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Organizational Changes Needed in Disasters and Public Health Emergencies:A Qualitative Study among managers at a major Hospital

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International Journal of Disaster Risk Science 2022年第4期13卷 481-494页

作者： Ingela Wennman Catharina Jacobson eric carlström Anders Hyltander Amir Khorram‑manesh Institute of Health and Care Sciences Sahlgrenska AcademyGothenburg University41346GothenburgSweden Preparedness Unit Sahlgrenska University Hospital41305 GothenburgSweden Institute of Clinical Sciences Department of SurgerySahlgrenska AcademyGothenburg University41345GothenburgSweden

most hospitals have a contingency plan,based on all-risks and all-hazards assessment ***,emerging threats and risks often necessitate a flexible approach to emergency management at several levels of a disaster response system,for example,in ***,and possibly other countries,has limited possibilities of surge capacity in the management of large-scale disasters and emergencies,which necessitates a local/national partnership and a flexible local disaster and contingency *** study evaluates the opinions of a selected managerial group,both at operative and strategic levels,regarding possible changes in a major hospital's contingency plan during the ongoing COVID-19 *** interviews were conducted to explore the elements of surge capacity and an operational tool,consisting of command and control,safety,communication,assessment,triage,treatment,and *** results show a need to create feasible management methods that can be evaluated,establish clear leadership,put preparedness as a constant point on the highest managerial agenda,improve external monitoring,and create a regional coordinating ***,the results emphasize the significant role played by the incident command system and qualified leadership to facilitate competent and crucial medical decision making,as well as to provide reliable communication,collaboration,and coordination in a multi-agency response system during dynamic and unexpected *** steps enable a constant connection between reactive contingency plans and the proactivity in continuous risk assessment and enhance the flexibility of the contingency plans.

关键词： Disaster risks Organizational changes Public health emergencies Sweden

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Assessing Thai Hospitals’Evacuation Preparedness Using the Flexible Surge Capacity Concept and Its Collaborative Tool

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International Journal of Disaster Risk Science 2023年第1期14卷 52-63页

作者： Phatthranit Phattharapornjaroen eric carlström Lina Dahlén Holmqvist Yuwares Sittichanbuncha Amir Khorram-manesh Institute of Clinical Sciences Department of SurgerySahlgrenska AcademyUniversity of Gothenburg40530GothenburgSweden Department of Emergency medicine Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok10400Thailand Institute of Health and Care Sciences Sahlgrenska AcademyUniversity of Gothenburg40100GothenburgSweden Gothenburg Emergency medicine Research Group Sahlgrenska AcademyUniversity of Gothenburg40530GothenburgSweden USN School of Business University of South-Eastern Norway3603KongsbergNorway Institute of medicine Department of Internal Medicine and Clinical NutritionSahlgrenska University Hospital40530GothenburgSweden

According to the concept of“flexible surge capacity,”hospitals may need to be evacuated on two occasions:(1)when they are exposed to danger,such as in war;and(2)when they are contaminated,such as during the Covid-19 *** the former,the entire hospital must be evacuated,while in the latter,the hospital becomes a pandemic center necessitating the transfer of its non-contaminated staff,patients,and routine activities to other *** occasions involve several degrees of evacuation—partial or total—yet all require deliberate surge planning and collaboration with diverse *** study aimed to investigate the extent of hospital evacuation preparedness in Thailand,using the main elements of the flexible surge capacity concept.A mixed method cross-sectional study was conducted using a hospital evacuation questionnaire from a previously published multinational hospital evacuation *** tool contained questions regarding evacuation preparedness encompassing surge capacity and collaborative elements and an open-ended inquiry to grasp potential *** 143 secondary care,tertiary care,and university hospitals received the questionnaire;43 hospitals provided *** findings indicate glitches in evacuation protocols,particularly triage systems,the inadequacies of surge planning and multiagency collaboration,and knowledge limitations in community *** conclusion,the applications of the essential components of flexible surge capacity allow the assessment of hospital preparedness and facilitate the evaluation of guidelines and instructions through scenario-based training exercises.

关键词： Collaborative tool Disaster preparedness Flexible surge capacity Hospital evacuation multiagency collaboration Thailand

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Disaster Collaborative Exercises for Healthcare Teamwork in a Saudi Context

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International Journal of Disaster Risk Science 2023年第2期14卷 183-193页

作者： mohammed Ali Salem Sultan Amir Khorram-manesh Jarle Lφwe Sφrensen Johan Berlin eric carlstrōm model of Care Healthcare TransformationRegional Health DirectorateNajran66255Saudi Arabia Institute of Health and Care Sciences Sahlgrenska AcademyGothenburg University40530GothenburgSweden Institute of Clinical Sciences Sahlgrenska AcademyGothenburg University40530GothenburgSweden Gothenburg Emergency medicine Research Group(GEmREG) Sahlgrenska Academy41345GothenburgSweden USN School of Business University of South-Eastern Norway3199BorreNorway Department of Social and Behavioural Studies University West46186TrolhättanSweden

This study aimed to evaluate the development of healthcare teamwork during and after the collaboration tabletop exercises,through observation and interview *** and maturity theoretical models were employed to explain the collaborative challenges in teams that may suffer from unequally distributed power,hierarchies,and *** three-level collaboration tabletop exercises and the Command and control,Safety,Communication,Assessment,Treatment,Triage,Transport(CSCATTT)instrument,100 healthcare workers were observed during each step in the implementation of the CSCATTT instrument using two simulated *** results show a lack of integration and team maturity among participants in the first scenario,leading to the delayed start of the activity,task distribution,and decision *** shortcomings were improved in the second ***-depth interviews with 20 participants in the second phase of the study revealed improved knowledge and practical skills,self-confidence,and ability in team building within trans-professional groups in the second scenario,which in concordance with the integration theory,was due to the attempts made in the first ***,there was an improvement in the team’s maturity,which in concordance with the maturity theory,was due to the knowledge and practical skills during scenario *** results indicate the importance of continuous tabletop training,and the use of CSCATTT as a collaborative instrument,to promote the development of collaboration and to test the concept of preparedness.

关键词： Collaboration exercises Disaster education Emergency management Healthcare personnel training Saudi Arabia Teamwork

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Impact of Virtual Disaster Collaboration Exercises on Disaster Leadership at Hospitals in Saudi Arabia

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International Journal of Disaster Risk Science 2021年第6期12卷 879-889页

作者： mohammed Ali Salem Sultan Amir Khorram-manesh eric carlström Johan Berlin Jarle Løwe Sørensen Healthcare Transformation Model of CareRegional Health DirectorateNajran 66255Saudi Arabia Institute of Health and Care Sciences Sahlgrenska AcademyGothenburg University40530 GothenburgSweden Institute of Clinical Sciences Sahlgrenska AcademyGothenburg University40530 GothenburgSweden Department of Research and Development Swedish Armed Forces Centre for Defence Medicine42676 Gothenburg Sweden Gothenburg Emergency medicine Research Group(GEmREG) Sahlgrenska Academy41345 GothenburgSweden USN School of Business Campus VestfoldUniversity of South-Eastern Norway3603 KongsbergNorway Department of Social and Behavioural StudiesUniversity West46186 TrolhattanSweden

This study measured the impact of virtual three-level collaboration (3LC) exercises on participants’ perceived levels of collaboration, learning, and utility (CLU) at hospitals in the southern region of Saudi Arabia. Our 3LC exercise is a tabletop training tool used to facilitate disaster education and document CLU. This model enables the practitioner to acquire new knowledge and promotes active learning. An English version of the CLU scale, the validated Swedish survey tool, was applied to 100 healthcare managers or leaders in various positions at both the operational and tactical levels after conducting the 3LC exercises. The response rate was 100%, although not all questions were answered in some cases. The results show that most participants strongly agreed that the exercises focused on collaboration (r^(2) = 0.767) and that they had acquired new knowledge during the exercises. There was a statistically significant association between participation in the collaboration exercises and perceived learning (r^(2) = 0.793), as well as between perceived learning and utility (r^(2) = 0.811). The collaboration exercises enhance the perceived effects of CLU. They also improve the ability of participants to adapt situational strategies to achieve a safer society. Although exercises were conducted virtually, they were well received by the participants and achieved a value m = 4.4 CLU score, which opens up new dimensions in collaboration simulation exercises.

关键词： Collaboration exercises Disaster education Emergency management Healthcare personnel training Saudi Arabia

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A comparative review of artificial muscles for microsystem applications

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microsystems & Nanoengineering 2021年第6期7卷 25-43页

作者： mayue Shi eric m.Yeatman Department of Electrical and Electronic Engineering Imperial College LondonExhibition RoadLondon SW72AZUK

Artificial muscles are capable of generating actuation in microsystems with outstanding *** years have witnessed a growing academic interest in artificial muscles and their application in many areas,such as soft robotics and biomedical *** paper aims to provide a comparative review of recent advances in artificial muscle based on various operating *** advantages and limitations of each operating mechanism are analyzed and *** to the unique application requirements and electrical and mechanical properties of the muscle types,we suggest suitable artificial muscle mechanisms for specific microsystem ***,we discuss potential strategies for energy delivery,conversion,and storage to promote the energy autonomy of microrobotic systems at a system level.

关键词： artificial generating limitations

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A new methodology for energy-based seismic design of steel moment frames

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Earthquake Engineering and Engineering Vibration 2017年第1期16卷 131-152页

作者： mebrahtom Gebrekirstos mezgebo eric m. Lui michael Baker International Hamilton NJ 08619 USA Department of Civil and Environmental Engineering Syracuse University Syracuse NY 13244-1240 USA

A procedure is proposed whereby input and hysteretic energy spectra developed for single-degree-of-freedom （SDOF） systems are applied to multi-degree-of-freedom （mDOF） steel moment resisting frames. The proposed procedure is verified using four frames, viz., frame with three-, five-, seven- and nine-stories, each of which is subjected to the fault- normal and fault-parallel components of three actual earthquakes. A very good estimate for the three- and five-story frames, and a reasonably acceptable estimate for the seven-, and nine-story frames, have been obtained. A method for distributing the hysteretic energy over the frame height is also proposed. This distribution scheme allows for the determination of the energy demand component of a proposed energy-based seismic design （EBSD） procedure for each story. To address the capacity component of EBSD, a story-wise optimization design procedure is developed by utilizing the energy dissipating capacity from plastic hinge formation/rotation for these moment frames. The proposed EBSD procedure is demonstrated in the design of a three-story one-bay steel moment frame.

关键词： energy-based seismic design hysteretic energy distribution mDOF systems steel moment frames story-wise optimization design

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High efficiency GHz laser processing with long bursts

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International Journal of Extreme manufacturing 2023年第1期5卷 202-210页

作者： eric Audouard eric mottay Amplitude PessacFrance

Bursts of GHz repetition rate pulses involve more ablation mechanisms than single femtosecond *** ablation by GHz laser pulses is a multi-step process,consisting of a first thermal incubation phase,followed by a highly efficient ablation *** ablation therefore combines thermal and non-thermal ablation *** an optimal choice of the burst duration,the ablation efficiency can be highly *** bursts,comprising tens of pulses to hundreds of pulses,are needed to take full advantage of the increase in ablation efficiency.

关键词： femtosecond laser temporal pulses shaping GHz bursts femtosecond processing

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Celiac disease:a model disease for gene-environment interaction

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Cellular & molecular Immunology 2011年第2期8卷 93-95页

作者： Raivo Uibo Zhigang Tian m eric Gershwin Immunology Group IGMPUniversity of TartuRavila 19TartuEstonia University of Science and Technology of China HefeiChina Division of Rheumatology Allergy and Clinical ImmunologyUniversity of California at Davis School of MedicineDavisCAUSA

Celiac sprue remains a model autoimmune disease for dissection of genetic and environmental influences on disease *** 2010 Congress of Autoimmunity included several key sessions devoted to genetics and *** papers from these symposia were selected for in-depth discussion and *** issue is devoted to this *** goal is not to discuss genetic and environmental interactions,but rather to focus on key elements of diagnosis,the inflammatory response and the mechanisms of autoimmunity.

关键词： environment andautoimmunity geoepidemiology autoimmunity

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Collaboration Exercises——The Lack of Collaborative Benefits

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International Journal of Disaster Risk Science 2014年第3期5卷 192-205页

作者： Johan m.Berlin eric D.carlstrom Department of Social and Behavioral Studies University West46186 TrollhattanSweden Sahlgrenska Academy Institute of Health and Care SciencesUniversity of Gothenburg40530 GothenburgSweden

The purpose of this article is to analyze what professional emergency personnel learn during collaboration exercises and the benefits of what they have ***(n = 19) and semistructured interviews(n = 32) were carried out in conjunction with major exercises held in Sweden(2007–2012). The results show that exercises tend to be based on their own logic, which differs from actual events. Exercise participants believe that they mainly learn single-track, parallel, and pathdependent behavior. The exercises do not facilitate the use of cross-boundary activities. This means that learning, as well as benefits from the exercises for actual events, is limited. The exercises would be more appropriate if those participating had the opportunity to identify weaknesses,try alternative ways, and engage in comprehensive organizational analyses at the conclusion of the *** on the results of the study, alternative models for collaboration exercises are suggested, with elements that would better develop collaboration and contribute to learning.

关键词： Ambulance Collaboration exercises Emergency personnel Police Rescue services Sweden

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The impact of hypoxic-ischemic brain injury on stem cell mobilization,migration,adhesion,and proliferation

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Neural Regeneration Research 2018年第7期13卷 1125-1135页

作者： Stephanie m.Parry eric S.Peeples Department of Pediatrics University of Nebraska Medical Center

Neonatal hypoxic-ischemic encephalopathy continues to be a significant cause of death or neurodevelopmental delays despite standard use of therapeutic *** use of stem cell transplantation has recently emerged as a promising supplemental therapy to further improve the outcomes of infants with hypoxic-ischemic *** the injury,the brain releases several chemical mediators,many of which communicate directly with stem cells to encourage mobilization,migration,cell adhesion and *** manuscript reviews the biomarkers that are released from the injured brain and their interactions with stem cells,providing insight regarding how their upregulation could improve stem cell therapy by maximizing cell delivery to the injured tissue.

关键词： brain-derived neurotrophic hypoxia inducible erythropoietin factor matrix metalloproteinase neonatal stromal cell-derived vascular endothelial growth

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