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Sacchetto D, Raviolo M, Hubloue I, Valente M, Ragazzoni L. Team Dynamics and Nontechnical Skills Perception During the Disaster Response in Mozambique in 2019: A Survey Study Among the Italian Emergency Medical Team. Disaster Med Public Health Prep 2023; 17:e440. [PMID: 37519067 DOI: 10.1017/dmp.2023.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Team dynamics and nontechnical skills in general are crucial for emergency medical teams (EMT). No study has ever examined these important issues during a real mission in the field. This study aimed to better investigate team dynamics and nontechnical skills for EMTs; it tried to understand if a real mission, when the people are obliged to work together for the first time, without a prior specific training focused on teamwork, is enough or not to work as an effective team in the field. METHODS The study is designed as a pre-test/post-test survey study, and it collected data from 51 people deployed to Mozambique in 2019. Three indexes (the self-efficacy (SE), the teamwork (TW), and the overall team's performance (TW12)) were calculated as the average value of the rating given by all the participants. Open text feedback was also collected. RESULTS A positive trend was observed comparing the "post" data to the "pre" data, but results did not show a statistical significance, with the only exception of stratified analyses showing a P-value less than 0.05 for SE and TW12 for some categories. CONCLUSIONS According to the study findings, humanitarian workers feel good but not at their best; training programs focused on team dynamics can be really useful to improve self-confidence of people leaving for a mission.
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Affiliation(s)
- Daniela Sacchetto
- Disaster Medicine Service 118, ASL CN1, Levaldigi, Cuneo, Italy
- CRIMEDIM, Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Mario Raviolo
- Disaster Medicine Service 118, ASL CN1, Levaldigi, Cuneo, Italy
| | - Ives Hubloue
- Research Group on Emergency and Disaster Medicine (ReGEDiM) Vrije Universiteit Brussel, Brussels, Belgium
| | - Martina Valente
- CRIMEDIM, Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Luca Ragazzoni
- CRIMEDIM, Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
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Lame CA, Atila M, Dembele B, Obeng MK. Management of a Long-Standing Huge Goiter During a Humanitarian Mission: A Case Report. Cureus 2023; 15:e39365. [PMID: 37362472 PMCID: PMC10285428 DOI: 10.7759/cureus.39365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Giant goiters are still encountered in low-income countries where diagnosis and management remain challenging. The authors report a case of an endemic giant goiter, treated during a humanitarian mission. A 50-year-old female with no particular history presented during a humanitarian mission with a giant nontoxic goiter evolving for 30 years. She underwent a total thyroidectomy removing a 3 kg thyroid gland. The postoperative period was uneventful. Giant goiters are not exceptional in goiter-endemic areas. Diagnostic and surgical management do not require particular technology. Surgery remains feasible even in countries with limited resources.
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Affiliation(s)
| | - Mehmet Atila
- Center for Aesthetic Plastic Surgery, Medical Inn, Düsseldorf, DEU
| | - Bertin Dembele
- Plastic Surgery and Oncology Department, Hôpital de Dermatologie de Bamako, Bamako, MLI
| | - Michael K Obeng
- Plastic Surgery Department, University of Pittsburgh School of Medicine, Los Angeles, USA
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Maaroufi A, Diai A, El M'rabet I, Laidouni O, Omari M, Kechna H, Laoutid J. Anaesthetic management and surgical care in a field refugee hospital: experience of the Moroccan 1st Field Medical-Surgical hospital at the Zaatari Camp for Syrian refugees. Br J Anaesth 2023; 130:e414-6. [PMID: 36567217 DOI: 10.1016/j.bja.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/16/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
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Johnson AR, Hagerman TR, Preston SL. Self-care and Wellness Checks in Emergency Field Hospitals During COVID-19 Pandemic: A New Self-check Tool for Military Personnel and Civilians. Innov Clin Neurosci 2022; 19:39-45. [PMID: 35382073 PMCID: PMC8970237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The authors explore the impact of cumulative stress on United States (US) military service members (SM), including soldiers and medical personnel, deployed to serve in New York City (NYC) communities. Their mission was to assist in establishing emergency field hospitals during the COVID-19 pandemic. Causative biopsychosocial factors are presented, as well as the impact of wellness checks, which were utilized to monitor the mood and morale of frontline healthcare providers, military personnel, and infected patients in a 2,500-bed emergency field hospital and a 1,000-bed Naval hospital ship operating in the metropolitan NYC area. The authors introduce a self-care and wellness tool, which assesses five core domains (physical, mental, emotional, social, and spiritual) for the purpose of assessing and improving individual overall well-being during periods of heightened stress. This instrument could aid attending medical personnel in identifying patients at risk of suicide. Likewise, the utility of this self-care tool is applicable to both military SM and civilians, and includes soldiers and medical personnel.
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Affiliation(s)
- Adrian R Johnson
- Mr. Johnson is Deputy, Installation Director of Psychological Health, Department of Behavioral Health, Desmond T. Doss Health Clinic in Schofield Barracks, Hawaii
- Ms. Hagerman is a Behavioral Health Officer (BHO), Carl R. Darnall Army Medical Center in Fort Hood, Texas
- Dr. Preston is an Associate Faculty of Psychiatry, Uniformed Services University of Health Sciences in Bethesda, Maryland, and Psychiatry Consultant, Office of the Army Surgeon General in Falls Church, Virginia
| | - Taryn R Hagerman
- Mr. Johnson is Deputy, Installation Director of Psychological Health, Department of Behavioral Health, Desmond T. Doss Health Clinic in Schofield Barracks, Hawaii
- Ms. Hagerman is a Behavioral Health Officer (BHO), Carl R. Darnall Army Medical Center in Fort Hood, Texas
- Dr. Preston is an Associate Faculty of Psychiatry, Uniformed Services University of Health Sciences in Bethesda, Maryland, and Psychiatry Consultant, Office of the Army Surgeon General in Falls Church, Virginia
| | - Samuel L Preston
- Mr. Johnson is Deputy, Installation Director of Psychological Health, Department of Behavioral Health, Desmond T. Doss Health Clinic in Schofield Barracks, Hawaii
- Ms. Hagerman is a Behavioral Health Officer (BHO), Carl R. Darnall Army Medical Center in Fort Hood, Texas
- Dr. Preston is an Associate Faculty of Psychiatry, Uniformed Services University of Health Sciences in Bethesda, Maryland, and Psychiatry Consultant, Office of the Army Surgeon General in Falls Church, Virginia
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Pulvirenti R, Gortan M, Cumba D, Gamba P, Tognon C. Pediatric Surgery and Anesthesia in Low-Middle Income Countries: Current Situation and Ethical Challenges. Front Pediatr 2022; 10:908699. [PMID: 35967563 PMCID: PMC9369455 DOI: 10.3389/fped.2022.908699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/30/2022] [Indexed: 11/04/2022] Open
Abstract
Low-middle income countries (LMICs) are currently experiencing an important population growth, leading to a substantial raise in the number of children living in those areas. As a consequence, the existing gap between the need for surgical and anesthetic care and the available therapeutic options will increase. To overcome this, an improvement in the available expertise, infrastructures, and supplies will be mandatory. The implementation of educational and training programs for local healthcare providers should be a top priority. Alongside, the population's awareness on the necessity to seek for medical care should be deployed, together with an eased access to health facilities. Based on the existing literature and our 20-years' experience in humanitarian missions, our article aims to investigate the status of pediatric surgery in LMICs, and the role of western aids in the implementation of this ever-increasing field of expertise.
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Affiliation(s)
- Rebecca Pulvirenti
- Pediatric Surgery Unit, Department of Woman's and Child's Health, Padua University Hospital, Padua, Italy
| | - Marianna Gortan
- Pediatric Surgery Unit, Department of Woman's and Child's Health, Padua University Hospital, Padua, Italy
| | - Dioniso Cumba
- Department of Surgery, Pediatric Hospital of Sao José Em Bor, Bissau, Guinea-Bissau
| | - Piergiorgio Gamba
- Pediatric Surgery Unit, Department of Woman's and Child's Health, Padua University Hospital, Padua, Italy
| | - Costanza Tognon
- Anesthesiology Pediatric Unit, Department of Woman's and Child's Health, Padua University Hospital, Padua, Italy
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Heidekrueger PI, Thu M, Mühlbauer W, Holm-Mühlbauer C, Schucht P, Anderl H, Schoeneich H, Aung K, Mg Ag M, Thu Soe Myint A, Juran S, Aung T, Ehrl D, Ninkovic M, Broer PN. Safe and sustainable: the extracranial approach toward frontoethmoidal meningoencephalocele repair. J Neurosurg Pediatr 2017; 20:334-340. [PMID: 28731403 DOI: 10.3171/2017.5.peds1762] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Although rare, frontoethmoidal meningoencephaloceles continue to pose a challenge to neurosurgeons and plastic reconstructive surgeons. Especially when faced with limited infrastructure and resources, establishing reliable and safe surgical techniques is of paramount importance. The authors present a case series in order to evaluate a previously proposed concise approach for meningoencephalocele repair, with a focus on sustainability of internationally driven surgical efforts. METHODS Between 2001 and 2016, a total of 246 patients with frontoethmoidal meningoencephaloceles were treated using a 1-stage extracranial approach by a single surgeon in the Department of Neurosurgery of the Yangon General Hospital in Yangon, Myanmar, initially assisted by European surgeons. Outcomes and complications were evaluated. RESULTS A total of 246 patients (138 male and 108 female) were treated. Their ages ranged from 75 days to 32 years (median 8 years). The duration of follow-up ranged between 4 weeks and 16 years (median 4 months). Eighteen patients (7.3%) showed signs of increased intracranial pressure postoperatively, and early CSF rhinorrhea was observed in 27 patients (11%), with 5 (2%) of them requiring operative dural repair. In 8 patients, a decompressive lumbar puncture was performed. There were 8 postoperative deaths (3.3%) due to meningitis. In 15 patients (6.1%), recurrent herniation of brain tissue was observed; this herniation led to blindness in 1 case. The remaining patients all showed good to very good aesthetic and functional results. CONCLUSIONS A minimally invasive, purely extracranial approach to frontoethmoidal meningoencephalocele repair may serve well, especially in middle- and low-income countries. This case series points out how the frequently critiqued lack of sustainability in the field of humanitarian surgical missions, as well as the often-cited missing aftercare and dependence on foreign supporters, can be circumvented by meticulous training of local surgeons.
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Affiliation(s)
- Paul I Heidekrueger
- Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM-Klinikum Bogenhausen, Academic Teaching Hospital, Technical University Munich.,Center of Plastic, Hand, and Reconstructive Surgery, University Medical Center Regensburg, Germany
| | - Myat Thu
- Department of Neurosurgery, Yangon General Hospital, Yangon
| | | | | | - Philippe Schucht
- Department of Neurosurgery, Yangon General Hospital, Yangon.,Department of Neurosurgery, University Hospital Inselspital and University of Bern, Switzerland
| | - Hans Anderl
- Department of Plastic and Reconstructive Surgery, Innsbruck University Hospital, Innsbruck, Austria; and
| | - Heinrich Schoeneich
- Department of Plastic and Reconstructive Surgery, Interplast Germany, Section Munich
| | - Kyawzwa Aung
- Department of Neurosurgery, Mandalay University Hospital, Mandalay, Myanmar
| | - Mg Mg Ag
- Department of Neurosurgery, Yangon General Hospital, Yangon
| | | | - Sabrina Juran
- Population and Development Branch, Technical Division, United Nations Population Fund, New York, New York
| | - Thiha Aung
- Center of Plastic, Hand, and Reconstructive Surgery, University Medical Center Regensburg, Germany
| | - Denis Ehrl
- Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM-Klinikum Bogenhausen, Academic Teaching Hospital, Technical University Munich
| | - Milomir Ninkovic
- Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM-Klinikum Bogenhausen, Academic Teaching Hospital, Technical University Munich
| | - P Niclas Broer
- Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM-Klinikum Bogenhausen, Academic Teaching Hospital, Technical University Munich
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Bassetto F, Staffieri A, Reho F, Facchin F, Shehata J, Maged D, Tiengo C. Management of complex pediatric burn scars in a humanitarian collaboration. Ann Burns Fire Disasters 2015; 28:46-49. [PMID: 26668562 PMCID: PMC4665182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 09/15/2014] [Accepted: 09/17/2014] [Indexed: 06/05/2023]
Abstract
Burn scars still represent a challenge to the reconstructive surgeon. Their management requires a specific expertise and set up involving the possibility of long term rehabilitation and follow up. Cases encountered in humanitarian missions present additional issues. Often the local environment is not suitable for an appropriate treatment plan, requiring the case to be transferred to a foreign country for surgical care as part of an integrated international and multidisciplinary management. We present the case of a three year-old patient injured in a bomb explosion during the Arab Spring and suffering from severe scar contracture limiting thoracic and upper limb movement. After initial consultation at distance, transfer to our country was organized and an intensive surgical and rehabilitative program was carried out over three months. After five months, the patient returned to his home country where a supportive network had been set up for continued rehabilitation, ensuring follow up for over a year and ultimate success.
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Affiliation(s)
- F. Bassetto
- Clinic of Plastic Surgery, University of Padova, Padua, Italy
| | - A. Staffieri
- ENT Department, University of Padova, Padua, Italy
| | - F. Reho
- Clinic of Plastic Surgery, University of Padova, Padua, Italy
| | - F. Facchin
- Clinic of Plastic Surgery, University of Padova, Padua, Italy
| | - J. Shehata
- Institute of Hygiene and Public Health, Catholic University, Rome, Italy
| | - D. Maged
- Italian hospital Umberto Primo in Cairo, Cairo, Egypt
| | - C. Tiengo
- Clinic of Plastic Surgery, University of Padova, Padua, Italy
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