1
|
Walter TG, Bricknell LK, Preston RG, Crawford EGC. Climate Change Adaptation Methods for Public Health Prevention in Australia: an Integrative Review. Curr Environ Health Rep 2024; 11:71-87. [PMID: 38221599 PMCID: PMC10907446 DOI: 10.1007/s40572-023-00422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE OF REVIEW Climate change poses a serious threat to human health and well-being. Australia is not immune to the public health impacts and continues to be underprepared, putting the population health at risk. However, there is a dearth in knowledge about how the Australian public health system will address the impacts of climate change. RECENT FINDINGS This integrative review synthesises tools, frameworks, and guidance material suitable for climate change adaptation from a preventive public health perspective. The literature search was conducted in electronic databases MEDLINE, PubMed, CINAHL, and Web of Science. Of 4507 articles identified, 19 articles met the inclusion criteria that focused on operational methods in public health and excluded the clinical context and reactive disaster response approaches. This review revealed that Australia is ill-prepared to manage climate change adverse health impacts due to ineffective adaptation strategies. The review highlights that Australia urgently requires effective adaptation strategies such as undertaking a National Adaptation Plan process and an improved understanding in managing complex health risks. Taking this action will strengthen the public health system and build health resilience especially for vulnerable populations. These findings will help understand and develop of the necessary adaptive strategies in Australia.
Collapse
Affiliation(s)
- Tony G Walter
- School of Health, Medical and Applied Sciences, Central Queensland University, 554-700 Yaamba Road, Norman Gardens, 4701, Australia.
| | - Lisa K Bricknell
- School of Health, Medical and Applied Sciences, Central Queensland University, 554-700 Yaamba Road, Norman Gardens, 4701, Australia
| | - Robyn G Preston
- School of Health, Medical and Applied Sciences, Central Queensland University, 538 Flinders Street, Townsville, QLD, 4810, Australia
| | - Elise G C Crawford
- School of Health, Medical and Applied Sciences, Central Queensland University, 554-700 Yaamba Road, Norman Gardens, 4701, Australia
| |
Collapse
|
2
|
Guido A, Marconi E, Peruzzi L, Dinapoli N, Tamburrini G, Attinà G, Romano A, Maurizi P, Mastrangelo S, Chiesa S, Gambacorta MA, Ruggiero A, Chieffo DPR. Psychological Experiences of Parents of Pediatric Cancer Patients during and after COVID-19 Pandemic. Cancers (Basel) 2024; 16:891. [PMID: 38473253 DOI: 10.3390/cancers16050891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Family members dealing with the devastating impact of a cancer diagnosis are now facing even greater vulnerability due to the COVID-19 pandemic. Alongside the already overwhelming trauma, they must also bear the distressing burden of the infection risks. The purpose of this study was to examine and explore the effects in parents of pediatric cancer patients two years after the start of the COVID-19 pandemic to compare these data with the previous data. METHODS We conducted a single-center prospective observational study, enrolling 75 parents of 42 pediatric oncology patients. Four questionnaires (IES-R; PSS; STAI-Y and PedsQL) were given to the parents 2 years after the first evaluation. RESULTS The bivariate matrix of correlation found a strong significant positive correlation between IES-R and PSS scores (r = 0.526, p < 0.001) as in T1. Stress symptoms (t = 0.00, p < 0.001) and levels of anxiety (trait) (t = 0.32, p < 0.001) remained unchanged; anxiety state levels appeared to have increased (t = 0.425, p < 0.001); there was a significant decrease in the PedsQL tot (t = 5.25, p < 0.001). CONCLUSIONS The COVID-19 pandemic has influenced the levels of stress and anxiety of parents and the quality of life of patients, also correlating with the traumatic impact of the diagnosis.
Collapse
Affiliation(s)
- Antonella Guido
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Elisa Marconi
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Laura Peruzzi
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Nicola Dinapoli
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Gianpiero Tamburrini
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Giorgio Attinà
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Alberto Romano
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Palma Maurizi
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Woman and Child Health and Public Health, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Stefano Mastrangelo
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Woman and Child Health and Public Health, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Silvia Chiesa
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Maria Antonietta Gambacorta
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Antonio Ruggiero
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Woman and Child Health and Public Health, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Life Sciences and Public Health Department, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| |
Collapse
|
3
|
Tan MZY, Prager G, McClelland A, Dark P. Healthcare resilience: a meta-narrative systematic review and synthesis of reviews. BMJ Open 2023; 13:e072136. [PMID: 37730383 PMCID: PMC10514640 DOI: 10.1136/bmjopen-2023-072136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered 'resilient' have performed poorly. Available organisational and system frameworks tend to be context-dependent and focus heavily on physical capacities. This study aims to explore and synthesise evidence about healthcare resilience and present a unified framework for future resilience-building. DESIGN Systematic review and synthesis of reviews using a meta-narrative approach. SETTING Healthcare organisations and systems. PRIMARY AND SECONDARY OUTCOME MEASURES Definitions, concepts and measures of healthcare resilience. We used thematic analysis across included reviews to summarise evidence on healthcare resilience. RESULTS The main paradigms within healthcare resilience include global health, disaster risk reduction, emergency management, patient safety and public health. Definitions of healthcare resilience recognise various hierarchical levels: individual (micro), facility or organisation (meso), health system (macro) and planetary or international (meta). There has been a shift from a focus on mainly disasters and crises, to an 'all-hazards' approach to resilience. Attempts to measure resilience have met with limited success. We analysed key concepts to build a framework for healthcare resilience containing pre-event, intra-event, post-event and trans-event domains. Alongside, we synthesise a definition which dovetails with our framework. CONCLUSION Resilience increasingly takes an all-hazards approach and a process-oriented perspective. There is increasing recognition of the relational aspects of resilience. Few frameworks incorporate these, and they are difficult to capture within measurement systems. We need to understand how resilience works across hierarchical levels, and how competing priorities may affect overall resilience. Understanding these will underpin interdisciplinary, cross-sectoral and multi-level approaches to healthcare resilience for the future. PROSPERO REGISTRATION NUMBER CRD42022314729.
Collapse
Affiliation(s)
- Mark Z Y Tan
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
| | - Gabrielle Prager
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrew McClelland
- Alliance Manchester Business School, The University of Manchester, Manchester, UK
| | - Paul Dark
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
- Clinical Research Network, National Institute for Health and Care Research, London, UK
| |
Collapse
|
4
|
Karreinen S, Paananen H, Kihlström L, Janhonen K, Huhtakangas M, Viita-Aho M, Tynkkynen LK. Living through uncertainty: a qualitative study on leadership and resilience in primary healthcare during COVID-19. BMC Health Serv Res 2023; 23:233. [PMID: 36894990 PMCID: PMC9997436 DOI: 10.1186/s12913-023-09223-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Resilience is often referred to when assessing the ability of health systems to maintain their functions during unexpected events. Primary healthcare forms the basis for the health system and thus its resilient responses are vital for the outcomes of the whole system. Understanding how primary healthcare organisations are able to build resilience before, during, and after unexpected or sudden shocks, is key to public health preparedness. This study aims to identify how leaders responsible for local health systems interpreted changes in their operational environment during the first year of COVID-19, and to elucidate how these views reflect aspects of resilience in healthcare. METHODS The data consist of 14 semi-structured individual interviews with leaders of local health systems in Finland representing primary healthcare. The participants were recruited from four regions. An abductive thematic analysis was used to identify entities from the viewpoints of the purpose, resources, and processes of resilience in the healthcare organisation. RESULTS Results were summarised as six themes, which suggest that embracing uncertainty is viewed by the interviewees a basis for primary healthcare functioning. Leading towards adaptability was regarded a distinct leadership task enabling the organisation to modify its functions according to demands of the changing operational environment. Workforce, knowledge and sensemaking, as well as collaboration represented what the leaders viewed as the means for achieving adaptability. The ability to adapt functioned to comprehensively meet the population's service needs built on a holistic approach. CONCLUSIONS The results showed how the leaders who participated in this study adapted their work during changes brought on by the pandemic, and what they viewed as critical for maintaining organisational resilience. The leaders considered embracing uncertainty as a principal feature of their work rather than viewing uncertainty as aberrant and something to avoid. These notions, along with what the leaders considered as critical means for building resilience and adaptability should be addressed and elaborated in future research. Research on resilience and leadership should be conducted more in the complex context of primary healthcare, where cumulative stresses are encountered and processed continuously.
Collapse
Affiliation(s)
- Soila Karreinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland.
| | - Henna Paananen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Laura Kihlström
- Welfare State Research and Reform, Finnish Institute for Health and Welfare, Helsinki, Finland.,Cultural, Behavioral & Media Insights Centre, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kristiina Janhonen
- Welfare State Research and Reform, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Moona Huhtakangas
- Welfare State Research and Reform, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Liina-Kaisa Tynkkynen
- Faculty of Social Sciences, Tampere University, Tampere, Finland.,Welfare State Research and Reform, Finnish Institute for Health and Welfare, Helsinki, Finland
| |
Collapse
|
5
|
Kong JD, Akpudo UE, Effoduh JO, Bragazzi NL. Leveraging Responsible, Explainable, and Local Artificial Intelligence Solutions for Clinical Public Health in the Global South. Healthcare (Basel) 2023; 11:healthcare11040457. [PMID: 36832991 PMCID: PMC9956248 DOI: 10.3390/healthcare11040457] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/12/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
In the present paper, we will explore how artificial intelligence (AI) and big data analytics (BDA) can help address clinical public and global health needs in the Global South, leveraging and capitalizing on our experience with the "Africa-Canada Artificial Intelligence and Data Innovation Consortium" (ACADIC) Project in the Global South, and focusing on the ethical and regulatory challenges we had to face. "Clinical public health" can be defined as an interdisciplinary field, at the intersection of clinical medicine and public health, whilst "clinical global health" is the practice of clinical public health with a special focus on health issue management in resource-limited settings and contexts, including the Global South. As such, clinical public and global health represent vital approaches, instrumental in (i) applying a community/population perspective to clinical practice as well as a clinical lens to community/population health, (ii) identifying health needs both at the individual and community/population levels, (iii) systematically addressing the determinants of health, including the social and structural ones, (iv) reaching the goals of population's health and well-being, especially of socially vulnerable, underserved communities, (v) better coordinating and integrating the delivery of healthcare provisions, (vi) strengthening health promotion, health protection, and health equity, and (vii) closing gender inequality and other (ethnic and socio-economic) disparities and gaps. Clinical public and global health are called to respond to the more pressing healthcare needs and challenges of our contemporary society, for which AI and BDA can help unlock new options and perspectives. In the aftermath of the still ongoing COVID-19 pandemic, the future trend of AI and BDA in the healthcare field will be devoted to building a more healthy, resilient society, able to face several challenges arising from globally networked hyper-risks, including ageing, multimorbidity, chronic disease accumulation, and climate change.
Collapse
Affiliation(s)
- Jude Dzevela Kong
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON M3J 1P3, Canada
- Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), York University, Toronto, ON M3J 1P3, Canada
- Correspondence: (J.D.K.); (N.L.B.)
| | - Ugochukwu Ejike Akpudo
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON M3J 1P3, Canada
| | - Jake Okechukwu Effoduh
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON M3J 1P3, Canada
- Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), York University, Toronto, ON M3J 1P3, Canada
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON M3J 1P3, Canada
- Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), York University, Toronto, ON M3J 1P3, Canada
- Correspondence: (J.D.K.); (N.L.B.)
| |
Collapse
|
6
|
Shaker Ardakani E, Gilani Larimi N, Oveysi Nejad M, Madani Hosseini M, Zargoush M. A resilient, robust transformation of healthcare systems to cope with COVID-19 through alternative resources. OMEGA 2023; 114:102750. [PMID: 36090537 PMCID: PMC9444250 DOI: 10.1016/j.omega.2022.102750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic - as a massive disruption - has significantly increased the need for medical services putting an unprecedented strain on health systems. This study presents a robust location-allocation model under uncertainty to increase the resiliency of health systems by applying alternative resources, such as backup and field hospitals and student nurses. A multi-objective optimization model is developed to minimize the system's costs and maximize the satisfaction rate among medical staff and COVID-19 patients. A robust approach is provided to face the data uncertainty, and a new mathematical model is extended to linearize a nonlinear constraint. The ICU beds, ward beds, ventilators, and nurses are considered the four main capacity limitations of hospitals for admitting different types of COVID-19 patients. The sensitivity analysis is performed on a real-world case study to investigate the applicability of the proposed model. The results demonstrate the contribution of student nurses and backup and field hospitals in treating COVID-19 patients and provide more flexible decisions with lower risks in the system by managing the fluctuations in both the number of patients and available nurses. The results showed that a reduction in the number of available nurses incurs higher costs for the system and lower satisfaction among patients and nurses. Moreover, the backup and field hospitals and the medical staff elevated the system's resiliency. By allocating backup hospitals to COVID-19 patients, only 37% of severe patients were lost, and this rate fell to less than 5% after establishing field hospitals. Moreover, medical students and field hospitals curbed the costs and increased the satisfaction rate of nurses by 75%. Finally, the system was protected from failure by increasing the conservatism level. With a 2% growth in the price of robustness, the system saved 13%.
Collapse
Affiliation(s)
| | - Niloofar Gilani Larimi
- Gustavson School of Business, University of Victoria, Victoria, British Columbia, Canada
| | - Maryam Oveysi Nejad
- School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Mahsa Madani Hosseini
- Ted Rogers School of Management, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Manaf Zargoush
- Health Policy and Management, DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
7
|
Komasawa N. Challenges for interprofessional simulation-based sedation training courses: Mini review. Acute Med Surg 2023; 10:e913. [PMID: 38152161 PMCID: PMC10752690 DOI: 10.1002/ams2.913] [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: 06/27/2023] [Revised: 10/04/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023] Open
Abstract
Sedation for invasive procedures is given for various clinical purposes to patients of all ages worldwide. However, sedation is a continuum to general anesthesia and contains severe inherent risks leading to mortality. Providing a simulation-based sedation training course (SEDTC) to various medical staff could be an effective strategy to improve patient and medical safety associated with sedation. The SEDTC generally includes basic airway management such as upper airway obstruction release or rapid response action toward excessive sedation, utilizing problem-based learning or simulators. However, participation alone in the SEDTC can only achieve Level 1 (reaction) or 2 (learning) in the Kirkpatrick model. A patient safety improvement of Level 3 (transfer) or 4 (result) of the Kirkpatrick model can be achieved when all members related to sedation undergo experiential learning and reach a consensus. Accordingly, in-hospital interprofessional SEDTC focusing on a resilience approach is essential to achieve effective sedation patient safety in Level 3 or 4 of the Kirkpatrick model.
Collapse
Affiliation(s)
- Nobuyasu Komasawa
- Community Medicine Education Promotion Office, Faculty of MedicineKagawa UniversityIkenobeKita‐gunKagawaJapan
| |
Collapse
|
8
|
Dong M, Zhou C, Zhang Z. Analyzing the Characteristics of Policies and Political Institutions for the Prevention and Control Governance of the COVID-19 Pandemic: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710980. [PMID: 36078703 PMCID: PMC9518029 DOI: 10.3390/ijerph191710980] [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: 07/20/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 05/05/2023]
Abstract
This study explores the institutional reasons for and logical mechanism of the Chinese government's rapid positive results and major strategic achievements in coronavirus disease 2019 (COVID-19) pandemic prevention and control. Based on the ROST Content Mining System version 6.0 (ROST) and VOSviewer V1.6.1 (VOSviewer), we conduct an econometric visualization analysis of COVID-19 pandemic prevention and control policies to explore which strengths of Chinese political institutions have been brought into play by the Chinese government and how to systematically analyze the approaches by which these strengths support effective public governance. The findings show that: (1) "institutional strength", "medical terminology", "policy content", "policy implementation object", "policy implementation requirement", and "policy-making and implementation actor" are the six groups of high-frequency keywords in prevention and control policies. (2) The occurrences, links, and total link strength of the seven Chinese institutional strength keywords are very high. These results mean that the Chinese government has made full use of its institutional strengths to prevent and control COVID-19. These findings indicate that institutional strengths are critical to public health crisis prevention and control. They also illustrate that institutional strength is the prerequisite and key factor for achieving effective governance in the policy process. Scientific policymaking, efficient policy implementation, and strict oversight are undeniably necessary for effective governance during public health crises.
Collapse
Affiliation(s)
- Mingniu Dong
- School of Public Administration, Nanjing Normal University, Nanjing 210023, China
- School of Marxism, Tongling University, Tongling 244061, China
| | - Cheng Zhou
- School of Public Administration, Nanjing Normal University, Nanjing 210023, China
- Correspondence:
| | - Zhenhua Zhang
- Institute of Green Finance, Lanzhou University, Lanzhou 730000, China
| |
Collapse
|
9
|
Goldman KN, McCaffrey C, Riley J, Jungheim E, Grifo JA. Disaster preparedness in assisted reproductive technology. Fertil Steril 2022; 118:230-238. [PMID: 35878943 DOI: 10.1016/j.fertnstert.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 11/18/2022]
Abstract
The American Society for Reproductive Medicine compels centers providing reproductive medicine care to develop and implement an emergency preparedness plan in the event of a disaster. Reproductive care is vulnerable to disruptions in energy, transportation, and supply chains as well as may have potential destructive impacts on infrastructure. With the relentless progression of events related to climate change, centers can expect a growing number of such disruptive events and must prepare to deal with them. This article provides a case study of the impact of Hurricane Sandy on one center in New York City and proposes recommendations for future preparedness and mitigation.
Collapse
Affiliation(s)
- Kara N Goldman
- Northwestern Feinberg School of Medicine, Chicago, Illinois.
| | | | - Joan Riley
- Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Emily Jungheim
- Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Jamie A Grifo
- New York University Langone Health, New York, New York
| |
Collapse
|