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Lemon C, Rizer N, Bradshaw J. Climate Change. Emerg Med Clin North Am 2024; 42:679-693. [PMID: 38925782 DOI: 10.1016/j.emc.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
As human-induced climate change warms the planet, its health impacts will affect all populations, but certain groups will be more vulnerable to its impacts. Given its role as a health care safety net, emergency medicine will play a crucial role in addressing these health conditions. Additionally, with its expertise in disaster medicine, interdisciplinary collaboration, and health care systems knowledge, emergency medicine has the potential to lead the health care sector's response to climate change.
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Affiliation(s)
- Christopher Lemon
- Department of Emergency Medicine, Johns Hopkins School of Medicine, The Johns Hopkins University School of Medicine, Davis Building, Suite 3220, Smith Avenue, Baltimore, MD 21209, USA.
| | - Nicholas Rizer
- Department of Emergency Medicine, Johns Hopkins Medicine, The Johns Hopkins University School of Medicine, Davis Building, Suite 3220, Smith Avenue, Baltimore, MD 21209, USA
| | - Jace Bradshaw
- Department of Emergency Medicine, Johns Hopkins Medicine, The Johns Hopkins University School of Medicine, Davis Building, Suite 3220, Smith Avenue, Baltimore, MD 21209, USA; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine
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Wettstein ZS, Hall J, Buck C, Mitchell SH, Hess JJ. Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington. J Am Coll Emerg Physicians Open 2024; 5:e13098. [PMID: 38250197 PMCID: PMC10799240 DOI: 10.1002/emp2.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024] Open
Abstract
Objectives Extreme heat events (EHEs) are associated with excess healthcare utilization but specific impacts on emergency department (ED) operations and throughput are unknown. In 2021, the Pacific Northwest experienced an unprecedented heat dome that resulted in substantial regional morbidity and mortality. The aim of this study was to examine its impact on ED utilization, unplanned hospitalization, and hospital operations in a large academic healthcare system. Methods Retrospective electronic medical records from three Seattle-area hospitals were used to compare healthcare utilization during the EHE compared to a pre-event reference period within the same month. Interrupted time series analysis was used to evaluate the association between EHE exposure and ED visits and hospitalizations. Metrics of ED crowding for the EHE were compared to the reference period using Student's t-tests and chi-squared tests. Additionally, multivariable Poisson regression was used to identify risk factors for heat-related illness and hospital admission. Results Interrupted time series analysis showed an increase of 21.7 ED visits per day (95% confidence interval [CI] = 14.7, 28.6) and 9.9 unplanned hospitalizations per day (95% CI = 8.3, 11.5) during the EHE, as compared to the reference period. ED crowding and process measures also displayed significant increases, becoming the most pronounced by day 3 of the EHE; the EHE was associated with delays in ED length of stay of 1.0 h (95% CI = 0.4, 1.6) compared to the reference period. Higher incidence rate ratios for heat-related illness were observed for patients who were older (incidence rate ratio [IRR] = 1.02; 95% CI = 1.01,1.03), female (IRR = 1.47; 95% CI = 1.06, 2.04), or who had pre-existing diabetes (IRR = 3.19; 95% CI = 1.47, 6.94). Conclusions The 2021 heat dome was associated with a significant increase in healthcare utilization including ED visits and unplanned hospitalizations. Substantial impacts on ED and hospital throughput were also noted. These findings contribute to the understanding of the role extreme heat events play on impacting patient outcomes and healthcare system function.
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Affiliation(s)
- Zachary S. Wettstein
- Department of Emergency MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
- Center for Health and the Global EnvironmentUniversity of Washington School of Public HealthSeattleWashingtonUSA
| | - Jane Hall
- Department of Emergency MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - Cameron Buck
- Department of Emergency MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - Steven H. Mitchell
- Department of Emergency MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
- Washington Medical Coordination CenterSeattleWashingtonUSA
| | - Jeremy J. Hess
- Department of Emergency MedicineUniversity of Washington School of MedicineSeattleWashingtonUSA
- Center for Health and the Global EnvironmentUniversity of Washington School of Public HealthSeattleWashingtonUSA
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Jalali R, Romaszko J, Dragańska E, Gromadziński L, Cymes I, Sokołowski JB, Poterała M, Markuszewski L, Romaszko-Wojtowicz AM, Jeznach-Steinhagen A, Glińska-Lewczuk K. Heat and cold stress increases the risk of paroxysmal supraventricular tachycardia. PLoS One 2024; 19:e0296412. [PMID: 38165960 PMCID: PMC10760728 DOI: 10.1371/journal.pone.0296412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/12/2023] [Indexed: 01/04/2024] Open
Abstract
Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia in adults. Its occurrence depends on the presence of the reentry circuit and the trigger of the paroxysm. Stress, emotional factors, and comorbidities favour the occurrence of such an episode. We hypothesized that the occurrence of PSVT follows extreme thermal episodes. The retrospective analysis was based on the data collected from three hospital emergency departments in Poland (Olsztyn, Radom, and Wroclaw) involving 816 admissions for PSVT in the period of 2016-2021. To test the hypothesis, we applied the Universal Climate Thermal Index (UTCI) to objectively determine exposure to cold or heat stress. The risk (RR) for PSVT increased to 1.37 (p = 0.006) in cold stress and 1.24 (p = 0.05) in heat stress when compared to thermoneutral conditions. The likelihood of PSVT during cold/heat stress is higher in women (RR = 1.59, p< 0.001 and RR = 1.36, p = 0.024, respectively) than in men (RR = 0.64 at p = 0.088 and RR = 0.78, p = 0.083, respectively). The susceptibility for PSVT was even higher in all groups of women after exclusion of perimenopausal group of women, in thermal stress (RR = 1.74, p< 0.001, RR = 1.56, p = 0.029, respectively). Females, particularly at the perimenopausal stage and men irrespective of age were less likely to develop PSVT under thermal stress as compared to thermoneutral conditions. Progress in climate change requires searching for universal methods and tools to monitor relationships between humans and climate. Our paper confirms that the UTCI is the universal tool describing the impact of thermal stress on the human body and its high usefulness in medical researches.
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Affiliation(s)
- Rakesh Jalali
- Department of Emergency Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, School of Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Ewa Dragańska
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Iwona Cymes
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | | | - Magdalena Poterała
- Department of Medicine, Faculty of Medical Sciences and Health Science, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland
| | - Leszek Markuszewski
- Department of Medicine, Faculty of Medical Sciences and Health Science, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland
| | - Anna Maria Romaszko-Wojtowicz
- Department of Pulmonology, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | | | - Katarzyna Glińska-Lewczuk
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
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Shrikhande S, Merten S, Cambaco O, Lee TT, Lakshmanasamy R, Röösli M, Dalvie MA, Utzinger J, Cissé G. Barriers to climate change and health research in India: a qualitative study. BMJ Open 2023; 13:e073381. [PMID: 37821134 PMCID: PMC10582851 DOI: 10.1136/bmjopen-2023-073381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES Almost a quarter of the global burden of disease and mortalities is attributable to environmental causes, the magnitude of which is projected to increase in the near future. However, in many low- and middle-income settings, there remains a large gap in the synthesis of evidence on climate-sensitive health outcomes. In India, now the world's most populous country, little remains known about the impacts of climate change on various health outcomes. The objective of this study is to better understand the challenges faced in conducting climate change and health research in Puducherry, India. DESIGN AND SETTING In this study, we employed key informant interviews to deepen the understanding of the perceived research barriers in Puducherry. The findings were analysed using data-driven qualitative thematic analysis to elaborate the major perceived barriers to conducting environmental health research. PARTICIPANTS This study was conducted among 16 public health professionals, including medical researchers, and professionals involved in environmental policies and planning in Puducherry. RESULTS We identify three key barriers faced by public health professionals as key stakeholders, namely: (1) political and institutional barriers; (2) education and awareness barriers; and (3) technical research barriers. We show there is a need, from the professionals' perspective, to improve community and political awareness on climate change and health; strengthen technical research capacity and collaboration among researchers; and strengthen health surveillance, resource allocation and access to health data for research. CONCLUSION Evidence informed policies and interventions are a key element in the adaptation response for countries. In the context of the paucity of data on environmental health from India, despite recognised climate change related health vulnerabilities, these findings could contribute to the development and improvement of relevant interventions conducive to a strong research environment.
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Affiliation(s)
- Shreya Shrikhande
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Olga Cambaco
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Manhiça Health Research Centre, Maputo, Mozambique
| | - Tristan T Lee
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ravivarman Lakshmanasamy
- Department of Health and Family Welfare Services, Goverment of Puducherry, Puducherry, India
- Non-communicable Diseases Team, World Health Organization Country Office for India, New Delhi, India
| | - Martin Röösli
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Mohammad Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Jürg Utzinger
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Guéladio Cissé
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Hess JJ, Sheehan TJ, Miller A, Cunningham R, Errett NA, Isaksen TB, Vogel J, Ebi KL. A novel climate and health decision support platform: Approach, outputs, and policy considerations. ENVIRONMENTAL RESEARCH 2023; 234:116530. [PMID: 37394172 DOI: 10.1016/j.envres.2023.116530] [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: 03/30/2023] [Revised: 06/14/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND The adverse health impacts of climate change are increasingly apparent and the need for adaptation activities is pressing. Risks, drivers, and decision contexts vary significantly by location, and high-resolution, place-based information is needed to support decision analysis and risk reduction efforts at scale. METHODS Using the Intergovernmental Panel on Climate Change (IPCC) risk framework, we developed a causal pathway linking heat with a composite outcome of heat-related morbidity and mortality. We used an existing systematic literature review to identify variables for inclusion and the authors' expert judgment to determine variable combinations in a hierarchical model. We parameterized the model for Washington state using observational (1991-2020 and June 2021 extreme heat event) and scenario-driven temperature projections (2036-2065), compared outputs against relevant existing indices, and analyzed sensitivity to model structure and variable parameterization. We used descriptive statistics, maps, visualizations and correlation analyses to present results. RESULTS The Climate and Health Risk Tool (CHaRT) heat risk model contains 25 primary hazard, exposure, and vulnerability variables and multiple levels of variable combinations. The model estimates population-weighted and unweighted heat health risk for selected periods and displays estimates on an online visualization platform. Population-weighted risk is historically moderate and primarily limited by hazard, increasing significantly during extreme heat events. Unweighted risk is helpful in identifying lower population areas that have high vulnerability and hazard. Model vulnerability correlate well with existing vulnerability and environmental justice indices. DISCUSSION The tool provides location-specific insights into risk drivers and prioritization of risk reduction interventions including population-specific behavioral interventions and built environment modifications. Insights from causal pathways linking climate-sensitive hazards and adverse health impacts can be used to generate hazard-specific models to support adaptation planning.
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Affiliation(s)
- Jeremy J Hess
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Emergency Medicine, School of Medicine, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA; Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, USA.
| | - Timothy J Sheehan
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA
| | - Alyssa Miller
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA
| | | | - Nicole A Errett
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA
| | - Tania Busch Isaksen
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA
| | - Jason Vogel
- Climate Impacts Group, College of the Environment, University of Washington, Seattle, WA, USA
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA; Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, USA
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Kiarsi M, Amiresmaili M, Mahmoodi MR, Farahmandnia H, Nakhaee N, Zareiyan A, Aghababaeian H. Heat waves and adaptation: A global systematic review. J Therm Biol 2023; 116:103588. [PMID: 37499408 DOI: 10.1016/j.jtherbio.2023.103588] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/14/2023] [Accepted: 04/23/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Given the increasing trend of global warming and extreme weather conditions, including heat waves and its effects on health, the present study was done to investigate adaptive behaviors of communities in the world for combating heat waves. METHOD ology: In this systematic review, out of 1529 results, 57 relevant and authoritative English papers on adaptation to heat waves hazard were extracted and evaluated using valid keywords from valid databases (PubMed, WOS, EMBASE, and Scopus). In addition, multiple screening steps were done and then, the selected papers were qualitatively assessed. Evaluation results were summarized using an Extraction Table. RESULTS In this paper, the adaptive behaviors for combating heat waves hazard were summarized into 11 categories: Education and awareness raising, Adaptation of critical infrastructure, Governments measures, Health-related measures, Application of early warning system, Protective behaviors in workplace, Physical condition, Adaptive individual behaviors, Design and architecture of the building, Green infrastructure (green cover), and Urban design. CONCLUSION The findings of this study showed that community actions have significant effects on adaptation to heat wave. Therefore, for reducing heat wave-related negative health effects and vulnerability, more attention should be paid to the above-mentioned actions for mitigation, preparation, and responding regarding heat waves. PROSPERO REGISTRATION NUMBER CRD42021257747.
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Affiliation(s)
- Maryam Kiarsi
- Department of Medical Emergencies, Dezful University of Medical Sciences, Dezful, Iran; Center for Climate Change and Health Research (CCCHR), Dezful University of Medical Sciences, Dezful, Iran.
| | - Mohammadreza Amiresmaili
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Department of Health in Emergencies and Disasters, School of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran.
| | - Mohammad Reza Mahmoodi
- Department of Health in Emergencies and Disasters, School of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran; Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Department of Nutrition, Faculty of Public Health, Kerman, Iran.
| | - Hojjat Farahmandnia
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Department of Health in Emergencies and Disasters, School of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran.
| | - Nouzar Nakhaee
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Health Services Management Research Center, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Armin Zareiyan
- Public Health Department, Health in Emergencies and Disasters Department, Nursing Faculty, AJA University of Medical Sciences, Tehran, Iran.
| | - Hamidreza Aghababaeian
- Department of Medical Emergencies, Dezful University of Medical Sciences, Dezful, Iran; Center for Climate Change and Health Research (CCCHR), Dezful University of Medical Sciences, Dezful, Iran.
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Ignatowicz A, Tarrant C, Mannion R, El-Sawy D, Conroy S, Lasserson D. Organizational resilience in healthcare: a review and descriptive narrative synthesis of approaches to resilience measurement and assessment in empirical studies. BMC Health Serv Res 2023; 23:376. [PMID: 37076882 PMCID: PMC10113996 DOI: 10.1186/s12913-023-09242-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/03/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND The coronavirus pandemic has had a profound impact on organization and delivery of care. The challenges faced by healthcare organizations in dealing with the pandemic have intensified interest in the concept of resilience. While effort has gone into conceptualising resilience, there has been relatively little work on how to evaluate organizational resilience. This paper reports on an extensive review of approaches to resilience measurement and assessment in empirical healthcare studies, and examines their usefulness for researchers, policymakers and healthcare managers. METHODS Various databases (MEDLINE, EMBASE, PsycINFO, CINAHL (EBSCO host), Cochrane CENTRAL (Wiley), CDSR, Science Citation Index, and Social Science Citation Index) were searched from January 2000 to September 2021. We included quantitative, qualitative and modelling studies that focused on measuring or qualitatively assessing organizational resilience in a healthcare context. All studies were screened based on titles, abstracts and full text. For each approach, information on the format of measurement or assessment, method of data collection and analysis, and other relevant information were extracted. We classified the approaches to organizational resilience into five thematic areas of contrast: (1) type of shock; (2) stage of resilience; (3) included characteristics or indicators; (4) nature of output; and (5) purpose. The approaches were summarised narratively within these thematic areas. RESULTS Thirty-five studies met the inclusion criteria. We identified a lack of consensus on how to evaluate organizational resilience in healthcare, what should be measured or assessed and when, and using what resilience characteristic and indicators. The measurement and assessment approaches varied in scope, format, content and purpose. Approaches varied in terms of whether they were prospective (resilience pre-shock) or retrospective (during or post-shock), and the extent to which they addressed a pre-defined and shock-specific set of characteristics and indicators. CONCLUSION A range of approaches with differing characteristics and indicators has been developed to evaluate organizational resilience in healthcare, and may be of value to researchers, policymakers and healthcare managers. The choice of an approach to use in practice should be determined by the type of shock, the purpose of the evaluation, the intended use of results, and the availability of data and resources.
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Affiliation(s)
- Agnieszka Ignatowicz
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
| | - Carolyn Tarrant
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Russell Mannion
- Russell Mannion, Health Services and Management Centre, College of Social Sciences, University of Birmingham, Birmingham, UK
| | - Dena El-Sawy
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Simon Conroy
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
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Kiarsi M, Amiresmaili M, Mahmoodi M, Farahmandnia H, Nakhaee N, Zareiyan A, Aghababaeian H. Heat wave adaptation paradigm and adaptation strategies of community: A qualitative phenomenological study in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:408. [PMID: 36824085 PMCID: PMC9942165 DOI: 10.4103/jehp.jehp_440_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/29/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Heat wave adaptation is a new concept related to experiencing heat. The present study aims at investigating a conceptual definition, that is, the mental framework of heat wave adaptation and its strategies. MATERIALS AND METHODS A phenomenological study was performed to explain the mental concept. At the same time with the data collection process, data analysis was also performed using Colaizzi method. Semi-structured interview method and purposeful sampling with maximum variety were used. Interviews were conducted with 23 different subjects in the community. The accuracy of the data was guaranteed using Lincoln & Guba scientific accuracy criteria. RESULTS The two main themes of the adaptation paradigm as well as its strategies were divided into the main categories of theoretical and operational concepts, as well as personal care measures and government measures. Under the category of individual measures, we obtained "clothing, nutrition, building, place of residence and lifestyle," and under the category of governance actions, the "managerial, research, health, organizational" subcategories were obtained. CONCLUSION According to the results of the conceptual-operational definition, heat wave adaptation is an active process and an effort to reduce the adverse effects of heat waves on individual and social life, and striking a balance that will not only result in individual awareness and actions that will lead to lifestyle changes, but also mostly requires integrated and comprehensive planning in the community. On the one hand, heat waves could not only be regarded as a threat or danger, but can also become an opportunity for the development of a community through identification and smart measures, and for adaptation, the community must take it as a risk. The community should have a plan in advance, apply the necessary rules and training, and use the new facilities and rules where necessary. This practical concept definition includes the main features of heat wave adaptation.
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Affiliation(s)
- Maryam Kiarsi
- Department of Medical Emergencies, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
- Center for Climate Change and Health Research (CCCHR), Dezful University of Medical Sciences, Dezful, Iran
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammadreza Amiresmaili
- Department of Medical Emergencies, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
- Center for Climate Change and Health Research (CCCHR), Dezful University of Medical Sciences, Dezful, Iran
| | - Mohammadreza Mahmoodi
- Department of Health in Emergencies and Disasters, School of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Department of Nutrition, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hojjat Farahmandnia
- Department of Medical Emergencies, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
- Center for Climate Change and Health Research (CCCHR), Dezful University of Medical Sciences, Dezful, Iran
| | - Nouzar Nakhaee
- Department of Medical Emergencies, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
- Health Services Management Research Center, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Iran
| | - Armin Zareiyan
- Public Health Department, Health in Emergencies and Disasters Department, Nursing Faculty, AJA University of Medical Sciences, Tehran, Iran
| | - Hamidreza Aghababaeian
- Department of Medical Emergencies, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
- Center for Climate Change and Health Research (CCCHR), Dezful University of Medical Sciences, Dezful, Iran
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Khalil M, Ravaghi H, Samhouri D, Abo J, Ali A, Sakr H, Camacho A. What is "hospital resilience"? A scoping review on conceptualization, operationalization, and evaluation. Front Public Health 2022; 10:1009400. [PMID: 36311596 PMCID: PMC9614418 DOI: 10.3389/fpubh.2022.1009400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background COVID-19 underscored the importance of building resilient health systems and hospitals. Nevertheless, evidence on hospital resilience is limited without consensus on the concept, its application, or measurement, with practical guidance needed for action at the facility-level. Aim This study establishes a baseline for understanding hospital resilience, exploring its 1) conceptualization, 2) operationalization, and 3) evaluation in the empirical literature. Methods Following Arksey and O'Malley's model, a scoping review was conducted, and a total of 38 articles were included for final extraction. Findings and discussion In this review, hospital resilience is conceptualized by its components, capacities, and outcomes. The interdependence of six components (1) space, 2) stuff, 3) staff, 4) systems, 5) strategies, and 6) services) influences hospital resilience. Resilient hospitals must absorb, adapt, transform, and learn, utilizing all these capacities, sometimes simultaneously, through prevention, preparedness, response, and recovery, within a risk-informed and all-hazard approach. These capacities are not static but rather are dynamic and should improve continuously occur over time. Strengthening hospital resilience requires both hard and soft resilience. Hard resilience encompasses the structural (or constructive) and non-structural (infrastructural) aspects, along with agility to rearrange the space while hospital's soft resilience requires resilient staff, finance, logistics, and supply chains (stuff), strategies and systems (leadership and coordination, community engagement, along with communication, information, and learning systems). This ultimately results in hospitals maintaining their function and providing quality and continuous critical, life-saving, and essential services, amidst crises, while leaving no one behind. Strengthening hospital resilience is interlinked with improving health systems and community resilience, and ultimately contributes to advancing universal health coverage, health equity, and global health security. The nuances and divergences in conceptualization impact how hospital resilience is applied and measured. Operationalization and evaluation strategies and frameworks must factor hospitals' evolving capacities and varying risks during both routine and emergency times, especially in resource-restrained and emergency-prone settings. Conclusion Strengthening hospital resilience requires consensus regarding its conceptualization to inform a roadmap for operationalization and evaluation and guide meaningful and effective action at facility and country level. Further qualitative and quantitative research is needed for the operationalization and evaluation of hospital resilience comprehensively and pragmatically, especially in fragile and resource-restrained contexts.
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Affiliation(s)
- Merette Khalil
- Department for Universal Health Coverage and Health Systems, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt,*Correspondence: Merette Khalil
| | - Hamid Ravaghi
- Department for Universal Health Coverage and Health Systems, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Dalia Samhouri
- Health Emergencies Programme, World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - John Abo
- Asian Disaster Preparedness Center, Bangkok, Thailand
| | - Ahmed Ali
- Health Emergencies Programme, World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Hala Sakr
- Department of Healthier Populations, World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Alex Camacho
- Health Emergencies Programme, World Health Organization, Regional Office for the Americas, Washington, DC, United States
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10
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Establishing the Domains of a Hospital Disaster Preparedness Evaluation Tool: A Systematic Review. Prehosp Disaster Med 2022; 37:674-686. [PMID: 36052843 PMCID: PMC9470528 DOI: 10.1017/s1049023x22001212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction: Recent disasters emphasize the need for disaster risk mitigation in the health sector. A lack of standardized tools to assess hospital disaster preparedness hinders the improvement of emergency/disaster preparedness in hospitals. There is very limited research on evaluation of hospital disaster preparedness tools. Objective: This study aimed to determine the presence and availability of hospital preparedness tools across the world, and to identify the important components of those study instruments. Method: A systematic review was performed using three databases, namely Ovid Medline, Embase, and CINAHL, as well as available grey literature sourced by Google, relevant websites, and also from the reference lists of selected articles. The studies published on hospital disaster preparedness across the world from 2011-2020, written in English language, were selected by two independent reviewers. The global distribution of studies was analyzed according to the World Health Organization’s (WHO) six geographical regions, and also according to the four categories of the United Nations Human Development Index (UNHDI). The preparedness themes were identified and categorized according to the 4S conceptual framework: space, stuff, staff, and systems. Result: From a total of 1,568 articles, 53 met inclusion criteria and were selected for data extraction and synthesis. Few published studies had used a study instrument to assess hospital disaster preparedness. The Eastern Mediterranean region recorded the highest number of such publications. The countries with a low UNHDI were found to have a smaller number of publications. Developing countries had more focus on preparedness for natural disasters and less focus on chemical, biological, radiological, and nuclear (CBRN) preparedness. Infrastructure, logistics, capacity building, and communication were the priority themes under the space, stuff, staff, and system domains of the 4S framework, respectively. The majority of studies had neglected some crucial aspects of hospital disaster preparedness, such as transport, back-up power, morgue facilities and dead body handling, vaccination, rewards/incentive, and volunteers. Conclusion: Important preparedness themes were identified under each domain of the 4S framework. The neglected aspects should be properly addressed in order to ensure adequate preparedness of hospitals. The results of this review can be used for planning a comprehensive disaster preparedness tool.
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11
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Romaszko J, Dragańska E, Jalali R, Cymes I, Glińska-Lewczuk K. Universal Climate Thermal Index as a prognostic tool in medical science in the context of climate change: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 828:154492. [PMID: 35278561 DOI: 10.1016/j.scitotenv.2022.154492] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/17/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
The assessment of the impact of meteorological factors on the epidemiology of various diseases and on human pathophysiology and physiology requires a comprehensive approach and new tools independent of currently occurring climate change. The thermal comfort index, i.e., Universal Climate Thermal Index (UTCI), is gaining more and more recognition from researchers interested in such assessments. This index facilitates the evaluation of the impact of cold stress and heat stress on the human organism and the assessment of the incidence of weather-related diseases. This work aims at identifying those areas of medical science for which the UTCI was applied for scientific research as well as its popularization among clinicians, epidemiologists, and specialists in public health management. This is a systematic review of literature found in Pubmed, Sciencedirect and Web of Science databases from which, consistent with PRISMA guidelines, original papers employing the UTCI in studies related to health, physiological parameters, and epidemiologic applications were extracted. Out of the total number of 367 papers identified in the databases, 33 original works were included in the analysis. The selected publications were analyzed in terms of determining the areas of medical science in which the UTCI was applied. The majority of studies were devoted to the broadly understood mortality, cardiac events, and emergency medicine. A significant disproportion between publications discussing heat stress and those utilizing the UTCI for its assessment was revealed.
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Affiliation(s)
- Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, School of Medicine, University of Warmia and Mazury in Olsztyn, Poland.
| | - Ewa Dragańska
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Poland
| | - Rakesh Jalali
- School of Medicine, Department of Emergency Medicine, University of Warmia and Mazury in Olsztyn, Poland
| | - Iwona Cymes
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Poland
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12
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Romaszko J, Dragańska E, Cymes I, Drozdowski M, Gromadziński L, Glińska-Lewczuk K. Are the levels of uric acid associated with biometeorological conditions? THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 819:152020. [PMID: 35007576 DOI: 10.1016/j.scitotenv.2021.152020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 06/14/2023]
Abstract
Hyperuricemia is an independent risk factor for renal and cardiovascular diseases and is closely associated with gout episodes. It is caused, inter alia, by nutritional habits and genetic factors, and also displays seasonal variability conditioned by meteorological factors. The impact of meteorological factors, including both cold and heat stress, on the human physiology is presented based on the Universal Thermal Climate Index (UTCI) - a biometeorological index derived from an analysis of human thermal balance. The aim of our study was to establish whether seasonal variations significantly affect routinely measured urine acid (UA) levels and could eventually support the clinical decision making process, as well as assessing whether UTCI values are correlated with UA levels in blood serum. This work presents a retrospective epidemiological study of data collected in Olsztyn (Poland). Study material comprised 54,536 results of ambulatory tests measuring UA levels, performed during the period 2016-2019. The analysis concerned correlations between UA and the ages of female and male subjects as well as existing biometeorological conditions as represented by UTCI values in an annual cycle. UA levels in females were found to be lower (4.94 ± 1.37 SD) as compared to those of males (6.13 ± 1.43 SD) and demonstrated a strong positive correlation with age. UA values differed significantly (p < 0.05) on days characterized by cold stress and heat stress, for the oldest age group. UA levels were found to differ depending on the season, but these relationships were not statistically significant, except for significantly higher UA levels in females in autumn (p < 0.001). However, there was an evident difference in population UA levels under cold stress conditions (lower) and heat stress conditions (higher) in the elderly. The UTCI is an adequate predictor of population variations in UA levels since it takes into account the variability of local meteorological conditions.
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Affiliation(s)
- Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, School of Medicine, University of Warmia and Mazury in Olsztyn, Poland.
| | - Ewa Dragańska
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Poland
| | - Iwona Cymes
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Poland
| | - Marek Drozdowski
- Department of Psychology and Sociology of Health and Public Health, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn
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13
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Advanced Operationalization Framework for Climate-Resilient Urban Public Health Care Services: Composite Indicators-Based Scenario Assessment of Khon Kaen City, Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031283. [PMID: 35162320 PMCID: PMC8834807 DOI: 10.3390/ijerph19031283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/10/2022] [Accepted: 01/18/2022] [Indexed: 02/01/2023]
Abstract
Conventional local public health planning and monitoring are insufficiently addressing the conjugated impact of urban development change and climate change in the future. The existing checklist and index often ignore the spatial-network interaction determining urban public health services in forward-looking aspects. This study offers and demonstrates a climate-resilient operationalization framework for urban public health services considering the interaction between urban development change and climate change across scales. A combination of collaborative scenario planning and tailor-made composite indicators were applied based on the IPCC Fifth Assessment Report (AR5)’s climate risk concept to adhere to local realities and diverse sets of scenarios. The framework was contested in a medium-sized city with a universal health care coverage setting, Khon Kaen city, Thailand. The results show that the coupling of collaborative scenario planning and composite indicators allows local public health care to operationalize their potential impact and climate-resilient targets in the future(s) in multiple service operation aspects. The scenarios assessment outcomes prove that although public health devotion can be fail-safe, achieving climate-resilient targets requires sectoral integration with urban development and health determining domains. Further exploration and disputation of the framework with a wider scale and diversified settings are recommended to enhance their robustness and universality.
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14
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Verderber S, Gray S, Suresh-Kumar S, Kercz D, Parshuram C. Intensive Care Unit Built Environments: A Comprehensive Literature Review (2005-2020). HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:368-415. [PMID: 34000842 PMCID: PMC8597197 DOI: 10.1177/19375867211009273] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/15/2021] [Accepted: 03/23/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The intensive care environment in hospitals has been the subject of significant empirical and qualitative research in the 2005-2020 period. Particular attention has been devoted to the role of infection control, family engagement, staff performance, and the built environment ramifications of the recent COVID-19 global pandemic. A comprehensive review of this literature is reported summarizing recent advancements in this rapidly expanding body of knowledge. PURPOSE AND AIM This comprehensive review conceptually structures the recent medical intensive care literature to provide conceptual clarity and identify current priorities and future evidence-based research and design priorities. METHOD AND RESULT Each source reviewed was classified as one of the five types-opinion pieces/essays, cross-sectional empirical investigations, nonrandomized comparative investigations, randomized studies, and policy review essays-and into nine content categories: nature engagement and outdoor views; family accommodations; intensive care unit (ICU), neonatal ICU, and pediatric ICU spatial configuration and amenity; noise considerations; artificial and natural lighting; patient safety and infection control; portable critical care field hospitals and disaster mitigation facilities including COVID-19; ecological sustainability; and recent planning and design trends and prognostications. CONCLUSIONS Among the findings embodied in the 135 literature sources reviewed, single-bed ICU rooms have increasingly become the norm; family engagement in the ICU experience has increased; acknowledgment of the therapeutic role of staff amenities; exposure to nature, view, and natural daylight has increased; the importance of ecological sustainability; and pandemic concerns have increased significantly in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review includes topics noticeably overlooked or underinvestigated in the 2005-2020 period and priorities for future research.
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Affiliation(s)
- Stephen Verderber
- Centre for Design + Health Innovation, John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Seth Gray
- Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Center for Safety Research, Toronto, Ontario, Canada
| | - Shivathmikha Suresh-Kumar
- John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Damian Kercz
- John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Christopher Parshuram
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
- Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Center for Safety Research, Toronto, Ontario, Canada
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15
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Biddle L, Wahedi K, Bozorgmehr K. Health system resilience: a literature review of empirical research. Health Policy Plan 2021; 35:1084-1109. [PMID: 32529253 PMCID: PMC7553761 DOI: 10.1093/heapol/czaa032] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2020] [Indexed: 11/25/2022] Open
Abstract
The concept of health system resilience has gained popularity in the global health discourse, featuring in UN policies, academic articles and conferences. While substantial effort has gone into the conceptualization of health system resilience, there has been no review of how the concept has been operationalized in empirical studies. We conducted an empirical review in three databases using systematic methods. Findings were synthesized using descriptive quantitative analysis and by mapping aims, findings, underlying concepts and measurement approaches according to the resilience definition by Blanchet et al. We identified 71 empirical studies on health system resilience from 2008 to 2019, with an increase in literature in recent years (62% of studies published since 2017). Most studies addressed a specific crisis or challenge (82%), most notably infectious disease outbreaks (20%), natural disasters (15%) and climate change (11%). A large proportion of studies focused on service delivery (48%), while other health system building blocks were side-lined. The studies differed in terms of their disciplinary tradition and conceptual background, which was reflected in the variety of concepts and measurement approaches used. Despite extensive theoretical work on the domains which constitute health system resilience, we found that most of the empirical literature only addressed particular aspects related to absorptive and adaptive capacities, with legitimacy of institutions and transformative resilience seldom addressed. Qualitative and mixed methods research captured a broader range of resilience domains than quantitative research. The review shows that the way in which resilience is currently applied in the empirical literature does not match its theoretical foundations. In order to do justice to the complexities of the resilience concept, knowledge from both quantitative and qualitative research traditions should be integrated in a comprehensive assessment framework. Only then will the theoretical ‘resilience idea’ be able to prove its usefulness for the research community.
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Affiliation(s)
- Louise Biddle
- Social Determinants, Equity and Migration Working Group, Department of General Practice & Health Services Research, University Hospital Heidelberg, Marsilius Arkaden, Turm West, Heidelberg 69120, Germany
| | - Katharina Wahedi
- Social Determinants, Equity and Migration Working Group, Department of General Practice & Health Services Research, University Hospital Heidelberg, Marsilius Arkaden, Turm West, Heidelberg 69120, Germany
| | - Kayvan Bozorgmehr
- Social Determinants, Equity and Migration Working Group, Department of General Practice & Health Services Research, University Hospital Heidelberg, Marsilius Arkaden, Turm West, Heidelberg 69120, Germany.,Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
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16
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Abstract
The main objective of this paper is to measure the level of household resilience to cyclone and storm surges in the coastal area of Bangladesh. We draw on four general disaster frameworks in terms of addressing household-level resilience to cyclones and storm surges. We use a composite indicator approach organized around four components: (1) household infrastructure (HI); (2) household economic capacity (HEC); (3) household self-organization and learning (HSoL), and; (4) social safety nets (SSN). Drawing on a household survey (N = 1188) in nine coastal union parishads in coastal Bangladesh purposively selected as among the most vulnerable places in the world, we use principal components analysis applied to a standardized form of the survey data that identifies key household resilience features. These household index scores can be used for the assessment and monitoring of household capacities, training, and other efforts to improve household cyclone resilience. Our innovative methodological approach allows us to (a) identify patterns and reveal the underlying factors that accurately describe the variation in the data; (b) reduce a large number of variables to a much smaller number of core dimensions of household resilience, and (c) to detect spatial variations in resilience among communities. Aggregated to the community level, our new index reveals significant differences in community cyclone resilience in different areas of the coastal region. In this way, we can show that shoreline and island communities, in particular, have significant deficits in terms of household resilience, which seem to be mutually reinforcing one another and making for lower resilience.
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17
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Danquah E. The Influence of Emotional Intelligence on the Work Engagement of Clinical Leadership: Resilience as a Moderator. Hosp Top 2021; 100:55-61. [PMID: 34058965 DOI: 10.1080/00185868.2021.1922113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined the moderating influence of resilience on the association between emotional intelligence and work engagement in clinical leaders. The study population was leaders working in the emergency wards of some health facilities in Accra. A total of 310 leaders participated in the study by completing a self-reported questionnaire. The analysis of data showed that emotional intelligence makes a positive influence on work engagement in clinical leaders working in emergency departments. The moderating influence of Health facilities can improve work engagement in emergency settings by utilizing training programs to improve both emotional intelligence and resilience.
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18
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Core Competencies for Health Workers to Deal with Climate and Environmental Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083849. [PMID: 33916887 PMCID: PMC8067548 DOI: 10.3390/ijerph18083849] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 11/17/2022]
Abstract
Rapid, detrimental climate change and environmental degradation pose real threats to the health, environment, social, economic and technological wellbeing of society (HESET). It has become even more imperative that the health workforce (public health and medical healthcare as well as auxiliary and support workers) be ‘climate-environment’ competent to fulfil their role in managing the environmental public health risks and impacts as climate and environment inevitably continue to change. We developed a broad six-domain competency framework consisting of (1) climate and environment sciences, (2) drivers of climate change (3) evidence, projections and assessments (4) iterative risk management (5) mitigation, adaptation and health co-benefits and (6) collective strategies—harnessing international/regional/local agreements and frameworks. The framework can be used by health/medical trainers to design cross-sectoral sub-competencies and learning content for training health workers to function at local, regional and global levels. Reaching, maintaining and improving the different levels of competency, the health workforce will be increasingly invaluable partners in intra- as well as inter-sectoral responses to climate and environmental risks and impacts.
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19
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Lemence ALG, Tamayao MM. Techno‐Economic Potential of Hybrid Renewable Energy Systems for Rural Health Units in the Philippines. WORLD MEDICAL & HEALTH POLICY 2021. [DOI: 10.1002/wmh3.388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Shankar HM, Rice MB. Update on Climate Change: Its Impact on Respiratory Health at Work, Home, and at Play. Clin Chest Med 2021; 41:753-761. [PMID: 33153692 DOI: 10.1016/j.ccm.2020.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Climate change is a crisis of vast proportions that has serious implications for pulmonary health. Increasing global temperatures influence respiratory health through extreme weather events, wildfires, prolonged allergy seasons, and worsening air pollution. Children, elderly patients, and patients with underlying lung disease are at elevated risk of complications from these effects of climate change. This paper summarizes the myriad ways in which climate change affects the respiratory health of patients at home and in outdoor environments and outlines measures for patients to protect themselves.
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Affiliation(s)
- Hari M Shankar
- Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, 3400 Spruce Street, 839 West Gates Building, Philadelphia, PA 19104, USA.
| | - Mary B Rice
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, KS/BM23, 330 Brookline Avenue, Boston, MA 02215, USA
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21
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Spruell T, Webb H, Steley Z, Chan J, Robertson A. Environmentally sustainable emergency medicine. Emerg Med J 2021; 38:315-318. [PMID: 33483340 DOI: 10.1136/emermed-2020-210421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/24/2020] [Accepted: 12/20/2020] [Indexed: 11/04/2022]
Abstract
Emergency clinicians worldwide are demonstrating increasing concern about the effect of climate change on the health of the populations they serve. The movement for sustainable healthcare is being driven by the need to address the climate emergency. Globally, healthcare contributes significantly to carbon emissions, and the healthcare sector has an important role to play in contributing to decarbonisation of the global economy. In this article, we consider the implications for emergency medicine of climate change, and suggest ways to improve environmental sustainability within emergency departments. We identify examples of sustainable clinical practice, as well as outlining research proposals to address the knowledge gap that currently exists in the area of provision of environmentally sustainable emergency care.
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Affiliation(s)
- Timothy Spruell
- Anaesthetics Department, Croydon Health Services NHS Trust, London, UK
| | - Hannah Webb
- Emergency Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, East Sussex, UK.,Environmental Special Interest Group, The Royal College of Emergency Medicine, London, UK
| | - Zoe Steley
- Environmental Special Interest Group, The Royal College of Emergency Medicine, London, UK.,Emergency Department, Royal Free London NHS Foundation Trust, London, UK
| | - James Chan
- Environmental Special Interest Group, The Royal College of Emergency Medicine, London, UK.,Emergency Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Alexander Robertson
- Emergency Department, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.,The Royal College of Emergency Medicine, London, UK
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22
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Romaszko-Wojtowicz A, Cymes I, Dragańska E, Doboszyńska A, Romaszko J, Glińska-Lewczuk K. Relationship between biometeorological factors and the number of hospitalizations due to asthma. Sci Rep 2020; 10:9593. [PMID: 32533079 PMCID: PMC7293260 DOI: 10.1038/s41598-020-66746-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/26/2020] [Indexed: 11/09/2022] Open
Abstract
The incidence of asthma exacerbation depends on atmospheric conditions, including such meteorological factors as the ambient temperature, relative air humidity or concentration of atmospheric aerosols. An assessment of relations between the frequency of asthma exacerbation and environmental conditions was made according to the meteorological components, the biometeorological index UTCI (Universal Thermal Climate Index), as well as selected air quality parameters, including concentrations of PM10 and PM2.5. The study was conducted on the basis of a retrospective analysis of medical data collected at the Independent Public Hospital of Tuberculosis and Pulmonary Diseases in Olsztyn (Poland). Our analysis of patient data (from 1 January 2013 until 31 December 2017) showed a significant correlation between the number of asthma exacerbation and the UTCI value. More frequent asthma exacerbations are observed in patients aged over 65 years when air humidity increases. The UTCI values contained within class 5, describing thermoneutral conditions, correspond to an average frequency of asthma exacerbation. A decline in the UTCI value leads to a reduced number of asthma exacerbation, while a rise makes the cases of asthma exacerbations increase.
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Affiliation(s)
- Anna Romaszko-Wojtowicz
- Faculty of Health Sciences, Department of Pulmonology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
| | - Iwona Cymes
- Department of Water Resources, Climatology and Environmental Management, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Ewa Dragańska
- Department of Water Resources, Climatology and Environmental Management, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Anna Doboszyńska
- Faculty of Health Sciences, Department of Pulmonology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Jerzy Romaszko
- School of Medicine, Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Katarzyna Glińska-Lewczuk
- Department of Water Resources, Climatology and Environmental Management, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
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23
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Fallah-Aliabadi S, Ostadtaghizadeh A, Ardalan A, Fatemi F, Khazai B, Mirjalili MR. Towards developing a model for the evaluation of hospital disaster resilience: a systematic review. BMC Health Serv Res 2020; 20:64. [PMID: 31996213 PMCID: PMC6988294 DOI: 10.1186/s12913-020-4915-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 01/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hospitals play a vital role in disaster stricken regions. The resilient hospitals will be able to provide essential services to affected people and it can mitigate the risk of injuries during and after disasters. This study aimed to obtain the indicators required for the evaluation of hospital resilience. METHODS This systematic review was conducted in 2018. Through this systematic review, international electronic databases were investigated for the research studies published in English. The exclusion and inclusion criteria were determined to extract the hospital resilience indicators. These indicators will be used in order to develop a model to keep the system performance at an acceptable level during disasters. RESULTS Out of 1794 research studies published until September 2018, 89 articles and guidelines with full text were surveyed. Thirty-two articles and guidelines were then selected and analyzed to collect the indicators related to hospital disaster resilience (HDR). The domains and the indicators were extracted from these selected research studies. The authors collected and categorized them into three domains and twenty seven subdomains. The three domains included constructive, infrastructural, and administrative resilience. The relevant indicators were designed for each subdomain to assess HDR. CONCLUSION Since diverse indicators affect hospital resilience, other studies should be conducted to propose some models or tools to quantify the hospital resilience in different countries and scopes with an all hazards approach.
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Affiliation(s)
- Saeed Fallah-Aliabadi
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ostadtaghizadeh
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Ardalan
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Harvard Humanitarian Initiative, Harvard University, Cambridge, USA
| | - Farin Fatemi
- Research Center for Health Services and Technologies, Semnan University of Medical Sciences, Semnan, Iran
| | - Bijan Khazai
- Karlsruhe Institute of Technology (KIT), Center for Disaster Management and Risk Reduction Technology, Karlsruhe, Germany
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24
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Wooldridge G, Murthy S. Pediatric Critical Care and the Climate Emergency: Our Responsibilities and a Call for Change. Front Pediatr 2020; 8:472. [PMID: 32974244 PMCID: PMC7468581 DOI: 10.3389/fped.2020.00472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/06/2020] [Indexed: 01/09/2023] Open
Abstract
Critical care is perhaps one of the most "climate-intensive" divisions of health care. As greenhouse gas emissions continue to rise, the unprecedented threat of climate change has belatedly prompted an increased awareness of critical care's environmental impact. Within our role as pediatric critical care providers, we have a dual responsibility not only to care for children at their most vulnerable, but also to advocate on their behalf. There are clear, demonstrable effects of our worsening climate on the health of children, with the resultant increased burden of pediatric critical illness and disruption to health care systems. From increasing wildfires and their effect on lung health, to the spread of vector-borne diseases such as dengue, and the increased migration of children due to a changing climate, the effects of a changing climate are here, and we are beginning to see the changing epidemiology of pediatric critical illness. Ensuring that the effects of ongoing changes are minimized, including its future effects on child health, requires a multifaceted approach. As part of this review, we will use the Lancet Countdown on Climate Change indicators to explore the impact of pediatric critical care on climate change and the inevitable influence climate change will have on the future practice of pediatric critical care globally.
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Affiliation(s)
- Gavin Wooldridge
- St Mary's Hospital, Imperial College London, London, United Kingdom
| | - Srinivas Murthy
- Pediatric Critical Care, BC Children's Hospital, Vancouver, BC, Canada
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Abstract
INTRODUCTION Health and climate change are inexorably linked through the exacerbation of health risks and the contribution of the health sector to greenhouse gas emissions. Climate action in healthcare settings is critical to reduce risks and impacts of climate change through the smarter use of energy, minimising waste and enhancing disaster preparedness. Globally, hospital climate action is growing; however, the potential for further progress and impacts remains. The literature on this topic lacks synthesis, and this poses challenges for hospital leadership in tracking the impact of climate action. This scoping review will summarise the current knowledge about hospital climate action and existing tools to measure progress in this area. METHODS AND ANALYSIS This scoping review will be conducted applying the six-stage protocol proposed by Arksey and O'Malley. The study includes literature of how hospitals have addressed climate change (mitigation and adaptation) since the Kyoto Protocol was signed in 1997. All identified studies indexed in Medline, Scopus, Embase and CINAHL will be examined. The search strategy will also include Google Scholar to capture relevant grey literature. Quantitative and thematic analysis will be used to evaluate and categorise the study results. ETHICS AND DISSEMINATION This scoping review is part of the climate-smart healthcare initiative which will provide a valuable synthesis to aid understanding of hospitals' climate actions, and tools used to measure its implementation. As such it will contribute to mobilising and accelerating the implementation of climate action in hospitals. The findings will be disseminated with all members of the International Health Promoting Hospital and Health Services (HPH) and the Global Green and Healthy Hospital network. Dissemination will occur through peer-reviewed publications; and with the HPH and GGHH members through its annual conference and newsletter.
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Affiliation(s)
- Connie Cai Ru Gan
- Centre for Environment and Population Health, Griffith University, Nathan, Queensland, Australia
| | - Nicola Banwell
- Cooperation and Development, École Polytechnique Fédérale de Lausanne, Lausanne, VD, Switzerland
| | | | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Nathan, Queensland, Australia
| | - Ying Wei Wang
- Health Promotion Administration Ministry of Health and Welfare, Taipei City, Taiwan
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26
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Rathnayake D, Clarke M, Jayasooriya L. Hospital surge capacity: The importance of better hospital pre-planning to cope with patient surge during dengue epidemics – A systematic review. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1692517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Mike Clarke
- Centre for Public Health, Institute of Clinical Sciences, Queens University, Belfast, UK
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27
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Ouarda TBMJ, Charron C. Nonstationary Temperature-Duration-Frequency curves. Sci Rep 2018; 8:15493. [PMID: 30341366 PMCID: PMC6195567 DOI: 10.1038/s41598-018-33974-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/09/2018] [Indexed: 11/15/2022] Open
Abstract
Persistent extreme heat events are of growing concern in a climate change context. An increase in the intensity, frequency and duration of heat waves is observed in several regions. Temperature extremes are also influenced by global-scale modes of climate variability. Temperature-Duration-Frequency (TDF) curves, which relate the intensity of heat events of different durations to their frequencies, can be useful tools for the analysis of heat extremes. To account for climate external forcings, we develop a nonstationary approach to the TDF curves by introducing indices that account for the temporal trend and teleconnections. Nonstationary TDF modeling can find applications in adaptive management in the fields of health care, public safety and energy production. We present a one-step method, based on the maximization of the composite likelihood of observed heat extremes, to build the nonstationary TDF curves. We show the importance of integrating the information concerning climate change and climate oscillations. In an application to the province of Quebec, Canada, the influence of Atlantic Multidecadal Oscillations (AMO) on heat events is shown to be more important than the temporal trend.
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Affiliation(s)
- Taha B M J Ouarda
- Canada Research Chair in Statistical Hydro-Climatology, INRS-ETE, 490 de la Couronne, Québec, QC, G1K 9A9, Canada.
| | - Christian Charron
- Canada Research Chair in Statistical Hydro-Climatology, INRS-ETE, 490 de la Couronne, Québec, QC, G1K 9A9, Canada
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28
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Banwell N, Rutherford S, Mackey B, Street R, Chu C. Commonalities between Disaster and Climate Change Risks for Health: A Theoretical Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030538. [PMID: 29547592 PMCID: PMC5877083 DOI: 10.3390/ijerph15030538] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/08/2018] [Accepted: 03/13/2018] [Indexed: 12/11/2022]
Abstract
Disasters and climate change have significant implications for human health worldwide. Both climate change and the climate-sensitive hazards that result in disasters, are discussed in terms of direct and indirect impacts on health. A growing body of literature has argued for the need to link disaster risk reduction and climate change adaptation. However, there is limited articulation of the commonalities between these health impacts. Understanding the shared risk pathways is an important starting point for developing joint strategies for adapting to, and reducing, health risks. Therefore, this article discusses the common aspects of direct and indirect health risks of climate change and climate-sensitive disasters. Based on this discussion a theoretical framework is presented for understanding these commonalities. As such, this article hopes to extend the current health impact frameworks and provide a platform for further research exploring opportunities for linked adaptation and risk reduction strategies.
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Affiliation(s)
- Nicola Banwell
- Centre for Environment and Population Health, School of Environment, Griffith University, Brisbane 4111, Australia.
| | - Shannon Rutherford
- Centre for Environment and Population Health, School of Environment, Griffith University, Brisbane 4111, Australia.
| | - Brendan Mackey
- Griffith Climate Change Response Program, Griffith University, Gold Coast City 4222, Australia.
| | - Roger Street
- UK Climate Impacts Programme, Environmental Change Institute, University of Oxford, Oxford OX1 3QY, UK.
| | - Cordia Chu
- Centre for Environment and Population Health, School of Medicine, Griffith University, Brisbane 4111, Australia.
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29
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Sellers S, Ebi KL. Climate Change and Health under the Shared Socioeconomic Pathway Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:ijerph15010003. [PMID: 29267204 PMCID: PMC5800104 DOI: 10.3390/ijerph15010003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/02/2017] [Accepted: 12/18/2017] [Indexed: 01/26/2023]
Abstract
A growing body of literature addresses how climate change is likely to have substantial and generally adverse effects on population health and health systems around the world. These effects are likely to vary within and between countries and, importantly, will vary depending on different socioeconomic development patterns. Transitioning to a more resilient and sustainable world to prepare for and manage the effects of climate change is likely to result in better health outcomes. Sustained fossil fuel development will likely result in continued high burdens of preventable conditions, such as undernutrition, malaria, and diarrheal diseases. Using a new set of socioeconomic development trajectories, the Shared Socioeconomic Pathways (SSPs), along with the World Health Organization’s Operational Framework for Building Climate Resilient Health Systems, we extend existing storylines to illustrate how various aspects of health systems are likely to be affected under each SSP. We also discuss the implications of our findings on how the burden of mortality and the achievement of health-related Sustainable Development Goal targets are likely to vary under different SSPs.
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Affiliation(s)
- Samuel Sellers
- Center for Health and the Global Environment, University of Washington, Seattle, WA 98105, USA.
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA 98105, USA.
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30
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Curtis S, Fair A, Wistow J, Val DV, Oven K. Impact of extreme weather events and climate change for health and social care systems. Environ Health 2017; 16:128. [PMID: 29219105 PMCID: PMC5773887 DOI: 10.1186/s12940-017-0324-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This review, commissioned by the Research Councils UK Living With Environmental Change (LWEC) programme, concerns research on the impacts on health and social care systems in the United Kingdom of extreme weather events, under conditions of climate change. Extreme weather events considered include heatwaves, coldwaves and flooding. Using a structured review method, we consider evidence regarding the currently observed and anticipated future impacts of extreme weather on health and social care systems and the potential of preparedness and adaptation measures that may enhance resilience. We highlight a number of general conclusions which are likely to be of international relevance, although the review focussed on the situation in the UK. Extreme weather events impact the operation of health services through the effects on built, social and institutional infrastructures which support health and health care, and also because of changes in service demand as extreme weather impacts on human health. Strategic planning for extreme weather and impacts on the care system should be sensitive to within country variations. Adaptation will require changes to built infrastructure systems (including transport and utilities as well as individual care facilities) and also to institutional and social infrastructure supporting the health care system. Care sector organisations, communities and individuals need to adapt their practices to improve resilience of health and health care to extreme weather. Preparedness and emergency response strategies call for action extending beyond the emergency response services, to include health and social care providers more generally.
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Affiliation(s)
- Sarah Curtis
- Department of Geography, Durham University, Durham, DH1 3LE UK
| | - Alistair Fair
- Edinburgh School of Architecture & Landscape Architecture, University of Edinburgh, Edinburgh, UK
| | - Jonathan Wistow
- School of Applied Social Science, Durham University, Durham, UK
| | - Dimitri V. Val
- School of Energy, Geoscience, Infrastructure and Society, Hariot-Watt University, Edinburgh, UK
| | - Katie Oven
- Department of Geography, Durham University, Durham, DH1 3LE UK
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31
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Ebi KL, Hess JJ. The past and future in understanding the health risks of and responses to climate variability and change. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:71-80. [PMID: 28733859 DOI: 10.1007/s00484-017-1406-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/06/2017] [Accepted: 07/06/2017] [Indexed: 06/07/2023]
Abstract
Climate change and health was established as a formal field of endeavor in the early 1990s, with the number of publications increasing since the mid-2000s. The key findings in assessment reports from the Intergovernmental Panel on Climate Change in 1995, 2001, 2007, and 2014 indicate the progress in understanding the magnitude and pattern of the health risks of a changing climate. The assessments maintained a similar structure, focusing on assessing the state of knowledge of individual climate-sensitive health outcomes, with confidence in the key findings tending to increase over time with greater understanding. The knowledge base is smaller than for other key sectors (e.g., agriculture) because of limited research investment in climate change and health. Vulnerability, adaptation, and capacity assessments can inform prioritization of the significant research gaps in understanding and managing the health risks of a changing climate; filling these research gaps would provide policy- and decision-makers with insights to increase short- and longer-term resilience in health and other sectors. Research needs include to understand how climate and development pathways could interact to alter health risks over time, better understand upstream drivers of climate-sensitive health outcomes, project aggregate health impacts to understand the breadth and depth of challenges that may need to be managed at geographic scales of interest, and project the time of emergence of changes in the geographic range and intensity of transmission of infectious diseases and other climate conditions. Engagement with other sectors is needed to ensure that their mitigation and adaptation activities also promote and protect health and take the health sector's needs into account. Making progress in these areas is critical for protecting the health of future populations.
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Affiliation(s)
- Kristie L Ebi
- Center for Health and the Global Environment (CHanGE), University of Washington, Seattle, WA, 98105, USA.
| | - Jeremy J Hess
- Center for Health and the Global Environment (CHanGE), University of Washington, Seattle, WA, 98105, USA
- Departments of Medicine, Global Health, and Environmental and Occupational Health Sciences, Seattle, WA, USA
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Hancock T, Capon AG, Dietrich U, Patrick RA. Governance for health in the Anthropocene. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2016. [DOI: 10.1108/ijhg-08-2016-0041] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore the pressing issues facing health and health systems governance in the Anthropocene – a new geological time period that marks the age of colossal and rapid human impacts on Earth’s systems.
Design/methodology/approach
The viewpoint illustrates the extent of various human induced global ecological changes such as climate change and biodiversity loss and explores the social forces behind the new epoch. It draws together current scientific evidence and expert opinion on the Anthropocene’s health and health system impacts and warns that many these are yet unknown and likely to interact and compound each other.
Findings
Despite this uncertainty, health systems have four essential roles in the Anthropocene from adapting operations and preparing for future challenges to reducing their own contribution to global ecological changes and an advocacy role for social and economic changes for a healthier and more sustainable future.
Practical implications
To live up to this challenge, health services will need to expand from a focus on health governance to one on governance for health with a purpose of achieving equitable and sustainable human development.
Originality/value
As cities and local governments work to create more healthy, just and sustainable communities in the years ahead, health systems need to join with them as partners in that process, both as advocates and supporters and – through their own action within the health sector – as leading proponents and models of good practice.
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Hudson SW. Insights in Public Health: Climate Change: A Public Health Challenge and Opportunity for Hawai'i. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2016; 75:245-250. [PMID: 27563502 PMCID: PMC4982331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Samantha W Hudson
- Yale School of Forestry and Environmental Studies, 2016; New Haven, CT
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