caring For Children Foundation, Hong Kong, China
- Committee for Rehabilitation Disaster Relief, International Society for Physical and Rehabilitation Medicine, Geneva, Switzerland
| | - Mingyue Xiao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Caring For Children Foundation, Hong Kong, China
| | - Ling Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Caring For Children Foundation, Hong Kong, China
| | - Hong Jin
- Mianzhu County People’s Hospital, Sichuan, China
| | - Xianmin Zeng
- Shifang County People’s Hospital, Sichuan, China
| | - Jianan Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Committee for Rehabilitation Disaster Relief, International Society for Physical and Rehabilitation Medicine, Geneva, Switzerland
- * E-mail:
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North CS. Rethinking disaster mental health response in a post-9/11 world. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2013; 58:125-7. [PMID: 23461882 DOI: 10.1177/070674371305800301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Carol S North
- Director, Program in Trauma and Disaster, Veterans Affairs North Texas Health Care System, Dallas, Texas; The Nancy and Ray L Hunt Chair in Crisis Psychiatry and Professor of Psychiatry and Surgery/Division of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
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